Archives of gerontology and geriatrics最新文献

{"title":"Effects of vitamin D intake alone on elderly body composition: A systematic review and meta-analysis of RCTs","authors":"Tomoyuki Matsuyama,&nbsp;Hiroshi Okada,&nbsp;Yuto Saijo,&nbsp;Yuka Hasegawa,&nbsp;Hanako Nakajima,&nbsp;Takuro Okamura,&nbsp;Rieko Nakatani,&nbsp;Emi Ushigome,&nbsp;Naoko Nakanishi,&nbsp;Masahide Hamaguchi,&nbsp;Michiaki Fukui","doi":"10.1016/j.archger.2025.106093","DOIUrl":"10.1016/j.archger.2025.106093","url":null,"abstract":"<div><h3>Background</h3><div>This study investigated the effect of vitamin D on body composition in individuals aged 60 years and older.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Cochrane databases were searched from inception to April 22, 2024, for randomized controlled trials reporting skeletal muscle mass index (SMI), lean mass (LM), handgrip strength, and fat mass (FM) as primary or secondary outcomes in elderly individuals with a mean age of 60 years or older were included. The primary outcome was the change in SMI between vitamin D and control groups; secondary outcomes were changes in LM, FM, and handgrip strength.</div></div><div><h3>Results</h3><div>Seven randomized controlled trials met eligibility criteria. Mean age ranged from 60 to 74 years, participants ranged from 50 to 1094, and study durations ranged from 3 to 36 months. The mean baseline 25(OH)D concentration ranged from 15.1 to 33.0 ng/mL. The vitamin D intake group was not associated with an increase in SMI, LM, or handgrip strength compared to the control group, although a decrease in FM was observed. In the meta-analysis excluding studies that used active vitamin D, the vitamin D intake group was not associated with increases in SMI, LM, or handgrip strength, nor with a decrease in FM compared to the control group.</div></div><div><h3>Conclusion</h3><div>In the present study, vitamin D intake did not increase SMI, LM, or handgrip strength in the elderly individuals, although a possible decrease in FM was observed. Further studies are needed to better elucidate the effects of vitamin D on body composition in the elderly.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"142 ","pages":"Article 106093"},"PeriodicalIF":3.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of gut microbiota and arginine-agmatine metabolism with postoperative delirium in elderly patients following lower limb fracture surgery: a prospective nested case-control study","authors":"Xinyu Cao,&nbsp;Jing Wang,&nbsp;Yv Zhang,&nbsp;Jing Zhang,&nbsp;Jianli Li","doi":"10.1016/j.archger.2025.106094","DOIUrl":"10.1016/j.archger.2025.106094","url":null,"abstract":"<div><h3>Objective</h3><div><strong>:</strong> This study aimed to investigate the role of gut microbiota and arginine-agmatine metabolic levels in the pathogenesis of postoperative delirium (POD) in elderly patients following lower limb fracture surgery.</div></div><div><h3>Methods</h3><div><strong>:</strong> This prospective nested case-control study enrolled 111 patients aged ≥65 years who were scheduled for elective lower limb orthopedic surgery. POD was assessed twice daily (08:00–10:00 and 18:00–20:00) using the Confusion Assessment Method-Chinese Reversion (CAM-CR). Thirty patients who developed POD were matched to thirty non-POD patients via propensity score matching (PSM). Fecal samples collected one day preoperatively underwent gut microbiota analysis using 16S rRNA gene sequencing, with α-diversity, β-diversity, and linear discriminant analysis effect size (LEfSe) analyses performed. Additionally, fasting venous blood samples collected one day preoperatively were analyzed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) to quantify plasma levels of arginine, agmatine, putrescine, spermidine, and spermine. Spearman correlation analysis was performed to explore associations between differential bacterial genus abundance, arginine-agmatine metabolite levels, and CAM-CR scores.</div></div><div><h3>Results</h3><div><strong>:</strong> Compared to controls, the POD group showed significantly altered gut microbiota β-diversity (P &lt; 0.001) but no change in α-diversity. At the genus level, LEfSe analysis revealed increased abundance of <em>Megasphaera</em> and <em>Clostridium innocuum group</em>, and decreased abundance of <em>Paraprevotella</em> and <em>Akkermansia</em> in the POD group. Additionally, the POD group exhibited significantly elevated arginine levels (P = 0.044) and reduced agmatine (P = 0.016) and spermine (P = 0.005) levels. Correlation analysis demonstrated that arginine levels were positively correlated with <em>Megasphaera</em> abundance and CAM-CR score, but negatively correlated with <em>Paraprevotella</em> and <em>Akkermansia</em> abundance; agmatine concentrations were positively correlated with <em>Akkermansia</em> abundance but negatively correlated with CAM-CR score; putrescine levels were negatively correlated with <em>Clostridium innocuum group</em> abundance; spermine levels were positively correlated with <em>Paraprevotella</em> abundance but negatively correlated with CAM-CR score. CAM-CR score was negatively associated with <em>Akkermansia</em> abundance and positively associated with <em>Megasphaera</em> abundance (all P &lt; 0.05).