Archives of gerontology and geriatrics最新文献_第5页

Ultrasound-derived muscle variables and physical function in older adults: A scoping review 超声来源的肌肉变量和老年人的身体功能：范围回顾。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-04-01 Epub Date: 2026-01-20 DOI: 10.1016/j.archger.2026.106151

Jeppe Grabov Phillip , Kristoffer Kittelmann Brockhattingen , Tobias Kaarsbo , Morten Tange Kristensen , Jesper Ryg , Charlotte Suetta , Tahir Masud , Lisbeth Rosenbek Minet

Background

Evidence on use of ultrasound to assess muscles in older adults, and its relation to clinically relevant measures is diverse and inconsistent.

Objective

To map and synthesize evidence on use of ultrasound-derived muscle variables and their associations with measures of physical function in older adults.

Methods

A scoping review was conducted in accordance with PRISMA-ScR and JBI guidance. MEDLINE, Cochrane, Embase, Scopus, CINAHL, and grey literature was searched. Eligible studies included adults ≥65 years, including frail cohorts, reporting association between ultrasound-derived muscle variables (muscle thickness (MT), cross-sectional area (CSA), echo intensity (EI), pennation angle (PA), fascicle length (FL), or shear-wave elastography (SWE)) and physical function measures (handgrip strength (HGS), sit-to-stand (STS), gait speed (GS), timed up-and-go (TUG), or short physical performance battery (SPPB)).

Results

Seventy studies met inclusion criteria. Mapping revealed that rectus femoris MT at mid-thigh was most frequently examined, with considerable protocol variation. Most studies used cross-sectional designs, and frail cohorts were underrepresented. MT and CSA showed weak to moderate associations with muscle strength-related measures (HGS and STS) and generally very weak to weak associations with physical performance-related measures (GS, TUG, SPPB). Evidence for EI, SWE, PA, and FL was limited and inconsistent.

Conclusion

Current evidence provides limited support for ultrasound-derived muscle variables as markers of physical function in older adults. Muscle thickness and cross-sectional area capture aspects of muscle strength but insufficiently reflect physical performance. Establishing harmonized protocols and exploring responsiveness in frail populations, in longitudinal studies are critical steps for future research and clinical application.

背景：使用超声评估老年人肌肉的证据及其与临床相关措施的关系是多样和不一致的。目的：绘制和综合使用超声来源的肌肉变量及其与老年人身体功能测量的关联的证据。方法：根据PRISMA-ScR和JBI指南进行范围审查。检索MEDLINE、Cochrane、Embase、Scopus、CINAHL和灰色文献。符合条件的研究包括≥65岁的成年人，包括虚弱的队列，报告超声来源的肌肉变量（肌肉厚度（MT）、横截面积（CSA）、回波强度（EI）、笔角（PA）、束长（FL）或剪切波弹性成像（SWE））与身体功能测量（握力（HGS）、坐立（STS）、步态速度（GS）、时间起-走（TUG）或短物理性能测试（SPPB））之间的关联。结果：70项研究符合纳入标准。测绘显示，股骨正中的股直肌MT最常被检查，有相当大的协议差异。大多数研究采用横断面设计，脆弱队列的代表性不足。MT和CSA与肌肉力量相关指标（HGS和STS）呈弱至中度相关性，与体能相关指标（GS、TUG、SPPB）呈极弱至弱相关性。EI、SWE、PA和FL的证据有限且不一致。结论：目前的证据有限地支持超声来源的肌肉变量作为老年人身体功能的标志物。肌肉厚度和横截面积反映了肌肉力量的各个方面，但不足以反映身体表现。在纵向研究中建立统一的方案和探索虚弱人群的反应性是未来研究和临床应用的关键步骤。

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引用次数: 0

Watching sports and subsequent health and well-being in older adults: a longitudinal outcome-wide study 老年人观看体育运动与随后的健康和幸福：一项纵向结果研究。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-03-01 Epub Date: 2025-12-12 DOI: 10.1016/j.archger.2025.106120

Taishi Tsuji , Kenjiro Kawaguchi , Kazushige Ide , Atsushi Nakagomi , Yuya Narita , Satoru Kanamori , Katsunori Kondo

Background

Although watching sports has increasingly been associated with mental health benefits among older adults, its broader implications, positive and negative, across diverse health and well-being outcomes remain unclear. This longitudinal study examined the associations between sports watching and subsequent health and well-being outcomes among older adults.

