Archives of gerontology and geriatrics最新文献

Aim: Frailty and Subjective Life Expectancy are important determinants of the health and well-being of older adults. This study aims to investigate the relationship between frailty and Subjective Life Expectancy in Sub-Sahara Africa.

Methods: This study is a cross-sectional study involving 1,017 older adults aged 50 years and above across three regions of Côte d'Ivoire. A 30-item Frailty Index was used to determine the prevalence of frailty. Subjective Life Expectancy was measured using self-reported estimates of expected lifespan. The point estimate and probabilistic procedures were used, with target ages set at 60, 80, 85, and 90 years. A non-parametric estimation procedure was used to compute the average life expectancy at individual level based on data from the probabilistic procedure. The distributional effects of frailty on Subjective Life Expectancy were assessed with the quantile selection model.

Results: The results indicate that, more than half (59.3 %) of the study participants were frail, 24.6 % were pre-frail and 16.1 % were non-frail. Being frail was negatively associated with Subjective Life Expectancy. Frail individuals had up to 3.7 years lower Subjective Life Expectancy compared to the non-frail individuals. Compared to individuals aged 50-54, those aged 55-59 and 80+ years had 4.8 and 27.8 years lower Subjective Life Expectancy respectively.

Conclusion: The study demonstrates a close connection between frailty and Subjective Life Expectancy among older adults, suggesting that interventions aimed at preventing or reducing frailty can influence Subjective Life Expectancy and overall well-being.

Background: Both air pollution and low socioeconomic status (SES) are associated with worse cognitive function. The extent to which low SES may compound the adverse effect of air pollution on cognitive function remains unclear.

Methods: 7,087 older adults aged 65 and above were included from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and followed up in 4 waves during 2008-2018. Cognitive function was measured repeatedly at each wave using the modified Chinese Mini-Mental State Examination (MMSE). Concentrations of particulate matter (PM₁, PM_2.5, and PM₁₀) were evaluated using satellite-based spatiotemporal models. SES was measured based on five components and categorized into three levels (low, middle, and high). Generalized estimating equation models were used to estimate the association of PM and SES with cognitive function. Stratified analyses and effect modification by SES levels were further conducted.

Results: Each 10 µg/m³ increase in PM₁, PM_2.5, and PM₁₀ was associated with a 0.43 (95 % CI: -0.58, -0.27), 0.29 (95% CI: -0.37, -0.20), and 0.17 (95 % CI: -0.22, -0.13) unit decrease in MMSE scores, respectively. Lower SES was associated with worse cognitive function. Significant effect modifications were observed by SES, with the corresponding association of PM exposure being more pronounced among participants with a lower SES (p-interaction = 0.006, 0.001, and 0.006 for PM₁, PM_2.5, and PM₁₀, respectively).

Conclusions: SES is an important effect modifier, and lower SES may compound the detrimental effect of PM on cognitive health. This finding may have implications for identifying vulnerable populations and targeted interventions against air pollution.

Objective: Phase angle is a promising tool for diagnosing sarcopenia. This study aimed to summarize its diagnostic performance by performing a systematic review and meta-analysis.

Methods: We conducted a systematic search of PubMed, Web of Science, Embase, and Scopus. The Quality Assessment of Diagnostic Accuracy Studies, Version 2, was used to evaluate the quality of the studies. A bivariate random effects model was employed for data synthesis, and diagnostic performance was reported in terms of pooled sensitivity, specificity, and the area under the summary receiver operating characteristic curve (AUC). Additionally, meta-regression, subgroup analyses, and sensitivity analyses were performed.

Results: A total of 15 studies were included in this meta-analysis, involving 4,063 participants. The overall risk of bias in the included studies was high. The meta-analysis revealed that the pooled sensitivity and specificity across all studies were 0.74 [95 % confidence interval (CI): 0.71-0.78] and 0.75 (95 % CI: 0.70-0.79), respectively, with an AUC of 0.79 (95 % CI: 0.76-0.83). Meta-regression indicated that study design, country, population, sex-specificity, and age may influence the diagnostic performance of phase angle. The optimal diagnostic performance was observed in the cut-off interval of 4.20 to 4.50°.

Conclusion: The phase angle demonstrated moderate diagnostic performance for sarcopenia, and the possible cut-off interval is 4.20 to 4.50 °. However, large-scale, multicenter prospective studies are necessary to assess its clinical applicability at specific cut-off values.

Objectives: Relationships among social isolation, loneliness, and disability onset remain unclear. We investigated the distinct patterns of disability development among Japanese older adults who experience social isolation and loneliness.

Design: This study applied a prospective observational approach.

Participants: Data from 4,716 community-dwelling independent older adults were analyzed.

Measurements: The Japanese version of the University of California, Los Angeles Loneliness Scale Version 3 and the Social Isolation Scale were used to measure loneliness and social isolation, respectively. The long-term care insurer conducted monthly follow-ups with participants over two years to determine their care needs. Disability onset was defined as the point at which participants were certified by a care manager as requiring long-term care.

