Archives of gerontology and geriatrics最新文献

Background: Functional ability (FA), a key determinant of healthy aging, is determined by intrinsic capacity (IC), environmental factors, and their interactions. IC is a composite of physical and mental capacities that undergo constant change. Therefore, understanding the factors that influence IC requires a multi-level analysis of individuals to optimize its trajectory.

Methods: Individuals aged ≥ 65 were included in the Korean Longitudinal Study of Aging (2012-2020). Impaired IC (IIC) scores were tracked over eight years using latent class growth modeling to classify trajectory patterns. Determinants were identified through multinomial logistic regression. The relationship between IIC trajectory and FA decline was assessed using Kaplan-Meier analysis and the Cox proportional hazards model.

Results: Of the 7486 subjects, 2268 (mean age 72.26 [SD 5.31] years; female 56.4 %) were included after excluding those who were underage, had lost independence, or were missing baseline data. The IIC trajectories were categorized into four classes: low-persistent (Class 1, 48.46 %); low-increasing (Class 2, 17.46 %); high-decreasing (Class 3, 20.37 %); and high-stable (Class 4, 13.71 %). Over a mean follow-up of 7.21 years, 536 individuals experienced a decline in FA. After adjusting for confounders, the hazard ratios (HRs) were 1.95 (95 % CI 1.51-2.50) for class 2, 1.93 (1.50-2.46) for class 3, and 3.41 (2.64-4.39) for class 4 compared to class 1. Additionally, age, gender, marital status, employment, social participation, and living status had overlapping effects on both IC and FA.

Conclusions: Understanding the heterogeneity of IC, combined with multidomain interventions, can enable FA maintenance and promote healthy aging.

Purpose: Although several studies have reported positive associations between functional social support (FSS) and memory, few have explored how other social variables, such as marital status, may affect the magnitude and direction of this association. We examined whether marital status modifies the association between FSS and memory in a sample of community-dwelling, middle-aged and older adults.

Methods: Data at three timepoints, spanning six years, were analyzed from the Tracking Cohort of the Canadian Longitudinal Study on Aging (n = 10,318). Linear mixed models were used to regress memory onto FSS across all three timepoints, adjusting for multiple covariates. The moderating effect of marital status was assessed by adding its interaction with FSS in the model. Separate regression models were built for overall FSS and four subtypes (positive interactions, affectionate, emotional/informational, and tangible support).

Results: We found significant and positive adjusted associations for overall FSS (β: 0.07; 95 % CI: 0.01, 0.13), positive interactions (β: 0.06; 95 % CI: 0.01, 0.11), and affectionate support (β: 0.05; 95 % CI: 0.00, 0.11) with memory. However, the interaction between marital status and FSS (overall and subtypes) was not statistically significant (likelihood ratio test p-value = 0.75), indicating that FSS does not have differing effects on memory depending on marital status.

Conclusion: Our findings do not provide evidence to suggest that marital status affects the association between FSS and memory in middle-aged and older adults. Nonetheless, policymakers and practitioners should take a comprehensive approach when exploring how various dimensions of social relationships may uniquely influence cognitive trajectories.

Background: Vascular aging is the basis of many chronic diseases of the aged, such as hypertension, coronary heart disease and stroke.

Objective: This study aims to deepen our understanding of the pathological mechanisms of vascular aging by combining multiple big data research methods, and reveal potential therapeutic targets and biomarkers.

Methods: WGCNA method was used to integrate the aortic transcriptome data of multiple age stages, and extract the key module and key pathway. The gene of aortic rhythm was integrated by JTK algorithm. Correlation calculation was performed for core gene and associated pathways. Finally, the expression of the core gene and their interaction with the associated pathways were verified in cell senescence.

Results: WGCNA showed that circadian rhythm is the key pathway of vascular aging, and circadian rhythm and metabolism interact to promote the occurrence of vascular aging. Cry2 has been identified as the most critical core rhythm gene. Lipid metabolism is the most Cry2-related subpathway, among which phospholipid metabolism and Serac1 have the strongest and most significant correlation with Cry2. Cry2 is mainly distributed in endothelial cells in both young and senescent blood vessels, and affects five lipid-related metabolic processes including lipid transport during endothelial senescence.

Conclusion: This study suggests that circadian rhythm and Cry2 may be potential targets of vascular aging, and further studies on their interaction with lipid metabolism will provide effective strategies for the prevention and treatment of age-related vascular diseases.