Methods

We analyzed three-wave data (2016, 2019, and 2022) from the Japan Gerontological Evaluation Study (n = 5226 or 6975, depending on the outcome). The exposure was watching sports on-site and via television/internet in 2019. In 2022, 47 health and well-being outcomes across seven domains were assessed. Analyses adjusted for pre-baseline covariates, including corresponding outcome values from 2016.

Results

Among 5226 participants, 1260 (24.1 %) reported watching sports on-site at least once per year, and 4155 (79.5 %) reported watching via television or the internet. On-site watching (a few times per year) and media-based watching (regardless of frequency) were associated with a reduced risk of worsening depressive symptoms. Both forms were positively associated with social well-being indicators, including participation in sports groups and the number of friends seen. No significant associations were observed for health behavior outcomes. However, frequent on-site watching was associated with an increased risk of dementia.

Conclusions

Watching sports, on-site or via media, was associated with fewer depressive symptoms and enhanced social well-being in older adults. However, no associations were found with health behaviors, and frequent on-site watching may elevate dementia risk. These findings highlight the need to balance the benefits and risks of sports watching in healthy aging strategies.

背景：尽管观看体育运动越来越多地与老年人的心理健康益处联系在一起，但其对各种健康和福祉结果的积极和消极的更广泛影响尚不清楚。这项纵向研究调查了老年人观看体育比赛与随后的健康和幸福结果之间的关系。方法：我们分析了来自日本老年学评估研究的三波数据（2016年、2019年和2022年）（n = 5226或6975，取决于结果）。2019年的曝光是在现场和通过电视/互联网观看体育比赛。2022年，对七个领域的47项健康和福祉成果进行了评估。分析调整了基线前协变量，包括2016年相应的转归值。结果：在5226名参与者中，1260名（24.1%）报告每年至少观看一次现场体育比赛，4155名（79.5%）报告通过电视或互联网观看体育比赛。现场观看（每年几次）和基于媒体的观看（无论频率如何）与降低抑郁症状恶化的风险相关。这两种形式都与社会幸福感指标呈正相关，包括参加体育团体和见朋友的数量。没有观察到健康行为结果的显著关联。然而，频繁的现场观看会增加患痴呆症的风险。结论：观看体育比赛，无论是现场观看还是通过媒体观看，都与老年人抑郁症状的减少和社会幸福感的增强有关。然而，没有发现与健康行为有关，频繁的现场观看可能会增加患痴呆症的风险。这些发现强调了在健康老龄化策略中平衡观看体育比赛的益处和风险的必要性。

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引用次数: 0

Chronic loneliness and incident chronic lung diseases in two prospective cohorts 两个前瞻性队列的慢性孤独和偶发慢性肺部疾病

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-03-01 Epub Date: 2025-12-06 DOI: 10.1016/j.archger.2025.106112

Bo Yan , Yuechang Li , Haoyu Wu , Xiaomin Wang , Hui Zhu , Xudong Zhou

Background

Loneliness has been recognized as an independent predictor of incident chronic lung diseases. However, previous studies only focused on baseline loneliness status, not taking into consideration the changes in loneliness status during follow-up. This study examined the association of chronic loneliness and incident chronic lung diseases.

Methods

This multicohort study used data from the US Health and Retirement Study (HRS) and the China Health and Retirement Longitudinal Study (CHARLS), consisting of participants aged 45 years or older from China and participants aged 50 years or older from the US. Participants’ self-reported loneliness at baseline was treated as both a continuous variable and a dichotomous variable (low vs. High), and its change patterns were categorised as “stable low”, “low-high”, “high-low”, and “stable high”. Cox proportional hazards regression models were used to estimate the risk of developing chronic lung diseases.

