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

Ageism and the feminization of old age: A Systematic review 年龄歧视与老年女性化：系统回顾。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-02-01 Epub Date: 2025-11-14 DOI: 10.1016/j.archger.2025.106084

Juan Robles Costa , Angélica Quintero-Flórez , Emilio García-Cabrera , Julia Romero-Barranca , Ángel Vilches-Arenas

Background

Increases in life expectancy and declining birth rates have intensified the demographic weight of older adults, particularly women. This population frequently faces intersecting age and gender-based discrimination, resulting in greater health burdens and lower quality of life compared to men.

Objective

To examine gender-based disparities affecting older adults, particularly older women, intending to uncover underlying mechanisms and contribute to the formulation of more equitable, gender-responsive, and age-sensitive public health policies.

Study design

This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD420251104219).

Methods

Six databases were searched (2014–2024) for studies in English or Spanish on gender- and age-based health inequalities in older adults. Eligible systematic reviews, observational, and experimental studies were quality-assessed (PRISMA, STROBE, CONSORT), and findings were synthesized qualitatively.

Results

Fourteen studies met the inclusion criteria. Across contexts, older women consistently exhibited higher prevalence of disability, frailty, depression, and poorer self-rated health, frequently linked to lower educational attainment and income. In contrast, older men showed lower prevalence of these conditions but faced higher mortality risks from frailty and suicide. Men also tended to report better subjective quality of life.

Conclusions

While women live longer, they often experience greater illness and functional limitations. Socioeconomic disadvantages explain part of these gaps, but a considerable proportion remains unexplained. These findings highlight the urgent need for gender- and age-sensitive public health strategies to reduce inequities in later life.

背景：预期寿命的延长和出生率的下降加剧了老年人，特别是妇女的人口比重。这一人口经常面临年龄和性别的交叉歧视，与男子相比，造成更大的健康负担和更低的生活质量。目的：研究影响老年人，特别是老年妇女的性别差异，旨在揭示潜在机制，并有助于制定更公平、对性别问题敏感和对年龄敏感的公共卫生政策。研究设计：本系统评价遵循PRISMA指南，在PROSPERO注册（CRD420251104219）。方法：检索了6个数据库（2014-2024年），检索了英语或西班牙语关于老年人基于性别和年龄的健康不平等的研究。对合格的系统评价、观察性和实验性研究进行质量评估（PRISMA、STROBE、CONSORT），并对研究结果进行定性综合。结果：14项研究符合纳入标准。在各种情况下，老年妇女始终表现出更高的残疾、虚弱、抑郁和较差的自我评价健康，这往往与较低的教育程度和收入有关。相比之下，老年男性的患病率较低，但因身体虚弱和自杀而面临更高的死亡风险。男性也倾向于报告更好的主观生活质量。结论：虽然女性寿命更长，但她们往往会经历更大的疾病和功能限制。社会经济劣势解释了这些差距的一部分，但仍有相当大一部分无法解释。这些发现突出表明，迫切需要制定对性别和年龄敏感的公共卫生战略，以减少晚年生活中的不平等现象。

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引用次数: 0

Effectiveness of Home-Based interventions for older adults with frailty or pre-frailty: a systematic review and meta-analysis 以家庭为基础的干预措施对虚弱或虚弱前期老年人的有效性：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 : 2026-02-01 Epub Date: 2025-11-10 DOI: 10.1016/j.archger.2025.106083

Gengxin Yao , Fei Li , Xuehan Ma , Xinyu Wan , Yali Yang , Yiran Xu , Lishuang Zheng , Guichen Li , Li Chen

Aim

To systematically summarise the characteristics and effectiveness of home-based interventions on health outcomes in older adults with frailty or pre-frailty.

Design

Systematic review and meta-analysis.

Methods

Seven databases were searched from their inception through 31st October 2024. Two reviewers independently performed study screening, selection, data extraction, and quality appraisal. Pooled effects were quantified using standardised mean differences (SMDs) with 95 % confidence intervals (CIs). Risk of bias and evidence certainty were assessed using RoB2 and GRADE, respectively.

Results

Twenty-four studies (20 RCTs; n = 3, 826 participants) were included. The meta-analysis demonstrated that home-based interventions significantly reduced frailty phenotype scores (SMD = -0.27, 95 % CI:0.39 to -0.15) and depressive symptoms (SMD = -0.11, 95 % CI:0.20 to -0.01), alongside marked increases in grip strength (MD = 0.84, 95 % CI: 0.26 to 1.42) and mental health-related quality of life (SMD = 0.17, 95 % CI: 0.04 to 0.30). Subgroup analyses indicated that significant improvements in physical function were observed only in supervised subgroup. No significant changes were observed for overall quality of life, or physical health-related quality of life.