Background: Engagement in non-exercise physical activities (NEPA) has a significant correlation with health. This study aimed to compare the impact of moderate-to-vigorous-intensity NEPA and exercise habit (EH) on frailty among community-dwelling older adults.

Methods: This study utilized data from the Kashiwa cohort study in Japan, with baseline assessments in 2014 with a 7-year follow ups (4.0 [2.0-7.0]). A total of 1,288 participants were included. Frailty was assessed using the Cardiovascular Health Study Index, NEPA through the Global Physical Activity Questionnaire, and EH via self-reported exercise engagement at each follow-up examination. Generalized estimating equations (GEE) and Cox regression analyses were used to estimate associations between NEPA, EH, and frailty.

Results: Compared to participants with no NEPA nor EH, those with NEPA only, with EH only, and with both showed significantly lower adjusted odds ratio (95 %CI) of frailty: 0.29 (0.16-0.52), 0.21 (0.11-0.41) and 0.21 (0.12-0.36). NEPA and EH at baseline were predictor variables for new-onset frailty during the 7-year follow-up period, with adjusted hazard ratios (95 % CI) of 0.55 (0.33-0.92) for NEPA only, 0.51 (0.29-0.90) for EH only, and 0.42 (0.25-0.70) for both. No significant differences were observed between the associations of NEPA and EH with frailty.

Conclusions: NEPA is associated with lower frailty risk in older adults, with a similar but non-additive effect to that of EH. These findings highlight the importance of NEPA for frailty prevention, particularly for those not engaged in formal exercise programs.

Objectives: To examine how homeboundness is associated with psychosocial outcomes in terms of life satisfaction, positive affect, negative affect and loneliness among middle-aged and older adults.

Methods: Longitudinal data were taken from the nationally representative sample German Ageing Survey (wave 1 to wave 4; n = 18,491 observations). This study included community-dwelling individuals aged 40 years and over in Germany. The mean age in the analytic sample was 62.3 years (SD: 11.8 years). Established tools were used to quantify the psychosocial outcomes. Spending six or more days per week at home was defined as homeboundness. It was adjusted for several time-varying covariates. An asymmetric linear FE regression model with cluster-robust standard errors was applied.

Results: There was a robust association between the onset of homeboundness and an increase in loneliness. Among individuals aged 40 to 64 years, the onset of homeboundness was significantly associated with decreases in positive affect, whereas the end of homeboundness was significantly associated with decreases in negative affect. In contrast, changes in homeboundness status were not significantly associated with changes in psychosocial outcomes among individuals aged 65 years and over.

Conclusion: The onset of homeboundness in particular can contribute to unfavorable psychosocial outcomes, particularly in terms of increases in loneliness. Efforts to avoid homeboundness may assist in ageing successfully.

Background and aims: Good Selenium (Se) status predicts favorable prognoses for various diseases and a reduced overall mortality. The primary objective of the study was to determine whether Selenium status, i.e. Selenoprotein P (SeP) levels, is associated with risk of 90-day mortality in elderly patients with acute dyspnea at the Emergency Department (ED).

Methods and results: Patients presenting with dyspnea were enrolled from the ED at the University Hospital in Malmö between 2013 and 2018. Cox regression analyses were conducted to evaluate hazard ratios (HRs) for 90-day mortality. This analysis was performed in two steps. Model A included adjustments for age and sex with 95 % confidence intervals (95 % CI) for individual factors such as SeP levels, the Medical Emergency Triage and Treatment System - Adult (METTS-A), BMI levels, comorbidities, and smoking status. Model B was a multivariate analysis with 99 % confidence intervals (99 % CI), incorporating age, sex, and statistically significant factors from Model A, including SeP levels, BMI, heart failure, anemia, and stroke. A lower concentration of SeP was independently associated with a higher risk of death within 90 days. In the continuous model of SeP, the HR was 0.798 (99 % CI 0.678-0.940). When comparing the lowest quartile to the highest quartile of SeP, the HR was 2.462 (99 % CI 1.240-4.891).

Conclusion: Low SeP concentrations were found to predict 90-day mortality in ED patients presenting with dyspnea. The assessment of SeP levels could serve as a valuable tool in the initial evaluation of elderly patients in the ED.

Objectives: To investigate the relationship between estimated glucose disposal rates (eGDR) and the progression of frailty, using longitudinal data.

