The relationship between healthy lifestyle and frailty remains unclear. Healthy weight is crucial for overall well-being, but using body mass index (BMI) to evaluate weight management is inefficient. This study clarifies the association between healthy lifestyle or its factors (non-smoking, moderate drinking, healthy weight, healthy diet, sufficeint physical activity, and non-sedentary) and frailty, and the feasibility of using the weight-adjusted waist index (WWI) reflecting central obesity as an intermediate indicator. This study included 4,473 participants from the 2007–2018 National Health and Nutrition Examination Survey (NHANES). Healthy lifestyle quality was assessed by summing the scores of each healthy lifestyle factor. Frailty was assessed using a 49-item frailty index (FI), categorizing participants into robust, pre-frail, and frail. Logistic regression to investigate the association between healthy lifestyle or its factors, WWI, and frailty. Smooth curve fitting and threshold effect analyses were used to elucidate the nonlinear association. Subgroup and two other sensitivity analyses were conducted to confirm the stability of the results. A causal mediation model examined the proportion of frailty mediated by WWI. The study identified 13.98% of the participants as frail. Optimal healthy lifestyle and frailty were negatively associated (OR: 0.39, 95%CI: 0.27–0.58). Five healthy lifestyle factors (non-smoking, healthy weight, healthy diet, sufficient physical activity, and non-sedentary) were associated with a lower prevalence of frailty, with odds ratios (OR) ranging from 0.48 to 0.61. We also analyzed the association between a healthy lifestyle and WWI (OR: 0.32, 95%CI: 0.27–0.37), WWI and frailty (OR: 1.85, 95%CI: 1.59–2.16). A positive association between WWI and FI was observed beyond the inflection point (9.99) (OR: 0.03, 95%CI: 0.02–0.03). Subgroup and sensitivity analyses confirmed stable associations between healthy lifestyle, WWI, and frailty. WWI partially mediated the association between a healthy lifestyle and frailty (mediating ratio = 20.50–20.65%). An optimal healthy lifestyle and positive healthy lifestyle factors are associated with a lower incidence of frailty. WWI may mediate the relationship between a healthy lifestyle and frailty.
{"title":"Association between healthy lifestyle and frailty in adults and mediating role of weight-adjusted waist index: results from NHANES","authors":"Shibo Liu, Xiangjun Pan, Bo Chen, Dapeng Zeng, Shenghao Xu, Ruiyan Li, Xiongfeng Tang, Yanguo Qin","doi":"10.1186/s12877-024-05339-w","DOIUrl":"https://doi.org/10.1186/s12877-024-05339-w","url":null,"abstract":"The relationship between healthy lifestyle and frailty remains unclear. Healthy weight is crucial for overall well-being, but using body mass index (BMI) to evaluate weight management is inefficient. This study clarifies the association between healthy lifestyle or its factors (non-smoking, moderate drinking, healthy weight, healthy diet, sufficeint physical activity, and non-sedentary) and frailty, and the feasibility of using the weight-adjusted waist index (WWI) reflecting central obesity as an intermediate indicator. This study included 4,473 participants from the 2007–2018 National Health and Nutrition Examination Survey (NHANES). Healthy lifestyle quality was assessed by summing the scores of each healthy lifestyle factor. Frailty was assessed using a 49-item frailty index (FI), categorizing participants into robust, pre-frail, and frail. Logistic regression to investigate the association between healthy lifestyle or its factors, WWI, and frailty. Smooth curve fitting and threshold effect analyses were used to elucidate the nonlinear association. Subgroup and two other sensitivity analyses were conducted to confirm the stability of the results. A causal mediation model examined the proportion of frailty mediated by WWI. The study identified 13.98% of the participants as frail. Optimal healthy lifestyle and frailty were negatively associated (OR: 0.39, 95%CI: 0.27–0.58). Five healthy lifestyle factors (non-smoking, healthy weight, healthy diet, sufficient physical activity, and non-sedentary) were associated with a lower prevalence of frailty, with odds ratios (OR) ranging from 0.48 to 0.61. We also analyzed the association between a healthy lifestyle and WWI (OR: 0.32, 95%CI: 0.27–0.37), WWI and frailty (OR: 1.85, 95%CI: 1.59–2.16). A positive association between WWI and FI was observed beyond the inflection point (9.99) (OR: 0.03, 95%CI: 0.02–0.03). Subgroup and sensitivity analyses confirmed stable associations between healthy lifestyle, WWI, and frailty. WWI partially mediated the association between a healthy lifestyle and frailty (mediating ratio = 20.50–20.65%). An optimal healthy lifestyle and positive healthy lifestyle factors are associated with a lower incidence of frailty. WWI may mediate the relationship between a healthy lifestyle and frailty.