Conclusions

Home-based interventions are a valuable strategy for improving frailty, grip strength, and mental health outcomes in older adults with frailty or pre-frailty. Improvements in physical function appear to depend on home-based interventions delivered under professional supervision, while the unsupervised mode may pose the risk of potential iatrogenic harm and therefore necessitates caution alongside safety monitoring.

Reporting Method

This review followed PRISMA guidelines (PROSPERO: CRD42024604527).

目的：系统地总结以家庭为基础的干预措施对虚弱或虚弱前期老年人健康结果的特点和有效性。设计：系统回顾和荟萃分析。方法：检索自建库至2024年10月31日的7个数据库。两名审稿人独立进行研究筛选、选择、数据提取和质量评估。采用95%置信区间（ci）的标准化平均差异（SMDs）对合并效应进行量化。分别用RoB2和GRADE评估偏倚风险和证据确定性。结果：共纳入24项研究（20项随机对照试验，n = 3826名受试者）。荟萃分析表明，以家庭为基础的干预显著降低了脆弱表型评分（SMD = -0.27, 95% CI:0.39至-0.15）和抑郁症状（SMD = -0.11, 95% CI:0.20至-0.01），同时握力（MD = 0.84, 95% CI: 0.26至1.42）和精神健康相关生活质量（SMD = 0.17, 95% CI: 0.04至0.30）显著增加。亚组分析表明，仅在监督亚组中观察到身体功能的显著改善。总体生活质量或与身体健康相关的生活质量未观察到显著变化。结论：以家庭为基础的干预措施是一种有价值的策略，可以改善虚弱或虚弱前期老年人的虚弱、握力和心理健康结果。身体功能的改善似乎取决于在专业监督下提供的以家庭为基础的干预措施，而无监督模式可能造成潜在的医源性危害，因此需要在安全监测的同时谨慎行事。报告方法：本综述遵循PRISMA指南（PROSPERO: CRD42024604527）。

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引用次数: 0

Association between changes in social isolation status and frailty among older adults 老年人社会孤立状况的变化与虚弱之间的关系。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-02-01 Epub Date: 2025-11-05 DOI: 10.1016/j.archger.2025.106080

Cho Rong Kim , Jisu Ko , Min Jin Ha , Kui Son Choi , Eun-Cheol Park

Introduction

Considering social isolation in approaches to frailty is important for the early detection of health problems in older adults and the development of appropriate intervention strategies. This study aims to investigate the relationship between changes in social isolation and frailty using the data the Korea Longitudinal Study of Aging (2006–2022).

Methods

A longitudinal study was conducted with 17,932 adults aged ≥65 years. Frailty was assessed using the frailty index, changes in social isolation were categorized into four groups. Associations between changes in social isolation and frailty were examined using generalized estimating equations with logistic regression to account for repeated measures and within-subject correlations.

Results

Compared to participants who remained non-isolated, those whose social isolation status changed from a non-isolated to isolated state had 3.47 times higher odds of frailty (95 % confidence interval [CI]: 3.03–3.96), and those in a consistently isolated state had 3.18 times higher odds (95 % CI: 2.80–3.62). Analysis by frailty type indicated that the transition from non-isolated to isolated status exhibited a stronger association with psychological frailty (odds ratio [OR] 4.38, 95 % CI 4.36–4.39) than physical frailty, and the highest increase was observed in the likelihood of exhibiting both physical and psychological frailty (OR 6.81, 95 % CI 6.77–6.84).

Conclusions

The transition to an isolated state was associated with frailty among older adults. These findings emphasize the need for early identification and active interventions to address social isolation to prevent frailty among older adults.

导言：在处理衰弱问题时考虑到社会孤立对于早期发现老年人的健康问题和制定适当的干预策略很重要。本研究旨在利用韩国老龄化纵向研究（2006-2022）的数据，探讨社会孤立的变化与脆弱性之间的关系。方法：对17932名年龄≥65岁的成年人进行纵向研究。脆弱性是用脆弱性指数来评估的，社会孤立的变化被分为四组。使用广义估计方程和逻辑回归来检验社会隔离变化与脆弱性之间的关联，以解释重复测量和受试者内部相关性。结果：与未隔离的参与者相比，社会隔离状态从非隔离状态变为隔离状态的参与者虚弱的几率高3.47倍（95%置信区间[CI]: 3.03-3.96），持续隔离状态的参与者虚弱的几率高3.18倍（95% CI: 2.80-3.62）。虚弱类型分析表明，与身体虚弱相比，从非孤立状态到孤立状态的转变与心理虚弱的关联更强（比值比[OR] 4.38, 95% CI 4.36-4.39），并且观察到表现出身体和心理虚弱的可能性的最高增加（比值比[OR] 6.81, 95% CI 6.77-6.84）。结论：老年人向孤立状态的转变与虚弱有关。这些发现强调需要及早发现并采取积极干预措施，解决社会孤立问题，以防止老年人虚弱。