Methods: We analyzed four waves of data from the China Health and Retirement Longitudinal Study (CHARLS) from 2011 to 2018, involving 6,778 middle-aged and older adults. eGDR was calculated using a specific formula, categorizing participants into high and low eGDR groups based on the lowest quartile (8.5). Frailty status was assessed using the frailty index (FI). Linear mixed-effects models were employed to analyze the association between eGDR and frailty progression, as well as the impact of transitions in eGDR.

Results: We found that the baseline FI was significantly higher in the low eGDR group compared to the high eGDR group. Furthermore, participants in the low eGDR group exhibited a faster progression of frailty, compared to those in the high eGDR group. Among non-frail participants at baseline, the association between low eGDR and accelerated frailty progression was even more pronounced. Further analysis revealed that, compared to participants who maintained a stable high eGDR, those who transitioned from high to low eGDR and those who consistently remained in the low eGDR group both experienced significantly accelerated frailty progression. On the contrary, participants who transitioned from low to high eGDR did not show a significant acceleration in frailty progression compared to those who consistently maintained a high eGDR.

Conclusion: Low eGDR is linked to accelerated frailty progression in middle-aged and older Chinese adults. Transitioning from low to high eGDR may mitigate this progression, highlighting the importance of eGDR in frailty management.

Background: Previous longitudinal studies have linked multimorbidity to loneliness (feeling alienated) and social isolation (having reduced social contact). However, the nature of these associations over time is unclear.

Objective: To examine bidirectional associations of multimorbidity with loneliness and social isolation over a 14-year follow-up in a nationally representative cohort of adults aged ≥ 50 years.

Methods: This retrospective cohort study used seven waves of data (collected between 2004/2005 and 2018/2019) from adults in the English Longitudinal Study of Ageing. Multimorbidity was defined as the presence of ≥2 long-term conditions. Loneliness was measured using the 3-item University of California Los Angeles (UCLA) scale. Social isolation was derived based on cohabitation status, frequency of contact with children, relatives, and friends, and social organisation membership. We used Cox proportional hazards models adjusted for social isolation or loneliness, demographic and health behaviour variables.

Results: The cohort consisted of 6031 adults with baseline and follow-up data on loneliness, social isolation, multimorbidity, and other covariates. Loneliness was associated with increased risk of incident multimorbidity [aHR (95 % CI): 1.38 (1.15-1.65)], whereas social isolation was not [aHR (95 % CI): 0.97 (0.81-1.16)]. Multimorbidity was associated with increased risk of incident loneliness [aHR (95 % CI): 1.55 (1.30-1.84)], but not significantly associated with subsequent risk of incident social isolation [aHR (95 % CI): 1.09 (0.92-1.28)].

Conclusions: An independent bidirectional association exists between loneliness and multimorbidity. Interventions targeting loneliness may prevent or delay multimorbidity and also improve wellbeing for people with multimorbidity.

Objective: Sarcopenia not only affects patients' quality of life but also may exacerbate the pathological processes of coronary artery disease (CAD). This study aimed to identify potential biomarkers to improve the combined diagnosis and treatment of sarcopenia and CAD.

Methods: Datasets for sarcopenia and CAD were sourced from the Gene Expression Omnibus (GEO). Weighted gene co-expression network analysis (WGCNA) was used to identify key module genes. Functional enrichment analysis was conducted to explore biological significance. Three machine learning algorithms were applied to further determine candidate hub genes, including SVM-RFE, LASSO regression, and random forest (RF). Then, we generated receiver operating characteristic (ROC) curves to evaluate the diagnostic efficacy of the candidate genes. Moreover, mendelian randomization (MR) analysis was conducted based on GWAS summary data, along with sensitivity analysis to explore causal relationships.

Results: WGCNA analysis identified 278 genes associated with sarcopenia and CAD. The results of the enrichment analysis indicated a complex interplay between RNA metabolism, signaling pathways, and cellular stress responses. Through machine learning methods and ROC curves, we identified the key gene semaphorin 3C (SEMA3C). MR analysis revealed that higher plasma levels of SEMA3C are associated with an increased risk of CAD (OR = 1.068, 95 % CI 1.012-1.128, P = 0.016) and low hand grip strength (HGS) (OR = 1.059, 95 % CI 1.010-1.110, P = 0.018) .

Conclusion: SEMA3C has been identified as a key gene for sarcopenia and CAD. This insight suggests that targeting SEMA3C may offer new therapeutic opportunities in related conditions.