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A decline in cognitive function is associated with inflammatory processes. However, the association between high-sensitivity C-reactive protein (hs-CRP) levels and cognitive decline in the Japanese population remains inconclusive. Thus, this study aimed to determine whether hs-CRP is associated with low cognitive function in 70- and 80-year-old community-dwelling Japanese individuals. The participants in this cross-sectional study were 872 Japanese residents aged 70 and 80 years who voluntarily participated in the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study between 2010 and 2011. Blood sample collection, cognitive assessment, and other measurements were performed at the venue. Low cognitive function was defined as a score of 25 points or lower on the Japanese version of the Montreal Cognitive Assessment. The odds ratio (OR) and 95% confidence interval (95% CI) for each hs-CRP quartile were calculated using logistic regression analysis. A total of 288 (69.9%) parsons in the 70-year-old group and 372 (80.9%) in the 80-year-old group exhibited low cognitive function. The association between hs-CRP levels and low cognitive function was significant among 70- and 80-year-old Japanese community-dwelling adults. In particular, the fourth quartile of hs-CRP (0.727–7.420 mg/L) in the 70-year-old group and the second and fourth quartiles (0.214–0.404 and 0.911–9.890 mg/L) in the 80-year-old group were associated with low cognitive function. Furthermore, the third quartile (0.409–0.892 mg/L) in the 80-year-old group was closely associated with low cognitive function. High hs-CRP levels were associated with lower cognitive function in 70- and 80-year-old Japanese community-dwelling individuals, suggesting that high hs-CRP levels may influence cognitive function.
{"title":"Cross-sectional association between high-sensitivity C-reactive protein and cognitive function in community-dwelling older adults: the SONIC study","authors":"Mariko Hosokawa, Mai Kabayama, Kayo Godai, Yuya Akagi, Yuka Tachibana, Yasuyuki Gondo, Saori Yasumoto, Yukie Masui, Takumi Hirata, Tatsuro Ishizaki, Hiroshi Akasaka, Yasushi Takeya, Yoichi Takami, Koichi Yamamoto, Masahiro Kitamura, Kazunori Ikebe, Yasumichi Arai, Hiromi Rakugi, Kei Kamide","doi":"10.1186/s12877-024-05354-x","DOIUrl":"https://doi.org/10.1186/s12877-024-05354-x","url":null,"abstract":"A decline in cognitive function is associated with inflammatory processes. However, the association between high-sensitivity C-reactive protein (hs-CRP) levels and cognitive decline in the Japanese population remains inconclusive. Thus, this study aimed to determine whether hs-CRP is associated with low cognitive function in 70- and 80-year-old community-dwelling Japanese individuals. The participants in this cross-sectional study were 872 Japanese residents aged 70 and 80 years who voluntarily participated in the Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study between 2010 and 2011. Blood sample collection, cognitive assessment, and other measurements were performed at the venue. Low cognitive function was defined as a score of 25 points or lower on the Japanese version of the Montreal Cognitive Assessment. The odds ratio (OR) and 95% confidence interval (95% CI) for each hs-CRP quartile were calculated using logistic regression analysis. A total of 288 (69.9%) parsons in the 70-year-old group and 372 (80.9%) in the 80-year-old group exhibited low cognitive function. The association between hs-CRP levels and low cognitive function was significant among 70- and 80-year-old Japanese community-dwelling adults. In particular, the fourth quartile of hs-CRP (0.727–7.420 mg/L) in the 70-year-old group and the second and fourth quartiles (0.214–0.404 and 0.911–9.890 mg/L) in the 80-year-old group were associated with low cognitive function. Furthermore, the third quartile (0.409–0.892 mg/L) in the 80-year-old group was closely associated with low cognitive function. High hs-CRP levels were associated with lower cognitive function in 70- and 80-year-old Japanese community-dwelling individuals, suggesting that high hs-CRP levels may influence cognitive function.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142223937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Five-guaranteed elderly individuals are a special group of the elderly Chinese population faced with unique challenges; these individuals lack any financial resources (including support by relatives), and are solely reliant on the government to provide food, clothing, medical care, and housing as well as burials. In this article, we aim to investigate mood problems (depression, anxiety) and cognitive functioning in Five-guaranteed elderly individuals, and to validate the effectiveness of two promising interventions, graphene far-infrared intervention (GFII; an exploratory and noninvasive technique) and social network intervention (SNI), for elderly people to lay the foundation for future social service work. To address the emotional and cognitive difficulties experienced by this special group, we designed this study, which is the first to apply GFII in this population. We also administered SNI given the social isolation of these individuals, in addition to a corresponding control group. 108 elderly individuals in 3 elder care facilities were screened to evaluate eligibility to participate in the current study, including 44 from Facility A (allocated to the GFII group), 43 from Facility B (allocated to the SNI group), and 21 from Facility C (allocated to the control group). GFII lasts for four weeks, with professionally trained carers putting on and removing intervention caps for half an hour each day. SNI lasts for three weeks, three times a week, and consists of a total of nine themed activities. The length of an activity is 90 min. We also did pre- and post-test comparisons of depression, anxiety and cognition in each group of older adults. The results showed that GFII led to immediate improvements in anxiety and cognitive impairment in the five-guaranteed elderly individuals, and the improvement in cognitive function was sustained over time. Moreover, SNI group showed significant improvements in cognitive function after the intervention period. The GFII is a promising intervention that can be applied to intervene in cognitive and mood disorders in older adults. The GFII has short-term interventions for anxiety in older adults, but long-term effects for cognitive impairment. SNI also had an interventional effect on cognition.