Findings

A total of 18,031 (HRS: 8636; CHARLS: 9395) individuals were included for loneliness change analyses. Compared with individuals assigned to “stable low” loneliness change status, significant increased risks of incident chronic lung diseases were observed among those belonging to “low-high”, “high-low” and “stable high” groups in both cohorts ([CHARLS] “low-high”, HR:1.46, 95 % CI:1.24–1.72; “high-low”, HR:1.19, 95 % CI:1.02–1.38; “stable high”, HR:1.60, 95 % CI:1.36–1.89; [HRS] “low-high”, HR:1.39, 95 % CI:1.05–1.84; “high-low”, HR:1.34, 95 % CI:1.03–1.75; “stable high”, HR:1.60, 95 % CI:1.20–2.15).

Conclusions

Chronic loneliness was associated with higher risks of incident chronic lung diseases. Recovery or relief from loneliness might play an important role in the prevention of chronic lung diseases.

背景：孤独感已被认为是慢性肺部疾病发生的独立预测因子。然而，以往的研究只关注基线的孤独感状态，没有考虑到随访中孤独感状态的变化。本研究探讨慢性孤独感与偶发慢性肺部疾病的关系。方法本多队列研究采用美国健康与退休研究（HRS）和中国健康与退休纵向研究（CHARLS）的数据，包括来自中国的45岁及以上的参与者和来自美国的50岁及以上的参与者。参与者基线自述的孤独感被视为连续变量和二分类变量（低与高），其变化模式被分类为“稳定低”、“低-高”、“高-低”和“稳定高”。采用Cox比例风险回归模型估计发生慢性肺部疾病的风险。结果：共有18031人（HRS: 8636; CHARLS: 9395）被纳入孤独感变化分析。与被分配到“稳定低”孤独变化状态的个体相比，两个队列中属于“低-高”、“高-低”和“稳定高”组的个体发生慢性肺部疾病的风险显著增加([CHARLS]“低-高”组，HR:1.46, 95% CI: 1.24-1.72；“高-低”组，HR:1.19, 95% CI: 1.02-1.38；“稳定高”组，HR:1.60, 95% CI: 1.36-1.89; [HRS]“低-高”组，HR:1.39, 95% CI: 1.05-1.84；“稳定高位”，HR:1.60, 95% CI: 1.20-2.15)。结论慢性孤独感与慢性肺部疾病发生风险增高有关。从孤独中恢复或缓解可能在预防慢性肺部疾病中发挥重要作用。

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引用次数: 0

Mortality prediction among older people in primary care: a comparison of predictive performance of the frailty index with regression-based and machine learning models 初级保健老年人的死亡率预测：衰弱指数与基于回归和机器学习模型的预测性能比较

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI: 10.1016/j.archger.2025.106096

Collin JC Exmann , Karlijn J Joling , Robert Verheij , Iris van der Heide , Hein PJ van Hout , Emiel O Hoogendijk

Introduction

The frailty index is widely used to identify vulnerable individuals at risk of adverse outcomes like mortality. However, its predictive performance compared to other mortality prediction models, especially in subpopulations like people with dementia, is not well known. This study aimed to compare frailty index’s performance with regression-based and machine learning models for predicting mortality among community-dwelling older adults, and to test performance in a dementia subgroup.

Methods

We selected 355,958 community-dwelling adults aged 60 years and older from primary care with electronic health records (EHR) linked to mortality registrations. We developed one- and five-year mortality prediction models using a 36-item frailty index and compared discrimination and calibration of a regression model including the frailty index with two types of regression models and two types of machine learning models using single health deficits as predictors. Lastly, we evaluated the models’ performance in 6394 persons with dementia.

Results

The frailty index model showed moderate performance with an AUC-ROC of 0.793 and 0.804 for one- and five-year mortality. The other models, using the single deficits as predictors, reached higher AUC-ROCs up to 0.828 and 0.824, with good calibration. Overall, the models performed worse in the dementia subgroup, with AUC-ROCs between 0.678 and 0.704.

