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

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。

{"title":"Effects of dual-task prioritization training on dual-task walking in older people: A single-blinded randomized controlled trial","authors":"Wei-Chen Chen , Yea-Ru Yang , Ching-Ya Chiu , Ray-Yau Wang","doi":"10.1016/j.archger.2025.106050","DOIUrl":"10.1016/j.archger.2025.106050","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>The PF group showed significant improvements in both cognitive and motor DTW performance, including speed (cognitive: <em>p</em> = 0.001, motor: <em>p</em> = 0.008), cadence (<em>p</em> < 0.001), and dual-task cost (DTC-speed) (<em>p</em> < 0.001). Compared to the SF and control groups, the PF group showed greater improvements in stride length (<em>p</em> = 0.009 vs. SF; <em>p</em> = 0.001 vs. control) and DTC (<em>p</em> = 0.025 vs. SF; <em>p</em> = 0.005 vs. control) during cognitive DTW. During motor DTW, improvements in speed (<em>p</em> = 0.008), cadence (<em>p</em> = 0.016), and DTC (<em>p</em> = 0.049) were also greater than in the SF group.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106050"},"PeriodicalIF":3.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325081","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

Association between chronic kidney disease and sarcopenia: a national cohort study and two-step Mendelian randomization analysis 慢性肾脏疾病和肌肉减少症之间的关系：一项国家队列研究和两步孟德尔随机化分析。

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.2025.106051

Hongji Wang , Ying Zhou , Chen Chen , Lihai Zhang , Gongzi Zhang

Objective

: To investigate the causal relationships between chronic kidney disease (CKD) and sarcopenia using cohort data and Mendelian randomization (MR), and to further assess the mediating roles of physical activity and sedentary behavior using two-step MR.

Methods

: Data from 5648 participants in the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. A linear mixed-effects model was used to evaluate the relationship between CKD and sarcopenia. Two-sample MR was then utilized to assess the causality of the observed association. Additionally, we applied a two-step MR to evaluate the mediating role of physical activities in the pathway from CKD to sarcopenia.

Results

: Chronic kidney disease demonstrated a persistent and statistically significant association with elevated sarcopenia risk throughout the entire study period (P < 0.01). Similarly, lower estimated glomerular filtration rate (eGFR) showed a significant positive association with increased sarcopenia risk (P = 0.017). MR analysis further indicates a causal relationship between CKD and sarcopenia (Low hand grip strength: OR[95 %CI] = 0.920[0.874 to 0.969], P < 0.01) (Appendicular lean mass: β[95 %CI] = -0.028[-0.053 to -0.004], P = 0.024). Mediation analysis showed that sedentary behavior (mediation proportion = 3.050 %) and physical activity (mediation proportion = 2.869 %) had mediating effects.

Conclusions

: CKD is an independent risk factor for sarcopenia, with a clear temporal association. Mendelian randomization studies confirm this link and identify sedentary behavior and physical activity as mediators. These results underscore the need for early screening and individualized intervention strategies in CKD patients to prevent sarcopenia.

目的：利用队列数据和孟德尔随机化（MR）研究慢性肾脏疾病（CKD）与肌肉减少症之间的因果关系，并利用两步MR进一步评估体力活动和久坐行为的中介作用。方法：对中国健康与退休纵向研究（CHARLS）的5648名参与者的数据进行分析。采用线性混合效应模型评估CKD与肌肉减少症之间的关系。然后使用双样本MR来评估观察到的关联的因果关系。此外，我们应用了两步MR来评估身体活动在从CKD到肌肉减少的途径中的中介作用。结果：在整个研究期间，慢性肾脏疾病与肌肉减少症风险升高存在持续且有统计学意义的关联（P < 0.01）。同样，较低的肾小球滤过率（eGFR）与肌肉减少症风险增加呈显著正相关（P = 0.017）。MR分析进一步表明CKD与肌肉减少症之间存在因果关系（低握力：OR[95% CI] = 0.920[0.874 ~ 0.969], P < 0.01）（阑尾瘦质量：β[95% CI] = -0.028[-0.053 ~ -0.004], P = 0.024）。中介分析显示，久坐行为（中介比例= 3.050%）和体育活动（中介比例= 2.869%）具有中介作用。结论：CKD是肌少症的独立危险因素，具有明确的时间相关性。孟德尔随机化研究证实了这种联系，并确定久坐行为和身体活动是中介。这些结果强调了CKD患者早期筛查和个性化干预策略的必要性，以预防肌肉减少症。

