Archives of gerontology and geriatrics最新文献_第7页

Meaning in life and Parkinson’s disease: Evidence from a 17-year study across 14 countries 生活意义与帕金森病：来自14个国家的一项为期17年的研究的证据

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-24 DOI: 10.1016/j.archger.2025.106062

Selin Karakose , Antonio Terracciano , Martina Luchetti , Yannick Stephan , Angelina R. Sutin

Background

Meaning in life is associated consistently with a reduced risk of incident Alzheimer’s disease and related dementias. It also changes across the disease continuum. Less work has examined the association between meaning in life and Parkinson’s disease and the natural history of meaning with onset of Parkinson’s disease has yet to be evaluated. This study examines the prospective association between meaning in life and incident Parkinson’s disease and evaluates changes in meaning in life prior and after onset of Parkinson’s disease.

Methods

This prospective cohort study used assessments of meaning in life and incident Parkinson’s disease from 2004 to 2022 in the Survey of Health, Ageing and Retirement in Europe. Meaning in life was measured with a single-item measure from the Control, Autonomy, Self-realization and Pleasure scale. Parkinson’s disease was self/proxy-reported doctor diagnosis up to 2022.

Results

Accounting for age, sex, and education, greater meaning in life was associated with lower risk of developing incident Parkinson’s disease over up to 17 years follow-up. This association was accounted for behavioral, clinical, and psychological factors. Accounting for demographic differences and normative changes that occur in meaning, meaning in life did not decline significantly before the onset of Parkinson’s disease but showed a significant and accelerated decline following disease onset.

Conclusions

Behavioral, clinical, and psychological risk factors accounted for the association between meaning in life and risk of Parkinson’s disease. Meaning in life levels remained stable before Parkinson’s disease’s onset but declined significantly afterward, paralleling the worsening of psychological outcomes in Parkinson’s disease.

背景生活的意义与降低阿尔茨海默病和相关痴呆的发病风险一致相关。它也会随着疾病的变化而变化。研究生活意义与帕金森病之间关系的工作较少，而意义与帕金森病发病的自然历史也有待评估。本研究探讨了生活意义与帕金森病发病之间的前瞻性联系，并评估了帕金森病发病前后生活意义的变化。方法本前瞻性队列研究采用欧洲健康、老龄化和退休调查中2004年至2022年生活意义和帕金森病发病率的评估。生活意义是通过控制、自主、自我实现和快乐量表中的单项测量来衡量的。截至2022年，帕金森病是自我/代理报告的医生诊断。结果：考虑到年龄、性别和教育程度，在长达17年的随访中，生活意义越大，患帕金森病的风险越低。这种关联考虑了行为、临床和心理因素。考虑到人口统计学差异和意义发生的规范性变化，生活意义在帕金森病发病前并没有显著下降，但在疾病发病后却出现了显著的加速下降。结论：行为、临床和心理风险因素解释了生活意义与帕金森病风险之间的关联。在帕金森氏症发病前，生活意义水平保持稳定，但发病后显著下降，与帕金森氏症心理结果的恶化平行。

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引用次数: 0

Environmental chemical factors associated with human biological age acceleration: an interpretable machine learning study 与人类生物年龄加速相关的环境化学因素：可解释的机器学习研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-21 DOI: 10.1016/j.archger.2025.106058

Jian Xu , Zexin Zhu , Bo Dai , Minghao Lin , Huhu Yang , Shilin Liu , Zheng Nan

This study utilized an interpretable machine learning (ML) framework to analyze data from 1693 adults in the 2015–2016 National Health and Nutrition Examination Survey (NHANES), investigating the association between 78 environmental chemicals and two biological age acceleration (BA-Accel) measures: KDM-BA-Accel and PhenoAge-Accel.

The ML models demonstrated moderate predictive performance, with the best models achieving R² values between 0.20 and 0.27. Including chemical exposure data did not statistically improve model performance compared to baseline models with only demographic and clinical covariates. The analysis identified clinical factors like diabetes and body mass index (BMI) as the most significant predictors of BA-Accel. Concurrently, Shapley Additive Explanations (SHAP) analysis identified blood toluene (B_TOL), a urinary benzene metabolite (U_DHB), and urinary benzophenone-3 (U_BP3) as key chemical contributors. Furthermore, the framework revealed complex nonlinear relationships and potential synergistic interactions between these chemicals and BA-Accel. A sensitivity analysis confirmed a significant interaction between diabetes status and blood toluene.

