Pub Date : 2025-09-11DOI: 10.1016/j.archger.2025.106025
Lorinda A. Coombs , Myoungsuk Kim
Objective
This study examined the effects of web-based interventions on depression and anxiety in older adults.
Methods
We conducted a systematic search of PubMed, CINAHL, Cochrane, Embase, PsycINFO, and Web of Science from their inception to March 05, 2025. We included randomized controlled trials (RCTs) examining the effects of web-based interventions on depression and anxiety in individuals aged 60 and older. The quality of included studies was evaluated using the revised Cochrane risk-of-bias tool for RCTs. A random-effects model was applied for the meta-analysis, with pooled standardized mean differences (SMD) used to estimate intervention effects. Heterogeneity was quantified using the I² statistic, and subgroup and meta-regression analyses were performed to investigate potential moderators.
Results
A total of 19 studies were included in the final analysis. The meta-analysis showed that web-based interventions significantly reduced depression (SMD = -0.48, 95 % CI = -0.72 to -0.24) and anxiety (SMD = -0.70, 95 % CI = -0.97 to -0.43) in older adults. Subgroup analyses indicated that participant characteristics and publication year significantly moderated heterogeneity, while meta-regression analysis revealed that mean age significantly moderated the intervention effect.
Conclusion
This meta-analysis confirmed that web-based interventions effectively reduce depression and anxiety in older adults. The effects were particularly pronounced among older adults with existing or diagnosed symptoms of depression or anxiety. Furthermore, the observed reduction in intervention effectiveness after COVID-19 highlights the need to investigate the underlying causes of this decline.
目的：本研究考察了网络干预对老年人抑郁和焦虑的影响。方法：系统检索PubMed、CINAHL、Cochrane、Embase、PsycINFO和Web of Science自成立至2025年3月5日的数据库。我们纳入了随机对照试验（rct），检查了网络干预对60岁及以上个体抑郁和焦虑的影响。使用修订后的Cochrane随机对照试验风险偏倚工具评估纳入研究的质量。采用随机效应模型进行meta分析，采用标准平均差异（SMD）估计干预效果。异质性使用I²统计量进行量化，并进行亚组和元回归分析以调查潜在的调节因素。结果：共纳入19项研究。荟萃分析显示，基于网络的干预显著降低了老年人的抑郁（SMD = -0.48, 95% CI = -0.72至-0.24）和焦虑（SMD = -0.70, 95% CI = -0.97至-0.43）。亚组分析显示，受试者特征和出版年份显著调节异质性，而元回归分析显示，平均年龄显著调节干预效果。结论：本荟萃分析证实，基于网络的干预有效地减少了老年人的抑郁和焦虑。这种影响在存在或被诊断为抑郁或焦虑症状的老年人中尤为明显。此外，观察到的2019冠状病毒病后干预效果下降的情况突出表明，有必要调查这种下降的根本原因。
{"title":"Effectiveness of web-based interventions on depression and anxiety in older adults: a systematic review and meta-analysis of randomized controlled trials","authors":"Lorinda A. Coombs , Myoungsuk Kim","doi":"10.1016/j.archger.2025.106025","DOIUrl":"10.1016/j.archger.2025.106025","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined the effects of web-based interventions on depression and anxiety in older adults.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of PubMed, CINAHL, Cochrane, Embase, PsycINFO, and Web of Science from their inception to March 05, 2025. We included randomized controlled trials (RCTs) examining the effects of web-based interventions on depression and anxiety in individuals aged 60 and older. The quality of included studies was evaluated using the revised Cochrane risk-of-bias tool for RCTs. A random-effects model was applied for the meta-analysis, with pooled standardized mean differences (SMD) used to estimate intervention effects. Heterogeneity was quantified using the I² statistic, and subgroup and meta-regression analyses were performed to investigate potential moderators.</div></div><div><h3>Results</h3><div>A total of 19 studies were included in the final analysis. The meta-analysis showed that web-based interventions significantly reduced depression (SMD = -0.48, 95 % CI = -0.72 to -0.24) and anxiety (SMD = -0.70, 95 % CI = -0.97 to -0.43) in older adults. Subgroup analyses indicated that participant characteristics and publication year significantly moderated heterogeneity, while meta-regression analysis revealed that mean age significantly moderated the intervention effect.</div></div><div><h3>Conclusion</h3><div>This meta-analysis confirmed that web-based interventions effectively reduce depression and anxiety in older adults. The effects were particularly pronounced among older adults with existing or diagnosed symptoms of depression or anxiety. Furthermore, the observed reduction in intervention effectiveness after COVID-19 highlights the need to investigate the underlying causes of this decline.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106025"},"PeriodicalIF":3.8,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082649","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}
Pub Date : 2025-09-10DOI: 10.1016/j.archger.2025.106024
Xiaowei Li , Chenxi Wu , Tao Feng , Xinyu Chen , Huan Chen , Xianying Lu , Jing Gao , Chaoming Hou
Background
Loneliness in older adults is a critical public health issue with dynamic changes over time. Understanding its longitudinal patterns is vital for identifying high-risk individuals and developing timely interventions. This review synthesizes evidence on loneliness trajectories, their predictors, and associated health outcomes in older populations.