</div></div><div><h3>Conclusions</h3><div><strong>:</strong> Gut microbiota and arginine-agmatine metabolism are associated with the pathogenesis of POD in elderly lower limb fracture patients, though their precise mechanistic roles require further investigation.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"142 ","pages":"Article 106094"},"PeriodicalIF":3.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-cell transcriptomic analysis reveals the molecular alterations of endothelial cells during ageing","authors":"Yongle Sun ,&nbsp;Yini Dai ,&nbsp;Yehu Yin","doi":"10.1016/j.archger.2025.106088","DOIUrl":"10.1016/j.archger.2025.106088","url":null,"abstract":"<div><div>Ageing of the vasculature is the fundamental cause for the development of cardiovascular diseases. Endothelial cells play an important role in ageing of the cardiovascular system, but the potential mechanisms of vascular ageing and the molecular changes of endothelial cells during ageing remain unclear. Here, we analyzed the cellular and molecular alterations of endothelial cells in young and aged aortas using single-cell transcriptome analysis. We identified 191 up-regulated genes and 282 down-regulated genes between old and young group. We found that most of the down-regulated genes were mainly enriched in normal biological pathways and some stress response pathways. Protein–protein interaction and transcription factor analysis revealed that AP-1 and Egr1 might be the key transcription factors related to vascular ageing. We proposed that ageing is resulted from the gradual loss of normal functional genes. Our research provides new ideas for further understanding the mechanism of ageing.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"142 ","pages":"Article 106088"},"PeriodicalIF":3.8,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between frailty and white matter hyperintensities: A systematic review and meta-analysis","authors":"Xuzi Li,&nbsp;Anling Luo,&nbsp;Yiting Deng,&nbsp;Yujia Yang,&nbsp;Qin Yang,&nbsp;Yujie Chen,&nbsp;Li He,&nbsp;Muke Zhou","doi":"10.1016/j.archger.2025.106089","DOIUrl":"10.1016/j.archger.2025.106089","url":null,"abstract":"<div><h3>Background</h3><div>Frailty, common in aging, contributes to cognitive and motor decline. White matter hyperintensity (WMH), markers of cerebral small vessel disease, show similar effects. Although studies suggest an association between frailty and WMH, the evidence is inconsistent, and their relationship remains uncertain.</div></div><div><h3>Objective</h3><div>This research aimed to examine the relationship between frailty and WMH.</div></div><div><h3>Methods</h3><div>Systematic literature search and meta-analytic methods were employed. Study screening and data extraction were conducted, and quality assessment was performed using the Newcastle-Ottawa Scale and American Agency for Healthcare Research and Quality evaluation tools. StataSE 15.0 software was utilized to carry out statistical analyses.</div></div><div><h3>Results</h3><div>Nine articles, including 10 studies, were included. The meta-analysis results demonstrated a significant positive relationship between WMH and frailty (odds ratio [OR] = 1.38, 95 % confidence interval [CI]: 1.17–1.64, <em>P</em> &lt; 0.001). Subgroup analysis showed a consistent association between WMH and frailty, which was stronger in hospitalized patients, Asian populations, and studies using the Fried or Fazekas criteria. Sensitivity analyses validated the robustness of the results. After adjustment for publication bias via the trim-and-fill method, the association was still significant (OR = 1.25, 95 % CI: 1.05–1.50, <em>P</em> = 0.012), though limitations of this method and other potential biases should be considered.</div></div><div><h3>Conclusions</h3><div>WMH is significantly associated with frailty, offering new insights into its potential role in frailty. This meta-analysis suggests that WMH is worth exploring in future longitudinal studies to understand its relevance to frailty mechanisms.