Results: During the follow-up period, 265 participants (5.6 %) required long-term care insurance certification due to disability onset. The incidence of disability in the lonely and not lonely groups was 8.0 % and 4.5 %, respectively. In the socially isolated and not socially isolated groups, it was 7.1 % and 4.4 %, respectively. The Cox proportional hazards regression model revealed a significantly higher risk of disability incidence in the lonely and socially isolated groups. The high-risk group experiencing both loneliness and social isolation exhibited significantly higher hazard ratios than the low-risk group without these symptoms.

Conclusions: The results indicated that older adults experiencing both social isolation and loneliness were at high-risk for future disability incidence. This finding provides insight into the complex interplay between social factors and disability, which can contribute to the development of effective interventions to promote healthy aging and prevent disability.

Introduction: Lower urinary tract symptoms (LUTS) significantly impact men's quality of life and can cause bothersome symptoms, which often interfere with daily functioning and contribute to psychological distress. While pharmacological and surgical treatments are effective, they can have side effects, and not all men require or desire these interventions. The aim of this study is to assess the impact of self-management interventions on symptom severity.

Methods: We conducted a systematic search across multiple databases, including PubMed, Embase, and Cochrane Library, from inception to August 2024. We identified randomized controlled trials (RCTs) assessing self-management interventions for LUTS in men. Studies were evaluated for quality and analyzed for outcomes on BPH Impact Index, International Prostate Symptom Score (IPSS), and QoL. Publication bias and heterogeneity were examined through LFK indices, sensitivity analyses, and Doi plots.

Results: Self-management significantly reduced the BPH Impact Index at 3 months (SMD: -0.73; p = 0.0003) and 6 months (SMD: -0.95; p = 0.05), though publication bias was indicated. The IPSS decreased significantly at 3 months (MD: -5.52; p < 0.01), 6 months (MD: -5.50; p = 0.002), and 12 months (MD: -3.51; p = 0.01). Quality of life also improved at 6 and 12 months (SMD: -0.34, p = 0.002, and SMD: -0.30, p < 0.01, respectively). Sensitivity analysis confirmed the consistency of these findings after adjusting for study heterogeneity.

Conclusion: Our findings suggest that self-management interventions provide a significant benefit in reducing LUTS severity and enhancing quality of life in men.

Ischemic stroke, a severe cerebrovascular disease, is particularly prevalent among the elderly. Rsearch has indicated that histone deacetylases (HDACs) are pivotal in the pathogenesis of ischemic stroke. We introduce a novel HDACs inhibitor, HDI-1, as a potential therapeutic strategy for this condition. Our study reveals that HDI-1 expedites the restoration of tight junction proteins, Occludin and Claudin-5, in the oxygen-glucose deprivation/reoxygenation (OGD/R) model using human cerebral microvascular endothelial cells (hCMEC/D3). Moreover, HDI-1 mitigates the impairment of cellular monolayer membrane permeability following injury. This effect may stem from HDI-1's ability to selectively suppress the enzymatic activity of HDAC2. By inhibiting the activation of the NF-κB pathway triggered by OGD/R injury, HDI-1 reduces the secretion of pro-inflammatory cytokines IL-1β, IL-6, and TNF-α, thereby diminishing the inflammatory response in hCMEC/D3 cells. Meanwhile, HDI-1 exhibits antioxidant properties by enhancing the Nrf2/HO-1 signaling pathway. Collectively, our findings propose HDI-1 as a promising candidate for ischemic stroke treatment.

Decreased physical activity and high blood pressure are both risk factors for cardiovascular diseases. Controlling blood pressure within the normal range can prevent or delay these complications. This systematic review and meta-analysis analyzed the effects of different types of exercise training on the blood pressure and lipid profiles of older adults patients with hypertension. Five electronic databases (Web of Science, Cochrane, PubMed, Google Scholar, and Scopus) were searched from their inception until March 03, 2024. English publications and randomized controlled trials involving different types of exercise training treatments for hypertensive populations were included. Data were analyzed using a random-effects model to estimate weighted mean differences (WMD) and 95 % confidence intervals. The systematic search identified 1998 articles, of which 92 studies met the inclusion criteria and were deemed eligible for inclusion. The results of the meta-analysis indicated that reduced systolic (SBP) and diastolic blood pressures (DBP) after aerobic training (p < 0.01), resistance training (p < 0.01), combined (aerobic + resistance) exercise training (p < 0.01) and isometric handgrip training (p < 0.01). Significant reductions were also observed in low-density lipoprotein (LDL) and triglyceride (TG) levels following combined (aerobic + resistance) exercise training (p < 0.05 and p < 0.001), and resistance training (p < 0.01), respectively. High-density lipoprotein (HDL) levels were increased following aerobic training (p < 0.01), and combined (aerobic + resistance) exercise training (p < 0.01), but not after resistance and Tai chi training. Isometric handgrip training leads to greater reductions in blood pressure in hypertensive patients compared to the effects of aerobic, resistance, combined aerobic and resistance exercise, and tai chi training. Additional studies are needed to determine the exercise prescription protocols to maximize the health of older adults patients with hypertension.