Methods
A systematic search across nine databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL, PsycINFO, CNKI, VIP, Wanfang) was conducted from inception to December 1, 2024, updated on August 18, 2025, focusing on longitudinal studies of adults aged ≥60 years. Quality was assessed using JBI tools, and a narrative synthesis was performed due to methodological heterogeneity.
Results
Of the 2985 screened records, 16 studies met the predefined inclusion criteria. Fifteen of these studies were rated as moderate or high quality. Despite heterogeneity in analytical approaches, four loneliness trajectory patterns were identified: stable-low, stable-high, ascending, and descending. The stable-high and ascending trajectories were consistently associated with adverse health outcomes, including accelerated cognitive decline and greater severity of depressive symptoms. Key predictors of high-risk loneliness trajectories included social isolation, functional impairment, and exposure to major life stressors.
Conclusions
Loneliness among older adults follows heterogeneous trajectories, with the stable-high and ascending patterns indicating the highest risk for adverse health outcomes. These findings underscore the need for early screening of key risk factors and the implementation of trajectory-tailored interventions. Future research should prioritize standardized loneliness measurement tools and integrated analytical approaches to enhance the comparability of findings and their translation into clinical practice.
背景：老年人的孤独感是一个重要的公共卫生问题，随着时间的推移而发生动态变化。了解其纵向模式对于识别高危个体和制定及时的干预措施至关重要。本综述综合了老年人孤独轨迹、预测因素和相关健康结果的证据。方法：系统检索9个数据库（PubMed、Web of Science、Embase、Cochrane Library、CINAHL、PsycINFO、CNKI、VIP、万方），检索时间为研究开始至2024年12月1日，更新时间为2025年8月18日，重点检索年龄≥60岁成人的纵向研究。使用JBI工具评估质量，由于方法的异质性，进行了叙述综合。结果：在2985项筛选记录中，16项研究符合预定义的纳入标准。其中15项研究被评为中等或高质量。尽管分析方法存在异质性，但确定了四种孤独轨迹模式：稳定-低、稳定-高、上升和下降。稳定-高和上升轨迹始终与不良健康结果相关，包括认知能力下降加速和抑郁症状更严重。高风险孤独轨迹的关键预测因素包括社会隔离、功能障碍和暴露于主要生活压力源。结论：老年人的孤独感遵循异质性轨迹，稳定-高和上升模式表明不良健康结果的风险最高。这些发现强调了早期筛查关键风险因素和实施针对性干预措施的必要性。未来的研究应优先考虑标准化的孤独感测量工具和综合分析方法，以提高研究结果的可比性，并将其转化为临床实践。
{"title":"Loneliness trajectories in older adults: A systematic review","authors":"Xiaowei Li , Chenxi Wu , Tao Feng , Xinyu Chen , Huan Chen , Xianying Lu , Jing Gao , Chaoming Hou","doi":"10.1016/j.archger.2025.106024","DOIUrl":"10.1016/j.archger.2025.106024","url":null,"abstract":"<div><h3>Background</h3><div>Loneliness in older adults is a critical public health issue with dynamic changes over time. Understanding its longitudinal patterns is vital for identifying high-risk individuals and developing timely interventions. This review synthesizes evidence on loneliness trajectories, their predictors, and associated health outcomes in older populations.</div></div><div><h3>Methods</h3><div>A systematic search across nine databases (PubMed, Web of Science, Embase, Cochrane Library, CINAHL, PsycINFO, CNKI, VIP, Wanfang) was conducted from inception to December 1, 2024, updated on August 18, 2025, focusing on longitudinal studies of adults aged ≥60 years. Quality was assessed using JBI tools, and a narrative synthesis was performed due to methodological heterogeneity.</div></div><div><h3>Results</h3><div>Of the 2985 screened records, 16 studies met the predefined inclusion criteria. Fifteen of these studies were rated as moderate or high quality. Despite heterogeneity in analytical approaches, four loneliness trajectory patterns were identified: stable-low, stable-high, ascending, and descending. The stable-high and ascending trajectories were consistently associated with adverse health outcomes, including accelerated cognitive decline and greater severity of depressive symptoms. Key predictors of high-risk loneliness trajectories included social isolation, functional impairment, and exposure to major life stressors.</div></div><div><h3>Conclusions</h3><div>Loneliness among older adults follows heterogeneous trajectories, with the stable-high and ascending patterns indicating the highest risk for adverse health outcomes. These findings underscore the need for early screening of key risk factors and the implementation of trajectory-tailored interventions. Future research should prioritize standardized loneliness measurement tools and integrated analytical approaches to enhance the comparability of findings and their translation into clinical practice.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106024"},"PeriodicalIF":3.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087951","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}
Pub Date : 2025-09-10DOI: 10.1016/j.archger.2025.106022
Thomas Iverson , Marie Schulze , Kaylen Gill , Yola Switkowski , Isis Kelly dos Santos , Maureen C. Ashe
Objectives
Social support may assist people’s health as they age but less is known about how this relationship may differ for older adults living in rural communities. Knowledge of this information can inform the implementation of social prescribing, a care model aiming to address people’s unmet non-medical social needs.