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引用次数: 0

Evidence for health promotion interventions to improve cognitive and physical functioning outcomes in older adults with MCI: A state-of-the-art review 健康促进干预改善老年轻度认知损伤患者认知和身体功能结局的证据：一项最新综述

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-01 DOI: 10.1016/j.archger.2025.106049

Tasmin Alanna Rookes , Rachael Frost , Louise Marston , Megan Armstrong , Yolanda Barrado-Martin , Kate Walters

Background

Health promotion activities for people with mild cognitive impairment (MCI) may improve their overall health and prevent progression to dementia. We need to understand the best approaches to behaviour change in this population.

Aim

To summarise the types of health promotion interventions and current clinical effectiveness evidence for physical and cognitive functioning outcomes in people with MCI.

Design

State-of-the art review

Method

Medline was searched in April 2025, for systematic reviews synthesising randomised controlled trials testing effectiveness of health promotion interventions in older adults with MCI, published since 2015. Abstracts, titles, and full texts were single screened and, for eligible reviews, the characteristics, intervention type, primary outcome, and evidence for people with MCI, were extracted. Key messages were narratively synthesised across reviews, grouping by type of intervention and outcome measure.

Results

From 1776 titles and abstracts, 57 systematic reviews were eligible. Regular moderate intensity multicomponent physical exercise and memory-focussed cognitive training interventions had the strongest evidence base for improving cognitive functioning. However, combining physical exercise and cognitive training was more beneficial for cognitive domains and physical functioning, in comparison to doing them individually. The evidence for nutrition interventions was mixed. One review of psychological interventions showed improvements for wellbeing.

Conclusion

There is evidence that health promotion interventions can support people with MCI and dementia to improve or maintain their cognitive function, through multicomponent physical activity combined with cognitive training. More evidence is needed for nutritional recommendations, psychological interventions, and social inclusion interventions.

背景：轻度认知障碍（MCI）患者的健康促进活动可以改善他们的整体健康状况并预防痴呆症的发展。我们需要了解改变这一人群行为的最佳方法。目的：总结MCI患者身体和认知功能结局的健康促进干预类型和当前临床有效性证据。方法：于2025年4月检索Medline，检索自2015年以来发表的综合随机对照试验的系统综述，这些试验测试了老年轻度认知障碍患者健康促进干预措施的有效性。摘要、标题和全文是单筛选的，对于符合条件的综述，提取了MCI患者的特征、干预类型、主要结局和证据。关键信息通过综述进行叙述性综合，按干预类型和结果测量分组。结果：从1776篇题目和摘要中，有57篇系统评价符合条件。有规律的中等强度多成分体育锻炼和以记忆为重点的认知训练干预对改善认知功能有最有力的证据基础。然而，与单独进行相比，体育锻炼和认知训练相结合对认知领域和身体功能更有益。营养干预的证据好坏参半。一项关于心理干预的综述显示，人们的幸福感得到了改善。结论：有证据表明，健康促进干预可以通过多组分体育活动结合认知训练，支持MCI和痴呆患者改善或维持其认知功能。需要更多的证据来支持营养建议、心理干预和社会包容干预。

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引用次数: 0

Causal association between sleep disorders and delirium: A bidirectional mendelian randomization analysis for clinical practice 睡眠障碍和谵妄之间的因果关系：临床实践的双向孟德尔随机分析。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-10-01 DOI: 10.1016/j.archger.2025.106046

Wenxiu Niu , Jingjing Zhang , Xuhong Lan , Yuhan Sha , Xiaomeng Han , Jijun Qiao , Fei Zheng , Lu Liu , Fangli Ma , Li Yao , Zhigang Zhang

Background

Numerous studies have identified a correlation between sleep disorders and delirium; however, the causal relationship remains ambiguous. This bidirectional two-sample Mendelian randomization (MR) study, combined with colocalization and enrichment analyses, aims to investigate the potential causal relationship between sleep-associated phenotypes and delirium.

Methods

We performed a two-sample bidirectional Mendelian randomization analysis using 10 gene variants associated with sleep phenotypes to investigate the causal relationship between sleep disorders and delirium. Five methods for MR Analysis. Moreover, sensitivity analyses were conducted to assess the robustness of our findings. Enrichment and colocalization analyses were conducted to uncover the genetic mechanisms linking sleep phenotypes and delirium.