Objective: This study investigated the bidirectional longitudinal association between subjective oral health (SOH) and subjective well-being (SWB) over time.

Methods: This cohort study was based on a four-wave surveys conducted by the English Longitudinal Study of Aging. SOH was measured by oral impacts on daily performance (OIDP), self-rated oral health (SROH), and SWB was measured by the Center for Epidemiologic Studies-Depression (CES-D) scale, Control, Autonomy, Self-Realization, and Pleasure (CASP-19), and satisfaction with life scale (SWLS). To evaluate the bidirectional associations between SOH and SWB, separate models were created using SOH and SWB as the outcome and exposure, respectively. Additionally, the synchronous and lagged effects of exposure on outcomes were checked by employing exposures measured at different time points. A generalized estimating equation model was fitted, including the exposure variables, outcome variables in the previous wave, and baseline covariates.

Results: Among 4,510 participants (mean age=61.7 years [1SD=7.9], men=43.1 %), 8.1 %, 18.2 %, 14.3 %, 30.5 %, and 25.0 % had poor SOH and SWB as measured by OIDP, SROH, CES-D, CASP-19, and SWLS at baseline, respectively. The results of the regression models with all combinations of SOH and SWB measures showed that poor conditions of SOH or SWB were significantly associated with poor conditions of the other measures (all p < 0.05). In almost all combinations of SOH and SWB measures, the synchronous effect was stronger than the lagged effect.

Conclusion: SOH and SWB are closely linked, and comprehensive care that considers oral health could contribute to well-being later in life.

Background: The relationship between dietary live microbe intake, non-dietary prebiotics/probiotics, and mortality in older adults remains unclear.

Methods: Participants from the National Health and Nutrition Examination Survey 2003-2018 were included. Participants were categorized into three groups based on estimated live microbe intake: low, medium, and high. Additionally, they were divided by their consumption of foods with medium or high microbial content. Text mining was employed to identify the use of non-dietary prebiotics and probiotics by analyzing the names and ingredients of dietary supplements and drugs. Associations between live microbe intake, non-dietary prebiotics/probiotics, and all-cause or cardiovascular mortality were assessed using Kaplan-Meier survival curves and Cox regression models. Inverse Probability of Treatment Weighting was used for sensitivity analysis RESULT: A total of 7882 participants were included in the study. During a mean follow-up of 8.08 years, all-cause mortality was 18 % lower in older adults with high dietary live microbe intake in fully adjusted models (HR, 0.82; 95 %CI 0.70-0.96), and cardiovascular mortality was reduced by 23 % (HR, 0.77; 95 %CI 0.61-0.98). The risk of all-cause mortality was reduced by 21 % in the G3 group compared with the G1 group (HR, 0.79; 95 % CI 0.69-0.89) and a 29 % reduction in the risk of cardiovascular disease-specific death (HR, 0.71;95 %CI 0.59-0.86). In addition, we also observed that nondietary prebiotic and probiotic supplement intake was also associated with a reduced risk of mortality in an older US population.

Conclusion: In older U.S. adults, higher dietary live microorganisms and non-dietary probiotics/prebiotics intake was associated with a reduced risk of all-cause and cardiovascular mortality.

Background: Previous studies showed that physical performance was associated with mild cognitive impairment (MCI). As the easily measured aging biomarkers, grip strength and gait speed could effectively reflect physical function. However, whether grip strength, gait speed, and the combination of the two were bidirectionally associated with MCI and specific cognitive function domains, have not been explored.

Methods: The bidirectional relationships between grip strength and MCI, gait speed and MCI, and the combination of grip strength with gait speed and MCI, were examined by generalized estimating equation (GEE). GEE was performed to further estimate the bidirectional relationships between grip strength combined with gait speed and the five domains of cognitive function, respectively.

Results: In total, 2,227 older adults (3 waves) were included. The MCI risk was higher for low grip strength group (OR = 1.78; P < 0.001) compared to normal grip strength group, as well as higher for low gait speed group (OR = 1.71; P < 0.001) compared to normal gait speed group. Low grip strength combined with low gait speed had the maximum associations with MCI (OR = 4.13; P < 0.001) and decline in orientation, immediate memory, delayed memory, attention and calculation, and language. Older adults with MCI and decline in those five domains of cognition also longitudinally related to lower grip strength and lower gait speed.

Conclusion: The main findings revealed the importance of regularly monitoring grip strength, gait speed, global cognition, and specific cognitive function domains among older people. Early interventions for grip strength, gait speed, and cognition function might achieve reciprocal benefits.