In conclusion, while single cross-sectional measurements of chemical exposures have limited utility for predicting individual aging rates, the applied ML approach provides a method to identify key chemicals within mixed exposures and characterize their complex modes of action, which can inform public health risk management.

本研究利用可解释的机器学习（ML）框架分析了2015-2016年全国健康与营养检查调查（NHANES）中1693名成年人的数据，调查了78种环境化学物质与两种生物年龄加速（BA-Accel）指标之间的关系：KDM-BA-Accel和PhenoAge-Accel。ML模型表现出中等的预测性能，最佳模型的R²值在0.20 ~ 0.27之间。与仅包含人口统计学和临床协变量的基线模型相比，包括化学暴露数据在统计上并没有改善模型的性能。分析发现临床因素如糖尿病和身体质量指数（BMI）是BA-Accel最重要的预测因素。同时，Shapley添加剂解释（SHAP）分析发现血液甲苯（B_TOL）、尿苯代谢物（U_DHB）和尿二苯甲酮-3 （U_BP3）是主要的化学贡献者。此外，该框架揭示了这些化学物质与BA-Accel之间复杂的非线性关系和潜在的协同相互作用。敏感性分析证实了糖尿病状况与血液甲苯之间的显著相互作用。总之，虽然化学品暴露的单一横截面测量在预测个人老化率方面效用有限，但应用ML方法提供了一种方法，可以识别混合暴露中的关键化学品并表征其复杂的作用模式，从而为公共卫生风险管理提供信息。

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引用次数: 0

Association between oral health and physical frailty in community-dwelling older adults: A systematic review and meta-analysis 社区老年人口腔健康与身体虚弱之间的关系：一项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 : 2025-10-20 DOI: 10.1016/j.archger.2025.106059

Min Jung Ko , Seongwoo Seo , Jong Seob So , Hoi-In Jung , Hong-Seop Kho , Kyung Lhi Kang , Seung-Ryong Ha , Nam-Hee Kim , Jina Lee Linton , Jeong-Hyun Kang

Objective

Oral health and function are increasingly recognized as important determinants of overall health in the older population. This systematic review aimed to synthesize current pieces of evidences on how various oral factors are associated with the onset and progression of physical frailty in community-dwelling older adults.

Methods

A comprehensive literature search was conducted using Ovid-MEDLINE, Ovid-EMBASE, and Cochrane Library. Studies including community-dwelling adults aged 50 years or older with oral health-related measures and physical frailty were included. Meta-analyses were performed, and sensitivity and subgroup analyses were conducted to validate the findings. The quality of studies was evaluated using the Risk of Bias for Nonrandomized Studies version 2.0. tool.

Results

Twenty-five articles involving 63,842 adults were selected. The parameters related to the masticatory and swallowing function and oral dryness demonstrated significant associations with physical frailty. Meta-analyses revealed significant associations of physical frailty with having fewer than 20 teeth (OR 2.62, 95 % CI [1.95–3.53]), subjective swallowing difficulty (OR 2.48, 95 % CI [1.70–3.60]), edentulism (OR 2.04, 95 % CI [1.59–2.61]), subjective masticatory difficulty (OR 2.02, 95 % CI [1.64–2.50]), subjective perception of dry mouth (OR 1.97, 95 % CI [1.61–2.41]), and perceived oral health status (OR 1.66, 95 % CI [1.59–1.73]).

Conclusions

This systematic review demonstrated that poor oral health and impaired oral function were significantly associated with physical frailty among older adults. These findings strongly support incorporating oral health screenings into routine geriatric assessments to identify older adults at risk of physical frailty and to inform targeted preventive strategies.

目的口腔健康和功能越来越被认为是老年人整体健康的重要决定因素。本系统综述旨在综合目前关于各种口腔因素如何与社区居住老年人身体虚弱的发生和进展相关的证据。方法采用Ovid-MEDLINE、Ovid-EMBASE、Cochrane Library进行综合文献检索。研究纳入了年龄在50岁或以上、有口腔健康相关措施和身体虚弱的社区居民。进行meta分析，并进行敏感性和亚组分析以验证研究结果。使用非随机研究2.0版的偏倚风险评估研究的质量。工具。结果共纳入文献25篇，涉及成人63842人。与咀嚼和吞咽功能以及口腔干燥相关的参数显示与身体虚弱有显著关联。meta分析显示，身体虚弱与牙齿少于20颗（OR 2.62, 95% CI[1.95-3.53]）、主观吞咽困难（OR 2.48, 95% CI[1.70-3.60]）、蛀牙（OR 2.04, 95% CI[1.59-2.61]）、主观咀嚼困难（OR 2.02, 95% CI[1.64-2.50]）、主观口干感觉（OR 1.97, 95% CI[1.61-2.41]）和感知口腔健康状况（OR 1.66, 95% CI[1.59-1.73]）显著相关。结论本系统综述表明，口腔健康状况不佳和口腔功能受损与老年人身体虚弱显著相关。这些发现强烈支持将口腔健康筛查纳入常规老年评估，以识别有身体虚弱风险的老年人，并为有针对性的预防策略提供信息。