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"142 ","pages":"Article 106089"},"PeriodicalIF":3.8,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145584311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Actions to control the fear of falling in older people: An umbrella review","authors":"Ana Rita Capela Oliveira ,&nbsp;Carla Maria Pintado Magueja ,&nbsp;Armando Manuel Gonçalves de Almeida","doi":"10.1016/j.archger.2025.106087","DOIUrl":"10.1016/j.archger.2025.106087","url":null,"abstract":"<div><h3>Background</h3><div>Fear of falling in older adults is a multifactorial psychological condition associated with the degree of confidence in performing activities of daily living without falling, leading to reduced physical activity, quality of life, and life satisfaction, and resulting in social isolation.</div></div><div><h3>Purpose</h3><div>This study aimed to summarize and evaluate effective actions to control fear of falling in older adults.</div></div><div><h3>Method</h3><div>An umbrella review of interventions that control fear of falling in people aged ≥60 years was conducted, in accordance with JBI and PRISMA guidelines. The search was conducted in six electronic databases: CINAHL, Web of Science, MEDLINE, Scopus, Cochrane Reviews, and JBI Databases, during the period from February to April 2024.</div></div><div><h3>Results</h3><div>Of a total of 706 references identified, 25 met the eligibility criteria. Of those included, eleven studies are systematic review, three studies are meta-analysis, and eleven studies are systematic review with meta-analysis. Five types of action to control fear of falling with therapeutic potential were identified: Physical and functional therapy; Cognitive Behavioral Therapy; Combined strategies; Multifactorial preventive programs; Technological interventions.</div></div><div><h3>Conclusions</h3><div>The results of this umbrella review indicate that holistic exercises (Tai Chi, Yoga, Pilates) are the most effective in mitigating fear of falling in older adults. Interventions that incorporate multimodal approaches also appear to be beneficial. The combination of physical and cognitive actions is widely recognized as effective and long-lasting. Longitudinal studies are needed to assess the effectiveness of actions over time.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106087"},"PeriodicalIF":3.8,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive decline before and after incident depression: Evidence from three international prospective cohorts","authors":"Xiaoyu Qian ,&nbsp;Congdi Wang ,&nbsp;Xueman Zhao ,&nbsp;Min Jin ,&nbsp;Yonghao Xiao ,&nbsp;Ziwang Zhou ,&nbsp;Feifei Jia","doi":"10.1016/j.archger.2025.106086","DOIUrl":"10.1016/j.archger.2025.106086","url":null,"abstract":"<div><h3>Background</h3><div>Depression and cognitive decline frequently co-occur in late life, potentially reflecting shared biological, psychological, or social pathways. However, their temporal relationship remains unclear. Understanding how cognitive deterioration and depression unfold over time may inform prevention and intervention strategies.</div></div><div><h3>Methods</h3><div>This cohort study analyzed 40,167 older adults without baseline depression from CHARLS, HRS, and SHARE (2010–2021). Depressive symptoms were assessed using validated scales. Cognitive function was assessed across memory, executive function, and orientation, and standardized as z-scores. Linear mixed models estimated cognitive trajectories before, at, and after depression onset.</div></div><div><h3>Results</h3><div>Across 401,017.8 person-years, 10530 participants developed depression. Compared with non-depressed individuals, those with depression onset showed faster cognitive decline before onset, acute decline at onset, and accelerated decline thereafter across all cognitive domains (P &lt;0.001).</div></div><div><h3>Discussion</h3><div>Cognitive decline precedes, accompanies, and accelerates after the onset of depression among older adults. These findings suggest that cognitive impairment may be an early signal associated with depression risk, highlighting the importance of routine cognitive monitoring in preventive mental health strategies.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106086"},"PeriodicalIF":3.8,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bidirectional transitions of frailty states in middle-aged and older adults: Findings from two longitudinal cohorts studies","authors":"Sutong Wang ,&nbsp;Lin Wang ,&nbsp;Yongcheng Wang ,&nbsp;Xiaoyu Su ,&nbsp;Feihu Zhang ,&nbsp;Shuli Zong ,&nbsp;Lei Qi ,&nbsp;Yuehua Jiang ,&nbsp;Jifu He ,&nbsp;Xiao Li","doi":"10.1016/j.archger.2025.106085","DOIUrl":"10.1016/j.archger.2025.106085","url":null,"abstract":"<div><h3>Objective</h3><div>We aimed to characterize frailty dynamics in older adults by applying multi-state Markov models (MSMs) to English Longitudinal Study of Ageing (ELSA) and the China Health and Retirement Longitudinal Study (CHARLS) data to estimate transition intensities.