Archives of gerontology and geriatrics最新文献

Objective: This Bayesian network meta-analysis examined exercise effects on executive function in stroke patients, exploring dose-response relationships and comparing the efficacy of different modalities to identify the optimal rehabilitation protocol.

Methods: A systematic search was conducted in PubMed, Embase, the Cochrane Library, Web of Science, and SPORTDiscus from inception to September 15, 2025. Twenty randomized controlled trials (RCTs) were included. Study quality was assessed using the PEDro scale. A Bayesian random-effects network meta-regression model examined the nonlinear dose-response relationship between exercise dosage (in Metabolic Equivalent of Task-minutes, MET-mins) and executive function, with heterogeneity, publication bias, and model robustness evaluated.

Results: The analysis demonstrated a significant inverted U-shaped relationship between weekly exercise dose and improvements in executive function, with the peak effect occurring at approximately 1000 MET-minutes per week (mean effect size = 0.65, 95 % credible interval: 0.34-1.00). Among different exercise modalities, exercise combined with cognitive training showed the most favorable and consistent association across a broad weekly dose range (approximately 170-1000 MET-minutes). Multicomponent exercise exhibited apparent benefits only at higher weekly doses (around 890-1000 MET-minutes), though with greater statistical uncertainty, whereas other modalities did not demonstrate clear or consistent effects.

Conclusion: The association between exercise and executive function in stroke patients appears to follow an optimal weekly dose (∼1000 MET-minutes) rather than a maximal one. Exercise combined with cognitive training provides synergistic, stable benefits within this range. These findings offer moderate-quality evidence to guide individualized rehabilitation that optimizes cognitive recovery and improves quality of life after stroke.

An aging population necessitates strategies for extending healthy lifespan, with physical frailty as a key obstacle. Social activity participation is a potential intervention. However, previous studies examining the association between social activity participation and physical frailty have predominantly employed cross-sectional designs with single-wave surveys or longitudinal designs with two-wave surveys, and studies using multi-wave longitudinal designs are limited. Few studies have systematically evaluated the classification of physical frailty in subsequent follow-up assessments while considering temporal variations in social activity participation. Therefore, we studied the effect of temporal variations in social activity on subsequent physical frailty classifications using a three-wave survey. We found that sustained non-participation in sports-based activities significantly increased the risk of Pre-Frailty or Frailty at follow-up compared to sustained participation. Similarly, transitioning from participation to non-participation in culture-based activities increased this risk. These results suggest that maintaining participation in sports activities and avoiding cessation of cultural activities are crucial for preventing frailty. Individuals who consistently avoided sports or stopped cultural activities were more likely to be classified as pre-frail or frail in subsequent assessments.

Objectives: Poor health at the individual and area level has been shown to be associated with earlier labour market exit. This paper builds on work demonstrating that health in a place is associated with higher chances of work exit for older workers even once their own health is taken into account. This paper looks at an additional risk factor for work exit: industrial mix.

Study design: Data was drawn from the full 2011 Census and an approximately 1.1 % representative sample from England and Wales, the Office for National Statistics Longitudinal Study from 2001 to 2011.

Methods: We analysed people aged 40-64 in paid work in 2001 and measured their employment outcomes in 2011, at ages 50-74. Four industrial landscape clusters were derived by K-means cluster analysis using industry mix for 348 local authorities from 2011 Census. 'Health of a place' was measured using 2001 Census data for the usually resident population aged 50-74 years, the proportion who reported 'fair', 'bad' or 'very bad' self-rated health (as opposed to 'good' or 'very good') was calculated and split into tertiles.

Results: Work exit showed industrial landscape and area health inequalities. Older workers in healthy service sector areas in London had the lowest work exit chances with a gradient to those in unhealthy rural areas having the highest chance of work exit.

Conclusions: More research is required to investigate why, in areas where the same types of industry dominate, the health of the local population was associated with differing odds of work exit.

Objective: This systematic review and meta-analysis examined sex and gender differences in caregiver burden among family caregivers of persons with dementia and explored variations by region and country income level.

Methods: Following PRISMA guidelines, a comprehensive literature search was conducted in four databases (CINAHL, PubMed, EMBASE, and PsycINFO), including studies up to December 2024. Forty-seven studies representing 24 countries were included in the systematic review, with 39 studies (41 effect sizes) included in the meta-analysis. A random-effects model was used to calculate pooled effect sizes (Cohen's d), and subgroup analyses were performed based on region and national income level.

Results: Across the 47 studies, 14,919 family caregivers participated, of whom 70 % were women. Most family caregivers were either spouses (44 %) or adult children (43 %). Care recipients were predominantly diagnosed with Alzheimer's disease. Female caregivers reported significantly greater burden than males (Cohen's d= 0.21, 95 % CI: 0.13-0.29, p< 0.001). Subgroup analyses showed higher burden in Asian countries (d= 0.27) compared to Western countries (d= 0.19), though the difference was not statistically significant. High-income countries showed greater disparities (d= 0.21) than middle-income countries (d= 0.16), with no significant difference. High heterogeneity was observed among Western and high-income countries.

Conclusion: Female family caregivers experience a higher burden than male caregivers across regions and economic settings. Although regional and income-level subgroup differences were not statistically significant, findings underscore the role of cultural and structural contexts in shaping caregiver burden. Gender-sensitive, context specific interventions are essential to address these disparities.