Frailty is an ageing-associated multidimensional condition linked to higher long-term care (LTC) needs, healthcare expenditures, and mortality. In Japan, the Questionnaire for Medical Checkup of Old-Old (QMCOO) is used to assess frailty, but its implementation is resource-intensive. Claims-based prediction models may offer a scalable alternative for early frailty identification.
Methods
We developed a machine learning model using administrative claims data from older adults to predict frailty status as defined by the QMCOO. In Phase 1, the model was trained and validated using data from a single municipality. In Phase 2, the model's prognostic utility for predicting all-cause mortality was evaluated using data from seven other municipalities. We applied the eXtreme Gradient Boosting algorithm, incorporating demographic variables, LTC use, comorbidities, procedures, and medical device use. Model performance was assessed mainly using the area under the receiver operating characteristic curve (ROC-AUC). Mortality risk was estimated using Kaplan–Meier method and Cox regression models.
Results
In Phase 1, a total of 74,148 individuals were included (development cohort: 60,930, validation cohort: 13,218). The model achieved an ROC-AUC of 0.780 in internal validation and 0.728 in external validation. In Phase 2, external validation was conducted in a new cohort of 354,815 individuals. Frailty classification was associated with significantly higher mortality in both the development (hazard ratio: 7.03, 95% confidence interval: 6.47–7.63) and validation (6.75, 6.62–6.89) cohorts.
Conclusion
This claims-based frailty prediction model showed reasonable performance and prognostic value. It may support efficient, population-level frailty screenings where questionnaire-based assessments are impractical.
{"title":"Development and validation of a machine learning model for frailty screening using claims data in Japan: the Longevity Improvement & Fair Evidence Study","authors":"Kengo Kawaguchi , Megumi Maeda , Futoshi Oda , Yasuharu Nakashima , Haruhisa Fukuda","doi":"10.1016/j.exger.2026.113050","DOIUrl":"10.1016/j.exger.2026.113050","url":null,"abstract":"<div><h3>Background</h3><div>Frailty is an ageing-associated multidimensional condition linked to higher long-term care (LTC) needs, healthcare expenditures, and mortality. In Japan, the Questionnaire for Medical Checkup of Old-Old (QMCOO) is used to assess frailty, but its implementation is resource-intensive. Claims-based prediction models may offer a scalable alternative for early frailty identification.</div></div><div><h3>Methods</h3><div>We developed a machine learning model using administrative claims data from older adults to predict frailty status as defined by the QMCOO. In Phase 1, the model was trained and validated using data from a single municipality. In Phase 2, the model's prognostic utility for predicting all-cause mortality was evaluated using data from seven other municipalities. We applied the eXtreme Gradient Boosting algorithm, incorporating demographic variables, LTC use, comorbidities, procedures, and medical device use. Model performance was assessed mainly using the area under the receiver operating characteristic curve (ROC-AUC). Mortality risk was estimated using Kaplan–Meier method and Cox regression models.</div></div><div><h3>Results</h3><div>In Phase 1, a total of 74,148 individuals were included (development cohort: 60,930, validation cohort: 13,218). The model achieved an ROC-AUC of 0.780 in internal validation and 0.728 in external validation. In Phase 2, external validation was conducted in a new cohort of 354,815 individuals. Frailty classification was associated with significantly higher mortality in both the development (hazard ratio: 7.03, 95% confidence interval: 6.47–7.63) and validation (6.75, 6.62–6.89) cohorts.</div></div><div><h3>Conclusion</h3><div>This claims-based frailty prediction model showed reasonable performance and prognostic value. It may support efficient, population-level frailty screenings where questionnaire-based assessments are impractical.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"215 ","pages":"Article 113050"},"PeriodicalIF":4.3,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146081231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-25DOI: 10.1016/j.exger.2026.113046
Itzel Ivonn López-Tenorio, Luis Alejandro Constantino-Jonapa, Samuel Jaimez-Alvarado, Sandy Reyes-Martínez, Alma Reyna Escalona-Montaño, Claudia Tavera-Alonso, Rocío Valdez-Gómez, Marta Menicatti, Gianluca Bartolucci, Elena Niccolai, Baldi Simone, Amedeo Amedei, Nydia Ávila-Vanzzini, María Magdalena Aguirre-García
Background and aim: Advances in human microbiome research have highlighted its influence on host health. This study aimed to characterize the oral microbiome (OM) and gut microbiome (GM) and to examine their relationships with systemic fatty acid and cytokine profiles across different age groups in healthy adults.