Discussion

Regression-based and machine learning prediction models using single frailty deficits outperform the frailty index in predicting one- and five-year mortality. However, these models can be more complex and less interpretable. We found lower performance for people with dementia, suggesting the models are less applicable in this subpopulation.

脆弱指数被广泛用于识别有死亡等不良后果风险的脆弱个体。然而，与其他死亡率预测模型相比，特别是在痴呆症患者等亚群体中，其预测性能尚不清楚。本研究旨在将衰弱指数的表现与基于回归和机器学习的模型进行比较，以预测社区居住老年人的死亡率，并测试痴呆亚组的表现。方法我们选择了355,958名60岁及以上的社区居民，他们来自初级保健机构，拥有与死亡登记相关的电子健康记录（EHR）。我们使用36项脆弱指数建立了1年和5年死亡率预测模型，并将包括脆弱指数在内的回归模型的判别和校准与两种回归模型和两种使用单一健康缺陷作为预测因子的机器学习模型进行了比较。最后，我们在6394名痴呆症患者中评估了模型的性能。结果虚弱指数模型表现一般，1年和5年死亡率AUC-ROC分别为0.793和0.804。其他使用单一赤字作为预测因子的模型的auc - roc更高，分别达到0.828和0.824，具有良好的校准。总体而言，这些模型在痴呆亚组中的表现较差，auc - roc在0.678至0.704之间。基于回归和机器学习的预测模型使用单一虚弱缺陷在预测1年和5年死亡率方面优于虚弱指数。然而，这些模型可能更复杂，可解释性更差。我们发现痴呆症患者的表现较差，这表明这些模型在这一人群中不太适用。

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引用次数: 0

Relationship between frailty and white matter hyperintensities: A systematic review and meta-analysis 虚弱和白质高强度之间的关系：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 : 2026-03-01 Epub Date: 2025-11-22 DOI: 10.1016/j.archger.2025.106089

Xuzi Li, Anling Luo, Yiting Deng, Yujia Yang, Qin Yang, Yujie Chen, Li He, Muke Zhou

Background

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.

Objective

This research aimed to examine the relationship between frailty and WMH.

Methods

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.

Results

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, P < 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, P = 0.012), though limitations of this method and other potential biases should be considered.

Conclusions

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.

衰老中常见的虚弱会导致认知和运动能力下降。脑小血管疾病的标志物白质高强度（WMH）也表现出类似的效果。尽管研究表明虚弱和WMH之间存在关联，但证据并不一致，它们之间的关系仍然不确定。目的探讨体质虚弱与WMH的关系。方法采用系统文献检索和元分析方法。进行研究筛选和数据提取，并使用纽卡斯尔-渥太华量表和美国卫生保健研究和质量评估机构工具进行质量评估。采用StataSE 15.0软件进行统计分析。结果共纳入9篇文章，其中10项研究。meta分析结果显示WMH与虚弱之间存在显著正相关（优势比[OR] = 1.38, 95%可信区间[CI]: 1.17-1.64, P < 0.001）。亚组分析显示WMH与虚弱之间存在一致的关联，在住院患者、亚洲人群和使用Fried或Fazekas标准的研究中更为明显。敏感性分析验证了结果的稳健性。在通过trim- fill方法调整发表偏倚后，相关性仍然显著（OR = 1.25, 95% CI: 1.05-1.50, P = 0.012），但应考虑该方法的局限性和其他潜在偏倚。结论swmh与衰弱显著相关，为其在衰弱中的潜在作用提供了新的见解。这项荟萃分析表明，WMH值得在未来的纵向研究中探索，以了解其与脆弱性机制的相关性。

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引用次数: 0

Longitudinal association between pulmonary function and incident cognitive decline : Results of the SONIC cohort study 肺功能与偶发性认知衰退之间的纵向关联：SONIC队列研究的结果。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-03-01 Epub Date: 2025-11-30 DOI: 10.1016/j.archger.2025.106109

