Archives of gerontology and geriatrics最新文献_第4页

Comparative associations of height- and body mass index-adjusted muscle mass with sarcopenia under the Asian Working Group for Sarcopenia 2025 consensus 在亚洲肌肉减少症工作组2025共识下，身高和体重指数调整后的肌肉质量与肌肉减少症的比较关联。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-23 DOI: 10.1016/j.archger.2026.106153

Daijo Shiratsuchi , Hyuma Makizako , Kento Tabira , Yuto Miyake , Takuro Kubozono , Mitsuru Ohishi

引用次数: 0

Predicting dementia risk: Discrimination accuracy of the NCGG–FAT 预测痴呆风险：NCGG-FAT的识别准确性。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-19 DOI: 10.1016/j.archger.2026.106150

Osamu Katayama , Ryo Yamaguchi , Daiki Yamagiwa , Shoma Akaida , Hiroyuki Shimada

Objective

Early detection of mild cognitive impairment (MCI) is essential for dementia prevention. We developed the National Center for Geriatrics and Gerontology–Functional Assessment Tool (NCGG-FAT) using age- and education-adjusted norms with a 1.5 standard deviation (SD) cutoff. This study examined the associations between cognitive domains assessed by the NCGG-FAT and incident dementia using the existing and expanded databases.

Method

A 5-year prospective cohort of 2,441 participants without dementia at baseline was analyzed. Hazard ratios (HRs) and 95% confidence intervals (CIs) for individual cognitive tests and cognitive states (normal cognition, MCI, and global cognitive impairment) were estimated using Cox proportional hazards models. Competing risk of death was addressed using Fine–Gray models. Predictive models for dementia were also developed and validated.

Results

In the expanded database, declines ≥1.5 SD in word list memory, TMT-B, forward and backward digit span, and SDST were significantly associated with dementia onset (HRs 1.77–3.22). Fine–Gray analyses yielded similar results. For cognitive states, amnestic and non-amnestic MCI, particularly moderate subtypes, and global cognitive impairment showed elevated risks (HRs 1.55–2.92), although some associations lost significance after accounting for competing mortality. The NCGG-FAT composite score demonstrated high discrimination for incident dementia (AUC = 0.96; accuracy = 0.95).

Conclusion

The expanded NCGG-FAT database is a useful auxiliary tool for assessing future dementia risk in community-dwelling older adults.

目的：早期发现轻度认知障碍（MCI）是预防痴呆的必要条件。我们开发了国家老年病学和老年病学功能评估工具（NCGG-FAT），使用年龄和教育水平调整后的标准，标准偏差为1.5。本研究使用现有和扩展的数据库检查了NCGG-FAT评估的认知领域与痴呆发生率之间的关系。方法：对2441名基线时无痴呆的5年前瞻性队列进行分析。使用Cox比例风险模型估计个体认知测试和认知状态（正常认知、轻度认知障碍和整体认知障碍）的风险比（hr）和95%置信区间（ci）。使用Fine-Gray模型处理竞争死亡风险。痴呆的预测模型也被开发和验证。结果：在扩展后的数据库中，单词表记忆、TMT-B、前向和后向数字广度、SDST下降≥1.5 SD与痴呆发病显著相关（hr = 1.77 ~ 3.22）。精细灰色分析也得出了类似的结果。对于认知状态，遗忘型和非遗忘型轻度认知损伤，特别是中度亚型，以及整体认知障碍显示出较高的风险（hr 1.55-2.92），尽管在考虑了竞争死亡率后，一些关联失去了显著性。NCGG-FAT综合评分对痴呆的发生率有较高的鉴别性（AUC = 0.96，准确率= 0.95）。结论：扩展的NCGG-FAT数据库是评估社区居住老年人未来痴呆风险的有用辅助工具。

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引用次数: 0

What matters most to older adults? A systematic review of preferences for socially assistive robots 对老年人来说，什么最重要？对社会辅助机器人偏好的系统回顾

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-10 DOI: 10.1016/j.archger.2026.106139

Jing Wu, Jixia Cao, Pingshuang Li, Can Yang, Ying He

Background

The current level of social acceptance of socially assistive robots (SARs) remains limited. Research on user preferences plays an essential role in improving the acceptance of SARs among older adults. This study aimed to integrate evidence on older adults’ preferences for SARs to provide personalized guidance and establish a foundation for their future use in home care environments.