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引用次数: 0

Precision geromedicine: Science meets clinical practice 精准基因医学：科学与临床相结合。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-16 DOI: 10.1016/j.archger.2025.106057

Liang-Kung Chen

引用次数: 0

The effectiveness of artificial agents on loneliness reduction in older adults: a systematic review and meta-analysis 人工药物减少老年人孤独感的有效性：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 : 2025-10-14 DOI: 10.1016/j.archger.2025.106056

Zhengke Fu , Mengsi Yan , Xuefeng Han , Kaixuan Zhang , Xianghong Zhao

This meta-analysis reviewed studies comparing loneliness of older adults receiving artificial agent interventions with those not receiving them, to evaluate this treatment’s efficacy in alleviating loneliness and other mental health problems among older people; and assess factors that moderate intervention effectiveness. Eligible studies were identified by a systematic search of PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, CINAHL (EBSCO), PsycINFO (EBSCO), CNKI, Wanfang, Weipu, SinoMed, and ClinicalTrials.gov. Standardized mean differences with 95 % confidence intervals were extracted and pooled. Meta-regression and subgroup analysis determined the influence of trial characteristics. A total of 16 studies with 781 participants were included. Artificial agent treatment may significantly reduce loneliness in older adults, with acceptable heterogeneity (SMD= -0.69 [95 % CI, -0.89 to -0.40]; p=.000; I²=64.51 %). Artificial agents reduced loneliness more markedly for participants dwelling in non-community-based settings (p=.016). Social robots reduced loneliness more effectively than app/web-based agents (p=.033). Animal-shaped artificial agents had a significantly larger effect size than humanoid agents on loneliness reduction (p=.016). Longer session duration (p=.005), fewer weekly sessions (p=.000), and shorter session times (p=.005) produced greater loneliness reduction. Artificial agents had a significant effect on depression (SMD=-0.42, [95 % CI -0.72 to -0.12], P=.01), but no significant effects on quality of life or happiness (SMD=0.24, [95 % CI -1.0 to 0.58], P=.16 and SMD=0.63, [95 % CI -1.09 to 2.35], P=.47, respectively). Findings suggested artificial agents may alleviate loneliness in older adults. Treatment effectiveness may be moderated by participants’ settings, session length, treatment duration, sessions per week, agent delivery platform, and agent type.

本荟萃分析回顾了比较接受人工干预与未接受人工干预的老年人孤独感的研究，以评估这种治疗在缓解老年人孤独感和其他心理健康问题方面的疗效；并评估影响干预效果的因素。通过系统检索PubMed、Cochrane中央对照试验注册库、EMBASE、CINAHL （EBSCO）、PsycINFO （EBSCO）、中国知网、万方、唯普、中国医学信息网和ClinicalTrials.gov来确定符合条件的研究。提取95%置信区间的标准化平均差异并汇总。meta回归和亚组分析确定了试验特征的影响。共纳入16项研究，781名参与者。人工药物治疗可显著减少老年人的孤独感，存在可接受的异质性（SMD= -0.69 [95% CI, -0.89至-0.40];p= 0.000; I2= 64.51%）。对于居住在非社区环境中的参与者，人工代理更显著地减少了孤独感（p= 0.016）。社交机器人比应用程序/网络代理更有效地减少孤独感（p= 0.033）。动物形人工agent对减少孤独感的效果显著大于类人agent （p= 0.016）。较长的治疗时间（p= 0.005），较少的每周治疗（p= 0.00000）和较短的治疗时间（p= 0.005）产生了更大的孤独感减少。人工药物对抑郁有显著影响（SMD=-0.42, [95% CI -0.72 ~ -0.12]， P= 0.01），但对生活质量和幸福感无显著影响（SMD=0.24, [95% CI -1.0 ~ 0.58]， P= 0.16； SMD=0.63, [95% CI -1.09 ~ 2.35]， P= 0.47）。研究结果表明，人工药剂可能会减轻老年人的孤独感。治疗效果可能受到参与者设置、疗程长度、治疗持续时间、每周疗程、药物递送平台和药物类型的影响。