Yuka Tachibana , Keigo Kobayashi , Mai Kabayama , Michiko Kido , Yuya Akagi , Hiroshi Akasaka , Yoshio Iwashima , Saori Yasumoto , Yukie Masui , Kazunori Ikebe , Takumi Hirata , Yasumichi Arai , Yasuyuki Gondo , Koichi Yamamoto , Kei Kamide

Reduced pulmonary function may contribute to cognitive decline in older adults; however, few longitudinal studies adjust for frailty, lifestyle, and comorbidities. This study examined whether baseline spirometry predicts 3-year cognitive decline in community-dwelling older Japanese adults. Data were derived from the SONIC Study, a longitudinal cohort of older Japanese adults. This 3-year follow-up included community-dwelling adults in their 70 s and 80 s, stratified by age and sex. Baseline and follow-up assessed anthropometry, physical frailty indicators (grip strength and gait speed), cognition (Montreal Cognitive Assessment, Japanese version [MoCA-J]) and pulmonary function (percent vital capacity [%VC], percent forced vital capacity [%FVC], percent forced expiratory volume in one second [%FEV₁], forced expiratory volume in one second / forced vital capacity ratio [FEV₁/FVC], and percent peak expiratory flow [%PEF]). Associations with mild cognitive decline were examined using logistic regression, adjusted for comorbidities, health behaviors, and frailty. Most pulmonary function measures markedly decreased over 3 years, whereas the FEV₁/FVC ratio remained stable. MoCA-J scores markedly declined among adults in their 80 s but remained stable in those in their 70 s. Reduced %PEF was markedly associated with cognitive decline only in participants in their 70 s, in males and females. Additionally, reduced FEV₁/FVC ratio was associated with increased cognitive decline in females in their 70 s. No significant associations were found in participants in their 80 s. In older adults, declines in %PEF and FEV₁/FVC ratio increased cognitive decline in the 70 s age group, with sex differences noted. Simple pulmonary measures may help identify those at risk.

肺功能下降可能导致老年人认知能力下降；然而，很少有纵向研究对虚弱、生活方式和合并症进行调整。本研究考察了基线肺活量测定是否能预测日本社区老年人3年的认知能力下降。数据来自SONIC研究，这是一项针对日本老年人的纵向队列研究。这项为期3年的随访包括了70多岁和80多岁的社区居民，按年龄和性别分层。基线和随访评估了人体测量、身体虚弱指标（握力和步态速度）、认知（蒙特利尔认知评估，日文版[MoCA-J]）和肺功能（肺活量百分比[%VC]、用力肺活量百分比[%FVC]、一秒钟用力呼气量百分比[%FEV 1]、用力呼气量/用力肺活量比[FEV 1 /FVC]和呼气峰值流量百分比[%PEF]）。使用逻辑回归检查与轻度认知能力下降的关系，调整合并症、健康行为和虚弱。大多数肺功能指标在3年内显著下降，而FEV 1 /FVC比率保持稳定。在80多岁的成年人中，MoCA-J得分明显下降，但在70多岁的成年人中保持稳定。PEF的减少仅在70多岁的男性和女性参与者中与认知能力下降显著相关。此外，FEV 1 /FVC比率的降低与70多岁女性认知能力下降的加剧有关。在80多岁的参与者中没有发现明显的关联。在老年人中，PEF %和FEV 1 /FVC比率的下降加剧了70多岁年龄组的认知能力下降，并存在性别差异。简单的肺部测量可以帮助识别那些有危险的人。

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引用次数: 0

Timing of daily physical activity and onset of depressive symptoms: A longitudinal cohort study of community-dwelling older adults 每日体力活动的时间和抑郁症状的发作：一项对社区居住老年人的纵向队列研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI: 10.1016/j.archger.2025.106095

Masanori Morikawa , Kenji Harada , Chiharu Nishijima , Kazuya Fujii , Daisuke Kakita , Takuto Okuya , Kazuki Soma , Yukari Yamashiro , Naoto Takayanagi , Motoki Sudo , Hiroyuki Shimada

Background

Late-life depression is a major public-health concern. Although physical activity is protective, the longitudinal association of physical-activity timing on depressive-symptom onset in older adults remains unclear. We examined the association of physical activity timing with depressive symptoms in older adults.