Methods

We searched 7 databases to find any studies designed to focus on the preferences of older adults for SARs. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool (MMAT).

Results

A total of 21 studies were included. Although studies on older adults’ preferences for SARs varied considerably in design and scope, several consistent patterns emerged: (1) older adults preferred SARs that assist with household tasks; (2) they favored voice-based interaction; (3) they preferred human-like appearances; (4) their preferences regarding privacy, data storage, control, autonomy, and emotional or social interaction; and (5) most viewed SARs as assistants or companions.

Conclusion

This review highlights the diversity of older adults’ preferences for SARs, including service functions, communication, appearance, and ethical considerations. Future research should address these preferences to promote acceptance and support the integration of socially assistive robots into home care settings.

目前社会对社交辅助机器人（sar）的接受程度仍然有限。用户偏好研究在提高老年人对sar的接受度方面起着至关重要的作用。本研究旨在整合老年人对SARs偏好的证据，提供个性化指导，并为其未来在家庭护理环境中的应用奠定基础。方法我们检索了7个数据库，以找到任何旨在关注老年人对SARs的偏好的研究。使用混合方法评估工具（MMAT）评估纳入研究的质量。结果共纳入21项研究。尽管关于老年人对辅助助手的偏好的研究在设计和范围上有很大差异，但出现了一些一致的模式：(1)老年人更喜欢协助家务的辅助助手；(2)偏好语音交互；(3)他们更喜欢人类的外表；(4)他们在隐私、数据存储、控制、自主以及情感或社会互动方面的偏好；(5)大多数人将SARs视为助手或同伴。结论本综述强调了老年人对sar偏好的多样性，包括服务功能、通信、外观和伦理考虑。未来的研究应该解决这些偏好，以促进接受和支持社会辅助机器人融入家庭护理环境。

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引用次数: 0

Development and external validation of a mortality prediction model for community-dwelling adults aged ≥50 years with frailty or pre-frailty ≥50岁社区居民体弱或体弱前期成人死亡率预测模型的建立和外部验证

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-09 DOI: 10.1016/j.archger.2026.106143

Kang Fu , Ruizhe Chen , Shuwen Li , Yu Zhang , Kailu Fang , Luyan Zheng , Yushi Lin , Lanjuan Li , Jie Wu

Background

Frailty and pre-frailty raise mortality risk in older adults, yet clinicians lack tailored prognostic tools. We developed and externally validated a model predicting all-cause mortality in community-dwelling adults aged ≥50 years with frailty or pre-frailty.

Methods

Using SHARE 2006–07 data (n = 15,195), we fitted a Cox model with backward selection and multiple imputation. Predictors spanned demographics, lifestyle, ADL/IADL limitations, mobility, pain and key comorbidities. We assessed discrimination by integrated and time-specific AUCs and calibration by comparing predicted versus observed mortality. External validation occurred in ELSA (n = 4464) and HRS (n = 7414).

Results

Within the SHARE cohort (61.0% female; median follow-up 3.8 years), 18.5% (n = 2811) of participants died. The final model incorporated age, sex, BMI, smoking status, IADL limitations, mobility impairments, physical activity, pain, and major comorbidities. Internal validation demonstrated robust discrimination (optimism-corrected iAUC 0.81, 95% CI 0.79–0.82), with sustained accuracy at 1-, 5-, and 7-year intervals (AUCs 0.80–0.83). External validation in ELSA (iAUC 0.83) and HRS (iAUC 0.82) confirmed strong generalizability, alongside excellent calibration across all time points.