{"title":"Effects of graphene far-infrared and social network interventions on depression, anxiety and dementia in older adults","authors":"Yuqing Zhao, Yaru Chen, Feifei Yu, Chenyi Dai, Chengyuan Zhang, Minxue Liu, Nanfeng Zheng, Zhengkui Liu","doi":"10.1186/s12877-024-05344-z","DOIUrl":"https://doi.org/10.1186/s12877-024-05344-z","url":null,"abstract":"Five-guaranteed elderly individuals are a special group of the elderly Chinese population faced with unique challenges; these individuals lack any financial resources (including support by relatives), and are solely reliant on the government to provide food, clothing, medical care, and housing as well as burials. In this article, we aim to investigate mood problems (depression, anxiety) and cognitive functioning in Five-guaranteed elderly individuals, and to validate the effectiveness of two promising interventions, graphene far-infrared intervention (GFII; an exploratory and noninvasive technique) and social network intervention (SNI), for elderly people to lay the foundation for future social service work. To address the emotional and cognitive difficulties experienced by this special group, we designed this study, which is the first to apply GFII in this population. We also administered SNI given the social isolation of these individuals, in addition to a corresponding control group. 108 elderly individuals in 3 elder care facilities were screened to evaluate eligibility to participate in the current study, including 44 from Facility A (allocated to the GFII group), 43 from Facility B (allocated to the SNI group), and 21 from Facility C (allocated to the control group). GFII lasts for four weeks, with professionally trained carers putting on and removing intervention caps for half an hour each day. SNI lasts for three weeks, three times a week, and consists of a total of nine themed activities. The length of an activity is 90 min. We also did pre- and post-test comparisons of depression, anxiety and cognition in each group of older adults. The results showed that GFII led to immediate improvements in anxiety and cognitive impairment in the five-guaranteed elderly individuals, and the improvement in cognitive function was sustained over time. Moreover, SNI group showed significant improvements in cognitive function after the intervention period. The GFII is a promising intervention that can be applied to intervene in cognitive and mood disorders in older adults. The GFII has short-term interventions for anxiety in older adults, but long-term effects for cognitive impairment. SNI also had an interventional effect on cognition.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-12DOI: 10.1186/s12877-024-05355-w
Tiina Pesonen, Visa Väisänen, Mari Aaltonen, Johanna Edgren, Laura Corneliusson, Salla Ruotsalainen, Timo Sinervo
Ageing populations and care workforce shortages across Europe are causing challenges for care services for older people. Therefore, it is paramount that limited care resources are allocated optimally, based on the clients’ care needs. Multiple functioning-related factors have been identified that determine the amount of care time clients receive, while organizational and other factors remain largely unexplored. The aim was to examine how various individual and organizational factors are associated with clients’ received care time in different care settings. Cross-sectional observational study design with data from time and motion study, registers, and surveys was used. In total, 1477 home care clients and 1538 residents from assisted living facilities with 24/7 service participated, from 61 Finnish care units. Linear mixed-effect modeling was used to examine the association between individual and organizational-level variables and received care time. Physical functioning was the strongest predictor of received care time in both care settings. In home care, greater pain, more unstable health, and higher team autonomy were associated with increased care time. In assisted living, depressive mood and higher staffing level of the organization were associated with care time. Clients who received informal care also received significantly more care time from nurses in both care settings. Physical functioning was the main driver of received care time. Interventions that maintain or improve physical functioning can help restrain the growing need of care resources, although it is important to ensure that each client receives care according to their holistic care needs.