Methods: Participants aged 18-76 years without diagnosed diseases were grouped into young (18-29 years), middle-aged (30-49 years), and older adults (≥50 years). Blood, dental plaque, and fecal samples were collected. OM and GM composition were evaluated using 16 rRNA sequencing. Circulating free fatty acids (FFAs) were quantified by gas chromatography-mass spectrometry, and serum cytokines were assessed using flow cytometry.
Results: In the OM, Fusobacterium and Haemophilus were notably abundant in young adults, while Haemophilus and Neisseria predominated in middle-aged adults. In older adults, Neisseria and Capnocytophaga were the most prevalent oral genera. In the GM, Bacteroides was the most prevalent genus across all age groups, followed by Faecalibacterium, Blautia, and Prevotella_9. Additionally, circulating levels of decanoic, hexadecanoic, and octadecanoic acids, as well as the cytokine IP-10, were higher in young adults compared with the other age groups.
Conclusion: To our knowledge, this study is the first to characterize and correlate the diversity of both the OM and GM with systemic FFA and cytokine profiles in a cohort of healthy adults, highlighting the critical role of age in shaping microbiome composition and associated metabolites. Integrating microbial profiling with serum FFA and cytokine measurements enhances our understanding of how the microbiome may influence health and disease risk across the adult lifespan.
{"title":"Age-related diversity of the oral and gut microbiome and its correlation with systemic fatty acids and cytokine profiles in healthy subjects.","authors":"Itzel Ivonn López-Tenorio, Luis Alejandro Constantino-Jonapa, Samuel Jaimez-Alvarado, Sandy Reyes-Martínez, Alma Reyna Escalona-Montaño, Claudia Tavera-Alonso, Rocío Valdez-Gómez, Marta Menicatti, Gianluca Bartolucci, Elena Niccolai, Baldi Simone, Amedeo Amedei, Nydia Ávila-Vanzzini, María Magdalena Aguirre-García","doi":"10.1016/j.exger.2026.113046","DOIUrl":"10.1016/j.exger.2026.113046","url":null,"abstract":"<p><strong>Background and aim: </strong>Advances in human microbiome research have highlighted its influence on host health. This study aimed to characterize the oral microbiome (OM) and gut microbiome (GM) and to examine their relationships with systemic fatty acid and cytokine profiles across different age groups in healthy adults.</p><p><strong>Methods: </strong>Participants aged 18-76 years without diagnosed diseases were grouped into young (18-29 years), middle-aged (30-49 years), and older adults (≥50 years). Blood, dental plaque, and fecal samples were collected. OM and GM composition were evaluated using 16 rRNA sequencing. Circulating free fatty acids (FFAs) were quantified by gas chromatography-mass spectrometry, and serum cytokines were assessed using flow cytometry.</p><p><strong>Results: </strong>In the OM, Fusobacterium and Haemophilus were notably abundant in young adults, while Haemophilus and Neisseria predominated in middle-aged adults. In older adults, Neisseria and Capnocytophaga were the most prevalent oral genera. In the GM, Bacteroides was the most prevalent genus across all age groups, followed by Faecalibacterium, Blautia, and Prevotella_9. Additionally, circulating levels of decanoic, hexadecanoic, and octadecanoic acids, as well as the cytokine IP-10, were higher in young adults compared with the other age groups.</p><p><strong>Conclusion: </strong>To our knowledge, this study is the first to characterize and correlate the diversity of both the OM and GM with systemic FFA and cytokine profiles in a cohort of healthy adults, highlighting the critical role of age in shaping microbiome composition and associated metabolites. Integrating microbial profiling with serum FFA and cytokine measurements enhances our understanding of how the microbiome may influence health and disease risk across the adult lifespan.</p>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":" ","pages":"113046"},"PeriodicalIF":4.3,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146069363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-23DOI: 10.1016/j.exger.2026.113043
Shuaijie Chen , Qiong Su , Ruming Shen , Hailin Zhang , Xiaoyan Lin , Shengbin Yu , Mingqin Chen , Yuhong Shi , Feng Peng , Jinxiu Lin , Dajun Chai
Background
Rest-activity rhythm (RAR) is a fundamental biomarker of age-related circadian system deterioration. However, the long-term effect of RAR patterns on mortality in older adults remains unclear.