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引用次数: 0

The effects of Oligo-Fucoidan on muscle function in community-dwelling older adults: A double-blind, randomized, placebo-controlled trial 低聚岩藻多糖对社区老年人肌肉功能的影响：一项双盲、随机、安慰剂对照试验。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-14 DOI: 10.1016/j.archger.2025.106055

Yun-Ching Chang , Hung-Wen Liu , Tsung-Jen Hsieh , Sue-Joan Chang

Background

Sarcopenia, characterized by age-related loss of muscle mass and function, presents a growing public health concern in aging populations. While resistance training remains the gold standard for management, alternative interventions are needed for individuals with limited exercise capacity. Fucoidan, a sulfated polysaccharide derived from brown seaweed, has demonstrated promising biological activities, including potential muscle-enhancing effects. This study investigated the effects of low-molecular-weight Oligo-Fucoidan supplementation on muscle strength, muscle mass, and physical performance in community-dwelling older adults.

Methods

In this 12-week, randomized, double-blind, placebo-controlled trial, 60 participants aged ≥60 years were assigned to one of three groups: Oligo-Fucoidan, Oligo-Fucoidan with branched-chain amino acids (BCAA) and vitamin D, or placebo. Outcomes included handgrip strength, calf circumference, appendicular lean mass index (ALMI), five-times sit-to-stand (5STS), six-minute walk test (6MWT), and isokinetic knee extension (KE) strength.

Results

Oligo-Fucoidan supplementation significantly improved grip strength (p < 0.001; effect size r = 0.82), with 64.7 % of participants exceeding the minimal clinically important difference. Improvements in 6MWT distance (p < 0.001) were also observed, with 47.1 % of participants surpassing the minimal detectable change thresholds. No significant changes in muscle mass were noted, though the placebo group showed a reduction in calf circumference (p = 0.012). MANOVA of percent changes across six outcomes indicated significant overall group differences, driven primarily by greater improvements in grip strength in the Oligo-Fucoidan supplementation group compared with placebo. No adverse events were reported.

Conclusions

Oligo-Fucoidan supplementation improved muscle strength and physical performance in older adults, suggesting its potential as a safe, non-pharmacological intervention for sarcopenia. Further research is warranted to evaluate long-term effects and optimize formulation.

背景：骨骼肌减少症的特征是与年龄相关的肌肉质量和功能的丧失，在老龄化人群中引起了越来越多的公共卫生关注。虽然阻力训练仍然是管理的黄金标准，但对于运动能力有限的个人来说，需要其他干预措施。褐藻聚糖是一种从褐藻中提取的硫酸酸化多糖，已经显示出有希望的生物活性，包括潜在的肌肉增强作用。本研究调查了低分子量低聚岩藻糖聚糖补充剂对社区老年人肌肉力量、肌肉质量和身体表现的影响。方法：在这项为期12周的随机、双盲、安慰剂对照试验中，60名年龄≥60岁的参与者被分配到三组中的一组：低聚岩藻多糖、低聚岩藻多糖与支链氨基酸（BCAA）和维生素D，或安慰剂。结果包括握力、小腿围、附件瘦质量指数（ALMI）、5次坐立（5STS）、6分钟步行测试（6MWT）和等速膝关节伸展（KE）强度。结果：低聚岩藻多糖补充剂显著提高了握力（p < 0.001；效应大小r = 0.82）， 64.7%的参与者超过了最小的临床重要差异。6MWT距离的改善（p < 0.001）也被观察到，47.1%的参与者超过了最小可检测变化阈值。肌肉质量没有显著变化，尽管安慰剂组显示小腿围减小（p = 0.012）。六个结果的百分比变化的方差分析显示了显著的总体组差异，主要是由于低聚岩藻糖聚糖补充剂组与安慰剂组相比握力有更大的改善。无不良事件报告。结论：低聚岩藻糖聚糖补充剂可改善老年人的肌肉力量和身体机能，表明其作为一种安全的、非药物干预肌肉减少症的潜力。需要进一步的研究来评估长期效果和优化配方。