Methods

This study included 2542 community-dwelling adults aged ≥60 years from the NCGG-SGS cohort who were free of depressive symptoms at baseline. Physical activity was measured using an accelerometer and summarized in three-hour intervals. Functional principal component analysis classified participants into early and late active groups. Depressive symptoms (GDS score ≥5) were assessed after 26.4 months. Risk differences were estimated using inverse probability and overlap weighting, adjusting for demographic, health, and lifestyle factors.

Results

Depressive symptoms developed in 14.7% of participants. The late active group (activity peak in the afternoon) had a lower incidence (10.1%) than the early active group (16.1%). After inverse probability weighting, the risk difference was −3.9% (95% CI: −7.0% to −0.8%, P= 0.009). After overlap weighting, the risk difference was −3.5% (95% CI: −6.6% to −0.4%, P= 0.011). Subgroup analyses showed consistent results across age, sex, and activity levels.

Conclusions

A late active pattern was associated with a reduced risk of depressive symptoms in older adults. Timing of daily activity should be considered in depression-prevention strategies.

背景：晚年抑郁症是一个主要的公共卫生问题。尽管体力活动具有保护作用，但体力活动时间与老年人抑郁症状发作的纵向关联尚不清楚。我们研究了老年人体力活动时间与抑郁症状的关系。方法本研究纳入2542名来自NCGG-SGS队列、年龄≥60岁、基线时无抑郁症状的社区居住成年人。用加速度计测量身体活动，每隔三小时汇总一次。功能主成分分析将参与者分为早运动组和晚运动组。26.4个月后评估抑郁症状（GDS评分≥5）。使用逆概率和重叠加权来估计风险差异，并根据人口统计学、健康和生活方式因素进行调整。结果14.7%的参与者出现抑郁症状。晚活动组（活动高峰在下午）的发病率（10.1%）低于早活动组（16.1%）。逆概率加权后，风险差异为- 3.9% （95% CI: - 7.0% ~ - 0.8%， P= 0.009）。重叠加权后，风险差异为- 3.5% （95% CI: - 6.6%至- 0.4%，P= 0.011）。亚组分析显示，不同年龄、性别和活动水平的结果一致。结论晚期活动模式与老年人抑郁症状风险降低有关。在预防抑郁症的策略中，应该考虑日常活动的时间。

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引用次数: 0

Beyond access: Digital skills as a new social determinant of health among older adults — evidence from a longitudinal panel study 超越获取：数字技能作为老年人健康的一个新的社会决定因素——来自纵向小组研究的证据

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-03-01 Epub Date: 2025-12-16 DOI: 10.1016/j.archger.2025.106124

Hao Ji , Weiguang Pan , Junyi Xin

Background

As the digital divide shifts from access to skills, the impact of digital competence on older adults’ well-being remains underexplored. This study investigates the longitudinal relationship between digital skills and the multidimensional health of China’s older population.

Methods

Using multi-wave data from the China Longitudinal Aging Social Survey (CLASS), a nationally representative longitudinal panel study, we employed individual fixed-effects models. To mitigate endogeneity, we utilized a Bartik-style instrumental variable (IV-2SLS) strategy. A hybrid analytical approach was adopted to examine transmission mechanisms.

Results

Self-rated digital skills significantly predicted better health outcomes, including improved self-rated health (β=0.082, p < 0.001), fewer depressive symptoms (β=−0.307, p < 0.001), and greater social health (β=0.280, p < 0.001). These associations remained robust after correcting for endogeneity. The protective effect operates through a dual trajectory: reinforcing social participation and health behaviors, while enabling meaningful engagement with digital health technologies. Heterogeneity analysis revealed a pattern of “inclusive growth”: health returns were substantial for vulnerable groups (low income/education) and the oldest-old, functioning as a “compensatory resource,” though a “digital blind spot” persisted in peri‑urban areas.