Methods
This was a systematic rapid mixed-methods review following guidelines. We searched 10 electronic sources (all languages from 2000 and later) for peer-reviewed studies; our last search was on May 5, 2025. We followed the Joanna Briggs Institute (JBI) mixed-methods approach and used a convergent integrated method to create qualitative findings from quantitative studies and merged them with data from qualitative studies.
Synthesis
We included 12 studies (14 publications) with six quantitative studies, five qualitative studies, and one mixed methods study. Data were from Canada-wide surveys, or the provinces of New Brunswick, Ontario, Quebec, and Saskatchewan. There were some differences in findings between older adults from rural and urban settings for social support and satisfaction. Older people in rural settings may have less access to “formal” support and may rely more on family or friends, but this “patchwork” of support in rural communities may be less sustainable.
Conclusion
Social support is an important part of aging, but there may be some unique differences for people living in rural Canadian communities. Although the support provided in rural settings may offer some advantages, it may also be precarious in the long term and innovations to support aging in place (like social prescribing) are long overdue.
{"title":"Older adults and social support in rural Canada: A rapid mixed methods systematic review to inform social prescribing","authors":"Thomas Iverson , Marie Schulze , Kaylen Gill , Yola Switkowski , Isis Kelly dos Santos , Maureen C. Ashe","doi":"10.1016/j.archger.2025.106022","DOIUrl":"10.1016/j.archger.2025.106022","url":null,"abstract":"<div><h3>Objectives</h3><div>Social support may assist people’s health as they age but less is known about how this relationship may differ for older adults living in rural communities. Knowledge of this information can inform the implementation of social prescribing, a care model aiming to address people’s unmet non-medical social needs.</div></div><div><h3>Methods</h3><div>This was a systematic rapid mixed-methods review following guidelines. We searched 10 electronic sources (all languages from 2000 and later) for peer-reviewed studies; our last search was on May 5, 2025. We followed the Joanna Briggs Institute (JBI) mixed-methods approach and used a convergent integrated method to create qualitative findings from quantitative studies and merged them with data from qualitative studies.</div></div><div><h3>Synthesis</h3><div>We included 12 studies (14 publications) with six quantitative studies, five qualitative studies, and one mixed methods study. Data were from Canada-wide surveys, or the provinces of New Brunswick, Ontario, Quebec, and Saskatchewan. There were some differences in findings between older adults from rural and urban settings for social support and satisfaction. Older people in rural settings may have less access to “formal” support and may rely more on family or friends, but this “patchwork” of support in rural communities may be less sustainable.</div></div><div><h3>Conclusion</h3><div>Social support is an important part of aging, but there may be some unique differences for people living in rural Canadian communities. Although the support provided in rural settings may offer some advantages, it may also be precarious in the long term and innovations to support aging in place (like social prescribing) are long overdue.</div></div><div><h3>Systematic Review Registration</h3><div>PROSPERO 2024 CRD42024591884</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106022"},"PeriodicalIF":3.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095509","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}
Pub Date : 2025-09-08DOI: 10.1016/j.archger.2025.106021
Xuan Huang , Cui Ye , Ai Zhao , Ziyu Wang , Shufang Zuo , Lu Lin
Objectives
To evaluate the effectiveness of reminiscence therapy in enhancing cognitive function among older adults with cognitive impairment and to identify optimal intervention strategies in terms of format, session duration, frequency, and intervention period.
Methods
A systematic search of randomized controlled trials (RCTs) on reminiscence therapy for cognitively impaired older adults was conducted across PubMed, Web of Science, Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang databases from inception to October 2024. Two reviewers independently assessed the methodological quality of included studies using Cochrane Risk of Bias Tool (ROB 2.0). Data were extracted using standardized forms and analyzed with Review Manager version 5.4 and Stata version 18.0.
Results
A total of 18 studies were included, of which 14 studies (19 trials) provided complete data for meta-analysis. Study settings included hospitals, nursing facilities, and community centers, with all interventions based on simple recall reminiscence. Meta-analysis showed a significant effect of reminiscence therapy on cognitive function in older adults with cognitive impairment (SMD=1.15, 95%CI: 0.78-1.52, P<0.001). Subgroup analyses revealed greater effectiveness in participants from Asia (SMD=1.50, 95%CI: 0.98-2.01, P<0.001) and those with mild cognitive impairment (MCI)(SMD=1.56, 95%CI: 0.78-2.34, P<0.001). The optimal delivery strategies involved group sessions with more than six participants (SMD=1.63, 95%CI: 0.48-2.78, P=0.005), conducted weekly (SMD=1.37, 95%CI: 0.83-1.91, P<0.001) for 30-45 minutes per session (SMD=1.29, 95%CI: 0.59-1.99, P<0.001), over a 12-week period (SMD=1.60, 95%CI: 0.83-2.38, P<0.001).
