Archives of gerontology and geriatrics最新文献_第9页

Polygenic hazard score predicts synaptic and axonal degeneration and cognitive decline in Alzheimer's disease continuum 多基因危险评分图谱是预测阿尔茨海默氏症谱系中突触和轴突变性以及认知能力下降的有效遗传指标

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-15 DOI: 10.1016/j.archger.2024.105576

Mohammad-Erfan Farhadieh , Mehrdad Mozafar , Saameh Sanaaee , Parastoo Sodeifi , Kiana Kousha , Yeganeh Zare , Shahab Zare , Nooshin Maleki Rad , Faezeh Jamshidi-Goharrizi , Mohammad Allahverdloo , Arman Rahimi , Mohammad Sadeghi , Mahan Shafie , Mahsa Mayeli , for the Alzheimer's Disease Neuroimaging Initiative

Background

Growth associated protein-43 (GAP-43) and neurofilaments light (NFL) are biomarkers of synaptic and axonal injury, and are associated with cognitive decline in Alzheimer's disease (AD) contiuum. We investigated whether Polygenic Hazard Score (PHS) is associated with specific biomarkers and cognitive measures, and if it can predict the relationship between GAP-43, NFL, and cognitive decline in AD.

Method

We enrolled 646 subjects: 93 with AD, 350 with mild cognitive impairment (MCI), and 203 cognitively normal controls. Variables included GAP-43, plasma NFL, and PHS. A PHS of 0.21 or higher was considered high risk while a PHS below this threshold was considered low risk. A subsample of 190 patients with MCI with four years of follow-up cognitive assessments were selected for longitudinal analysis . We assessed the association of the PHS with AD biomarkers and cognitive measures, as well as the predictive power of PHS on cognitive decline and the conversion of MCI to AD.

Results

PHS showed high diagnostic accuracy in distinguishing AD, MCI, and controls. At each follow-up point, high risk MCI patients showed higher level of cognitive impairment compared to the low risk group. GAP-43 correlated with all follow-up cognitive tests in high risk MCI patients which was not detected in low risk MCI patients. Moreover, high risk MCI patients progressed to dementia more rapidly compared to low risk patients.

Conclusion

PHS can predict cognitive decline and impacts the relationship between neurodegenerative biomarkers and cognitive impairment in AD contiuum. Categorizing patients based on PHS can improve the prediction of cognitive outcomes and disease progression.

背景生长相关蛋白-43（GAP-43）和神经丝束光（NFL）是突触和轴突损伤的生物标志物，与阿尔茨海默病（AD）患者的认知能力下降有关。我们研究了多基因危险评分（PHS）是否与特定的生物标志物和认知指标相关，以及它是否能预测 GAP-43、NFL 和 AD 患者认知能力下降之间的关系：我们招募了 646 名受试者：93 名 AD 患者、350 名轻度认知功能障碍 (MCI) 患者和 203 名认知功能正常的对照组患者。变量包括 GAP-43、血浆 NFL 和 PHS。PHS 为 0.21 或更高被认为是高风险，而 PHS 低于此阈值被认为是低风险。我们选取了 190 名接受了四年随访认知评估的 MCI 患者作为子样本进行纵向分析。我们评估了PHS与AD生物标志物和认知指标的相关性，以及PHS对认知能力下降和MCI转为AD的预测能力。在每个随访点，与低风险组相比，高风险 MCI 患者的认知障碍程度更高。GAP-43 与高风险 MCI 患者的所有随访认知测试相关，而在低风险 MCI 患者中却检测不到。此外，与低风险患者相比，高风险 MCI 患者发展为痴呆症的速度更快。根据 PHS 对患者进行分类可以改善对认知结果和疾病进展的预测。

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引用次数: 0

Home-based care models for patients with terminal illnesses in low and middle-income countries: A systematic review of randomized and quasi-experimental studies 中低收入国家临终病人的家庭护理模式：随机和准实验研究的系统回顾

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-15 DOI: 10.1016/j.archger.2024.105580

Dalhat Khalid Sani , Umar Yunusa , Salihu Abdulrahman Kombo , Attahir Ibrahim , Hadiza Mohammed Sani , Shehu Salihu Umar , Muhammad Awwal Ladan

Background

With the increasing lifespan of people and the transition from communicable to non-communicable diseases across the globe, there is an increasing number of people with terminal illnesses requiring home-based care in Low- and Middle-Income Countries (LMICs).