Conclusion

Digital skills have emerged as a pivotal social determinant of health in later life. Policies must pivot from infrastructure provision to “precision empowerment,” prioritizing skill-building for disadvantaged older adults to ensure the equitable distribution of digital health benefits.

随着数字鸿沟从获取转向技能，数字能力对老年人福祉的影响仍未得到充分探讨。本研究探讨了数字技能与中国老年人口多维健康之间的纵向关系。方法采用具有全国代表性的纵向面板研究——中国纵向老龄化社会调查（CLASS）的多波数据，采用个体固定效应模型。为了减轻内生性，我们采用了bartik式工具变量（IV-2SLS）策略。采用混合分析方法来研究传动机制。结果自评数字技能显著预测更好的健康结果，包括改善的自评健康（β=0.082, p < 0.001），更少的抑郁症状（β= - 0.307, p < 0.001）和更大的社会健康（β=0.280, p < 0.001）。在校正了内生性后，这些关联仍然很强。这种保护作用通过双重轨迹发挥作用：加强社会参与和健康行为，同时使人们有意义地参与数字卫生技术。异质性分析揭示了一种“包容性增长”的模式：弱势群体（低收入/受教育）和最老群体的保健回报很大，可作为一种“补偿性资源”，尽管在城市周边地区仍然存在“数字盲点”。结论：数字技能已成为影响晚年健康的关键社会决定因素。政策必须从提供基础设施转向“精准赋权”，优先考虑弱势老年人的技能培养，以确保数字健康福利的公平分配。

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引用次数: 0

Trajectory of depressive symptom before and after incident hearing loss: A 24-year population-based longitudinal cohort study 听力损失前后抑郁症状的发展轨迹：一项24年基于人群的纵向队列研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-03-01 Epub Date: 2025-11-24 DOI: 10.1016/j.archger.2025.106090

Qin Li , Haohong Lai , Juntao Wu , Haidi Yang

Background

Although hearing loss (HL) is a known risk factor for depressive symptoms, how depressive symptoms progress after its onset remains insufficiently explored. This study aimed to explore whether incident HL is associated with an acute increase and a sustained progress in depressive symptoms, after accounting for pre-HL depressive trajectories.

Methods

Using longitudinal data from the Health and Retirement Study (1998–2022), depressive symptoms were assessed biennially using the 8-item Center for Epidemiologic Studies Depression Scale (CES-D). Linear mixed-effects models were employed to estimate acute changes at the time of HL onset and the annual rate of change in depressive symptoms post-HL, while adjusting for pre-HL trajectories and baseline covariates.

Results

Among 11,099 participants (mean age 64.8 years), 3024 developed incident HL over a mean follow-up of 15.7 years. Prior to HL onset, the annual increase in depressive symptoms did not differ significantly between those who developed HL and those who remained free of HL. Following HL onset, a significant acute increase in depressive symptoms was observed (β = 0.234; 95 % CI: 0.184 to 0.283). Additionally, there was a sustained acceleration in the annual rate of increase in depressive symptoms post-HL (β = 0.013/year; 95 % CI: 0.005 to 0.022).

Conclusions

Incident HL is associated with an immediate increase and a long-term progress in depressive symptoms, independent of pre-onset trajectories. These findings highlight HL as a preventable risk factor for late-life depressive symptoms and underscore the importance of early detection and intervention for hearing to mitigate depressive symptom risk in aging populations.