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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 : 2026-02-01 Epub 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。

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引用次数: 0

Engagement in cognitive activities and risk of loneliness: A longitudinal study among Japanese older adults 参与认知活动与孤独风险：日本老年人的一项纵向研究

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-02-01 Epub Date: 2025-10-25 DOI: 10.1016/j.archger.2025.106061

Fumio Sakimoto , Takehiko Doi , Sho Nakakubo , Soichiro Matsuda , Hiroyuki Shimada

Background

Loneliness is a growing public health concern due to its association with adverse health outcomes in older adults. Research on the relationship between participation in cognitive activities and the alleviation of loneliness remains limited. This study examined longitudinal associations between engagement in cognitive activities and the onset of loneliness among community-dwelling older adults in Japan.

Methods

The prospective cohort initially included 5563 older adults. After excluding participants with baseline loneliness or missing data, 2317 participants (mean age 73.5 ± 5.4 years; 58.1 % women) were analyzed and followed for 36.7 ± 2.3 months. Loneliness was assessed using the UCLA Loneliness Scale. Six cognitive activities were evaluated: reading, keeping a diary, solving crossword puzzles, playing board games, participating in group discussions, and playing musical instruments. Logistic regression, adjusted for demographic, lifestyle, health, and cognitive covariates, examined associations of individual activities and total activity frequency with the onset of loneliness.

Results

During follow-up, 574 participants (24.8 %) developed loneliness. Reading (OR = 0.61, 95 % CI = 0.41–0.91, p = .01) and participating in group discussions (OR = 0.63, 95 % CI = 0.51–0.77, p < .001) were significantly associated with a reduced risk of loneliness. Frequent engagement in other cognitive activities was not associated with lower loneliness.

Conclusions and implications

Engagement in specific cognitive activities was associated with lower odds of loneliness. These findings suggest that it may be important to consider not only the frequency of cognitive activities but also their specific characteristics and qualities.

孤独感与老年人的不良健康结果相关，已成为一个日益严重的公共卫生问题。参与认知活动与减轻孤独感之间的关系研究仍然有限。本研究调查了日本社区居住的老年人参与认知活动和孤独感之间的纵向联系。前瞻性队列研究最初包括5563名老年人。在排除基线孤独或缺失数据的参与者后，对2317名参与者（平均年龄73.5±5.4岁，58.1%为女性）进行了分析，随访36.7±2.3个月。孤独感采用加州大学洛杉矶分校孤独感量表进行评估。研究人员评估了六项认知活动：阅读、写日记、填字游戏、玩棋盘游戏、参加小组讨论和演奏乐器。经人口统计学、生活方式、健康和认知协变量调整后，Logistic回归检验了个体活动和总活动频率与孤独感发生的关系。结果随访期间，574名参与者（24.8%）出现孤独感。阅读（OR = 0.61, 95% CI = 0.41-0.91, p = 0.01）和参与小组讨论（OR = 0.63, 95% CI = 0.51-0.77, p < 0.001）与降低孤独感风险显著相关。频繁参与其他认知活动与孤独感的降低无关。结论和启示参与特定的认知活动与较低的孤独感相关。这些发现表明，不仅要考虑认知活动的频率，还要考虑它们的具体特征和质量，这一点可能很重要。

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引用次数: 0

Heterogeneity in the associations of community gathering place participation with healthy ageing 社区聚会场所参与与健康老龄化关系的异质性。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-02-01 Epub Date: 2025-10-25 DOI: 10.1016/j.archger.2025.106060

Kazushige Ide , Kenjiro Kawaguchi , Ryota Watanabe , Aki Shibata , Kiyomi Matsumura , Taishi Tsuji , Katsunori Kondo , Atsushi Nakagomi

Background

Extending healthy life expectancy is a critical policy priority in aging societies worldwide. In Japan, community gathering places (CGPs) for older adults, which are resident-led group activities conducted in accessible local spaces. While prior studies have suggested benefits of CGPs participation, most evidence is limited to single municipalities. The potential heterogeneity in benefits across sociodemographic subgroups remains unclear.

Methods

We analyzed data from 55,982 community-dwelling older adults aged 65 years or older across 21 municipalities participating in the Japan Gerontological Evaluation Study. We linked pre-baseline data from 2016, baseline data from 2019, and follow-up data from 2019 to 2022. Our outcome was loss of healthy life expectancy, defined as incident functional disability or death. Our exposure was CGPs participation. Logistic regression models estimated odds ratios, adjusting for pre-exposure covariates. We applied a moderator-wide approach to assess effect modification by sociodemographic characteristics.