Methods
This study analysed data from National Health and Nutrition Examination Survey 2011–2014. The RAR parameters were derived from wrist accelerometers, and four patterns were identified through clustering analysis using Gaussian mixture models. Cox models were used to compare the hazard ratio (HR) and 95% confidence interval (CI) of mortality among participants with different RAR parameters and patterns.
Results
This study included 1710 participants aged ≥60 years. The median follow-up duration was 6.67 years. In total, 269 all-cause deaths and 77 cardiovascular deaths occurred during follow-up period. Four RAR patterns were identified: ‘morning-type’, ‘earlier-type’, ‘delayed-type’, and ‘evening-type’. Compared to ‘morning-type’, ‘evening-type’ was associated with higher risks of cardiovascular (HR: 12.16, 95% CI: 4.02–36.82) and all-cause mortality (HR: 3.31, 95% CI: 1.91–5.72). Higher interdaily stability was associated with lower risks of cardiovascular (HR: 0.67, 95% CI: 0.55–0.81), and all-cause mortality (HR: 0.86, 95% CI: 0.74–1.00). Higher relative amplitude was associated with lower risks of cardiovascular (HR: 0.61, 95% CI: 0.49–0.75), and all-cause mortality (HR: 0.70, 95% CI: 0.60–0.81). Conversely, higher intradaily variability was associated with increased risk of cardiovascular (HR: 1.30, 95% CI: 1.15–1.46) and all-cause mortality (HR: 1.19, 95% CI: 1.10–1.30).
Conclusions
RAR patterns and parameters were significantly associated with cardiovascular and all-cause mortality in older adults. Early identification and intervention for adverse RAR patterns may help improve long-term health outcomes.
{"title":"Association of accelerometer-measured rest-activity rhythm patterns and parameters with cardiovascular and all-cause mortality in older adults: Population-based cohort study","authors":"Shuaijie Chen , Qiong Su , Ruming Shen , Hailin Zhang , Xiaoyan Lin , Shengbin Yu , Mingqin Chen , Yuhong Shi , Feng Peng , Jinxiu Lin , Dajun Chai","doi":"10.1016/j.exger.2026.113043","DOIUrl":"10.1016/j.exger.2026.113043","url":null,"abstract":"<div><h3>Background</h3><div>Rest-activity rhythm (RAR) is a fundamental biomarker of age-related circadian system deterioration. However, the long-term effect of RAR patterns on mortality in older adults remains unclear.</div></div><div><h3>Methods</h3><div>This study analysed data from National Health and Nutrition Examination Survey 2011–2014. The RAR parameters were derived from wrist accelerometers, and four patterns were identified through clustering analysis using Gaussian mixture models. Cox models were used to compare the hazard ratio (HR) and 95% confidence interval (CI) of mortality among participants with different RAR parameters and patterns.</div></div><div><h3>Results</h3><div>This study included 1710 participants aged ≥60 years. The median follow-up duration was 6.67 years. In total, 269 all-cause deaths and 77 cardiovascular deaths occurred during follow-up period. Four RAR patterns were identified: ‘morning-type’, ‘earlier-type’, ‘delayed-type’, and ‘evening-type’. Compared to ‘morning-type’, ‘evening-type’ was associated with higher risks of cardiovascular (HR: 12.16, 95% CI: 4.02–36.82) and all-cause mortality (HR: 3.31, 95% CI: 1.91–5.72). Higher interdaily stability was associated with lower risks of cardiovascular (HR: 0.67, 95% CI: 0.55–0.81), and all-cause mortality (HR: 0.86, 95% CI: 0.74–1.00). Higher relative amplitude was associated with lower risks of cardiovascular (HR: 0.61, 95% CI: 0.49–0.75), and all-cause mortality (HR: 0.70, 95% CI: 0.60–0.81). Conversely, higher intradaily variability was associated with increased risk of cardiovascular (HR: 1.30, 95% CI: 1.15–1.46) and all-cause mortality (HR: 1.19, 95% CI: 1.10–1.30).</div></div><div><h3>Conclusions</h3><div>RAR patterns and parameters were significantly associated with cardiovascular and all-cause mortality in older adults. Early identification and intervention for adverse RAR patterns may help improve long-term health outcomes.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"215 ","pages":"Article 113043"},"PeriodicalIF":4.3,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.exger.2026.113041
Jiadong Qiu , Xiongying Song , Jian Wang , Sungmin Kim
Objective
To compare community-feasible exercise effects on cognition and explore muscle–brain axis mechanisms in older adults.