Aim

This systematic review evaluated home-based care models for patients with terminal illnesses in LMICs. The primary outcomes measured are quality of life (QoL), adherence to treatment, fatigue, bimanual and related activities.

Methods

This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. Four databases; Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE (Ovid), Cochrane Library and Scopus, were systematically searched for potentially relevant studies. Screening of records (titles/abstracts from and full-texts) was done and a total of seven studies (four Randomized Control Trials [RCTs] and three quasi-experimental studies) were included in this review.

Results

Even though the included studies reported significant increase in the QoL of the studied patients, the studies have quality concerns.

Conclusion

Noting the general paucity of existing studies coupled with quality concerns across geographies in LMICs. More studies on home-based care for patients with terminal illness are needed with improved qualities and spread in these regions.

背景随着人类寿命的延长以及全球范围内传染性疾病向非传染性疾病的过渡，在中低收入国家（LMICs），越来越多的绝症患者需要居家护理。测量的主要结果包括生活质量（QoL）、治疗依从性、疲劳、双臂和相关活动。方法本综述根据系统综述和荟萃分析首选报告项目（PRISMA）建议进行。系统地检索了四个数据库：《护理及相关健康文献累积索引》（CINAHL）、MEDLINE（Ovid）、Cochrane Library 和 Scopus，以查找潜在的相关研究。结果尽管所纳入的研究报告显示患者的 QoL 显著提高，但这些研究仍存在质量问题。需要对临终病人的居家护理进行更多研究，以提高质量并在这些地区推广。

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引用次数: 0

Association between immune cells, inflammatory cytokines, and sarcopenia: Insights from a Mendelian randomization analysis 免疫细胞、炎症细胞因子与肌肉疏松症之间的关系：孟德尔随机分析的启示

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-11 DOI: 10.1016/j.archger.2024.105560

Jinqiu Zhou, Ying Liu, Jinhui Wu

Background

Recent studies have suggested a possible link between sarcopenia, immune dysregulation, and chronic inflammation, although the specific immune components implicated remain unclear. This investigation employs Mendelian Randomization (MR) to explore the reciprocal relationship between immune cells, inflammatory markers, and sarcopenia.

Method

We performed two-sample and multivariate MR analyses using publicly accessible genome-wide association studies (GWAS) summary statistics. Our analyses included 731 immune cells, 41 inflammatory cytokines, and sarcopenia related traits (appendicular lean mass [ALM], low hand-grip strength [LHS], and walking pace [WP]), with additional sensitivity analyses conducted to confirm the findings.

Results

After false discovery rate (FDR) correction, significant associations were found between ten immune traits and ALM, with the CD127 marker in the Treg panel showing consistent positive correlation across four sites. In contrast, NKT%lymphocyte negatively correlated with WP (OR = 0.99, P = 0.023). In terms of inflammatory cytokines, macrophage colony-stimulating factor (MCSF) (OR = 1.03, P = 0.024) and hepatocyte growth factor (HGF) (OR = 1.03, P = 0.002) demonstrated positive associations with ALM, while interleukin-16 (IL-16) (OR = 0.99, P = 0.006) was inversely related. The reverse Mendelian randomization analysis found no direct causal links between sarcopenia traits and immune or inflammatory markers. Sensitivity analyses underscored the findings' resilience to pleiotropy, and adjusting for inter-trait dynamics weakened these relationships in the multivariable MR analysis.

Conclusion

Our study reveals causal associations between specific immune phenotypes, inflammatory cytokines, and sarcopenia, providing insight into the development of sarcopenia and potential treatment strategies.

背景最近的研究表明，肌肉疏松症、免疫失调和慢性炎症之间可能存在联系，但其中涉及的具体免疫成分仍不清楚。本研究采用孟德尔随机化（Mendelian Randomization，MR）方法探讨免疫细胞、炎症标记物与肌肉疏松症之间的相互关系。我们的分析包括 731 个免疫细胞、41 个炎症细胞因子和肌肉疏松症相关性状（关节瘦体重[ALM]、低手握力[LHS]和步行速度[WP]），并进行了额外的敏感性分析以确认研究结果。结果经错误发现率（FDR）校正后，发现 10 个免疫性状与 ALM 之间存在显著关联，其中 Treg 面板中的 CD127 标记在四个位点上显示出一致的正相关性。相比之下，NKT%淋巴细胞与WP呈负相关（OR = 0.99，P = 0.023）。在炎性细胞因子方面，巨噬细胞集落刺激因子（MCSF）（OR = 1.03，P = 0.024）和肝细胞生长因子（HGF）（OR = 1.03，P = 0.002）与 ALM 呈正相关，而白细胞介素-16（IL-16）（OR = 0.99，P = 0.006）与 ALM 呈反相关。反向孟德尔随机分析发现，肌肉疏松症特征与免疫或炎症标记物之间没有直接因果关系。我们的研究揭示了特定免疫表型、炎症细胞因子和肌肉疏松症之间的因果关系，为肌肉疏松症的发展和潜在治疗策略提供了见解。