Results

Participation in CGPs was associated with lower odds of the incidence functional disability or death (OR, 0.88; 95 % CI, 0.79–0.98). Stratified analyses suggested stronger associations in subgroups including women, older adults (≥75), individuals with lower education or income, unemployed, living alone and rural residents. However, formal tests did not detect statistically significant effect modification.

Conclusion

Participation in CGPs may promote healthy aging across diverse older populations. These findings support CGPs as an equitable and scalable strategy for improving population health. Future research should involve longer follow-up periods and explore more dimensions of heterogeneity.

背景：延长健康预期寿命是全球老龄化社会的一项关键政策重点。在日本，老年人的社区聚会场所（CGPs）是居民主导的团体活动，在当地可访问的空间进行。虽然先前的研究表明了社区医生参与的好处，但大多数证据仅限于单个城市。在不同的社会人口亚组中获益的潜在异质性仍不清楚。方法：我们分析了参与日本老年学评估研究的21个城市的55,982名65岁或以上的社区老年人的数据。我们将2016年的基线前数据、2019年的基线数据和2019年至2022年的随访数据联系起来。我们的结果是健康预期寿命的丧失，定义为偶发性功能性残疾或死亡。我们的曝光是cgp的参与。逻辑回归模型估计了风险比，调整了暴露前的协变量。我们采用了一种调节因子范围的方法来评估社会人口统计学特征对效果的影响。结果：参与cgp与较低的功能性残疾或死亡发生率相关（or, 0.88; 95% CI, 0.79-0.98）。分层分析表明，妇女、老年人（≥75岁）、教育程度或收入较低的个体、失业、独居和农村居民等亚组的相关性更强。然而，正式测试没有检测到统计学上显著的影响修饰。结论：参与cgp可促进不同年龄人群的健康老龄化。这些研究结果支持cgp作为一种公平和可扩展的改善人口健康战略。未来的研究应该包括更长的随访期，探索更多的异质性维度。

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引用次数: 0

Nutritional status and frailty in rheumatoid arthritis: A multicenter observational study (T-FLAG) 类风湿性关节炎的营养状况和虚弱：一项多中心观察性研究（T-FLAG）。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-02-01 Epub Date: 2025-11-02 DOI: 10.1016/j.archger.2025.106073

Mochihito Suzuki , Shuji Asai , Yoshifumi Ohashi , Yasumori Sobue , Kenya Terabe , Shiro Imagama

Objective

Frailty is a relevant clinical issue in rheumatoid arthritis (RA) patients, particularly as the population ages. Malnutrition, decreased physical function, and a loss of social connections are key contributors to frailty. This study aimed to investigate the association of nutritional status with frailty in RA patients, with a focus on physical function and social frailty.

Methods

This cross-sectional study examined RA patients from a multicenter cohort at three hospitals. Nutritional status was assessed using the Geriatric Nutritional Risk Index (GNRI). Frailty was defined using the Kihon Checklist, physical function using the Health Assessment Questionnaire Disability Index (HAQ-DI), and social frailty using the Makizako Social Frailty Index. Multivariate logistic regression was performed to identify independent associations with frailty.

Results

A total of 667 patients were included (median age, 72 years; 73 % women). Frailty prevalence increased progressively with worsening nutritional status (GNRI), from 29.6 % in the no risk group to 66.7 % in the major risk group (P < 0.001). In multivariate models, GNRI and social frailty were significantly associated with frailty. This association, however, was no longer significant after adjusting for HAQ-DI, suggesting that physical function may influence this relationship. Stratified analysis confirmed that poor nutritional status was associated with increased frailty prevalence even among patients in HAQ remission (HAQ-DI ≤0.5).

Conclusion

Nutritional status is associated with frailty in RA patients, and this association may be influenced by physical function. A multidimensional approach addressing nutrition, physical function, and social factors is warranted in RA management.

目的：虚弱是类风湿性关节炎（RA）患者的一个相关临床问题，特别是随着人口老龄化。营养不良、身体机能下降和失去社会联系是导致身体虚弱的主要因素。本研究旨在探讨RA患者的营养状况与虚弱的关系，重点关注身体功能和社交虚弱。方法：本横断面研究调查了来自三家医院的多中心队列RA患者。采用老年营养风险指数（GNRI）评估营养状况。虚弱用Kihon检查表定义，身体功能用健康评估问卷残疾指数（HAQ-DI）定义，社会虚弱用Makizako社会虚弱指数定义。进行多变量逻辑回归以确定与虚弱的独立关联。结果：共纳入667例患者（中位年龄72岁，73%为女性）。随着营养状况（GNRI）的恶化，虚弱患病率逐渐增加，从无危险组的29.6%增加到主要危险组的66.7% （P < 0.001）。在多元模型中，GNRI和社会脆弱性与脆弱性显著相关。然而，在调整HAQ-DI后，这种关联不再显著，这表明身体功能可能影响这种关系。分层分析证实，即使在HAQ缓解（HAQ- di≤0.5）的患者中，营养状况不良也与虚弱患病率增加有关。结论：RA患者的营养状况与虚弱相关，这种关联可能受身体功能的影响。在类风湿性关节炎的管理中，需要从营养、身体功能和社会因素三个方面入手。