Methods
In this a single-blind, five-arm randomized controlled trial, participants were allocated to 12-form Chen-style Tai Chi (CTC12), 24-form Yang-style Tai Chi (TC24), square dancing (SD), walking, or control for 12 weeks (two sessions/week). Global cognition was assessed using Beijing Chinese MoCA. Body composition was evaluated using multifrequency bioimpedance: skeletal muscle mass (SMM), fat mass (FM), total body water, protein mass and basal metabolic rate (BMR). Physical performance was assessed using Short Physical Performance Battery (SPPB), maximal handgrip strength (HGS). Fasting interleukin-6 (IL-6) levels and other blood biomarkers were also measured.
Results
113 participants completed the intervention (mean age 62.3 years; 79.6% female). After 12 weeks training, MoCA scores were improved in CTC12 group (n = 22, Δ = +0.46, p = 0.0045) and SD group (n = 22, Δ = +0.50, p = 0.0046), with no change in TC24 group (n = 23), walking group (n = 23), and control group (n = 23). Physiologically, CTC12 group increased SMM and BMR with small SPPB/HGS gains and showed a significant reduction in IL-6 levels; SD group reduced BMI and FM and increased BMR and SPPB; TC24 group increased BMR only; walking showed no measurable changes. For correlation analyses, ΔMoCA was positively associated with ΔSMM (p = 0.014) and ΔBMR (p = 0.004) in the CTC12 group, and negatively associated with ΔBMI (p = 0.002) and ΔFM (p = 0.002) in the SD group.
Conclusions
CTC12, SD were associated with modest cognitive gains and distinct physiological patterns potentially linked to the muscle–brain axis, which may help guide exercise choices for older adults.