</div></div><div><h3>Methods</h3><div>Data from ELSA (2004–2012) and CHARLS (2011–2018) cohorts were analyzed using MSMs. Frailty was assessed using the Frailty Index (FI), and covariates like age, sex, marital status, physical activity, and economic status were included. Transition probabilities between frailty states were estimated, and subgroup analyses were performed to assess the influence of covariates on frailty transitions.</div></div><div><h3>Results</h3><div>A total of 8 187 participants from ELSA, and 9 171 participants from CHARLS were included in the analysis. In ELSA, the transition intensity from pre-frail to robust (0.226, 95 % CI 0.217–0.234) exceeded that from pre-frail to frail (0.105, 95 % CI 0.099–0.111), whereas in CHARLS a different pattern was observed. In the covariate analysis, we found that age, marital status, loneliness, physical activity, current drinking status, and economic status exerted both common and cohort-specific effects on frailty transitions in ELSA and CHARLS, with age and marital status influencing bidirectional frailty transitions in both cohorts.</div></div><div><h3>Conclusion</h3><div>Frailty is reversible, especially in the pre-frail stage. Transition intensities and influencing factors vary across older adult cohorts in different countries, and beyond age, marital support, physical activity quality, and economic status significantly shape frailty trajectories and should be incorporated into public health policy design.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106085"},"PeriodicalIF":3.8,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ageism and the feminization of old age: A Systematic review","authors":"Juan Robles Costa ,&nbsp;Angélica Quintero-Flórez ,&nbsp;Emilio García-Cabrera ,&nbsp;Julia Romero-Barranca ,&nbsp;Ángel Vilches-Arenas","doi":"10.1016/j.archger.2025.106084","DOIUrl":"10.1016/j.archger.2025.106084","url":null,"abstract":"<div><h3>Background</h3><div>Increases in life expectancy and declining birth rates have intensified the demographic weight of older adults, particularly women. This population frequently faces intersecting age and gender-based discrimination, resulting in greater health burdens and lower quality of life compared to men.</div></div><div><h3>Objective</h3><div>To examine gender-based disparities affecting older adults, particularly older women, intending to uncover underlying mechanisms and contribute to the formulation of more equitable, gender-responsive, and age-sensitive public health policies.</div></div><div><h3>Study design</h3><div>This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD420251104219).</div></div><div><h3>Methods</h3><div>Six databases were searched (2014–2024) for studies in English or Spanish on gender- and age-based health inequalities in older adults. Eligible systematic reviews, observational, and experimental studies were quality-assessed (PRISMA, STROBE, CONSORT), and findings were synthesized qualitatively.</div></div><div><h3>Results</h3><div>Fourteen studies met the inclusion criteria. Across contexts, older women consistently exhibited higher prevalence of disability, frailty, depression, and poorer self-rated health, frequently linked to lower educational attainment and income. In contrast, older men showed lower prevalence of these conditions but faced higher mortality risks from frailty and suicide. Men also tended to report better subjective quality of life.</div></div><div><h3>Conclusions</h3><div>While women live longer, they often experience greater illness and functional limitations. Socioeconomic disadvantages explain part of these gaps, but a considerable proportion remains unexplained. These findings highlight the urgent need for gender- and age-sensitive public health strategies to reduce inequities in later life.