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引用次数: 0

Association between obesity and the transitions of frailty based on multi-state Markov model: A prospective study 基于多态马尔可夫模型的肥胖与虚弱转变的关联：一项前瞻性研究。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-02-01 Epub Date: 2025-11-02 DOI: 10.1016/j.archger.2025.106074

Bosen Lv , Xiaohui Li , Qianning Lu , Xiangjie Kong , Bixuan Liu , Yan Wu , Liying Jing , Jingyi Wang , Wenjing Feng , Yili Wu

Background

New evidence has revealed the dynamic transition characteristics of frailty. However, the potential differences in the effects of different types of obesity on the transition of frailty remain unclear. This prospective study aims to assess the association between obesity-related indicators and frailty transition in older adults.

Methods

This study included 2375 individuals aged ≥60, excluding underweight ones from the English Longitudinal Study of Aging (ELSA) 2008–2016. Frailty was assessed via a 60-item frailty index. Obesity was rated by 4 indicators including body mass index (BMI), waist circumference (WC), conicity index, and body roundness index (BRI). Using multi-state Markov model to evaluate how the obesity affected the probability of frailty state transitions.

Results

During 8 years follow-up, 2517 frailty transitions were observed, with 1484 worsening and 1033 improving. Compared with normal participants, people with obesity were linked to higher risks of deterioration (non-frail to pre-frail: HR_BMI=1.32, 95 % CI=1.07–1.63, HR_WC=1.16, 95 % CI=1.00–1.35; pre-frail to frail: HR_BMI=1.90, CI=1.30–2.78; HR_WC=1.36, 95 % CI=1.03–1.81) and reduced likelihood of recovery (pre-frail to non-frail: HR_BMI=0.52, CI=0.40–0.67, HR_WC=0.66, CI=0.55–0.80). Compared with the low tertiles, the high tertiles of conicity index or BRI similarly accelerated the deterioration (non-frail to pre-frail: HR_{conicity index}=1.29, 95 % CI=1.04–1.59, HR_BRI=1.45, 95 % CI=1.20–1.76; pre-frail to frail: HR_BRI=1.58, 95 % CI=1.13–2.20) and hindered the recovery (pre-frail to non-frail: HR_{conicity index}=0.67, 95 % CI=0.53–0.84, HR_BRI=0.57, 95 % CI=0.46–0.72).

Conclusions

Different types of obesity all show that they accelerate the deterioration of frailty and hinder their ability to recover from frailty among older adults in UK.

背景：新的证据揭示了脆弱性的动态转变特征。然而，不同类型的肥胖对虚弱转变的影响的潜在差异仍不清楚。本前瞻性研究旨在评估老年人肥胖相关指标与虚弱转变之间的关系。方法：本研究纳入2375名年龄≥60岁的个体，不包括2008-2016年英国老龄化纵向研究（ELSA）中体重过轻的个体。虚弱程度通过60项虚弱指数进行评估。采用体重指数（BMI）、腰围指数（WC）、圆度指数（conicity index）、体圆度指数（BRI） 4项指标评价肥胖程度。利用多态马尔可夫模型评价肥胖对脆弱状态转变概率的影响。结果：在8年的随访中，观察到2517例虚弱转变，其中1484例恶化，1033例改善。与正常参与者相比，肥胖的人有更高的恶化风险（非体弱到体弱前期：HRBMI=1.32, 95% CI=1.07-1.63， HRWC=1.16, 95% CI=1.00-1.35；体弱前期到体弱：HRBMI=1.90， CI=1.30-2.78； HRWC=1.36, 95% CI=1.03-1.81）和更低的恢复可能性（体弱前期到体弱：HRBMI=0.52， CI=0.40-0.67， HRWC=0.66， CI=0.55-0.80）。与低三分位相比，高三分位或BRI同样加速了恶化（非虚弱到前期虚弱：HRconicity指数=1.29,95% CI=1.04 ~ 1.59， HRBRI=1.45, 95% CI=1.20 ~ 1.76；前期虚弱到前期虚弱：HRBRI=1.58, 95% CI=1.13 ~ 2.20），阻碍了恢复（前期虚弱到非虚弱：HRconicity指数=0.67,95% CI=0.53 ~ 0.84， HRBRI=0.57, 95% CI=0.46 ~ 0.72）。结论：在英国的老年人中，不同类型的肥胖都表明它们加速了虚弱的恶化，阻碍了他们从虚弱中恢复的能力。