{"title":"Muscle–brain axis mechanisms linking community-based exercise to cognitive function in older adults: A five-arm randomized controlled trial","authors":"Jiadong Qiu , Xiongying Song , Jian Wang , Sungmin Kim","doi":"10.1016/j.exger.2026.113041","DOIUrl":"10.1016/j.exger.2026.113041","url":null,"abstract":"<div><h3>Objective</h3><div>To compare community-feasible exercise effects on cognition and explore muscle–brain axis mechanisms in older adults.</div></div><div><h3>Methods</h3><div>In this a single-blind, five-arm randomized controlled trial, participants were allocated to 12-form Chen-style Tai Chi (CTC12), 24-form Yang-style Tai Chi (TC24), square dancing (SD), walking, or control for 12 weeks (two sessions/week). Global cognition was assessed using Beijing Chinese MoCA. Body composition was evaluated using multifrequency bioimpedance: skeletal muscle mass (SMM), fat mass (FM), total body water, protein mass and basal metabolic rate (BMR). Physical performance was assessed using Short Physical Performance Battery (SPPB), maximal handgrip strength (HGS). Fasting interleukin-6 (IL-6) levels and other blood biomarkers were also measured.</div></div><div><h3>Results</h3><div>113 participants completed the intervention (mean age 62.3 years; 79.6% female). After 12 weeks training, MoCA scores were improved in CTC12 group (<em>n</em> = 22, Δ = +0.46, <em>p</em> = 0.0045) and SD group (n = 22, Δ = +0.50, <em>p</em> = 0.0046), with no change in TC24 group (<em>n</em> = 23), walking group (n = 23), and control group (n = 23). Physiologically, CTC12 group increased SMM and BMR with small SPPB/HGS gains and showed a significant reduction in IL-6 levels; SD group reduced BMI and FM and increased BMR and SPPB; TC24 group increased BMR only; walking showed no measurable changes. For correlation analyses, ΔMoCA was positively associated with ΔSMM (<em>p</em> = 0.014) and ΔBMR (<em>p</em> = 0.004) in the CTC12 group, and negatively associated with ΔBMI (<em>p</em> = 0.002) and ΔFM (p = 0.002) in the SD group.</div></div><div><h3>Conclusions</h3><div>CTC12, SD were associated with modest cognitive gains and distinct physiological patterns potentially linked to the muscle–brain axis, which may help guide exercise choices for older adults.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"214 ","pages":"Article 113041"},"PeriodicalIF":4.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.exger.2026.113049
Xiao Long , Ruizhi Chen , Yanmin Lu , Binbin Ma , Yuxin Chang , Zichao Jiang , Ting Lei
Background
While accumulating points have been figured out the importance of muscle function, less clinical or epidemiological evidence have been provided. This study aimed to provide new evidence on the systemic effects of muscle mass on health condition, based on the National Health and Nutrition Examination Survey (NHANES) program.
Method
All used data was acquired from 11 survey cycles (1999–2020) of the NHANES program. The mortality information of participants was derived from the National Death Index (NDI) website. The disease status of participants was obtained from questionnaire surveys. The metabolism-related index was obtained from examination data. Multiple regression methods, smooth curve fitting, and threshold effect models were used for association analyses.
Result
In this large-scale study encompassing 46,733 participants, appendicular lean mass (ALM) demonstrated significant associations with multiple health outcomes: ALM exhibited L-shaped relationships with hyperuricemia and malignancy, inverse correlations with asthma, chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), nephrolithiasis, depression, and cancer-cause mortality, a positive correlation with bone mineral density (BMD), and notably, protective saturating effects against osteoarthritis (OA), all-cause mortality, and cardiovascular (CVD)-cause mortality. A significant inverse association was observed between sarcopenia and BMD, while positive correlations were identified between sarcopenia and COPD, asthma, OA, depression, and all-cause mortality.
Conclusions
In this study, we explored the association between ALM or sarcopenia and multiple health outcomes, highlighting the widespread impact of ALM on systemic health condition. These findings provide new epidemiological evidence on how ALM or sarcopenia influence the health status among the U.S. population.