{"title":"Determinants of received care time among Finnish home care clients and assisted living facility residents: a time-motion study","authors":"Tiina Pesonen, Visa Väisänen, Mari Aaltonen, Johanna Edgren, Laura Corneliusson, Salla Ruotsalainen, Timo Sinervo","doi":"10.1186/s12877-024-05355-w","DOIUrl":"https://doi.org/10.1186/s12877-024-05355-w","url":null,"abstract":"Ageing populations and care workforce shortages across Europe are causing challenges for care services for older people. Therefore, it is paramount that limited care resources are allocated optimally, based on the clients’ care needs. Multiple functioning-related factors have been identified that determine the amount of care time clients receive, while organizational and other factors remain largely unexplored. The aim was to examine how various individual and organizational factors are associated with clients’ received care time in different care settings. Cross-sectional observational study design with data from time and motion study, registers, and surveys was used. In total, 1477 home care clients and 1538 residents from assisted living facilities with 24/7 service participated, from 61 Finnish care units. Linear mixed-effect modeling was used to examine the association between individual and organizational-level variables and received care time. Physical functioning was the strongest predictor of received care time in both care settings. In home care, greater pain, more unstable health, and higher team autonomy were associated with increased care time. In assisted living, depressive mood and higher staffing level of the organization were associated with care time. Clients who received informal care also received significantly more care time from nurses in both care settings. Physical functioning was the main driver of received care time. Interventions that maintain or improve physical functioning can help restrain the growing need of care resources, although it is important to ensure that each client receives care according to their holistic care needs.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Creatinine-to-cystatin C ratio (CCR) has been associated with multiple adverse outcomes. However, little is known about its relationship with frailty. We aimed to explore the association between CCR and frailty among older adults. A total of 2599 participants aged ≥ 60 years (mean age 67.9 ± 6.0 years, 50.4% males) were included from the China Health and Retirement Longitudinal Study (2011–2015). Baseline CCR was calculated as plasma creatinine (mg/dL) / cystatin C (mg/L) × 10 and was grouped by quartiles. Frailty was evaluated by the validated physical frailty phenotype (PFP) scale and was defined as PFP score ≥ 3. The generalized estimating equations model was used to explore the relationship between CCR and frailty. The frailty risk decreased gradually with increasing CCR in the quartiles (P for trend = 0.002), and the fourth CCR quartile was associated with a significantly lower risk of frailty compared with the lowest quartile (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.19–0.70). When modeling as a continuous variable, per 1-unit increase in CCR was related to 17% decreased odds of frailty (OR 0.83, 95% CI 0.74–0.93). The association was consistent in male and female participants (P for interaction = 0.41). Poisson models revealed that frailty score was negatively associated with CCR (β= -0.11, 95% CI= -0.19 to -0.04), and sex did not significantly moderate the associations (P for interaction = 0.22). The results were not affected by further adjusting for high-sensitivity C-reactive protein. Similar results were observed by analyses with multiple imputation technique and analyses excluding participants with baseline frailty. Higher CCR was associated with a lower frailty risk. CCR may be a simple marker for predicting frailty in older adults.
肌酐-胱抑素 C 比值（CCR）与多种不良后果有关。然而，人们对其与虚弱之间的关系知之甚少。我们旨在探讨 CCR 与老年人虚弱之间的关系。中国健康与退休纵向研究（2011-2015 年）共纳入了 2599 名年龄≥ 60 岁的参与者（平均年龄为 67.9 ± 6.0 岁，男性占 50.4%）。基线CCR的计算方法为血浆肌酐（mg/dL）/胱抑素C（mg/L）×10，并按四分位数分组。体质虚弱通过有效的体质虚弱表型（PFP）量表进行评估，PFP评分≥3分即为体质虚弱。采用广义估计方程模型来探讨 CCR 与虚弱之间的关系。随着 CCR 四分位数的增加，虚弱风险逐渐降低（趋势 P = 0.002），与最低四分位数相比，CCR 四分位数的第四位与显著降低的虚弱风险相关（几率比 [OR] 0.37，95% 置信区间 [CI]0.19-0.70）。如果作为连续变量建模，CCR 每增加 1 个单位与虚弱几率降低 17% 有关（OR 0.83，95% CI 0.74-0.93）。男女参与者的相关性一致（交互作用 P = 0.41）。泊松模型显示，虚弱评分与 CCR 呈负相关（β= -0.11，95% CI=-0.19--0.04），而性别并没有显著调节相关性（交互作用 P = 0.22）。进一步调整高敏 C 反应蛋白后，结果不受影响。使用多重估算技术进行分析和排除基线虚弱参与者的分析也观察到了类似的结果。较高的 CCR 与较低的虚弱风险相关。CCR可能是预测老年人虚弱的一个简单标记。