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引用次数: 0

Prevalence of involuntary treatment among community-living older persons with dementia: A systematic review 社区生活的老年痴呆症患者接受非自愿治疗的普遍程度：系统回顾

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-11 DOI: 10.1016/j.archger.2024.105574

Minyan Liu , Yuqiang Wang , Qinglin Zeng , Jia Li , Liping Yang , Yanli Zeng

Objective

This systematic review and meta-analysis aimed to ascertain the prevalence of involuntary treatment among community-living older persons with dementia and explore associated factors.

Methods

We comprehensively searched seven electronic databases (PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PsycINFO, and Scopus) from their inception to October 17, 2023, with an update conducted on April 1, 2024. Meta-analysis synthesized prevalence estimates of involuntary treatment and its three subcategories, with 95% confidence intervals.

Results

This study included 11 research papers involving 12,136 community-dwelling individuals with cognitive impairment and dementia from 19 countries. The pooled prevalence of involuntary treatment among community-dwelling older persons with dementia was 45.2% (95% CI: 33.7−60.5%). Subcategories included physical restraints (9.8%, 95% CI: 5.1−18.8%), psychotropic medication (19.1%, 95% CI: 13.6−26.9%), and non-consensual care (34.3%, 27.6−42.7%). Factors influencing involuntary treatment were categorized as caregiver-related and care recipient-related.

Conclusion

This study underscores the prevalent use of involuntary treatment among community-dwelling older persons with dementia, emphasizing its association with specific caregiver and care recipient factors. Addressing these findings underscores the importance of proactive measures and targeted interventions to improve the quality of care for this vulnerable population.

方法我们对七个电子数据库（PubMed、Embase、Cochrane Library、Web of Science、CINAHL、PsycINFO 和 Scopus）进行了全面检索，检索时间从开始到 2023 年 10 月 17 日，并在 2024 年 4 月 1 日进行了更新。该研究共纳入 11 篇研究论文，涉及 19 个国家的 12,136 名居住在社区的认知障碍和痴呆症患者。在社区居住的痴呆症老年人中，非自愿治疗的总体流行率为 45.2%（95% CI：33.7%-60.5%）。子类别包括身体约束（9.8%，95% CI：5.1-18.8%）、精神药物治疗（19.1%，95% CI：13.6-26.9%）和非自愿护理（34.3%，27.6-42.7%）。影响非自愿治疗的因素分为与护理者相关的因素和与受护理者相关的因素。结论这项研究强调了在社区居住的老年痴呆症患者中普遍使用非自愿治疗的情况，并强调其与特定的护理者和受护理者因素有关。针对这些发现强调了采取积极措施和有针对性的干预措施以提高对这一弱势群体的护理质量的重要性。

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引用次数: 0

Association of the combination of social isolation and living alone with cognitive impairment in community-dwelling older adults: The IRIDE Cohort Study 社会隔离和独居与社区老年人认知障碍的关系：IRIDE队列研究。

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-09 DOI: 10.1016/j.archger.2024.105571

Keigo Imamura , Hisashi Kawai , Manami Ejiri , Takumi Abe , Mari Yamashita , Hiroyuki Sasai , Shuichi Obuchi , Hiroyuki Suzuki , Yoshinori Fujiwara , Shuichi Awata , Kenji Toba , IRIDE Cohort Investigators

Background

Living alone has been associated with cognitive impairment; however, findings have been inconsistent. Social isolation among older adults who live alone may contribute to cognitive impairment. This study was carried out to examine the association of social isolation and living alone with cognitive impairment in community-dwelling older adults.