Conclusions

We present a rigorously validated prognostic model for mortality in frail and pre-frail older adults, demonstrating high accuracy and clinical utility. By providing personalized risk estimates, this tool can enhance shared decision-making, optimize care planning, and improve outcomes for a growing at-risk population.

背景：虚弱和虚弱前期会增加老年人的死亡风险，但临床医生缺乏量身定制的预后工具。我们开发并外部验证了一个模型，该模型预测了≥50岁、体弱或体弱前期社区居住成年人的全因死亡率。方法采用SHARE 2006-07数据（n = 15,195），采用反向选择和多重插值方法拟合Cox模型。预测因素包括人口统计、生活方式、ADL/IADL限制、活动能力、疼痛和主要合并症。我们通过综合和特定时间的auc来评估歧视，并通过比较预测死亡率和观察死亡率来校准。ELSA （n = 4464）和HRS （n = 7414）进行了外部验证。在SHARE队列中（61.0%为女性，中位随访3.8年），18.5% （n = 2811）的参与者死亡。最终模型纳入了年龄、性别、BMI、吸烟状况、IADL限制、行动障碍、身体活动、疼痛和主要合并症。内部验证显示了稳健的区分（乐观校正的iAUC 0.81, 95% CI 0.79-0.82），在1年、5年和7年的间隔（auc 0.80-0.83）具有持续的准确性。ELSA （iAUC 0.83）和HRS （iAUC 0.82）的外部验证证实了较强的通用性，以及所有时间点的优秀校准。结论：我们提出了一个经过严格验证的老年人体弱和体弱前期死亡率预后模型，具有较高的准确性和临床实用性。通过提供个性化的风险评估，该工具可以加强共同决策，优化护理计划，并改善日益增长的风险人群的结果。

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引用次数: 0

Nature-based approaches to dementia, cognitive impairment, and caregiver well-being: A scoping review of gardening and therapeutic strategies 以自然为基础的痴呆症、认知障碍和照顾者福祉的方法：园艺和治疗策略的范围审查

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-22 DOI: 10.1016/j.archger.2026.106152

Mary Dioise Ramos, Marcy Purnell, Jolie Harris, Gloria Giarratano

Background

Dementia is a growing global health concern, with behavioral and psychological symptoms (BPSD) contributing significantly to diminished quality of life and caregiver burden. Non-pharmacological interventions, such as gardening and nature-based therapies, are increasingly recognized for their therapeutic potential.

Objectives

This scoping review aimed to: (1) map existing evidence on gardening and garden-based interventions for individuals with dementia; (2) assess impacts on caregivers; (3) identify mechanisms of benefit; and (4) summarize effective design and implementation strategies.

Methods

Following Joanna Briggs Institute methodology and PRISMA-ScR guidelines, a comprehensive search was conducted across five databases. Studies were screened using Covidence. Inclusion criteria encompassed peer-reviewed studies where gardening was the primary intervention for people with dementia or their caregivers. Thirty-two studies were included, spanning qualitative, quantitative, mixed-methods, and review designs.

Results

Gardening interventions consistently improved psychosocial well-being, mood, and reduced BPSD. Evidence for cognitive benefits was mixed, with stronger support for preventive effects. Caregivers experienced reduced psychological distress and enhanced social support. Mechanisms of benefit included engagement, purpose, identity reinforcement, and sensory stimulation. Effective interventions emphasized active participation, co-design, and integration into routine care. Barriers included staff risk aversion, limited access, and environmental constraints.

Conclusions

Gardening and garden-based interventions offer flexible, person-centered strategies to enhance well-being in dementia care. Their success depends on meaningful engagement, supportive design, and organizational commitment. Future research should standardize outcomes, explore caregiver-focused models, and assess economic impact.