{"title":"Creatinine-to-cystatin C ratio and frailty in older adults: a longitudinal cohort study","authors":"Quhong Song, Taiping Lin, Rui Liang, Yanli Zhao, Ning Ge, Jirong Yue","doi":"10.1186/s12877-024-05326-1","DOIUrl":"https://doi.org/10.1186/s12877-024-05326-1","url":null,"abstract":"Creatinine-to-cystatin C ratio (CCR) has been associated with multiple adverse outcomes. However, little is known about its relationship with frailty. We aimed to explore the association between CCR and frailty among older adults. A total of 2599 participants aged ≥ 60 years (mean age 67.9 ± 6.0 years, 50.4% males) were included from the China Health and Retirement Longitudinal Study (2011–2015). Baseline CCR was calculated as plasma creatinine (mg/dL) / cystatin C (mg/L) × 10 and was grouped by quartiles. Frailty was evaluated by the validated physical frailty phenotype (PFP) scale and was defined as PFP score ≥ 3. The generalized estimating equations model was used to explore the relationship between CCR and frailty. The frailty risk decreased gradually with increasing CCR in the quartiles (P for trend = 0.002), and the fourth CCR quartile was associated with a significantly lower risk of frailty compared with the lowest quartile (odds ratio [OR] 0.37, 95% confidence interval [CI] 0.19–0.70). When modeling as a continuous variable, per 1-unit increase in CCR was related to 17% decreased odds of frailty (OR 0.83, 95% CI 0.74–0.93). The association was consistent in male and female participants (P for interaction = 0.41). Poisson models revealed that frailty score was negatively associated with CCR (β= -0.11, 95% CI= -0.19 to -0.04), and sex did not significantly moderate the associations (P for interaction = 0.22). The results were not affected by further adjusting for high-sensitivity C-reactive protein. Similar results were observed by analyses with multiple imputation technique and analyses excluding participants with baseline frailty. Higher CCR was associated with a lower frailty risk. CCR may be a simple marker for predicting frailty in older adults.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-11DOI: 10.1186/s12877-024-05341-2
Chao Liu, Guanyi Chen, Yu Xia, Pingxiao Wang, Ziyue Zhao, JiaLin Zhang, Tao Xiao, Hui Li
With the advancement of world population aging, age-related sarcopenia (SP) imposes enormous clinical burden on hospital. Clinical research of SP in non-geriatric wards has not been appreciated, necessitating further investigation. However, observational studies are susceptible to confounders. Mendelian randomization (MR) can effectively mitigate bias to assess causality. To investigate the correlation between SP and comorbidities in orthopedic wards, and subsequently infer the causality, providing a theoretical basis for developing strategies in SP prevention and treatment. Logistic regression models were employed to assess the correlation between SP and comorbidities. The MR analysis was mainly conducted with inverse variance weighted, utilizing data extracted from the UK and FinnGen biobank (Round 9). In the cross-sectional analysis, SP exhibited significant associations with malnutrition (P = 0.013) and some comorbidities, including osteoporosis (P = 0.014), body mass index (BMI) (P = 0.021), Charlson Comorbidity Index (CCI) (P = 0.006). The MR result also provided supporting evidence for the causality between SP and hypertension, osteoporosis and BMI. These results also withstood multiple sensitivity analyses assessing the validity of MR assumptions. The result indicated a significant association between SP and BMI, CCI, malnutrition, and osteoporosis. We highlighted that SP and comorbidities deserved more attention in non-geriatric wards, urging further comprehensive investigation.
{"title":"Sarcopenia as a predictor of nutritional status and comorbidities: a cross-sectional and mendelian randomization study","authors":"Chao Liu, Guanyi Chen, Yu Xia, Pingxiao Wang, Ziyue Zhao, JiaLin Zhang, Tao Xiao, Hui Li","doi":"10.1186/s12877-024-05341-2","DOIUrl":"https://doi.org/10.1186/s12877-024-05341-2","url":null,"abstract":"With the advancement of world population aging, age-related sarcopenia (SP) imposes enormous clinical burden on hospital. Clinical research of SP in non-geriatric wards has not been appreciated, necessitating further investigation. However, observational studies are susceptible to confounders. Mendelian randomization (MR) can effectively mitigate bias to assess causality. To investigate the correlation between SP and comorbidities in orthopedic wards, and subsequently infer the causality, providing a theoretical basis for developing strategies in SP prevention and treatment. Logistic regression models were employed to assess the correlation between SP and comorbidities. The MR analysis was mainly conducted with inverse variance weighted, utilizing data extracted from the UK and FinnGen biobank (Round 9). In the cross-sectional analysis, SP exhibited significant associations with malnutrition (P = 0.013) and some comorbidities, including osteoporosis (P = 0.014), body mass index (BMI) (P = 0.021), Charlson Comorbidity Index (CCI) (P = 0.006). The MR result also provided supporting evidence for the causality between SP and hypertension, osteoporosis and BMI. These results also withstood multiple sensitivity analyses assessing the validity of MR assumptions. The result indicated a significant association between SP and BMI, CCI, malnutrition, and osteoporosis. We highlighted that SP and comorbidities deserved more attention in non-geriatric wards, urging further comprehensive investigation.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-10DOI: 10.1186/s12877-024-05336-z
Peipei Fu, Yi Wang, Dan Zhao, Shijun Yang, Chengchao Zhou