Conclusion
Reminiscence therapy effectively improves cognitive function in older adults with cognitive impairment, especially those with MCI. It is recommended as an early non-pharmacological intervention delivered through weekly group sessions of 30-45 minutes, with six or more participants over at least 12 weeks. Future research should involve high-quality studies with extended follow-up periods to fully validate the sustained effectiveness of reminiscence therapy.
{"title":"Effects of reminiscence therapy on cognitive function in older adults with cognitive impairment: a systematic review and meta-analysis of randomized controlled trials","authors":"Xuan Huang , Cui Ye , Ai Zhao , Ziyu Wang , Shufang Zuo , Lu Lin","doi":"10.1016/j.archger.2025.106021","DOIUrl":"10.1016/j.archger.2025.106021","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effectiveness of reminiscence therapy in enhancing cognitive function among older adults with cognitive impairment and to identify optimal intervention strategies in terms of format, session duration, frequency, and intervention period.</div></div><div><h3>Methods</h3><div>A systematic search of randomized controlled trials (RCTs) on reminiscence therapy for cognitively impaired older adults was conducted across PubMed, Web of Science, Cochrane Library, Embase, CNKI, CBM, VIP, and Wanfang databases from inception to October 2024. Two reviewers independently assessed the methodological quality of included studies using Cochrane Risk of Bias Tool (ROB 2.0). Data were extracted using standardized forms and analyzed with Review Manager version 5.4 and Stata version 18.0.</div></div><div><h3>Results</h3><div>A total of 18 studies were included, of which 14 studies (19 trials) provided complete data for meta-analysis. Study settings included hospitals, nursing facilities, and community centers, with all interventions based on simple recall reminiscence. Meta-analysis showed a significant effect of reminiscence therapy on cognitive function in older adults with cognitive impairment (SMD=1.15, 95%CI: 0.78-1.52, P<0.001). Subgroup analyses revealed greater effectiveness in participants from Asia (SMD=1.50, 95%CI: 0.98-2.01, P<0.001) and those with mild cognitive impairment (MCI)(SMD=1.56, 95%CI: 0.78-2.34, P<0.001). The optimal delivery strategies involved group sessions with more than six participants (SMD=1.63, 95%CI: 0.48-2.78, P=0.005), conducted weekly (SMD=1.37, 95%CI: 0.83-1.91, P<0.001) for 30-45 minutes per session (SMD=1.29, 95%CI: 0.59-1.99, P<0.001), over a 12-week period (SMD=1.60, 95%CI: 0.83-2.38, P<0.001).</div></div><div><h3>Conclusion</h3><div>Reminiscence therapy effectively improves cognitive function in older adults with cognitive impairment, especially those with MCI. It is recommended as an early non-pharmacological intervention delivered through weekly group sessions of 30-45 minutes, with six or more participants over at least 12 weeks. Future research should involve high-quality studies with extended follow-up periods to fully validate the sustained effectiveness of reminiscence therapy.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106021"},"PeriodicalIF":3.8,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145060388","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}
Pub Date : 2025-08-29DOI: 10.1016/j.archger.2025.106020
Hang Yuan , Yizhong Bao , Li Li , Yepeng Luan , Fangcai Li
Postmenopausal osteoporosis (PMOP) features reduced bone mass and deteriorated bone microstructure, increasing fracture risk. Estrogen deficiency-induced osteoclast overactivation is a primary driver. OCP-001, a novel highly selective HDAC1 inhibitor, was investigated. TRAP staining showed dose-dependent inhibition of osteoclast differentiation by OCP-001. qPCR revealed concomitant downregulation of RANKL-induced osteoclast marker genes (Trap, DC-Stamp, NFATc1, ATP60) and key regulatory proteins (c-Fos, NFATc1, Blimp-1, IRF-8). In an ovariectomized (OVX)-induced PMOP mouse model, body weight monitoring showed no toxicity from OCP-001 treatment. Micro-CT analysis confirmed that it effectively prevented femoral bone mass loss and microstructural deterioration. Histological analysis further verified its inhibition of OVX-induced osteoclastogenesis. Furthermore, OCP-001 normalized OVX-altered serum bone turnover markers (PINP, β-CTx). Mechanistically, OCP-001 suppressed osteoclast differentiation partly via inhibiting the Blimp-1/IRF-8 pathway. Thus, the selective HDAC1 inhibitor OCP-001 alleviates OVX-induced bone loss and deterioration by potently inhibiting osteoclastogenesis and function, supporting its potential as a PMOP therapeutic.