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引用次数: 0

The effect of leisure-time physical activities on bone mineral density in postmenopausal women: Systematic review and meta-analysis 绝经后妇女闲暇时间体育活动对骨密度的影响：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 : 2025-10-13 DOI: 10.1016/j.archger.2025.106054

Anıl Siyahtaş , Elif Ünlügedik Sayın , Döndü Kurnaz

The aim of this systematic review and meta-analysis was to evaluate the impact of leisure-time physical activity (LTPA) on bone mineral density (BMD) in postmenopausal women. The protocol was developed according to PRISMA guidelines and registered in PROSPERO. Searches were conducted from January to February 2025 across PubMed, The Cochrane Library, EBSCO, Web of Science, PsycINFO, Scopus, National Thesis Center, TR Index, and Turkiye Clinics search engines. The methodological quality of the studies was assessed using the RoB-2 tool. Data were pooled through meta-analysis, and certainty of evidence was appraised using GRADE. 13 findings of 12 studies with a total sample size of 9836 were included in the meta-analysis. BMD across multiple anatomical sites remained stable in intervention groups, but declined in controls, although differences were not statistically significant (p > 0.05). Subgroup analyses suggested varying effectiveness by activity type, ranking them as follows: Structured physical activity modalities > Tai Chi > Pilates ≈ Handball > Step/Dance. Intervention duration appeared most favorable at 6 months, followed by 3, 12, and 9 months. LTPA does not significantly increase BMD overall in postmenopausal women, yet may help maintain bone mass and exert localized benefits depending on activity type and duration. These findings underscore the potential role of structured exercise in mitigating age-related bone loss, although further high-quality trials are warranted.

本系统综述和荟萃分析的目的是评估休闲时间体力活动（LTPA）对绝经后妇女骨矿物质密度（BMD）的影响。该协议是根据PRISMA准则制定的，并在PROSPERO注册。检索于2025年1月至2月在PubMed、Cochrane图书馆、EBSCO、Web of Science、PsycINFO、Scopus、National Thesis Center、TR Index和Turkiye Clinics搜索引擎上进行。使用rob2工具评估研究的方法学质量。通过荟萃分析汇总数据，并使用GRADE评价证据的确定性。meta分析纳入了12项研究的13项结果，总样本量为9836。干预组多解剖部位骨密度保持稳定，对照组骨密度下降，但差异无统计学意义（p < 0.05）。亚组分析表明，不同活动类型的效果不同，排名如下：结构化体育活动模式>太极拳>普拉提≈手球>步/舞。干预时间最长的是6个月，其次是3个月、12个月和9个月。LTPA对绝经后妇女的总体骨密度没有显著增加，但可能有助于维持骨量，并根据活动类型和持续时间发挥局部益处。这些发现强调了有组织的锻炼在减轻与年龄相关的骨质流失方面的潜在作用，尽管需要进一步的高质量试验。

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引用次数: 0

The effectiveness of cognitive behavioral therapy on loneliness among older adults: A systematic review and meta-analysis 认知行为疗法对老年人孤独感的有效性：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 : 2025-10-10 DOI: 10.1016/j.archger.2025.106053

Taiyuan Luan , Yue Wang , Bing Li , Rixin Qin , Zhong Li , Xuexue Lei , Haiyan Guo

Objective

To evaluate the efficacy of Cognitive Behavioral Therapy (CBT) on improving loneliness among older adults.

Design

A systematic review and meta-analysis.

Methods

A systematic search was conducted across 10 electronic databases from their inception to June 21, 2025, to identify eligible randomized controlled trials (RCTs). Studies included older adult participants aged 60 years or above. Two reviewers independently performed the screening process, data extraction, and quality assessment of the selected studies. All statistical analyses were carried out using Stata version 18.0.

Results

Eight RCTs involving 720 participants were included. Pooled analysis revealed a significant and large effect of CBT on improving loneliness among older adults (SMD = -1.00, 95 % CI, -1.59 to -0.42, p < 0.001; low-quality evidence), though substantial heterogeneity was present (I² = 90.5 %). Subgroup analyses indicated that shorter intervention duration (≤12 weeks) (SMD = -1.41, 95 % CI: -2.51 to -0.32, p = 0.011), group-based format (SMD = -1.49, 95 % CI: -2.63 to -0.36, p = 0.010), and online delivery (SMD = -1.51, 95 % CI: -3.93 to 0.92, p = 0.233) may enhance intervention effectiveness. Subgroup analyses also revealed differences across settings. CBT interventions were effective among community-dwelling older adults (SMD = -0.91, 95 % CI: -1.46 to -0.35, p = 0.001), whereas no significant effect was observed among institution-dwelling populations.