In 2016, the Chinese government officially scaled up family doctor contracted services (FDCS) scheme to guide patients’ health seeking behavior from tertiary hospitals to primary health facilities. This study evaluated the overall gate-keeping effects of this scheme on healthcare utilization of rural residents by using a difference-in-differences (DiD) design. The analysis was based on Shandong Rural Elderly Health Cohort 2019 and 2020. Participants who contracted FDCS in second round and were not contracted with a family doctor in the first round were regarded as treatment group. In total, 310 respondents who have used medical care were incorporated for final study. Participants who contracted FDCS (treatment group) experienced a significant decline in the mean level of first-contact health-care facilities, decreasing from 2.204 to 1.981. In contrast, participants who did not contract FDCS (control group), showed an increasing trend in the mean level of first-contact health-care facilities, rising from 2.128 to 2.445. Our results showed that contracting FDCS is associated with approximately 0.54 extra lower mean level of first-contact health-care facilities (P = 0.03, 95% CI: -1.03 to 0.05), which suggests an approximately 24.5% reduction in the mean first-contact health-care facility level for participants compared with contracted FDCS than those who did not. The study suggested primary healthcare quality should be strengthened and restrictive first point of contact policy should be enacted to establish ordered healthcare seeking behavior among rural residents.
{"title":"Does contracting family doctor promote primary healthcare utilization among older adults? - evidence from a difference-in-differences analysis","authors":"Peipei Fu, Yi Wang, Dan Zhao, Shijun Yang, Chengchao Zhou","doi":"10.1186/s12877-024-05336-z","DOIUrl":"https://doi.org/10.1186/s12877-024-05336-z","url":null,"abstract":"In 2016, the Chinese government officially scaled up family doctor contracted services (FDCS) scheme to guide patients’ health seeking behavior from tertiary hospitals to primary health facilities. This study evaluated the overall gate-keeping effects of this scheme on healthcare utilization of rural residents by using a difference-in-differences (DiD) design. The analysis was based on Shandong Rural Elderly Health Cohort 2019 and 2020. Participants who contracted FDCS in second round and were not contracted with a family doctor in the first round were regarded as treatment group. In total, 310 respondents who have used medical care were incorporated for final study. Participants who contracted FDCS (treatment group) experienced a significant decline in the mean level of first-contact health-care facilities, decreasing from 2.204 to 1.981. In contrast, participants who did not contract FDCS (control group), showed an increasing trend in the mean level of first-contact health-care facilities, rising from 2.128 to 2.445. Our results showed that contracting FDCS is associated with approximately 0.54 extra lower mean level of first-contact health-care facilities (P = 0.03, 95% CI: -1.03 to 0.05), which suggests an approximately 24.5% reduction in the mean first-contact health-care facility level for participants compared with contracted FDCS than those who did not. The study suggested primary healthcare quality should be strengthened and restrictive first point of contact policy should be enacted to establish ordered healthcare seeking behavior among rural residents.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Exposure to indoor air pollution from solid cooking fuel use may increase mental disorders risk through pathways such as oroxidative stress, neuroinflammation, or cerebrovascular damage. However, few studies have explored the underlying mechanism between solid cooking fuel use and psychological distress. The present study aims to investigate the mediating role of sleep quality on the relationship between solid cooking fuel use and psychological distress among older adults in rural Shandong, China. This study used the cross-sectional data from the second follow-up survey of the Shandong Rural Elderly Health Cohort (SREHC). A total of 3,240 rural older adults were included in the analysis. Logistic regression and the Karlson, Holm, and Breen (KHB) mediation analyses were performed to investigate the relationship between solid cooking fuel use and psychological distress, as well as the mediating role of sleep quality in this association. This study found that solid cooking fuel use was significantly and positively associated with psychological distress among older adults in rural Shandong, China (OR = 1.38, 95% CI: 1.12,1.70). Mediation analysis revealed that sleep quality mediated the association between solid cooking fuel use and psychological distress among older adults (β = 0.06, P = 0.011). The mediation effect accounted for 16.18% of the total effect. Our study showed that solid cooking fuel use was associated with psychological distress among rural older adults, and sleep quality mediated this association. Interventions should focus on addressing cooking fuel types and poor sleep quality to reduce psychological distress. In the future, more aggressive environmental protection policies would be needed to lessen the adverse effects of indoor air pollution on the health of older adults in rural China.