{"title":"Association between obesity and the transitions of frailty based on multi-state Markov model: A prospective study","authors":"Bosen Lv , Xiaohui Li , Qianning Lu , Xiangjie Kong , Bixuan Liu , Yan Wu , Liying Jing , Jingyi Wang , Wenjing Feng , Yili Wu","doi":"10.1016/j.archger.2025.106074","DOIUrl":"10.1016/j.archger.2025.106074","url":null,"abstract":"<div><h3>Background</h3><div>New evidence has revealed the dynamic transition characteristics of frailty. However, the potential differences in the effects of different types of obesity on the transition of frailty remain unclear. This prospective study aims to assess the association between obesity-related indicators and frailty transition in older adults.</div></div><div><h3>Methods</h3><div>This study included 2375 individuals aged ≥60, excluding underweight ones from the English Longitudinal Study of Aging (ELSA) 2008–2016. Frailty was assessed via a 60-item frailty index. Obesity was rated by 4 indicators including body mass index (BMI), waist circumference (WC), conicity index, and body roundness index (BRI). Using multi-state Markov model to evaluate how the obesity affected the probability of frailty state transitions.</div></div><div><h3>Results</h3><div>During 8 years follow-up, 2517 frailty transitions were observed, with 1484 worsening and 1033 improving. Compared with normal participants, people with obesity were linked to higher risks of deterioration (non-frail to pre-frail: <em>HR</em><sub>BMI</sub>=1.32, 95 % <em>CI</em>=1.07–1.63, <em>HR</em><sub>WC</sub>=1.16, 95 % <em>CI</em>=1.00–1.35; pre-frail to frail: <em>HR</em><sub>BMI</sub>=1.90, <em>CI</em>=1.30–2.78; <em>HR</em><sub>WC</sub>=1.36, 95 % <em>CI</em>=1.03–1.81) and reduced likelihood of recovery (pre-frail to non-frail: <em>HR</em><sub>BMI</sub>=0.52, <em>CI</em>=0.40–0.67, <em>HR</em><sub>WC</sub>=0.66, <em>CI</em>=0.55–0.80). Compared with the low tertiles, the high tertiles of conicity index or BRI similarly accelerated the deterioration (non-frail to pre-frail: <em>HR</em><sub>conicity index</sub>=1.29, 95 % <em>CI</em>=1.04–1.59, <em>HR</em><sub>BRI</sub>=1.45, 95 % <em>CI</em>=1.20–1.76; pre-frail to frail: <em>HR</em><sub>BRI</sub>=1.58, 95 % <em>CI</em>=1.13–2.20) and hindered the recovery (pre-frail to non-frail: <em>HR</em><sub>conicity index</sub>=0.67, 95 % <em>CI</em>=0.53–0.84, <em>HR</em><sub>BRI</sub>=0.57, 95 % <em>CI</em>=0.46–0.72).</div></div><div><h3>Conclusions</h3><div>Different types of obesity all show that they accelerate the deterioration of frailty and hinder their ability to recover from frailty among older adults in UK.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106074"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491205","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

Effects of branched-chain amino acid-rich nutritional supplements combined with resistance training on body composition and body function in older patients with sarcopenia 富支链氨基酸营养补充剂联合抗阻训练对老年肌少症患者体成分和机体功能的影响

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-02-01 Epub Date: 2025-10-27 DOI: 10.1016/j.archger.2025.106063

Haoran Li , Runfa Zhang , Yongye Ma , Jiaxin He , Guoxing Li , Jian Sun , DuanyingLi

Background

Sarcopenia impairs self-care ability in older adults. While branched-chain amino acids (BCAAs)/leucine enhance muscle protein synthesis and resistance training promotes muscle growth, the combined effect on sarcopenia remains unclear. This meta-analysis evaluates whether combining resistance training with BCAA-rich supplements synergistically improves body composition and function in sarcopenic elders.

Methods

We systematically searched four databases and analyzed outcomes using Stata 18.0. Standardized mean differences (SMDs) were calculated via random-effects models.

Results

Twelve randomized trials (n = 459) were included. Only skeletal muscle index significantly improved with combined intervention vs. control (SMD = 0.337, 95 % CI [0.035,0.639], p = 0.029). No significant differences were found in: hand grip strength (SMD = 0.289, p = 0.080), 30-s chair stand (SMD = -0.794, p = 0.169), SPPB (SMD = -0.321, p = 0.124), walking speed (SMD = 0.344, p = 0.283), knee extension strength (SMD = 0.332,p = 0.328), total lean mass (SMD = 0.024, p = 0.908), or fat mass (SMD = -0.036, p = 0.866; all p > 0.05).