Results

The IVW method showed that insomnia positively correlates with delirium (OR = 2.523, 95 % CI: 1.048–6.079, P = 0.039). Morning person is causally negatively associated with delirium (OR = 0.869, 95 % CI: 0.774–0.977, P = 0.018). Conversely, delirium is negatively associated with daytime napping (OR = 0.987, 95 % CI: 0.984–0.990, P < 0.001), insomnia (OR = 0.985, 95 % CI: 0.981–0.989, P < 0.001), snoring (OR = 0.991, 95 % CI: 0.985–0.997, P = 0.002), and single item chronotype (beta = -0.161, 95 % CI:0.241–0.081, P = 0.002). Insomnia-related genes are enriched in neuro-metabolic and epigenetic pathways, while Morning person is linked to circadian rhythm regulation. A morning person shares genetic signals with delirium at the rs2398144 locus on chromosome 16 (PPH4 > 0.5).

Conclusions

Our findings provide evidence for a potential causal relationship between sleep disorders and delirium.These findings may support better prevention and management of delirium in older adults.

背景：许多研究已经确定了睡眠障碍和谵妄之间的相关性；然而，因果关系仍然模糊不清。这项双向双样本孟德尔随机化（MR）研究，结合共定位和富集分析，旨在探讨睡眠相关表型与谵妄之间的潜在因果关系。方法：采用10个与睡眠表型相关的基因变异进行双样本双向孟德尔随机化分析，探讨睡眠障碍与谵妄之间的因果关系。磁共振分析的五种方法。此外，还进行了敏感性分析，以评估我们研究结果的稳健性。富集和共定位分析揭示了连接睡眠表型和谵妄的遗传机制。结果：IVW方法显示失眠与谵妄呈正相关（OR = 2.523, 95% CI: 1.048 ~ 6.079, P = 0.039）。早起的人与谵妄呈负相关（OR = 0.869, 95% CI: 0.774-0.977, P = 0.018）。相反，谵妄与白天午睡（OR = 0.987, 95% CI: 0.984-0.990, P < 0.001）、失眠（OR = 0.985, 95% CI: 0.981-0.989, P < 0.001）、打鼾（OR = 0.991, 95% CI: 0.985-0.997, P = 0.002）和单项睡眠类型（β = -0.161, 95% CI:0.241-0.081, P = 0.002）负相关。与失眠相关的基因在神经代谢和表观遗传途径中富集，而早起的人则与昼夜节律调节有关。早起的人在16号染色体上的rs2398144位点（PPH4 > 0.5）与谵妄共享遗传信号。结论：我们的发现为睡眠障碍和谵妄之间潜在的因果关系提供了证据。这些发现可能支持更好地预防和管理老年人谵妄。

{"title":"Causal association between sleep disorders and delirium: A bidirectional mendelian randomization analysis for clinical practice","authors":"Wenxiu Niu , Jingjing Zhang , Xuhong Lan , Yuhan Sha , Xiaomeng Han , Jijun Qiao , Fei Zheng , Lu Liu , Fangli Ma , Li Yao , Zhigang Zhang","doi":"10.1016/j.archger.2025.106046","DOIUrl":"10.1016/j.archger.2025.106046","url":null,"abstract":"<div><h3>Background</h3><div>Numerous studies have identified a correlation between sleep disorders and delirium; however, the causal relationship remains ambiguous. This bidirectional two-sample Mendelian randomization (MR) study, combined with colocalization and enrichment analyses, aims to investigate the potential causal relationship between sleep-associated phenotypes and delirium.</div></div><div><h3>Methods</h3><div>We performed a two-sample bidirectional Mendelian randomization analysis using 10 gene variants associated with sleep phenotypes to investigate the causal relationship between sleep disorders and delirium. Five methods for MR Analysis. Moreover, sensitivity analyses were conducted to assess the robustness of our findings. Enrichment and colocalization analyses were conducted to uncover the genetic mechanisms linking sleep phenotypes and delirium.</div></div><div><h3>Results</h3><div>The IVW method showed that insomnia positively correlates with delirium (OR = 2.523, 95 % CI: 1.048–6.079, <em>P</em> = 0.039). Morning person is causally negatively associated with delirium (OR = 0.869, 95 % CI: 0.774–0.977, <em>P</em> = 0.018). Conversely, delirium is negatively associated with daytime napping (OR = 0.987, 95 % CI: 0.984–0.990, <em>P</em> < 0.001), insomnia (OR = 0.985, 95 % CI: 0.981–0.989, <em>P</em> < 0.001), snoring (OR = 0.991, 95 % CI: 0.985–0.997, <em>P</em> = 0.002), and single item chronotype (beta = -0.161, 95 % CI:0.241–0.081, <em>P</em> = 0.002). Insomnia-related genes are enriched in neuro-metabolic and epigenetic pathways, while Morning person is linked to circadian rhythm regulation. A morning person shares genetic signals with delirium at the rs2398144 locus on chromosome 16 (PPH4 > 0.5).</div></div><div><h3>Conclusions</h3><div>Our findings provide evidence for a potential causal relationship between sleep disorders and delirium.These findings may support better prevention and management of delirium in older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106046"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460824","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