虽然听力损失（HL）是已知的抑郁症状的危险因素，但抑郁症状在发病后如何发展仍未充分探讨。本研究旨在探讨在考虑HL前抑郁轨迹后，HL事件是否与抑郁症状的急性加重和持续进展相关。方法利用健康与退休研究（1998-2022）的纵向数据，采用8项流行病学研究中心抑郁量表（CES-D）每两年评估一次抑郁症状。采用线性混合效应模型来估计HL发病时的急性变化和HL后抑郁症状的年变化率，同时调整HL前的轨迹和基线协变量。结果在11,099名参与者（平均年龄64.8岁）中，3024人在平均15.7年的随访中发生了HL事件。在HL发病前，患HL者和未患HL者抑郁症状的年增长率没有显著差异。HL发病后，观察到抑郁症状显著急性加重（β = 0.234; 95% CI: 0.184 ~ 0.283）。此外，hl后抑郁症状的年增长率持续加速（β = 0.013/年；95% CI: 0.005至0.022）。结论：HL与抑郁症状的立即增加和长期进展相关，独立于发病前的发展轨迹。这些发现强调了HL是一个可预防的老年抑郁症状风险因素，并强调了早期发现和干预听力对于减轻老年人群抑郁症状风险的重要性。

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引用次数: 0

Associations between intrinsic capacity transitions and incident cardiovascular disease among middle-aged and older adults 中老年人内在能力转换与心血管疾病发病率之间的关系

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-03-01 Epub Date: 2025-12-04 DOI: 10.1016/j.archger.2025.106111

Shuanglong Hou , Yi Pan , Jing Luo , Rui Liu , Xueqiang Wang

Background

Emerging evidence suggests that intrinsic capacity (IC) impairments are potential predictors of cardiovascular disease (CVD), yet the impact of longitudinal IC transitions on CVD risk remain incompletely elucidated. This study investigates associations between short-term IC transitions and subsequent incident CVD to address this gap.

Methods

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). Seven biomarkers encompassing five IC domains were evaluated, and IC was categorized as high, moderate, and low levels based on total domain scores. IC transitions were evaluated using baseline and 2-year follow-up data. CVD was defined as self-reported physician-diagnosed heart disease or stroke. Cox proportional hazards models were employed to estimate the associations between IC transitions and incident CVD.

Results

Among 5190 eligible participants, 1072 (20.7 %) developed incident CVD. Compared with stable high IC, participants with high baseline IC who declined to moderate (HR 1.34, 95 % CI 1.05–1.71) or low IC (HR 1.61, 95 % CI 1.16–2.22) exhibited elevated risks of incident CVD. Similarly, increased CVD risks were observed in participants who declined from high to moderate IC compared with those stable moderate IC (HR 1.32, 95 % CI 1.04–1.69). In contrast, participants with low baseline IC who improved to high IC showed decreased risks of incident CVD relative to those with stable low IC (HR 0.55, 95 % CI 0.38–0.76).

Conclusion

Dynamic transitions in IC are associated with distinct CVD risks. IC decline is linked to a significantly elevated risk, whereas IC improvement correlates with a reduced risk.

背景：越来越多的证据表明，内在能力（IC）损伤是心血管疾病（CVD）的潜在预测因素，但纵向IC转换对CVD风险的影响仍未完全阐明。本研究调查了短期IC转变与随后发生的心血管疾病之间的关系，以解决这一差距。方法数据来源于中国健康与退休纵向研究（CHARLS）。包括5个IC域的7个生物标志物被评估，并根据IC的总域得分将IC分为高、中、低水平。使用基线和2年随访数据评估IC转移。心血管疾病被定义为自我报告的医生诊断的心脏病或中风。采用Cox比例风险模型来估计IC转换与事件CVD之间的关联。结果在5190名符合条件的参与者中，1072名（20.7%）发生心血管疾病。与稳定的高IC相比，基线IC高的参与者下降到中度（HR 1.34, 95% CI 1.05-1.71）或低IC （HR 1.61, 95% CI 1.16-2.22）时，心血管疾病发生的风险增加。同样，与稳定的中度IC相比，从高IC降至中度IC的参与者心血管疾病风险增加（HR 1.32, 95% CI 1.04-1.69）。相比之下，低基线IC改善到高IC的参与者与稳定低IC的参与者相比，CVD发生风险降低（HR 0.55, 95% CI 0.38-0.76）。结论IC的动态转变与不同的CVD风险相关。IC下降与风险显著升高有关，而IC改善与风险降低有关。

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引用次数: 0