痴呆症是一个日益严重的全球健康问题，行为和心理症状（BPSD）是导致生活质量下降和照顾者负担加重的重要原因。非药物干预措施，如园艺和基于自然的疗法，越来越多地认识到其治疗潜力。本综述旨在：(1)梳理现有的关于园艺和以园艺为基础的痴呆个体干预措施的证据；(2)评估对照顾者的影响；(3)确定效益机制；(4)总结有效的设计与实施策略。方法遵循Joanna Briggs研究所的方法和PRISMA-ScR指南，在五个数据库中进行了全面的搜索。使用covid筛查研究。纳入标准包括同行评议的研究，其中园艺是痴呆症患者或其照顾者的主要干预措施。纳入32项研究，包括定性、定量、混合方法和回顾设计。结果园艺干预持续改善心理社会健康、情绪和减少BPSD。认知益处的证据好坏参半，更有力地支持预防效果。照顾者的心理困扰减少，社会支持增强。利益机制包括参与、目的、身份强化和感官刺激。有效的干预措施强调积极参与、共同设计和融入常规护理。障碍包括员工风险规避、有限的访问和环境约束。结论园艺和基于花园的干预提供了灵活的、以人为本的策略来提高痴呆症护理的幸福感。他们的成功取决于有意义的参与、支持性设计和组织承诺。未来的研究应该使结果标准化，探索以护理者为中心的模式，并评估经济影响。

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引用次数: 0

Trends and cross-country inequalities in the global burden of environmental heat and cold exposure among the elderly population from 1990 to 2021: A population-based study 1990年至2021年全球老年人环境冷热暴露负担的趋势和跨国不平等：一项基于人群的研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-15 DOI: 10.1016/j.archger.2026.106148

Shenghao Xu , Haoyu Li , Jianlin Xiao

Background

Against the backdrop of rapid climate change, environmental heat and cold exposure (EHCE) represents a leading cause of mortality among older adults globally.

Methods

This study, based on data from the Global Burden of Disease Study 2021, analyzed the age-standardized incidence (ASIR), prevalence (ASPR), deaths (ASDR), and disability-adjusted life years (DALYs) rates of EHCE among the elderly population and evaluated the temporal trends of the burden, driving factors, and the effects of age, period, and cohort on the burden. Additionally, the slope index of inequality and concentration index were used to evaluate cross-country disparities.

Results

Although the ASIR and ASPR decreased by –1.47 % and –1.33 %, respectively, the total number of cases significantly increased. In 2021, the ASPR was 413.24 (95 % uncertainty interval [UI]: 362.36 to 475.62), with a total of 4,427,518.39 cases (95 % UI: 3,879,450.57 to 5,101,795.26), an increase of 52.48 % compared to 1990. At the regional level, Eastern Europe had the highest ASPR, at 1,233.25 (95 % UI: 1,060.62 to 1,428.94). Age had a significant positive impact on the EHCE burden, with the highest risk among individuals aged 95 and older. Decomposition analysis indicated that population growth was the primary driver of increased burden, while epidemiological changes significantly reduced it. Health inequality analysis revealed that the EHCE burden is concentrated in high SDI countries; although absolute inequality has decreased, relative inequality is still increasing.

Conclusion

This study underscores the necessity of developing interventions targeted at the elderly population and strengthening global cooperation to address climate change.

在气候快速变化的背景下，环境冷热暴露（EHCE）是全球老年人死亡的主要原因。方法本研究基于全球疾病负担研究2021的数据，分析老年人EHCE的年龄标准化发病率（ASIR）、患病率（ASPR）、死亡率（ASDR）和残疾调整生命年（DALYs）率，并评估负担的时间趋势、驱动因素以及年龄、时期和队列对负担的影响。此外，还利用不平等斜率指数和集中度指数对跨国差异进行了评价。结果虽然ASIR和ASPR分别下降了- 1.47%和- 1.33%，但总病例数明显增加。2021年，ASPR为413.24例（95%不确定区间[UI]: 362.36 ~ 475.62），共4427518.39例（95% UI: 3879450.57 ~ 5101795.26），较1990年增加52.48%。在区域一级，东欧的ASPR最高，为1,233.25 （95% UI: 1,060.62至1,428.94）。年龄对EHCE负担有显著的正向影响，95岁及以上人群的风险最高。分解分析表明，人口增长是疾病负担增加的主要原因，而流行病学变化显著降低了疾病负担。卫生不平等分析显示，EHCE负担集中在高SDI国家；虽然绝对不平等有所减少，但相对不平等仍在增加。结论本研究强调了制定针对老年人口的干预措施和加强全球合作应对气候变化的必要性。