Conclusion

CBT was associated with improvements on loneliness among older adults. However, given the substantial heterogeneity observed across studies, these pooled estimates should be interpreted as exploratory rather than definitive. Subgroup findings suggest that intervention format, intervention duration, delivery modality and settings may influence outcomes. Further well-designed rcts are needed to confirm the effectiveness.

目的：评价认知行为疗法（CBT）改善老年人孤独感的效果。设计：系统回顾和荟萃分析。方法：系统检索10个电子数据库，从其建立到2025年6月21日，以确定符合条件的随机对照试验（rct）。研究对象为60岁或以上的老年人。两名审稿人独立进行筛选过程、数据提取和所选研究的质量评估。所有统计分析使用Stata 18.0版本进行。结果：纳入8项随机对照试验，共720名受试者。合并分析显示，CBT对改善老年人孤独感有显著而巨大的影响（SMD = -1.00, 95% CI, -1.59至-0.42,p < 0.001；低质量证据），尽管存在大量异质性（I²= 90.5%）。亚组分析表明，较短的干预时间（≤12周）（SMD = -1.41, 95% CI: -2.51至-0.32,p = 0.011）、基于组的形式（SMD = -1.49, 95% CI: -2.63至-0.36,p = 0.010）和在线交付（SMD = -1.51, 95% CI: -3.93至0.92,p = 0.233）可提高干预效果。亚组分析也揭示了不同设置之间的差异。CBT干预在社区居住的老年人中是有效的（SMD = -0.91, 95% CI: -1.46至-0.35,p = 0.001），而在机构居住人群中没有观察到显著的效果。结论：CBT与老年人孤独感的改善有关。然而，考虑到研究中观察到的大量异质性，这些汇总估计应该被解释为探索性的，而不是决定性的。亚组研究结果表明，干预形式、干预持续时间、交付方式和环境可能会影响结果。需要进一步精心设计的随机对照试验来证实其有效性。

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引用次数: 0

Longitudinal bidirectional dynamic association between handgrip strength and cognitive function in Chinese older adults: a cross-lag modeling study 中国老年人握力与认知功能的纵向双向动态关联：一个交叉滞后模型研究。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-10 DOI: 10.1016/j.archger.2025.106052

Xuan Zhang, Chenxiao Jia, Haixia Hao, Yurong Liu, Wenli Lu, Yuan Wang

Objective

This study examined the bidirectional dynamic relationship between handgrip strength and cognitive function and the influence of gender and age differences among Chinese adults aged 60 and above.

Method

Data were derived from the 2013–2015 waves of the China Health and Retirement Longitudinal Study (CHARLS), including 4533 older adults. Cross-lagged panel models were used to analyze the temporal relationship between handgrip strength and cognitive function. Covariates covered sociodemographic characteristics, lifestyle factors, and health indicators. Data analysis was performed using SAS 9.4 and R 4.4.1.

Results

During the 2-year follow-up, both handgrip strength and cognitive function showed declining trends in older adults. Cross-lagged analysis revealed that baseline handgrip strength positively predicted follow-up cognitive function (P < 0.001), indicating that individuals with greater baseline grip strength maintained better cognitive performance. Conversely, baseline cognitive function also positively predicted follow-up handgrip strength (P < 0.001).These bidirectional associations exhibited gender differences: the predictive effect of handgrip strength on cognition was stronger in males (P < 0.001), whereas the effect of cognition on handgrip strength was more pronounced in females (P < 0.001). Age-stratified analysis demonstrated that the association between handgrip strength and cognition was strongest in the 70–79 age group (P < 0.001). However, this relationship weakened in adults aged 80 and above, potentially due to compensatory mechanisms or external environmental support.

Conclusion

A bidirectional muscle-cognition association exists in older adults, supporting the incorporation of handgrip strength testing into cognitive screening. Gender- and age-specific interventions should prioritize rural populations with low education and high-risk individuals aged 70–79 years. These findings provide a scientific basis for preventing cognitive decline in aging populations.