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106084"},"PeriodicalIF":3.8,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An explainable machine learning model for comorbidity risk stratification in patients with fractures admitted to the intensive care unit: a multicenter study","authors":"Xuelong Liang ,&nbsp;Weijie Zhao ,&nbsp;Weigui Liufu ,&nbsp;Jiale Qian ,&nbsp;Nantian Xiang ,&nbsp;Xinzhe Zhang ,&nbsp;Jihui Zhou ,&nbsp;Hongwang Cui","doi":"10.1016/j.archger.2025.106082","DOIUrl":"10.1016/j.archger.2025.106082","url":null,"abstract":"<div><h3>Background</h3><div>Among traumatic-fracture patients admitted to intensive care units (ICUs), those with substantial chronic comorbidities recover more slowly and die more often than their counterparts without such conditions. The age-adjusted Charlson Comorbidity Index (aCCI) quantifies this burden, yet clinicians still lack a tool that can identify—at the point of ICU admission—which fracture patients are likely to have a high aCCI. To fill this gap, we used a large electronic health-record repository to develop and externally validate an interpretable machine-learning model that predicts severe comorbidity burden in this population.</div></div><div><h3>Methods</h3><div>We extracted 3 763 adult fracture cases from MIMIC-IV (2008–2019) and split them 3:1 into training and internal validation sets. High comorbidity (aCCI ≥ 7) was defined as the optimal cut-off derived from one-year survival analysis. Nine key predictors emerged from the intersection of LASSO, SVM-RFE, and random-forest importance. Eleven candidate algorithms underwent grid-search hyperparameter tuning with 10-fold cross-validation, and their performance was compared to identify the optimal model, while SHAP clarified model logic. External validation in two Chinese tertiary centres (<em>n</em> = 558) confirmed generalisability, and the final model was deployed as a bedside Shiny calculator.</div></div><div><h3>Results</h3><div>XGBoost achieved the best internal discrimination (AUROC = 0.84; AUPRC = 0.76) and exhibited excellent calibration and net benefit across clinically relevant thresholds. In external validation, AUROC values were 0.88 (Hainan) and 0.83 (Guangdong). The interactive calculator delivers patient-specific risk explanations in real time.</div></div><div><h3>Conclusions</h3><div>An XGBoost-based, SHAP-interpretable model accurately predicts high aCCI in ICU fracture patients and generalises across institutions. The readily accessible web tool can help clinicians identify high-risk individuals early, personalise management, and allocate resources more efficiently.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106082"},"PeriodicalIF":3.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Home-Based interventions for older adults with frailty or pre-frailty: a systematic review and meta-analysis","authors":"Gengxin Yao ,&nbsp;Fei Li ,&nbsp;Xuehan Ma ,&nbsp;Xinyu Wan ,&nbsp;Yali Yang ,&nbsp;Yiran Xu ,&nbsp;Lishuang Zheng ,&nbsp;Guichen Li ,&nbsp;Li Chen","doi":"10.1016/j.archger.2025.106083","DOIUrl":"10.1016/j.archger.2025.106083","url":null,"abstract":"<div><h3>Aim</h3><div>To systematically summarise the characteristics and effectiveness of home-based interventions on health outcomes in older adults with frailty or pre-frailty.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>Seven databases were searched from their inception through 31st October 2024. Two reviewers independently performed study screening, selection, data extraction, and quality appraisal. Pooled effects were quantified using standardised mean differences (SMDs) with 95 % confidence intervals (CIs). Risk of bias and evidence certainty were assessed using RoB2 and GRADE, respectively.</div></div><div><h3>Results</h3><div>Twenty-four studies (20 RCTs; <em>n</em> = 3, 826 participants) were included. The meta-analysis demonstrated that home-based interventions significantly reduced frailty phenotype scores (SMD = -0.27, 95 % CI:0.39 to -0.15) and depressive symptoms (SMD = -0.11, 95 % CI:0.20 to -0.01), alongside marked increases in grip strength (MD = 0.84, 95 % CI: 0.26 to 1.42) and mental health-related quality of life (SMD = 0.17, 95 % CI: 0.04 to 0.30). Subgroup analyses indicated that significant improvements in physical function were observed only in supervised subgroup. No significant changes were observed for overall quality of life, or physical health-related quality of life.</div></div><div><h3>Conclusions</h3><div>Home-based interventions are a valuable strategy for improving frailty, grip strength, and mental health outcomes in older adults with frailty or pre-frailty. Improvements in physical function appear to depend on home-based interventions delivered under professional supervision, while the unsupervised mode may pose the risk of potential iatrogenic harm and therefore necessitates caution alongside safety monitoring.</div></div><div><h3>Reporting Method</h3><div>This review followed PRISMA guidelines (PROSPERO: CRD42024604527).</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106083"},"PeriodicalIF":3.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}