{"title":"Trends and cross-country inequalities in the global burden of environmental heat and cold exposure among the elderly population from 1990 to 2021: A population-based study","authors":"Shenghao Xu , Haoyu Li , Jianlin Xiao","doi":"10.1016/j.archger.2026.106148","DOIUrl":"10.1016/j.archger.2026.106148","url":null,"abstract":"<div><h3>Background</h3><div>Against the backdrop of rapid climate change, environmental heat and cold exposure (EHCE) represents a leading cause of mortality among older adults globally.</div></div><div><h3>Methods</h3><div>This study, based on data from the Global Burden of Disease Study 2021, analyzed the age-standardized incidence (ASIR), prevalence (ASPR), deaths (ASDR), and disability-adjusted life years (DALYs) rates of EHCE among the elderly population and evaluated the temporal trends of the burden, driving factors, and the effects of age, period, and cohort on the burden. Additionally, the slope index of inequality and concentration index were used to evaluate cross-country disparities.</div></div><div><h3>Results</h3><div>Although the ASIR and ASPR decreased by –1.47 % and –1.33 %, respectively, the total number of cases significantly increased. In 2021, the ASPR was 413.24 (95 % uncertainty interval [UI]: 362.36 to 475.62), with a total of 4,427,518.39 cases (95 % UI: 3,879,450.57 to 5,101,795.26), an increase of 52.48 % compared to 1990. At the regional level, Eastern Europe had the highest ASPR, at 1,233.25 (95 % UI: 1,060.62 to 1,428.94). Age had a significant positive impact on the EHCE burden, with the highest risk among individuals aged 95 and older. Decomposition analysis indicated that population growth was the primary driver of increased burden, while epidemiological changes significantly reduced it. Health inequality analysis revealed that the EHCE burden is concentrated in high SDI countries; although absolute inequality has decreased, relative inequality is still increasing.</div></div><div><h3>Conclusion</h3><div>This study underscores the necessity of developing interventions targeted at the elderly population and strengthening global cooperation to address climate change.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"143 ","pages":"Article 106148"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146035607","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}

引用次数: 0

Mapping assistive technologies along the progression of Alzheimer's disease: A scoping review 绘制辅助技术沿着阿尔茨海默病的进展：范围审查

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-09 DOI: 10.1016/j.archger.2026.106142

Nadia Mirjan , Aleksandra Zecevic , Leena Shoemaker

Background and objectives

A growing population of people living with Alzheimer’s Disease requires improved supports for aging in place. Assistive technologies (ATs) can delay institutionalization, reduce care partner strain, and improve quality of life for this population. The abilities and needs of this population change during disease progression, but it remains unclear which ATs are best suited for specific stages. The purpose of this scoping review was to provide a snapshot in time by mapping currently available ATs assessed in peer-reviewed research, across the seven stages of Alzheimer’s Disease progression.

Research design and methods

The review followed the Arksey and O’Malley framework to identify and harvest information from Medline, Scopus, CINAHL, and Embase databases. Inclusion criteria were Alzheimer’s Disease, technology interventions of any type and duration, English language, and the period between 2000 and 2023. Data was extracted and analyzed using six predetermined domains of ATs for dementia: safety devices, clinical devices, memory aids, ATs for preventing social isolation, ATs for leisure activities, and ATs for supporting everyday tasks.

Results

A total of 87 ATs, reported in 47 articles, were mapped along seven stages of the disease. A variety of ATs are available, with high technology (e.g., tracking devices) targeting initial stages, and low technology (e.g., weighted blanket) targeting later stages. Music therapies were present across all disease stages.