目的：探讨中国60岁及以上成年人握力与认知功能的双向动态关系及性别、年龄差异的影响。方法：数据来源于2013-2015年中国健康与退休纵向研究（CHARLS），共纳入4533名老年人。采用交叉滞后面板模型分析了手握力与认知功能的时间关系。协变量包括社会人口特征、生活方式因素和健康指标。采用SAS 9.4和R 4.4.1进行数据分析。结果：在2年的随访中，老年人握力和认知功能均呈现下降趋势。交叉滞后分析显示，基线握力正预测随访认知功能（P < 0.001），表明基线握力越大的个体保持更好的认知表现。相反，基线认知功能也能正向预测随访的握力（P < 0.001）。这些双向关联表现出性别差异：握力对认知的预测作用在男性中更强（P < 0.001），而认知对握力的影响在女性中更明显（P < 0.001）。年龄分层分析表明，握力与认知的相关性在70-79岁年龄组中最强（P < 0.001）。然而，这种关系在80岁及以上的成年人中减弱，可能是由于代偿机制或外部环境支持。结论：老年人存在双向肌肉认知关联，支持将握力测试纳入认知筛查。针对性别和年龄的干预措施应优先考虑农村低教育人群和70-79岁的高危人群。这些发现为预防老年人认知能力下降提供了科学依据。

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引用次数: 0

Effects of dual-task prioritization training on dual-task walking in older people: A single-blinded randomized controlled trial 双任务优先级训练对老年人双任务行走的影响：一项单盲随机对照试验

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-08 DOI: 10.1016/j.archger.2025.106050

Wei-Chen Chen , Yea-Ru Yang , Ching-Ya Chiu , Ray-Yau Wang

Objective

Dual-task walking (DTW) performance is commonly reduced in older adults and is associated with a higher risk of falls. While dual-task deficits have been documented, it remains unclear how different task prioritization strategies during training influence DTW outcomes. This study compared effects of posture-first (PF), supraposture-first (SF), and conventional training on DTW performance in older adults.

Methods

A three-arm randomized, single-blind controlled study was conducted. Thirty-nine community-dwelling older adults were randomly assigned to PF, SF, or control groups to receive 12-session of cognitive-motor dual-task training with distinct task prioritization instructions. Cognitive and motor DTW performance, Trail Making Test Part B, Berg Balance Scale, single-task walking performance, and secondary task performance were assessed pre- and post-intervention.

Results

The PF group showed significant improvements in both cognitive and motor DTW performance, including speed (cognitive: p = 0.001, motor: p = 0.008), cadence (p < 0.001), and dual-task cost (DTC-speed) (p < 0.001). Compared to the SF and control groups, the PF group showed greater improvements in stride length (p = 0.009 vs. SF; p = 0.001 vs. control) and DTC (p = 0.025 vs. SF; p = 0.005 vs. control) during cognitive DTW. During motor DTW, improvements in speed (p = 0.008), cadence (p = 0.016), and DTC (p = 0.049) were also greater than in the SF group.

Conclusions

Posture-first strategy during training enhances cognitive and motor DTW performance more effectively than other approaches. These findings support its implementation to improve functional mobility and dual-task coordination in older adults.

目的：老年人双任务行走（DTW）的表现通常会下降，并且与摔倒的风险增加有关。虽然双任务缺陷已被记录在案，但尚不清楚训练期间不同的任务优先级策略如何影响DTW结果。本研究比较了姿势优先（PF）、上姿势优先（SF）和常规训练对老年人DTW表现的影响。方法采用三组随机、单盲对照研究。39名居住在社区的老年人被随机分配到PF组、SF组或对照组，接受12次认知-运动双任务训练，并根据不同的任务优先级指示进行训练。评估干预前后的认知和运动DTW表现、造径测试B部分、Berg平衡量表、单任务步行表现和次要任务表现。结果PF组在认知和运动DTW表现上均有显著改善，包括速度（认知：p = 0.001，运动：p = 0.008）、节奏（p < 0.001）和双任务成本（DTC-speed）（p < 0.001）。与SF组和对照组相比，PF组在认知DTW期间步幅（p = 0.009 vs SF; p = 0.001 vs对照组）和DTC （p = 0.025 vs SF; p = 0.005 vs对照组）有更大的改善。在运动DTW期间，速度（p = 0.008），节奏（p = 0.016）和DTC （p = 0.049）的改善也大于SF组。结论在训练过程中，姿势优先策略比其他方法更能提高认知和运动能力。这些发现支持其实施，以改善老年人的功能流动性和双任务协调。

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