Conclusion

BCAA supplementation post-resistance training only increased skeletal muscle index in older adults, without improving other functional or body composition outcomes.

背景：骨骼肌减少症损害老年人的自我照顾能力。支链氨基酸(BCAAs)/亮氨酸促进肌肉蛋白质合成，抗阻训练促进肌肉生长，但对肌肉减少症的联合作用尚不清楚。这项荟萃分析评估了将抗阻训练与富含支链氨基酸的补充剂结合是否能协同改善肌肉减少症老年人的身体成分和功能。方法系统检索4个数据库，采用Stata 18.0软件对结果进行分析。标准化平均差异（SMDs）通过随机效应模型计算。结果纳入12项随机试验（n = 459）。联合干预组仅骨骼肌指数较对照组有显著改善（SMD = 0.337, 95% CI [0.035,0.639], p = 0.029）。在握力（SMD = 0.289, p = 0.080）、30-s椅架（SMD = -0.794, p = 0.169）、SPPB （SMD = -0.321, p = 0.124）、步行速度（SMD = 0.344, p = 0.283）、膝关节伸展力（SMD = 0.332,p = 0.328）、总瘦质量（SMD = 0.024, p = 0.908）、脂肪质量（SMD = -0.036, p = 0.866，均p >； 0.05）方面无显著差异。结论：抗阻训练后补充bcaa仅增加老年人骨骼肌指数，未改善其他功能或身体组成结果。

{"title":"Effects of branched-chain amino acid-rich nutritional supplements combined with resistance training on body composition and body function in older patients with sarcopenia","authors":"Haoran Li , Runfa Zhang , Yongye Ma , Jiaxin He , Guoxing Li , Jian Sun , DuanyingLi","doi":"10.1016/j.archger.2025.106063","DOIUrl":"10.1016/j.archger.2025.106063","url":null,"abstract":"<div><h3>Background</h3><div>Sarcopenia impairs self-care ability in older adults. While branched-chain amino acids (BCAAs)/leucine enhance muscle protein synthesis and resistance training promotes muscle growth, the combined effect on sarcopenia remains unclear. This meta-analysis evaluates whether combining resistance training with BCAA-rich supplements synergistically improves body composition and function in sarcopenic elders.</div></div><div><h3>Methods</h3><div>We systematically searched four databases and analyzed outcomes using Stata 18.0. Standardized mean differences (SMDs) were calculated via random-effects models.</div></div><div><h3>Results</h3><div>Twelve randomized trials (<em>n</em> = 459) were included. Only skeletal muscle index significantly improved with combined intervention vs. control (SMD = 0.337, 95 % CI [0.035,0.639], <em>p</em> = 0.029). No significant differences were found in: hand grip strength (SMD = 0.289, <em>p</em> = 0.080), 30-s chair stand (SMD = -0.794, <em>p</em> = 0.169), SPPB (SMD = -0.321, <em>p</em> = 0.124), walking speed (SMD = 0.344, <em>p</em> = 0.283), knee extension strength (SMD = 0.332,<em>p</em> = 0.328), total lean mass (SMD = 0.024, <em>p</em> = 0.908), or fat mass (SMD = -0.036, <em>p</em> = 0.866; all <em>p</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>BCAA supplementation post-resistance training only increased skeletal muscle index in older adults, without improving other functional or body composition outcomes.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106063"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464805","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

Targeting α7nAChR mitigates vascular aging and endothelial cell senescence through inhibiting oxidative stress and inflammation via α7nAChR/Nrf2/HO-1 signaling pathway 以α7nAChR为靶点，通过α7nAChR/Nrf2/HO-1信号通路抑制氧化应激和炎症，减轻血管老化和内皮细胞衰老。

IF 3.8 3区医学 Q2 GERIATRICS & GERONTOLOGY

Archives of gerontology and geriatrics

Pub Date : 2026-02-01 Epub Date: 2025-10-28 DOI: 10.1016/j.archger.2025.106064

Rui Ma , Yawen Zhang , Wencheng Wang , Qian Deng , Chi Cao , Shulin Li , Lei Shi , Chunyang Yu , Yinhua Yu , Jianying Tian