Discussion and implications

The map has the potential to inform people with Alzheimer’s Disease, care partners, technology companies, policy makers and service providers on current AT availability and need for further development.

背景与目的随着阿尔茨海默病患者人数的增加，需要对老年化提供更好的支持。辅助技术（at）可以延迟机构化，减少护理伙伴的压力，并改善这一人群的生活质量。这一人群的能力和需求在疾病进展过程中发生变化，但目前尚不清楚哪种ATs最适合特定阶段。本综述的目的是通过绘制同行评议研究中评估的目前可用的ATs，在阿尔茨海默病进展的七个阶段提供一个及时的快照。研究设计和方法本综述遵循Arksey和O 'Malley框架，从Medline、Scopus、CINAHL和Embase数据库中识别和获取信息。纳入标准为阿尔茨海默病、任何类型和持续时间的技术干预、英语语言和2000年至2023年之间的时间。数据的提取和分析使用了六个预先确定的痴呆人工智能领域：安全装置、临床装置、记忆辅助装置、防止社会隔离的人工智能、用于休闲活动的人工智能和用于支持日常任务的人工智能。结果47篇文章共报道了87个at，沿疾病的7个阶段进行了绘制。各种各样的ATs都是可用的，高技术（例如，跟踪装置）针对初始阶段，低技术（例如，加权毯）针对后期阶段。音乐疗法存在于所有疾病阶段。讨论和影响该地图有可能使阿尔茨海默病患者、护理合作伙伴、技术公司、政策制定者和服务提供商了解目前的辅助治疗可用性和进一步发展的需要。

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引用次数: 0

Development and validation of a 90-day complication prediction model for geriatric orthopedic surgery: A multicenter prospective study 老年骨科手术90天并发症预测模型的建立和验证：一项多中心前瞻性研究。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-02-02 DOI: 10.1016/j.archger.2026.106163

Doudou Li , Yanmei Ning , Ting Zhang , Xinwen Liu , Jiawen Yu , Guanghui Chen , Ronghui Wang , Jiana Shi , Ying Hu

Background

With the aging population, the demand for geriatric orthopedic surgery is increasing, and the rate of postoperative complications is escalating. This study aimed to construct a prediction model based on geriatric comprehensive assessment data and potential risk factors for surgery to assess the risk of complications in older patients within three months after various surgical procedures.

Methods

Using a prospective cohort design, we split a central dataset (7:3 ratio) into training and internal validation sets. We identified relevant variables using LASSO regression and built predictive models using logistic regression. External validation was performed using data from four other centers. Performance was evaluated by AUC, calibration plots, and DCA, and a Shiny web calculator was subsequently deployed.

Results

The study incorporated six variables related to frailty, nutrition, ADL, anesthesia modality, surgery complexity, and operation duration for modeling. To validate the model, we employed data from the training and validation sets independently. The AUC of the nomogram model based on the training set was 0.816 (95% CI: 0.769-0.863), and the AUC based on the internal validation set was 0.791 (95% CI: 0.716-0.866); the AUC for external validation was 0.789 (95% CI: 0.710-0.868). All calibration and DCA curves demonstrated good predictive performance.

Conclusions

The predictive model effectively identifies the risk of postoperative complications within three months in older individuals undergoing orthopedic surgery, aiding preoperative risk assessment and patient management to enhance clinical decision-making and improve patient outcomes.