{"title":"The mediating effect of sleep quality on solid cooking fuel use and psychological distress among rural older adults: evidence from Shandong, China","authors":"Jingjing Luo, Dan Zhao, Tingting Gao, Xuehong Wang, Xueqing Wang, Shujun Chai, Jiayan Li, Chengchao Zhou","doi":"10.1186/s12877-024-05327-0","DOIUrl":"https://doi.org/10.1186/s12877-024-05327-0","url":null,"abstract":"Exposure to indoor air pollution from solid cooking fuel use may increase mental disorders risk through pathways such as oroxidative stress, neuroinflammation, or cerebrovascular damage. However, few studies have explored the underlying mechanism between solid cooking fuel use and psychological distress. The present study aims to investigate the mediating role of sleep quality on the relationship between solid cooking fuel use and psychological distress among older adults in rural Shandong, China. This study used the cross-sectional data from the second follow-up survey of the Shandong Rural Elderly Health Cohort (SREHC). A total of 3,240 rural older adults were included in the analysis. Logistic regression and the Karlson, Holm, and Breen (KHB) mediation analyses were performed to investigate the relationship between solid cooking fuel use and psychological distress, as well as the mediating role of sleep quality in this association. This study found that solid cooking fuel use was significantly and positively associated with psychological distress among older adults in rural Shandong, China (OR = 1.38, 95% CI: 1.12,1.70). Mediation analysis revealed that sleep quality mediated the association between solid cooking fuel use and psychological distress among older adults (β = 0.06, P = 0.011). The mediation effect accounted for 16.18% of the total effect. Our study showed that solid cooking fuel use was associated with psychological distress among rural older adults, and sleep quality mediated this association. Interventions should focus on addressing cooking fuel types and poor sleep quality to reduce psychological distress. In the future, more aggressive environmental protection policies would be needed to lessen the adverse effects of indoor air pollution on the health of older adults in rural China.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aims to identify the risk factors for postoperative pulmonary complications (PPCs) in elderly patients undergoing major abdominal surgery and to investigate the relationship between patient-controlled analgesia (PCA) and PPCs. A retrospective study. Clinical data and demographic information of elderly patients (aged ≥ 60 years) who underwent upper abdominal surgery at the First Affiliated Hospital of Sun Yat-sen University from 2017 to 2019 were retrospectively collected. Patients with PPCs were identified using the Melbourne Group Scale Version 2 scoring system. A directed acyclic graph was used to identify the potential confounders, and multivariable logistic regression analyses were conducted to identify independent risk factors for PPCs. Propensity score matching was utilized to compare PPC rates between patients with and without PCA, as well as between intravenous PCA (PCIA) and epidural PCA (PCEA) groups. A total of 1,467 patients were included, with a PPC rate of 8.7%. Multivariable analysis revealed that PCA was an independent protective factor for PPCs in elderly patients undergoing major abdominal surgery (odds ratio = 0.208, 95% confidence interval = 0.121 to 0.358; P < 0.001). After matching, patients receiving PCA demonstrated a significantly lower overall incidence of PPCs (8.6% vs. 26.3%, P < 0.001), unplanned transfer to the intensive care unit (1.1% vs. 8.4%, P = 0.001), and in-hospital mortality (0.7% vs. 5.3%, P = 0.021) compared to those not receiving PCA. No significant difference in outcomes was observed between patients receiving PCIA or PCEA after matching. Patient-controlled analgesia, whether administered intravenously or epidurally, is associated with a reduced risk of PPCs in elderly patients undergoing major upper abdominal surgery.