Vascular aging is recognized as critical factor contributing to the onset and progression of cardiovascular diseases, which represent a leading cause of morbidity and mortality worldwide. The α7 nicotinic acetylcholine receptor (α7nAChR) exhibits widespread expressed in the cardiovascular system and is intricately linked to a diverse array of pathologies, in cardiovascular, conditions. Research indicates that oxidative stress plays a crucial role in exacerbating endothelial dysfunction and promoting vascular aging. However, less is known regarding the role of α7nAChR in vascular aging. In this study, we employed a combination of cellular experiments, animal models, and molecular biological techniques, utilizing an agonist (PNU282987) and antagonists (Malondialdehyde, MLA) of α7nAChR as pharmacological tools to investigate the role of α7nAChR in aging-related pathologies. The expression of α7nAChR in vascular tissue decreases with age both in rats and humans. Activation of α7nAChR alleviated vascular aging in aged rats, as evidenced by improving endothelium-dependent vasodilatation and endothelial continuity, decreased senescence-associated β-galactosidase activity, phosphorylation of H2A.X^Ser139, expression of p21 and p16INK4a and inflammation, Notably, effective activation of the α7nAChR mediated Nrf2/HO-1 signaling pathway and antioxidant activity by specific agonist, PNU282987, conversely, which were blocked by the α7nAChR-selective inhibitor MLA. The findings highlight the vital role of α7nAChR receptor in preserving vascular health and endothelial integrity in the development of vascular aging, Consequently, targeting the α7nAChR/Nrf2/HO-1 signaling pathway could serve as a potential therapeutic approach for the development of novel anti-aging strategies.

血管老化被认为是导致心血管疾病发生和发展的关键因素，心血管疾病是世界范围内发病率和死亡率的主要原因。α7烟碱乙酰胆碱受体（α7nAChR）在心血管系统中广泛表达，并与多种心血管疾病有着复杂的联系。研究表明，氧化应激在加剧内皮功能障碍和促进血管老化中起着至关重要的作用。然而，α7nAChR在血管衰老中的作用尚不清楚。在本研究中，我们采用细胞实验、动物模型和分子生物学技术相结合的方法，利用α7nAChR的激动剂（PNU282987）和拮抗剂（Malondialdehyde， MLA）作为药理学工具，研究α7nAChR在衰老相关病理中的作用。大鼠和人血管组织中α7nAChR的表达均随年龄增长而降低。α7nAChR的激活可缓解老年大鼠血管老化，其表现为改善内皮依赖性血管舒张和内皮连续性，降低衰老相关β-半乳糖苷酶活性和H2A磷酸化。值得注意的是，特异性激动剂PNU282987有效激活α7nAChR介导的Nrf2/HO-1信号通路和抗氧化活性，而这被α7nAChR选择性抑制剂MLA阻断。研究结果表明，α7nAChR受体在维持血管健康和血管内皮完整性方面发挥着重要作用，因此，靶向α7nAChR/Nrf2/HO-1信号通路可能是开发新型抗衰老策略的潜在治疗途径。

{"title":"Targeting α7nAChR mitigates vascular aging and endothelial cell senescence through inhibiting oxidative stress and inflammation via α7nAChR/Nrf2/HO-1 signaling pathway","authors":"Rui Ma , Yawen Zhang , Wencheng Wang , Qian Deng , Chi Cao , Shulin Li , Lei Shi , Chunyang Yu , Yinhua Yu , Jianying Tian","doi":"10.1016/j.archger.2025.106064","DOIUrl":"10.1016/j.archger.2025.106064","url":null,"abstract":"<div><div>Vascular aging is recognized as critical factor contributing to the onset and progression of cardiovascular diseases, which represent a leading cause of morbidity and mortality worldwide. The α7 nicotinic acetylcholine receptor (α7nAChR) exhibits widespread expressed in the cardiovascular system and is intricately linked to a diverse array of pathologies, in cardiovascular, conditions. Research indicates that oxidative stress plays a crucial role in exacerbating endothelial dysfunction and promoting vascular aging. However, less is known regarding the role of α7nAChR in vascular aging. In this study, we employed a combination of cellular experiments, animal models, and molecular biological techniques, utilizing an agonist (PNU282987) and antagonists (Malondialdehyde, MLA) of α7nAChR as pharmacological tools to investigate the role of α7nAChR in aging-related pathologies. The expression of α7nAChR in vascular tissue decreases with age both in rats and humans. Activation of α7nAChR alleviated vascular aging in aged rats, as evidenced by improving endothelium-dependent vasodilatation and endothelial continuity, decreased senescence-associated β-galactosidase activity, phosphorylation of H2A.X<sup>Ser139</sup>, expression of p21 and p16INK4a and inflammation, Notably, effective activation of the α7nAChR mediated Nrf2/HO-1 signaling pathway and antioxidant activity by specific agonist, PNU282987, conversely, which were blocked by the α7nAChR-selective inhibitor MLA. The findings highlight the vital role of α7nAChR receptor in preserving vascular health and endothelial integrity in the development of vascular aging, Consequently, targeting the α7nAChR/Nrf2/HO-1 signaling pathway could serve as a potential therapeutic approach for the development of novel anti-aging strategies.</div></div>","PeriodicalId":8306,"journal":{"name":"Archives of gerontology and geriatrics","volume":"141 ","pages":"Article 106064"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145454374","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