背景：随着人口老龄化，老年骨科手术需求不断增加，术后并发症发生率不断上升。本研究旨在构建基于老年综合评估数据和手术潜在危险因素的预测模型，评估老年患者各种手术后3个月内并发症的发生风险。方法：采用前瞻性队列设计，我们将中心数据集（7:3比例）分成训练集和内部验证集。我们使用LASSO回归识别相关变量，并使用逻辑回归建立预测模型。使用来自其他四个中心的数据进行外部验证。通过AUC、校准图和DCA评估性能，随后部署了Shiny网络计算器。结果：研究纳入了与虚弱、营养、ADL、麻醉方式、手术复杂性和手术时间相关的6个变量进行建模。为了验证模型，我们分别使用了来自训练集和验证集的数据。基于训练集的nomogram model的AUC为0.816 (95% CI: 0.769-0.863)，基于内部验证集的AUC为0.791 (95% CI: 0.716-0.866)；外部验证的AUC为0.789 （95% CI: 0.710-0.868）。所有的校准和DCA曲线都显示出良好的预测性能。结论：该预测模型可有效识别老年骨科手术患者术后3个月内发生并发症的风险，有助于术前风险评估和患者管理，提高临床决策水平，改善患者预后。

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引用次数: 0

Perioperative multicomponent exercise rehabilitation for frail elderly patients undergoing surgical procedures: A systematic review and meta-analysis 老年体弱多病手术患者围手术期多组分运动康复：系统回顾和荟萃分析

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2025-12-29 DOI: 10.1016/j.archger.2025.106127

Xiaoqing Xie , Lanping Lei , Yuan Zhan , Caiyun He

Background

Frailty among elderly patients undergoing surgical procedures constitutes a notable risk factor for adverse postoperative outcomes. Perioperative multicomponent exercise rehabilitation presents a promising strategy; however, its overall efficacy is still uncertain. This systematic review aimed to assess the effects of these programs on frail elderly patients undergoing surgery.

Methods

A search was conducted in MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Web of Science, and SPORTDiscus from inception to August 2025 for RCTs examining perioperative (primarily prehabilitation) multicomponent exercise in adults aged ≥ 65 with frailty. The JBI checklist was utilized to assess the risk of bias, while evidence certainty was evaluated using the GRADE system.

Results

Out of 663 identified records, 10 RCTs involving 1146 patients were included. A meta-analysis indicated that exercise significantly decreased postoperative complications (RR 0.72, 95% CI 0.58–0.87; high certainty) and enhanced functional capacity, evidenced by a mean difference of 26.7 meters in the Six-Minute Walk Test (95% CI 16.1–37.3; high certainty). A modest yet noteworthy decrease in length of stay (MD -0.51 days) and an enhancement in handgrip strength (MD 0.35 kg) were observed. The impacts on quality of life, disability, frailty, and readmission risk were determined to be non-significant, corroborated by low-to-moderate certainty evidence.

Conclusion

Perioperative multicomponent exercise rehabilitation significantly decreases complications and improves physical function in frail elderly patients undergoing surgery. Nonetheless, its impact on wider geriatric syndromes has yet to be established. Clinicians ought to implement these programs to enhance core recovery outcomes, while future research should focus on optimizing patient-centered benefits.

背景：接受外科手术的老年患者的虚弱是术后不良结果的一个显著危险因素。围手术期多组分运动康复是一种很有前景的康复策略；然而，其整体功效仍不确定。本系统综述旨在评估这些方案对接受手术的体弱老年患者的影响。方法检索MEDLINE、Embase、CINAHL、Cochrane CENTRAL、Web of Science和SPORTDiscus中从成立到2025年8月的rct，以检查≥65岁虚弱成人围手术期（主要是康复前）多组分运动。使用JBI检查表评估偏倚风险，使用GRADE系统评估证据确定性。结果在663份确定的记录中，纳入10项rct，涉及1146例患者。一项荟萃分析表明，运动显著降低了术后并发症（RR 0.72, 95% CI 0.58-0.87，高确定性），并增强了功能能力，6分钟步行测试的平均差异为26.7米（95% CI 16.1-37.3，高确定性）。观察到停留时间（MD -0.51天）的适度但值得注意的减少和握力（MD 0.35 kg）的增强。对生活质量、残疾、虚弱和再入院风险的影响被确定为无显著性，由低至中等确定性证据证实。结论围手术期多组分运动康复可明显减少老年体弱患者的并发症，改善患者的身体功能。尽管如此，它对更广泛的老年综合征的影响尚未确定。临床医生应该实施这些方案来提高核心康复结果，而未来的研究应侧重于优化以患者为中心的利益。