{"title":"Postoperative pulmonary complications after major abdominal surgery in elderly patients and its association with patient-controlled analgesia","authors":"Qiulan He, Zhenyi Lai, Senyi Peng, Shiqing Lin, Guohui Mo, Xu Zhao, Zhongxing Wang","doi":"10.1186/s12877-024-05337-y","DOIUrl":"https://doi.org/10.1186/s12877-024-05337-y","url":null,"abstract":"This study aims to identify the risk factors for postoperative pulmonary complications (PPCs) in elderly patients undergoing major abdominal surgery and to investigate the relationship between patient-controlled analgesia (PCA) and PPCs. A retrospective study. Clinical data and demographic information of elderly patients (aged ≥ 60 years) who underwent upper abdominal surgery at the First Affiliated Hospital of Sun Yat-sen University from 2017 to 2019 were retrospectively collected. Patients with PPCs were identified using the Melbourne Group Scale Version 2 scoring system. A directed acyclic graph was used to identify the potential confounders, and multivariable logistic regression analyses were conducted to identify independent risk factors for PPCs. Propensity score matching was utilized to compare PPC rates between patients with and without PCA, as well as between intravenous PCA (PCIA) and epidural PCA (PCEA) groups. A total of 1,467 patients were included, with a PPC rate of 8.7%. Multivariable analysis revealed that PCA was an independent protective factor for PPCs in elderly patients undergoing major abdominal surgery (odds ratio = 0.208, 95% confidence interval = 0.121 to 0.358; P < 0.001). After matching, patients receiving PCA demonstrated a significantly lower overall incidence of PPCs (8.6% vs. 26.3%, P < 0.001), unplanned transfer to the intensive care unit (1.1% vs. 8.4%, P = 0.001), and in-hospital mortality (0.7% vs. 5.3%, P = 0.021) compared to those not receiving PCA. No significant difference in outcomes was observed between patients receiving PCIA or PCEA after matching. Patient-controlled analgesia, whether administered intravenously or epidurally, is associated with a reduced risk of PPCs in elderly patients undergoing major upper abdominal surgery.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-09DOI: 10.1186/s12877-024-05333-2
Xuemei Qi, Xiaobin Guo, Suqin Han, Xiaoshuang Xia, Lin Wang, Xin Li
The association between ambient temperature and mortality has yielded inconclusive results with previous studies relying on in-patient data to assess the health effects of temperature. Therefore, we aimed to estimate the effect of ambient temperature on non-accidental mortality among elderly hypertensive patients through a prospective cohort study conducted in northeastern China. A total of 9634 elderly hypertensive patients from the Kailuan research who participated in the baseline survey and follow-up from January 1, 2006 to December 31, 2017, were included in the study. We employed a Poisson generalized linear regression model to estimate the effects of monthly ambient temperature and temperature variations on non-accidental mortality. After adjusting for meteorological parameters, the monthly mean temperature (RR = 0.989, 95% CI: 0.984–0.993, p < 0.001), minimum temperature (RR = 0.987, 95% CI: 0.983–0.992, p < 0.001) and maximum temperature (RR = 0.989, 95% CI: 0.985–0.994, p < 0.001) exhibited a negative association with an increased risk of non-accidental mortality. The presence of higher monthly temperature variation was significantly associated with an elevated risk of mortality (RR = 1.097, 95% CI:1.051–1.146, p < 0.001). Further stratified analysis revealed that these associations were more pronounced during colder months as well as among male and older individuals. Decreased temperature and greater variations in ambient temperature were observed to be linked with non-accidental mortality among elderly hypertensive patients, particularly notable within aging populations and males. These understanding regarding the effects of ambient temperature on mortality holds clinical significance for appropriate treatment strategies targeting these individuals while also serving as an indicator for heightened risk of death.
{"title":"The effects of ambient temperature on non-accidental mortality in the elderly hypertensive subjects, a cohort-based study","authors":"Xuemei Qi, Xiaobin Guo, Suqin Han, Xiaoshuang Xia, Lin Wang, Xin Li","doi":"10.1186/s12877-024-05333-2","DOIUrl":"https://doi.org/10.1186/s12877-024-05333-2","url":null,"abstract":"The association between ambient temperature and mortality has yielded inconclusive results with previous studies relying on in-patient data to assess the health effects of temperature. Therefore, we aimed to estimate the effect of ambient temperature on non-accidental mortality among elderly hypertensive patients through a prospective cohort study conducted in northeastern China. A total of 9634 elderly hypertensive patients from the Kailuan research who participated in the baseline survey and follow-up from January 1, 2006 to December 31, 2017, were included in the study. We employed a Poisson generalized linear regression model to estimate the effects of monthly ambient temperature and temperature variations on non-accidental mortality. After adjusting for meteorological parameters, the monthly mean temperature (RR = 0.989, 95% CI: 0.984–0.993, p < 0.001), minimum temperature (RR = 0.987, 95% CI: 0.983–0.992, p < 0.001) and maximum temperature (RR = 0.989, 95% CI: 0.985–0.994, p < 0.001) exhibited a negative association with an increased risk of non-accidental mortality. The presence of higher monthly temperature variation was significantly associated with an elevated risk of mortality (RR = 1.097, 95% CI:1.051–1.146, p < 0.001). Further stratified analysis revealed that these associations were more pronounced during colder months as well as among male and older individuals. Decreased temperature and greater variations in ambient temperature were observed to be linked with non-accidental mortality among elderly hypertensive patients, particularly notable within aging populations and males. These understanding regarding the effects of ambient temperature on mortality holds clinical significance for appropriate treatment strategies targeting these individuals while also serving as an indicator for heightened risk of death.","PeriodicalId":9056,"journal":{"name":"BMC Geriatrics","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142183539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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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