Methods

In this cross-sectional study, data from the Integrated Research Initiative for Living Well with Dementia Cohort Study, which comprises pooled data from five community-based geriatric cohorts, was used. Social isolation was defined as infrequent interactions with others. Participants were categorized into four groups based on their social isolation and living alone statuses. Cognitive function was assessed using the Mini-Mental State Examination, with a score <24 indicating cognitive impairment. The association between social isolation combined with living alone and cognitive impairment was analyzed using logistic regression.

Results

Of the 4362 participants included in the analysis (mean age 75.6 years, 44.3% male), 11% had cognitive impairment. Regardless of living alone, social isolation was associated with cognitive impairment (no social isolation x not living alone: reference, social isolation x not living alone; odds ratio (OR): 1.74, 95% confidence interval (CI): 1.29–2.33, social isolation x living alone; OR: 2.10, 95% CI: 1.46–3.01).

Conclusions

Social isolation is associated with cognitive impairment; however, living alone is not intrinsically associated with cognitive impairment in older adults. Healthcare providers must focus on social interactions to prevent cognitive impairment in older adults rather than simply focusing on living arrangements.

背景：独居与认知障碍有关，但研究结果并不一致。独居老年人的社会隔离可能会导致认知障碍。本研究旨在探讨社会隔离和独居与社区老年人认知障碍的关系：在这项横断面研究中，我们使用了 "痴呆症患者健康生活综合研究倡议队列研究"（Integrated Research Initiative for Living Well with Dementia Cohort Study）的数据。社交孤立被定义为不经常与他人交流。根据社会隔离和独居状况，参与者被分为四组。认知功能采用迷你精神状态检查（Mini-Mental State Examination）进行评估：在纳入分析的 4362 名参与者（平均年龄 75.6 岁，44.3% 为男性）中，11% 的人存在认知障碍。无论是否独居，社会隔离都与认知障碍有关（无社会隔离 x 非独居：参考值，社会隔离 x 非独居；几率比（OR）：1.74，95 % 置信区间（CI）：1.29-2.33，社会隔离 x 独居；OR：2.10，95 % CI：1.46-3.01）：结论：社会隔离与认知障碍有关，但独居与老年人认知障碍并无内在联系。医疗保健提供者必须重视社会交往，以预防老年人认知功能受损，而不是仅仅关注居住安排。

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引用次数: 0

Relationship between tooth loss and progression of frailty: Findings from the English longitudinal study of aging 牙齿脱落与衰弱进展之间的关系：英国老龄化纵向研究的发现

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-09 DOI: 10.1016/j.archger.2024.105572

Takamasa Komiyama , Jennifer E. Gallagher , Yoshinori Hattori

Objective

The objective of the present study was to investigate the relationship between indicators of oral health status (number of teeth; denture use) and the progression of frailty amongst adults in England.

Methods

The subjects were participants of the English Longitudinal Study of Aging [ELSA] aged 50 years and older. We used panel data from three waves of the study (Waves 7–9). Indicators of oral health comprised the number of teeth (≥20; 10–19; 1–9; 0) and combination of removable denture usage and the number of teeth. Frailty was assessed by the 32-item Frailty Index (FI). Covariates were age, sex, education, marital status, smoking, alcohol, and physical activity. The longitudinal relationship between oral health indicators and change in FI were investigated using linear mixed-effect models considering frailty as a time-varying variable.

Results

Among the 7,557 participants, compared to those people with 20 or more teeth, change in frailty over time was significantly higher among those with less than 20 teeth: 10–19 teeth (β: 0.249, 95 %CI: 0.116 to 0.382), and 1–9 teeth (β: 0.238, 95 %CI: 0.053 to 0.423) and being edentate (β: 0.286, 95 %CI: 0.106 to 0.465) when adjusting for co-variates. The rise in frailty over time was significantly higher among those with fewer teeth (<20 teeth), including those using dentures.

Conclusions and implications

This longitudinal analysis suggests that tooth loss is associated with accelerated progression of frailty and utilizing dentures did not reduce the trend in frailty. Thus, maintaining a functional natural dentition is important in healthy ageing.