The impact of music therapy on agitation in elderly patients with dementia: A systematic review and meta-analysis 音乐治疗对老年痴呆患者躁动的影响：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 : 2025-09-30 DOI: 10.1016/j.archger.2025.106048

Jing Hu, Ling Xu

Agitation impacts 50 - 80 % of elderly dementia patients, imposing burdens on caregivers and healthcare systems. Pharmacological treatments are limited, whereas non-pharmacological music therapy (MT) holds promise. This study sought to evaluate MT's efficacy in alleviating agitation. A thorough search across multiple databases was carried out, incorporating 14 studies (10 RCTs, 4 pre-post trials; n = 847). Meta-analysis demonstrated that MT significantly reduced agitation with a moderate effect size (d = 0.42). Subgroup analyses yielded consistent findings. Heterogeneity was low, and publication bias was negligible. MT effectively mitigated agitation in dementia patients despite heterogeneity in aspects like music duration and genre, underscoring its generalizability, particularly in resource-constrained areas and households lacking professional nursing support. It offers evidence for integrating MT into patient care. The review was registered on PROSPERO (CRD420251033860).

烦躁影响50 - 80%的老年痴呆患者，给护理人员和医疗保健系统带来负担。药物治疗是有限的，而非药物音乐疗法（MT）有希望。本研究旨在评估MT在缓解躁动方面的功效。对多个数据库进行全面检索，纳入14项研究（10项随机对照试验，4项前后试验；n = 847）。荟萃分析显示，MT显著减少躁动，具有中等效应（d = 0.42）。亚组分析结果一致。异质性低，发表偏倚可忽略不计。尽管音乐持续时间和流派等方面存在异质性，但MT有效减轻了痴呆患者的躁动，强调了其普遍性，特别是在资源受限地区和缺乏专业护理支持的家庭。它为将MT纳入患者护理提供了证据。该综述已在PROSPERO注册（CRD420251033860）。

引用次数: 0

The interaction between activities of daily living and psychological resilience on all-cause mortality and cognitive impairment among Chinese older adults: A cohort study based on CLHLS 日常生活活动和心理弹性对中国老年人全因死亡率和认知障碍的相互作用：基于CLHLS的队列研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2025-09-29 DOI: 10.1016/j.archger.2025.106047

Yingtian Wang , Haining Qi , Xinru Hu , Qian Yu , Manshu Yu , Fan Yang , Xirui Qiu , Fangyi Chen , Ye Ding , Meng Jiang , Xiaoxiao Wang , Li Liu , Wei Wang

Objectives

To investigate the joint effects and interactions of psychological resilience (PR) and activities of daily living (ADL) on cognitive impairment and all-cause mortality.

Methods

Chinese older adults were recruited from the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazards regression and log-binomial regression were employed to estimate the associations between exposures and all-cause mortality and cognitive impairment (defined as MMSE score <18 or self-reported dementia). Interactions were test on the basis of multivariable regressions.

Results

Compared to participants with normal ADL and high PR (Group 1), participants with limited ADL and high PR (Group 3, HR = 2.105; 95 % CI: 1.656, 2.676) and those with limited ADL and low PR (Group 4, HR = 3.076; 95 % CI: 2.436, 3.884) showed significantly increased risks of all-cause mortality. Moreover, the synergistic interactions between ADL and PR for all-cause mortality were evidenced by relative excess risk due to interaction (RERI = 0.824; 95 % CI: 0.363, 1.286), attributable proportion due to interaction (AP = 0.268; 95 % CI: 0.121, 0.415) and synergy index (SI = 1.659; 95 % CI: 1.134, 2.426). Regarding cognitive impairment, compared to Group 1, Group 3 (RR = 1.662; 95 % CI: 1.073, 2.576) and Group 4 (RR = 2.138; 95 % CI: 1.399, 3.8) exhibited increased risks. Additionally, subgroup analysis showed additive interaction for cognitive impairment was significant only in males.