{"title":"A novel HDAC1-specific inhibitor prevents estrogen deficiency-induced osteoporosis in mice by inhibiting osteoclast function","authors":"Hang Yuan , Yizhong Bao , Li Li , Yepeng Luan , Fangcai Li","doi":"10.1016/j.archger.2025.106020","DOIUrl":"10.1016/j.archger.2025.106020","url":null,"abstract":"<div><div>Postmenopausal osteoporosis (PMOP) features reduced bone mass and deteriorated bone microstructure, increasing fracture risk. Estrogen deficiency-induced osteoclast overactivation is a primary driver. OCP-001, a novel highly selective HDAC1 inhibitor, was investigated. TRAP staining showed dose-dependent inhibition of osteoclast differentiation by OCP-001. qPCR revealed concomitant downregulation of RANKL-induced osteoclast marker genes (<em>Trap, DC-Stamp, NFATc1, ATP60</em>) and key regulatory proteins (c-Fos, NFATc1, Blimp-1, IRF-8). In an ovariectomized (OVX)-induced PMOP mouse model, body weight monitoring showed no toxicity from OCP-001 treatment. Micro-CT analysis confirmed that it effectively prevented femoral bone mass loss and microstructural deterioration. Histological analysis further verified its inhibition of OVX-induced osteoclastogenesis. Furthermore, OCP-001 normalized OVX-altered serum bone turnover markers (PINP, β-CTx). Mechanistically, OCP-001 suppressed osteoclast differentiation partly via inhibiting the Blimp-1/IRF-8 pathway. Thus, the selective HDAC1 inhibitor OCP-001 alleviates OVX-induced bone loss and deterioration by potently inhibiting osteoclastogenesis and function, supporting its potential as a PMOP therapeutic.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106020"},"PeriodicalIF":3.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932596","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}
Pub Date : 2025-08-29DOI: 10.1016/j.archger.2025.106019
Zhuling Yu , Yanbo Teng , Le Peng
Background
Frailty is a dynamic condition that may affect mental health. This study aimed to investigate the associations of frailty and its changes with the risks of depressive symptoms across multiple regions in aging populations.
Methods
Data were drawn from five cohort studies in the United States, England, Europe, China, and Mexico. Frailty was assessed by frailty index which included chronic diseases, vision and hearing impairments, pain, self-reported health status, activity of daily living, instrumental activity of daily living, mobility, and cognitive function. Changes in frailty were evaluated by frailty at baseline and the first follow-up survey. Unadjusted and adjusted hazard ratios (HRs) with 95% confidence intervals [CIs] were estimated by Cox proportional hazards models and then pooled by meta-analyses.
Results
Of the 61,063 participants, 17,960 developed depressive symptoms during a median time of 5.9 to 9.0 years. Baseline frailty was significantly associated with an increased risk of depressive symptoms. Participants who changed from robust to pre-frail or frail status showed an elevated risk of depressive symptoms compared to stable robust participants (HR range: 1.38–1.81; pooled HR: 1.53, 95% CI: 1.37–1.72). Conversely, participants who transitioned from frail to robust or pre-frail status demonstrated a reduced risk of depressive symptoms compared to stable frail participants (HR range: 0.36–0.78; pooled HR: 0.71, 95% CI: 0.63–0.79).
Conclusion
Baseline frailty was associated with incident depressive symptoms. Deterioration of frailty elevated the risk of depressive symptoms, whereas improvement of frailty lowered the risk. This study suggests that timely interventions for frailty may prevent depressive symptoms.
{"title":"Associations of frailty and its changes with the risks of depressive symptoms: A multi-cohort study","authors":"Zhuling Yu , Yanbo Teng , Le Peng","doi":"10.1016/j.archger.2025.106019","DOIUrl":"10.1016/j.archger.2025.106019","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is a dynamic condition that may affect mental health. This study aimed to investigate the associations of frailty and its changes with the risks of depressive symptoms across multiple regions in aging populations.</div></div><div><h3>Methods</h3><div>Data were drawn from five cohort studies in the United States, England, Europe, China, and Mexico. Frailty was assessed by frailty index which included chronic diseases, vision and hearing impairments, pain, self-reported health status, activity of daily living, instrumental activity of daily living, mobility, and cognitive function. Changes in frailty were evaluated by frailty at baseline and the first follow-up survey. Unadjusted and adjusted hazard ratios (HRs) with 95% confidence intervals [CIs] were estimated by Cox proportional hazards models and then pooled by meta-analyses.</div></div><div><h3>Results</h3><div>Of the 61,063 participants, 17,960 developed depressive symptoms during a median time of 5.9 to 9.0 years. Baseline frailty was significantly associated with an increased risk of depressive symptoms. Participants who changed from robust to pre-frail or frail status showed an elevated risk of depressive symptoms compared to stable robust participants (HR range: 1.38–1.81; pooled HR: 1.53, 95% CI: 1.37–1.72). Conversely, participants who transitioned from frail to robust or pre-frail status demonstrated a reduced risk of depressive symptoms compared to stable frail participants (HR range: 0.36–0.78; pooled HR: 0.71, 95% CI: 0.63–0.79).</div></div><div><h3>Conclusion</h3><div>Baseline frailty was associated with incident depressive symptoms. Deterioration of frailty elevated the risk of depressive symptoms, whereas improvement of frailty lowered the risk. This study suggests that timely interventions for frailty may prevent depressive symptoms.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106019"},"PeriodicalIF":3.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019373","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}
Pub Date : 2025-08-28DOI: 10.1016/j.archger.2025.106014
Yaqi Huang , Youran Liu , Chun Man Wong , Yaqian Liu , Juan Chen , Angela Yee Man Leung
Background
Older adults with cognitive impairment face significant challenges in maintaining oral health while the barriers and facilitators for implementing communitybased oral health interventions are uncertain.