{"title":"Comprehensive evaluation of appendicular lean mass and sarcopenia on human health: evidence from the NHANES program","authors":"Xiao Long , Ruizhi Chen , Yanmin Lu , Binbin Ma , Yuxin Chang , Zichao Jiang , Ting Lei","doi":"10.1016/j.exger.2026.113049","DOIUrl":"10.1016/j.exger.2026.113049","url":null,"abstract":"<div><h3>Background</h3><div>While accumulating points have been figured out the importance of muscle function, less clinical or epidemiological evidence have been provided. This study aimed to provide new evidence on the systemic effects of muscle mass on health condition, based on the National Health and Nutrition Examination Survey (NHANES) program.</div></div><div><h3>Method</h3><div>All used data was acquired from 11 survey cycles (1999–2020) of the NHANES program. The mortality information of participants was derived from the National Death Index (NDI) website. The disease status of participants was obtained from questionnaire surveys. The metabolism-related index was obtained from examination data. Multiple regression methods, smooth curve fitting, and threshold effect models were used for association analyses.</div></div><div><h3>Result</h3><div>In this large-scale study encompassing 46,733 participants, appendicular lean mass (ALM) demonstrated significant associations with multiple health outcomes: ALM exhibited L-shaped relationships with hyperuricemia and malignancy, inverse correlations with asthma, chronic obstructive pulmonary disease (COPD), rheumatoid arthritis (RA), nephrolithiasis, depression, and cancer-cause mortality, a positive correlation with bone mineral density (BMD), and notably, protective saturating effects against osteoarthritis (OA), all-cause mortality, and cardiovascular (CVD)-cause mortality. A significant inverse association was observed between sarcopenia and BMD, while positive correlations were identified between sarcopenia and COPD, asthma, OA, depression, and all-cause mortality.</div></div><div><h3>Conclusions</h3><div>In this study, we explored the association between ALM or sarcopenia and multiple health outcomes, highlighting the widespread impact of ALM on systemic health condition. These findings provide new epidemiological evidence on how ALM or sarcopenia influence the health status among the U.S. population.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"215 ","pages":"Article 113049"},"PeriodicalIF":4.3,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146043331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/j.exger.2026.113047
Zijie Dang , Boning Zhou , Yongkang Su , Haocheng Huang , Xin Zhang , Yang Jiao , Jian Wang , Xiaoling Hou , Yanru Yang , Zhenhong Fu
Background
Previous studies showed that remnant cholesterol(RC) partially explained the residual risk of cardiovascular disease. We tried to test the hypothesis that remnant cholesterol is a risk factor for all-cause mortality and cardiovascular(CV) mortality in oldest-old(>80 years old) patients with acute coronary syndrome(ACS).
Methods
699 oldest-old patients with ACS and undergoing coronary angiography(CAG) were included in our study. RC was calculated by fasting total cholesterol(TC) minus low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDLC). With a maximum follow-up period of 10 years, 37 patients were lost to follow-up, and 662 were finally available for statistical analysis. Pearson's correlation test was used to assess the associations between RC and clinical parameter. Multivariable Cox regression analysis was used to identify the association between RC and all-cause mortality. Nelson-Aalen cumulative hazard curves and Fine-Gray plots were used to assess the association between RC and clinical outcomes, including all-cause mortality, major adverse cardiovascular events (MACEs), cardiovascular (CV) mortality, and non-CV mortality. Receiver operating characteristic(ROC) curve was used to compare the discrimination capacity of RC, TC, HDL-C and LDL-C to predict all-cause mortality.
Results
Among the 662 oldest-old patients enrolled, 92.90% accepted statin therapy. The average age was 81.87 ± 2.14 years old. Nelson-Aalen cumulative hazard curves showed that the cumulative hazard of all-cause mortality and MACEs in the high RC tertile was higher than that in the middle or low RC tertiles. In the fully-adjusted Cox regression model, the Hazard ratio(HR) [95% confidence interval (CI)] of all-cause mortality was 1.17 (1.01, 1.44) for each standard deviation(SD) increase in RC. Compared to RC tertile 1, RC tertile 3 was associated with a 94% increased risk of all-cause mortality (HR:1.94; 95%CI: 1.22–3.10). The increased risk of all-cause death from tertile 1 to tertile 3 was statistically significant. Fine-Gray test showed that regarding CV mortality, marginally statistically significant differences in cumulative incidence were observed among the three RC tertile groups (P = 0.054). For non-CV mortality, statistically significant differences were detected across three groups (P = 0.026). The subgroup analysis confirmed the significant association between RC and all-cause mortality. ROC curve showed that RC had a better discrimination capacity at predicting all-cause mortality (AUC (95% CI): 0.621(0.575–0.666)), and improved the prognostic value of the Gensini score combined with left ventricular ejection fraction(LVEF).
Conclusion
Remnant cholesterol was associated with all-cause mortality in oldest-old patients with ACS in a long-term follow-up.