本研究的目的是调查口腔健康状况指标（牙齿数量、义齿使用情况）与英格兰成年人体弱进展之间的关系。方法研究对象是英国老龄化纵向研究 (English Longitudinal Study of Aging [ELSA])的参与者，年龄在 50 岁及以上。我们使用了三波研究（第 7-9 波）的面板数据。口腔健康指标包括牙齿数量（≥20颗；10-19颗；1-9颗；0颗）以及活动义齿使用情况和牙齿数量的组合。虚弱程度通过 32 项虚弱指数（FI）进行评估。协变量包括年龄、性别、教育程度、婚姻状况、吸烟、酗酒和体育锻炼。使用线性混合效应模型研究了口腔健康指标与 FI 变化之间的纵向关系，并将虚弱程度视为时变变量。结果在 7557 名参与者中，与拥有 20 颗或 20 颗以上牙齿的人相比，牙齿少于 20 颗的人随着时间的推移体弱程度的变化明显更高：10-19 颗牙齿（β：0.249，95 %CI：0.116-0.382）、1-9 颗牙齿（β：0.238，95 %CI：0.053-0.423）和无牙齿（β：0.286，95 %CI：0.106-0.465）。随着时间的推移，牙齿较少（<20 颗牙齿）的人，包括使用假牙的人，体弱程度的上升幅度明显更高。结论和启示这项纵向分析表明，牙齿脱落与体弱程度的加速发展有关，而使用假牙并不能降低体弱的趋势。因此，保持功能性自然牙列对健康老龄化非常重要。

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引用次数: 0

Systematic Review on attitudes towards death and dying in adults 50 years and older living in countries with community transmission of COVID -19. 关于生活在 COVID -19 社区传播国家的 50 岁及以上成年人对死亡和濒死的态度的系统性综述。

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-07 DOI: 10.1016/j.archger.2024.105573

Alana Officer , Sophie Pautex , Andreea Badache , Barbara Broers , Matthew Prina

Background

The COVID-19 pandemic has underscored older adults’ vulnerability to severe illness or death. Increased public awareness of mortality, with daily reminders of preventive measures, spurred interest in understanding the impact on death-related thoughts. This systematic review analyses existing literature on death attitudes among individuals aged 50 and older during the COVID-19 pandemic and focuses on associated factors.

Methods

A systematic literature search was conducted using the WHO COVID database without any language limit, up until April 2023. The review protocol was registered in PROSPERO and PRISMA guidelines were followed. Included studies were systematically analysed and summarized using a predefined data extraction sheet.

Results

Of the 2297 studies identified, 9 met inclusion criteria. The review showed moderate to high levels of death anxiety during the pandemic, linked to direct health risks from COVID-19 rather than mitigation measures. The impact of health and personal factors on older people's death anxiety was complex, with a range of health and personal factors such as chronic conditions, loss of capacity, loneliness, occupation, and resilience associated with it, suggesting potential intervention avenues.

Conclusion

The systematic review shows a significant link between COVID-19 and heightened death anxiety among individuals aged 50 and above. Negative attitudes to death can harm physical and mental health, diminish life satisfaction, increase avoidance behaviour, impair coping mechanism and undermine end-of-life decision making. Findings underscore the need for further research into risk and protective factors (personal, health, and environmental) and the importance of standardized data collection to guide interventions and public health strategies aimed at mitigating death anxiety.

背景 COVID-19 大流行突显了老年人易患重病或死亡。公众对死亡的认识有所提高，每天都会提醒他们采取预防措施，这激发了人们对了解死亡相关想法的影响的兴趣。本系统综述分析了 COVID-19 大流行期间 50 岁及以上人群死亡态度的现有文献，并重点关注相关因素。综述方案已在 PROSPERO 中注册，并遵循了 PRISMA 指南。结果在确定的 2297 项研究中，有 9 项符合纳入标准。综述显示，大流行期间的死亡焦虑程度为中度到高度，与 COVID-19 带来的直接健康风险而非缓解措施有关。健康和个人因素对老年人死亡焦虑的影响是复杂的，一系列健康和个人因素，如慢性病、能力丧失、孤独、职业和复原力都与死亡焦虑有关，这表明有可能采取干预措施。对死亡的消极态度会损害身心健康、降低生活满意度、增加逃避行为、损害应对机制并破坏临终决策。研究结果强调了进一步研究风险和保护因素（个人、健康和环境因素）的必要性，以及标准化数据收集对指导旨在减轻死亡焦虑的干预措施和公共卫生策略的重要性。

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引用次数: 0

Can an active lifestyle offset the relationship that poor lifestyle behaviours have on frailty? 积极的生活方式能否抵消不良生活行为对体弱的影响？

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-06 DOI: 10.1016/j.archger.2024.105556

A. Mayo , M.W. O'Brien , J. Godin , D.S. Kehler , D.S. Kimmerly , O. Theou

Objective

To examine the association of lifestyle behaviours (LSB) with physical activity (PA) and frailty; also, to examine if associations differ by sex and age.