Objective
To understand the barriers and facilitators for the implementation of oral health intervention among community-dwelling older adults with cognitive impairment.
Methods
Literature was searched in PubMed, CINAHL, Embase, PsycINFO, Scopus and Google Scholar. Studies reporting oral health interventions for community-dwelling older adults with cognitive impairment were included. Behaviour Change Techniques (BCTs) were identified and classified using BCT Taxonomy v1. Barriers and facilitators to the implementation were synthesized using thematic analysis.
Results
Eleven studies were included. Four types of interventions with 20 distinct BCTs were identified. Facilitators included: 1) Adaptive solutions improved usability and accessibility; 2) Training and guidance enhance the feasibility; 3) The involvement of professionals and care partners ensured the adoption of the new oral hygiene routines; and 4) Participants in earlier stages of cognitive impairment can gradually adjust to new oral care routines. Barriers included: 1) Technique challenges and physical limitations affected participants’ ability to perform correct oral hygiene tasks; 2) Memory decline, emotional distress, and lack of motivation hindered participants' engagement and adherence to oral health practices; 3) Care partners burdens and unmet needs affected consistent support; and 4) Logistical constraints and cultural factors influenced participation and access to oral health interventions.
Conclusions
While various interventions have been developed, evidence remains limited. Incorporating user-friendly hygiene techniques, more BCTs, appropriate technical support, caregiver involvement, and oral–cognitive dual-task training were recommended.
{"title":"Understanding barriers and facilitators to oral health interventions in community-dwelling older adults with cognitive impairment: A scoping review","authors":"Yaqi Huang , Youran Liu , Chun Man Wong , Yaqian Liu , Juan Chen , Angela Yee Man Leung","doi":"10.1016/j.archger.2025.106014","DOIUrl":"10.1016/j.archger.2025.106014","url":null,"abstract":"<div><h3>Background</h3><div>Older adults with cognitive impairment face significant challenges in maintaining oral health while the barriers and facilitators for implementing communitybased oral health interventions are uncertain.</div></div><div><h3>Objective</h3><div>To understand the barriers and facilitators for the implementation of oral health intervention among community-dwelling older adults with cognitive impairment.</div></div><div><h3>Methods</h3><div>Literature was searched in PubMed, CINAHL, Embase, PsycINFO, Scopus and Google Scholar. Studies reporting oral health interventions for community-dwelling older adults with cognitive impairment were included. Behaviour Change Techniques (BCTs) were identified and classified using BCT Taxonomy v1. Barriers and facilitators to the implementation were synthesized using thematic analysis.</div></div><div><h3>Results</h3><div>Eleven studies were included. Four types of interventions with 20 distinct BCTs were identified. Facilitators included: 1) Adaptive solutions improved usability and accessibility; 2) Training and guidance enhance the feasibility; 3) The involvement of professionals and care partners ensured the adoption of the new oral hygiene routines; and 4) Participants in earlier stages of cognitive impairment can gradually adjust to new oral care routines. Barriers included: 1) Technique challenges and physical limitations affected participants’ ability to perform correct oral hygiene tasks; 2) Memory decline, emotional distress, and lack of motivation hindered participants' engagement and adherence to oral health practices; 3) Care partners burdens and unmet needs affected consistent support; and 4) Logistical constraints and cultural factors influenced participation and access to oral health interventions.</div></div><div><h3>Conclusions</h3><div>While various interventions have been developed, evidence remains limited. Incorporating user-friendly hygiene techniques, more BCTs, appropriate technical support, caregiver involvement, and oral–cognitive dual-task training were recommended.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106014"},"PeriodicalIF":3.8,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004740","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}
Pub Date : 2025-08-27DOI: 10.1016/j.archger.2025.106005
Xinyu Wan , Xuehan Ma , Gengxin Yao , Yiran Xu , Yali Yang , Lishuang Zheng , Li Chen , Guichen Li
Background
Frailty is defined as a biological syndrome characterized by a decreased reserve and resistance to stressors. Frailty is closely related to lifestyle, and improving lifestyle can effectively reduce the incidence of frailty and related adverse events. Multi-component interventions were an effective mean of improving lifestyle, which has been validated in studies of other populations. This review aimed to explore the effects of multi-component interventions on the lifestyle in pre-frail or frail older adults.
Methods
Six databases were systematically searched as of 19 November 2024. Only randomized controlled trials were included in the analysis. The mean difference (MD) or standardized mean difference (SMD) were calculated to determine the pooled intervention effects. Methodological quality and evidence were assessed using the RoB2 tool and GRADE online tool.