Conclusions

Limited ADL and low PR jointly increase the risks of cognitive impairment and all-cause mortality in Chinese older adults, with a synergistic additive interaction observed for all-cause mortality.

目的：探讨心理弹性（PR）和日常生活活动（ADL）对认知功能障碍和全因死亡率的共同影响和相互作用。方法：从中国健康长寿纵向调查中招募中国老年人。采用Cox比例风险回归和对数二项回归来估计暴露与全因死亡率和认知功能障碍之间的关系（定义为MMSE评分）结果：与正常ADL和高PR的参与者（1组）相比，有限ADL和高PR的参与者（3组，HR = 2.105; 95% CI: 1.656, 2.676）和有限ADL和低PR的参与者(4组，HR = 3.076；95% CI: 2.436, 3.884)显示全因死亡风险显著增加。此外，ADL和PR对全因死亡率的协同作用表现为相互作用的相对超额风险（RERI = 0.824; 95% CI: 0.363, 1.286）、相互作用的归因比例（AP = 0.268; 95% CI: 0.121, 0.415）和协同作用指数（SI = 1.659; 95% CI: 1.134, 2.426）。在认知障碍方面，与1组相比，3组（RR = 1.662; 95% CI: 1.073, 2.576）和4组（RR = 2.138; 95% CI: 1.399, 3.8）的风险增加。此外，亚组分析显示，认知障碍的加性相互作用仅在男性中显著。结论：有限的ADL和低PR共同增加了中国老年人认知功能障碍和全因死亡率的风险，并在全因死亡率中观察到协同加性相互作用。

{"title":"The interaction between activities of daily living and psychological resilience on all-cause mortality and cognitive impairment among Chinese older adults: A cohort study based on CLHLS","authors":"Yingtian Wang , Haining Qi , Xinru Hu , Qian Yu , Manshu Yu , Fan Yang , Xirui Qiu , Fangyi Chen , Ye Ding , Meng Jiang , Xiaoxiao Wang , Li Liu , Wei Wang","doi":"10.1016/j.archger.2025.106047","DOIUrl":"10.1016/j.archger.2025.106047","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the joint effects and interactions of psychological resilience (PR) and activities of daily living (ADL) on cognitive impairment and all-cause mortality.</div></div><div><h3>Methods</h3><div>Chinese older adults were recruited from the Chinese Longitudinal Healthy Longevity Survey. Cox proportional hazards regression and log-binomial regression were employed to estimate the associations between exposures and all-cause mortality and cognitive impairment (defined as MMSE score <18 or self-reported dementia). Interactions were test on the basis of multivariable regressions.</div></div><div><h3>Results</h3><div>Compared to participants with normal ADL and high PR (Group 1), participants with limited ADL and high PR (Group 3, HR = 2.105; 95 % CI: 1.656, 2.676) and those with limited ADL and low PR (Group 4, HR = 3.076; 95 % CI: 2.436, 3.884) showed significantly increased risks of all-cause mortality. Moreover, the synergistic interactions between ADL and PR for all-cause mortality were evidenced by relative excess risk due to interaction (RERI = 0.824; 95 % CI: 0.363, 1.286), attributable proportion due to interaction (AP = 0.268; 95 % CI: 0.121, 0.415) and synergy index (SI = 1.659; 95 % CI: 1.134, 2.426). Regarding cognitive impairment, compared to Group 1, Group 3 (RR = 1.662; 95 % CI: 1.073, 2.576) and Group 4 (RR = 2.138; 95 % CI: 1.399, 3.8) exhibited increased risks. Additionally, subgroup analysis showed additive interaction for cognitive impairment was significant only in males.</div></div><div><h3>Conclusions</h3><div>Limited ADL and low PR jointly increase the risks of cognitive impairment and all-cause mortality in Chinese older adults, with a synergistic additive interaction observed for all-cause mortality.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"140 ","pages":"Article 106047"},"PeriodicalIF":3.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245255","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