Methods

24,828 individuals [49.6 ± 17.6 years (range: 20–85), 51.6 % female] from the National Health and Nutrition Examination Survey (cycles 2009–2018) were included. Individuals were divided into Active (≥150 min/week of moderate-to-vigorous physical activity (MVPA)) and Inactive (<150 min/week MVPA) based on self-reported PA. Frailty was measured by a 46-item Frailty Index (FI). LSB consisted of stationary time, sleep, diet quality, and alcohol and smoking habits. LSB was summed into a score [0–5]. Linear regression models were used with each LSB in isolation and the summed LSB with frailty.

Results

There were 7,495 (30.1 %) Active and 17,333 (69.8 %) Inactive individuals. The FI was lower in the Active participants (Active: 0.10 ± 0.08; Inactive: 0.15 ± 0.12; p < 0.01). A worse LSB score was associated with an increased FI in all behaviours but females who binge drink and smoke (p-all>0.14). For inactive individuals, all LSBs were associated with an increased FI except those who binge drink and male smokers (p = 0.08). There was a significant association between increased summed LSB and an increased FI (β range: Active, 0.024–0.037; Inactive, 0.028, 0.046. p-all<0.01); the Active group had a lower FI at every age group than the Inactive group (p < 0.001).

Conclusion

PA was associated with a lower FI even among those with a poor LSB score. This association is dependent on age, with older individuals reporting a stronger association.

目的研究生活方式行为（LSB）与体力活动（PA）和虚弱之间的关系；同时研究不同性别和年龄之间的关系是否存在差异。方法纳入了全国健康与营养调查（2009-2018 年）中的 24 828 名个体[49.6 ± 17.6 岁（范围：20-85），51.6% 为女性]。根据自我报告的体力活动情况，研究对象被分为活跃型（每周中强度体力活动（MVPA）≥150 分钟）和不活跃型（每周中强度体力活动（MVPA）<150 分钟）。虚弱程度通过 46 项虚弱指数（FI）进行测量。LSB包括静止时间、睡眠、饮食质量、饮酒和吸烟习惯。LSB 总分为[0-5]分。使用线性回归模型对每项 LSB 进行单独计算，并将 LSB 总分与虚弱程度进行比较。结果共有 7,495 人（30.1%）处于活跃期，17,333 人（69.8%）处于非活跃期。活跃期参与者的 FI 较低（活跃期：0.10 ± 0.08；非活跃期：0.15 ± 0.12；p < 0.01）。在所有行为中，LSB得分越低，FI越高，但酗酒和吸烟的女性除外（p-all>0.14）。对于非活跃人群，除酗酒者和男性吸烟者外，所有 LSB 均与 FI 的增加相关（p = 0.08）。LSB总和的增加与FI的增加之间存在明显的关联（β范围：活跃组，0.024-0.037；不活跃组，0.028，0.046。p-all<0.01）；活跃组在每个年龄组的FI都低于不活跃组（p<0.001）。这种关联取决于年龄，年龄越大关联越强。

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引用次数: 0

Feasibility and effectiveness of a 6-month, home-based, resistance exercise delivered by a remote technological solution in healthy older adults 通过远程技术解决方案为健康老年人提供为期 6 个月的家庭阻力训练的可行性和有效性

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-05 DOI: 10.1016/j.archger.2024.105559

Luca Ferrari , Gianluca Bochicchio , Alberto Bottari , Alessandra Scarton , Valentina Cavedon , Chiara Milanese , Francesco Lucertini , Silvia Pogliaghi

Background

Aging is characterized by a physiological decline in physical function, muscle mass, strength, and power. Home-based resistance training interventions have gained increasing attention from scientists and healthcare system operators, but their efficacy is yet to be fully determined.

Aims

to verify the safety, feasibility, and efficacy of a home-based resistance training program delivered by innovative technological solution in healthy older adults.

Methods

73 participants (36 females) were randomly allocated to either a control (C) or an intervention (I) group consisting of a 6-months home-based resistance training program delivered through an innovative technological solution, which included a wearable inertial sensor and a dedicated tablet. The safety and feasibility of the intervention were assessed by recording training-related adverse events and training adherence. Body composition, standing static balance, 10-meter walking, and loaded 5 sit-to-stand tests were monitored to quantify efficacy.