Results
Seventeen randomized controlled trials were included in this study. The results showed that the multi-component interventions had positive effects on physical activity (SMD = 0.65, 95 %CI [0.36, 0.95]), social activity (SMD = 0.21, 95 %CI [0.04, 0.37]) and dietary nutrition (SMD = 0.78, 95 %CI [0.11, 1.44]), may reduce sedentary behavior (MD = -31.12, 95 %CI [-58.38, -3.85]).
Conclusion
In summary, this review analyzed existing literature and the results showed that multi-component interventions have significant benefits on the lifestyle in pre-frail or frail older adults. As the current evidence was limited, more researches were needed in the future to further enrich the evidence in the field of multi-component interventions for pre-frail or frail older adults.
{"title":"Effects of multi-component interventions on the lifestyle in pre-frail or frail older adults: A systematic review and meta-analysis","authors":"Xinyu Wan , Xuehan Ma , Gengxin Yao , Yiran Xu , Yali Yang , Lishuang Zheng , Li Chen , Guichen Li","doi":"10.1016/j.archger.2025.106005","DOIUrl":"10.1016/j.archger.2025.106005","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is defined as a biological syndrome characterized by a decreased reserve and resistance to stressors. Frailty is closely related to lifestyle, and improving lifestyle can effectively reduce the incidence of frailty and related adverse events. Multi-component interventions were an effective mean of improving lifestyle, which has been validated in studies of other populations. This review aimed to explore the effects of multi-component interventions on the lifestyle in pre-frail or frail older adults.</div></div><div><h3>Methods</h3><div>Six databases were systematically searched as of 19 November 2024. Only randomized controlled trials were included in the analysis. The mean difference (MD) or standardized mean difference (SMD) were calculated to determine the pooled intervention effects. Methodological quality and evidence were assessed using the RoB2 tool and GRADE online tool.</div></div><div><h3>Results</h3><div>Seventeen randomized controlled trials were included in this study. The results showed that the multi-component interventions had positive effects on physical activity (SMD = 0.65, 95 %CI [0.36, 0.95]), social activity (SMD = 0.21, 95 %CI [0.04, 0.37]) and dietary nutrition (SMD = 0.78, 95 %CI [0.11, 1.44]), may reduce sedentary behavior (MD = -31.12, 95 %CI [-58.38, -3.85]).</div></div><div><h3>Conclusion</h3><div>In summary, this review analyzed existing literature and the results showed that multi-component interventions have significant benefits on the lifestyle in pre-frail or frail older adults. As the current evidence was limited, more researches were needed in the future to further enrich the evidence in the field of multi-component interventions for pre-frail or frail older adults.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106005"},"PeriodicalIF":3.8,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019483","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}
Pub Date : 2025-08-26DOI: 10.1016/j.archger.2025.106003
Ji Won Kang , Charity Oga-Omenka , Suzanne L. Tyas , Joel A. Dubin , Mark Oremus
With growing recognition of psychosocial risks for cognitive impairment, research on social isolation (SI) and loneliness (LON) and their relationship to memory has increased over the past decade. However, most studies have examined SI and LON separately, leaving their combined influence on memory underexplored, particularly in qualitative research. This study presents the qualitative arm of a larger mixed-methods investigation, exploring how SI and LON, separately and together, shape memory in middle-aged and older adults. Ten individuals aged 47 – 81 were recruited through purposive and snowball sampling for semi-structured interviews, analyzed using thematic analysis informed by descriptive phenomenology. Participants generally viewed LON as more damaging to memory than SI, noting that mental stimulation is still possible during isolation, whereas LON often drains the motivation to engage in such activities. Some described SI positively (form of self-care), though extended SI was seen as detrimental due to increased social anxiety (further limits social engagement), disrupted routines, and diminished sense of purpose, all critical for memory. The combination of SI and LON was perceived as most harmful, creating a feedback loop that exacerbates both conditions and increases vulnerability to self-destructive behaviours (smoking, physical inactivity, poor diet). This research identifies distinctive indicators and psychosocial needs of those experiencing SI, LON, or both, supporting more precise screening and intervention triage in clinical and community settings. It underscores the value of targeted, multimodal brain health interventions addressing diverse contributing factors through strategies like social connection, purpose-driven living, cognitively stimulating activities, chronic disease management, and healthy lifestyle habits.
