BMC Geriatrics最新文献

Background: There is limited evidence on the prevalence of frailty and its impact on health outcomes in older adults with atrial fibrillation (AF) in Vietnam. This study aimed to (1) Compare the agreement of the physical frailty phenotype (Fried's criteria) and the Clinical Frailty Scale (CFS) in identifying frailty in older adults with AF, and (2) Compare the associations of these frailty definitions with hospitalisation.

Methods: Adults aged 65 or older with AF attending the outpatient clinics of a hospital in Vietnam. Frailty was defined as having ≥ 3/5 of Fried's criteria or a CFS ≥ 4. All participants were followed up for 9 months, recording hospitalisations. The kappa statistic was used to quantify the agreement between frailty defined by the modified physical frailty phenotype and the CFS. Logistic regression was applied to examine the association between frailty and hospitalisation.

Results: There were 305 participants. They had a mean age of 76.7 (SD 7.8), 40% were female. The prevalence of frailty was 34% according to the modified physical frailty phenotype criteria, and 88% according to the CFS (kappa coefficient 0.14, 95%CI 0.09-0.19). The hospitalisation rate during follow up was 28.8%, higher in frail participants compared to the non-frail. Frailty defined as CFS ≥ 4 was significantly associated with increased hospitalisation (adjusted OR 3.72, 95%CI 1.23-11.31, p = 0.020). A non-significant association was observed with frailty defined by the modified physical frailty phenotype (adjusted OR 1.64, 95%CI 0.95-2.84, p = 0.077). Similar results were obtained when frailty was analysed as a continuous score: adjusted ORs 1.39 (95%CI 1.05-1.83, p = 0.022) for each higher category of the CFS, and 1.24 (95%CI 1.00-1.53, p = 0.051) for each unit higher of of the physical frailty score.

Conclusion: Frailty was highly prevalent among older patients with AF. There was a poor agreement between the two frailty criteria when identifying frail and non-frail participants in the cohort using the cut-offs. The CFS had a stronger association with hospitalisations than the modified physical frailty phenotype criteria. Further studies are needed to compare the predictive values of these two frailty definitions in older adults in Vietnam.

Geriatric depression affects 12.95-28.4% of adults aged ≥ 60, yet treatment rates remain critically low globally. Lifestyle factors, particularly exercise and sleep demonstrate therapeutic potential, integrated interventions may exert synergistic effects on geriatric depression, though such interventions remain scarce. The Geriatric Exercise-Sleep Optimization (GESO) project aims to evaluate the clinical efficacy and cost-effectiveness of a combined exercise and sleep health intervention in alleviating depressive symptoms among community-dwelling older adults with depression, and exploring the potential underlying mechanisms. This is a stepped-wedge cluster-randomized trial (SW-CRT). A 12-week integrated exercise and sleep intervention will be implemented to all eligible participants during the study period. The primary aim is to evaluate the clinical efficacy in alleviating depressive symptoms. Secondary aims are to evaluate the additional health outcomes (i.e., quality of life, physical activity level, daily step count, sleep quality, and anxiety symptom), cost-effectiveness, and potential mechanisms. Costs will be aggregated and analyzed for economic evaluation. Costs will be aggregated and analyzed for economic evaluation. Salivary measured BDNF and irisin levels, and EEG-based brain function connectivity will be collected to assess potential intervention mechanisms. Mixed-effect linear regression models will be used to evaluate the effects of the integrated exercise-sleep intervention on primary and secondary outcomes. This study is expected to provide an effective and practical mode for an integrated exercise and sleep intervention among community-dwelling older adults with depression. Intended outcomes of the trial will facilitate changes in best practice to improve outcomes for this population.Trial registration Chinese Clinical Trail Registry ChiCTR2500107641, Registration date: 15 August 2025.

Background: Perioperative neurocognitive disorders (PND) in elderly patients undergoing abdominal surgery seriously affect their prognosis and long-term quality of life, yet the aetiology and pathogenesis of PND remain poorly understood. This study aims to identify the multidimensional physiological, psychological and social factors influencing PND in elderly patients undergoing abdominal surgery, to develop objective biomarkers for diagnosis, and to provide guidelines for treatment response, prognosis, early detection and intervention.

Methods: This is a multidimensional cohort study of the physiological, psychological, and social influencing factors of PND in elderly patients undergoing abdominal surgery. We plan to recruit more than 500 elderly patients aged 65-90 years who require elective abdominal surgery within 2 years. The study will include one baseline and four follow-up assessments: multidimensional influence factors and outcome indicators will be collected at baseline (T1), at surgery (T2), at discharge (postoperative days 1-7; T3), 1 month (T4), and 3 months (T5). The entire study will run from 11 December 2023 to 31 December 2025.

Discussion: In this study, a multimodal observation was implemented, combining physiological status and psychosocial factors. To our knowledge, this is the first longitudinal cohort study to examine multidimensional physiological (including biomarkers) and psychosocial factors. This study aims to provide early personalized intervention for elderly surgical patients, reducing the mortality rate and disease burden of elderly patients undergoing major abdominal surgery.

Trial registration: The protocol is registered at the ClinicalTrials.gov on December 21st, 2023. The trial registration number: NCT06182215.

Background: Previous studies have indicated that robotic surgery offers similar safety and efficacy to laparoscopic surgery in older colorectal cancer patients, while its potential advantages remain to be clarified.

Methods: This retrospective study analyzed older colorectal cancer patients undergoing robotic or laparoscopic surgery at Beijing Hospital. Propensity score matching (PSM) and inverse probability weighting (IPTW) to overcome selection bias. Primary outcomes focused on perioperative inflammatory markers (PNI, NLR, LMR, PLR, SII), while secondary endpoints included surgical, pathological, and clinical outcomes. The study evaluated robotic surgery's safety, efficacy, and potential advantages, offering insights into its clinical application for older patients.

Results: A total of 804 patients were initially enrolled in this study, and after screening, 539 cases were included in the final analysis. In the comparison of perioperative inflammatory marker changes, the robotic surgery group consistently demonstrated a lower inflammatory response. Additionally, the robotic surgery group had significantly lower postoperative drainage volumes at both 48 h (148 mL vs. 200 mL, p < 0.05) and 72 h (228 mL vs. 290 mL, p < 0.05). There were no significant differences between the two groups in terms of postoperative complications or length of hospital stay. During a median follow-up of 21.1 months, there were no significant differences in overall survival (OS) or disease-free survival (DFS) between the two groups.

Conclusion: Robotic surgery for older patients with colorectal cancer demonstrates comparable safety and efficacy to laparoscopic surgery, while offering significantly improved control of perioperative inflammatory responses.