Results

No adverse events were recorded. Adherence to the training program was relatively high (61 % of participants performed the target 3 sessions) in the first trimester, significantly dropping during the second one. The intervention positively affected walking parameters (p < 0.05) and maximal force (p = 0.009) while no effect was recorded on body composition, balance, and muscle power.

Conclusions

The home-based device-supported intervention was safe and feasible, positively affecting walking parameters and lower limbs' maximal force. This approach should be incentivized when barriers to participation in traditional resistance exercise programs are present.

背景衰老的特征是身体机能、肌肉质量、力量和功率的生理性下降。方法将 73 名参与者（36 名女性）随机分配到对照组（C）或干预组（I），对照组通过创新技术解决方案（包括可穿戴惯性传感器和专用平板电脑）进行为期 6 个月的家庭阻力训练。通过记录与训练相关的不良事件和训练坚持情况，对干预的安全性和可行性进行评估。通过监测身体成分、站立静态平衡、10米步行和5次坐立测试来量化疗效。在前三个月，训练计划的坚持率相对较高（61%的参与者完成了目标的3次训练），但在后三个月明显下降。干预对步行参数（p < 0.05）和最大力量（p = 0.009）有积极影响，而对身体成分、平衡和肌肉力量没有影响。如果参加传统阻力运动项目存在障碍，应鼓励采用这种方法。

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引用次数: 0

Effects of bottom-up versus top-down digital cognitive training in older adults: A randomized controlled trial 自下而上与自上而下数字认知训练对老年人的影响：随机对照试验

IF 3.5 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2024-07-02 DOI: 10.1016/j.archger.2024.105552

Erica Woodruff , Bruno Costa Poltronieri , Luisa Pedrosa de Albuquerque Sousa , Yasmin Guedes de Oliveira , Marcos Alexandre Reis , Linda Scoriels , Rogério Panizzutti

Introduction

Impairments in bottom-up perceptual processing have been associated to the age-related cognitive decline. Digital cognitive training focusing on bottom-up and/or top-down processes have been studied as a tool to remediate age-related cognitive decline. However, the most effective training type and order of application remain unclear.

Methods

One hundred and fifteen older adults were randomly assigned to 40 h of bottom-up then top-down or top-down then bottom-up digital cognitive training or an active control group. We evaluated cognition at baseline, after 20 h and 40 h of training and at follow-up using a mixed-model analysis.

Results

Global cognition improved, for the top-down group, after 20 h of training (p = 0.04; d = 0.7) and for all three groups after 40 h. The improvement in global cognition remained five months after the bottom-up/ top-down training (p = 0.009; d = 4.0). There were also improvements in the recall cognitive domain, after 20 h of training, for the bottom-up group and, after 40 h, for all three groups. Gains were observed in verbal fluency after 40 h of training for both therapeutic groups. Processing speed was significantly slower, after 20 h of training, for the control and bottom-up groups and, after 40 h, only for the control group. Emotion recognition improved, after 20 h, for the control group as compared to the therapeutic groups.

Conclusions

These results indicate that the bottom-up/top-down training has the most endurable effects, which reveals the importance of the order of application of the exercises for gains in cognition in older adults.

简介自下而上的感知处理能力受损与年龄相关的认知能力下降有关。研究发现，数字认知训练侧重于自下而上和/或自上而下的过程，可作为缓解老年性认知衰退的一种工具。然而，最有效的训练类型和应用顺序仍不明确：方法：115 名老年人被随机分配到先自下而上后自上而下或先自上而下后自下而上的数字认知训练组或积极对照组，每组 40 小时。我们采用混合模型分析法对基线、20 小时和 40 小时训练后以及随访时的认知能力进行了评估：自下而上组的整体认知能力在训练 20 小时后有所改善（p = 0.04；d = 0.7），所有三组的整体认知能力在训练 40 小时后均有所改善。在回忆认知领域，自下而上组在训练 20 小时后有所改善，而在 40 小时后，所有三个组都有所改善。在训练 40 小时后，两个治疗组的语言流畅性都有提高。训练 20 小时后，对照组和自下而上组的处理速度明显减慢，40 小时后，只有对照组的处理速度明显减慢。与治疗组相比，对照组的情绪识别能力在 20 小时后有所提高：这些结果表明，自下而上/自上而下的训练具有最持久的效果，这揭示了练习的应用顺序对于提高老年人认知能力的重要性。

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引用次数: 0