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引用次数: 0

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-29 DOI: 10.1016/j.archger.2026.106157

Mariana Teles

This exploratory study examined how depth of processing, intention to learn, and age interact to influence free recall performance and the temporal contiguity effect (TCE). A total of 119 participants, being 67 younger adults (M = 19.2 years) and 52 older adults (M = 73.9 years), completed free recall tasks that varied in levels of processing (no-orienting, shallow, deep) and learning intention (intentional vs. incidental). Given modest cell sizes (n = 10–17 per condition), findings should be considered exploratory and hypothesis-generating. Patterns suggest that deeper processing improves overall recall across age groups, while the organization of recall may differ with age and learning intention, though definitive conclusions about interactions require replication with larger samples. Intentional learning strengthened temporal organization compared with incidental learning, but this pattern diverged by age. In younger adults, deeper processing disrupted the TCE during intentional learning, whereas older adults maintained stable temporal organization across processing levels, a pattern that may reflect strategic compensation, reduced encoding flexibility, or preserved temporal binding mechanisms. These findings contribute to understanding how encoding strategies and learning intention shape memory organization across the adult lifespan and highlight potential pathways for supporting episodic memory in aging.

本研究考察了加工深度、学习意向和年龄对自由回忆表现和时间邻近效应的影响。共有119名参与者，67名年轻人（M = 19.2岁）和52名老年人（M = 73.9岁），完成了不同程度的加工（无定向，浅，深）和学习意图（有意与偶然）的自由回忆任务。给定适度的细胞大小（每种条件n = 10-17），研究结果应被视为探索性和假设生成。模式表明，深度处理提高了不同年龄组的整体回忆，而回忆的组织可能因年龄和学习意图而异，尽管关于相互作用的明确结论需要在更大的样本中复制。与偶然学习相比，有意学习增强了时间组织，但这种模式随着年龄的增长而分化。在年轻人中，深度加工在有意学习过程中破坏了TCE，而老年人在加工层次上保持了稳定的时间组织，这种模式可能反映了策略补偿、编码灵活性降低或保留了时间绑定机制。这些发现有助于理解编码策略和学习意图如何在整个成人生命周期中塑造记忆组织，并突出了在衰老过程中支持情景记忆的潜在途径。

{"title":"Age-related differences in memory organization: How depth of processing and learning intention affect free recall and temporal contiguity","authors":"Mariana Teles","doi":"10.1016/j.archger.2026.106157","DOIUrl":"10.1016/j.archger.2026.106157","url":null,"abstract":"<div><div>This exploratory study examined how depth of processing, intention to learn, and age interact to influence free recall performance and the temporal contiguity effect (TCE). A total of 119 participants, being 67 younger adults (<em>M</em> = 19.2 years) and 52 older adults (<em>M</em> = 73.9 years), completed free recall tasks that varied in levels of processing (no-orienting, shallow, deep) and learning intention (intentional vs. incidental). Given modest cell sizes (<em>n</em> = 10–17 per condition), findings should be considered exploratory and hypothesis-generating. Patterns suggest that deeper processing improves overall recall across age groups, while the organization of recall may differ with age and learning intention, though definitive conclusions about interactions require replication with larger samples. Intentional learning strengthened temporal organization compared with incidental learning, but this pattern diverged by age. In younger adults, deeper processing disrupted the TCE during intentional learning, whereas older adults maintained stable temporal organization across processing levels, a pattern that may reflect strategic compensation, reduced encoding flexibility, or preserved temporal binding mechanisms. These findings contribute to understanding how encoding strategies and learning intention shape memory organization across the adult lifespan and highlight potential pathways for supporting episodic memory in aging.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"143 ","pages":"Article 106157"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101179","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}

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