{"title":"How social isolation and loneliness leave distinct imprints on memory: a thematic analysis informed by descriptive phenomenology","authors":"Ji Won Kang , Charity Oga-Omenka , Suzanne L. Tyas , Joel A. Dubin , Mark Oremus","doi":"10.1016/j.archger.2025.106003","DOIUrl":"10.1016/j.archger.2025.106003","url":null,"abstract":"<div><div>With growing recognition of psychosocial risks for cognitive impairment, research on social isolation (SI) and loneliness (LON) and their relationship to memory has increased over the past decade. However, most studies have examined SI and LON separately, leaving their combined influence on memory underexplored, particularly in qualitative research. This study presents the qualitative arm of a larger mixed-methods investigation, exploring how SI and LON, separately and together, shape memory in middle-aged and older adults. Ten individuals aged 47 – 81 were recruited through purposive and snowball sampling for semi-structured interviews, analyzed using thematic analysis informed by descriptive phenomenology. Participants generally viewed LON as more damaging to memory than SI, noting that mental stimulation is still possible during isolation, whereas LON often drains the motivation to engage in such activities. Some described SI positively (form of self-care), though extended SI was seen as detrimental due to increased social anxiety (further limits social engagement), disrupted routines, and diminished sense of purpose, all critical for memory. The combination of SI and LON was perceived as most harmful, creating a feedback loop that exacerbates both conditions and increases vulnerability to self-destructive behaviours (smoking, physical inactivity, poor diet). This research identifies distinctive indicators and psychosocial needs of those experiencing SI, LON, or both, supporting more precise screening and intervention triage in clinical and community settings. It underscores the value of targeted, multimodal brain health interventions addressing diverse contributing factors through strategies like social connection, purpose-driven living, cognitively stimulating activities, chronic disease management, and healthy lifestyle habits.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106003"},"PeriodicalIF":3.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922594","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}
Pub Date : 2025-08-26DOI: 10.1016/j.archger.2025.106002
Yue Wang , Qing Wang , Ling Tong, Huaguang Zheng, Yongjun Wang, Shiping Li
Post-stroke cognitive impairment (PSCI) imposes a significant economic and social burden on patients and their families. High-density lipoprotein cholesterol (HDL-C) is reported to have protective effects on cognitive function in older adults. This study assesses the effects of HDL-C during the acute period of stroke on PSCI. This sub-study of the China National Clinical Research Center Alzheimer's Disease and Neurodegenerative Disorder Research (CANDOR) prospectively enrolled patients with acute ischemic stroke. HDL-C levels and brain magnetic resonance imaging findings were examined at the acute stage. All participants completed neuropsychological assessment at 3 months. A total of 394 acute ischemic stroke patients were enrolled, 297 (75.4 %) were men, with mean age 58.14 ± 9.25 years, and all participants finished the baseline and 3-month cognitive assessments. HDL-C levels showed nonlinear relationships with post-stroke cognitive functions and brain structures. Participants were divided into five groups based on HDL-C levels: first–20th, 21st–40th, 41st–60th, 61st–80th, and 81st–last percentiles. The HDL-C middle group (1.03-1.15 mmol/L) had greater baseline global brain volume and regional brain volumes, the lowest incidence of PSCI at 3 months (50.0 %), and better MMSE and MoCA scores at baseline and at the 3-month follow-up, as well as better multi-domain Z scores (construction, executive function, language and memory) at the 3-month follow-up. Curve estimation further confirms the quadratic models (U-shaped curve) fit the relationships between HDL-C and baseline global and regional brain volume, and cognitive performance at 3-month visits. U-shaped associations of HDL-C with post-stroke cognitive function and baseline brain structures were identified. Either too high or too low HDL-C indicates a higher risk of poor post-stroke cognition.
{"title":"U-shaped association between post-stroke cognitive impairment and high-density lipoprotein cholesterol at the acute period of stroke","authors":"Yue Wang , Qing Wang , Ling Tong, Huaguang Zheng, Yongjun Wang, Shiping Li","doi":"10.1016/j.archger.2025.106002","DOIUrl":"10.1016/j.archger.2025.106002","url":null,"abstract":"<div><div>Post-stroke cognitive impairment (PSCI) imposes a significant economic and social burden on patients and their families. High-density lipoprotein cholesterol (HDL-C) is reported to have protective effects on cognitive function in older adults. This study assesses the effects of HDL-C during the acute period of stroke on PSCI. This sub-study of the China National Clinical Research Center Alzheimer's Disease and Neurodegenerative Disorder Research (CANDOR) prospectively enrolled patients with acute ischemic stroke. HDL-C levels and brain magnetic resonance imaging findings were examined at the acute stage. All participants completed neuropsychological assessment at 3 months. A total of 394 acute ischemic stroke patients were enrolled, 297 (75.4 %) were men, with mean age 58.14 ± 9.25 years, and all participants finished the baseline and 3-month cognitive assessments. HDL-C levels showed nonlinear relationships with post-stroke cognitive functions and brain structures. Participants were divided into five groups based on HDL-C levels: first–20th, 21st–40th, 41st–60th, 61st–80th, and 81st–last percentiles. The HDL-C middle group (1.03-1.15 mmol/L) had greater baseline global brain volume and regional brain volumes, the lowest incidence of PSCI at 3 months (50.0 %), and better MMSE and MoCA scores at baseline and at the 3-month follow-up, as well as better multi-domain Z scores (construction, executive function, language and memory) at the 3-month follow-up. Curve estimation further confirms the quadratic models (U-shaped curve) fit the relationships between HDL-C and baseline global and regional brain volume, and cognitive performance at 3-month visits. U-shaped associations of HDL-C with post-stroke cognitive function and baseline brain structures were identified. Either too high or too low HDL-C indicates a higher risk of poor post-stroke cognition.</div></div><div><h3>Trail registration number</h3><div>NCT04320368.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"139 ","pages":"Article 106002"},"PeriodicalIF":3.8,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007724","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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