{"title":"Remnant cholesterol associated with all-cause mortality in oldest-old acute coronary syndrome patients: A cohort study","authors":"Zijie Dang , Boning Zhou , Yongkang Su , Haocheng Huang , Xin Zhang , Yang Jiao , Jian Wang , Xiaoling Hou , Yanru Yang , Zhenhong Fu","doi":"10.1016/j.exger.2026.113047","DOIUrl":"10.1016/j.exger.2026.113047","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies showed that remnant cholesterol(RC) partially explained the residual risk of cardiovascular disease. We tried to test the hypothesis that remnant cholesterol is a risk factor for all-cause mortality and cardiovascular(CV) mortality in oldest-old(>80 years old) patients with acute coronary syndrome(ACS).</div></div><div><h3>Methods</h3><div>699 oldest-old patients with ACS and undergoing coronary angiography(CAG) were included in our study. RC was calculated by fasting total cholesterol(TC) minus low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL<img>C). With a maximum follow-up period of 10 years, 37 patients were lost to follow-up, and 662 were finally available for statistical analysis. Pearson's correlation test was used to assess the associations between RC and clinical parameter. Multivariable Cox regression analysis was used to identify the association between RC and all-cause mortality. Nelson-Aalen cumulative hazard curves and Fine-Gray plots were used to assess the association between RC and clinical outcomes, including all-cause mortality, major adverse cardiovascular events (MACEs), cardiovascular (CV) mortality, and non-CV mortality. Receiver operating characteristic(ROC) curve was used to compare the discrimination capacity of RC, TC, HDL-C and LDL-C to predict all-cause mortality.</div></div><div><h3>Results</h3><div>Among the 662 oldest-old patients enrolled, 92.90% accepted statin therapy. The average age was 81.87 ± 2.14 years old. Nelson-Aalen cumulative hazard curves showed that the cumulative hazard of all-cause mortality and MACEs in the high RC tertile was higher than that in the middle or low RC tertiles. In the fully-adjusted Cox regression model, the Hazard ratio(HR) [95% confidence interval (CI)] of all-cause mortality was 1.17 (1.01, 1.44) for each standard deviation(SD) increase in RC. Compared to RC tertile 1, RC tertile 3 was associated with a 94% increased risk of all-cause mortality (HR:1.94; 95%CI: 1.22–3.10). The increased risk of all-cause death from tertile 1 to tertile 3 was statistically significant. Fine-Gray test showed that regarding CV mortality, marginally statistically significant differences in cumulative incidence were observed among the three RC tertile groups (<em>P</em> = 0.054). For non-CV mortality, statistically significant differences were detected across three groups (<em>P</em> = 0.026). The subgroup analysis confirmed the significant association between RC and all-cause mortality. ROC curve showed that RC had a better discrimination capacity at predicting all-cause mortality (AUC (95% CI): 0.621(0.575–0.666)), and improved the prognostic value of the Gensini score combined with left ventricular ejection fraction(LVEF).</div></div><div><h3>Conclusion</h3><div>Remnant cholesterol was associated with all-cause mortality in oldest-old patients with ACS in a long-term follow-up.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"214 ","pages":"Article 113047"},"PeriodicalIF":4.3,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/j.exger.2026.113048
Xiaohan Liu , Guihong Yang , Yuanli Ye , Weifei Wang , Yongpeng Su , Jianxin Wu , Yiting Feng , Mingdi He , Zhenglin Li , Lingbo Li , Lingfei Li , Yi Liang , Mingxing Lei , Xia Lei
Eccrine sweat glands (ESGs) are critical organs for human thermoregulation, yet their function progressively declines with aging. This study aims to investigate the underlying mechanisms responsible for the age-related impairment of ESG function. Through comparative analysis between skin tissues from young and aged mice/human, we observed structural loosening of aged ESG and a significant reduction in the expression of extracellular matrix (ECM) components—type I and type II collagen. Further investigation revealed a significant upregulation of the inflammatory cytokine interleukin (IL)-1β and matrix metalloproteinases and proteases (MMP)-1 in aged tissues, which can modulate the collagen degradation, suggesting that ECM degradation may be regulated by an inflammatory microenvironment. To validate this hypothesis, we established a model of chronic inflammation by intradermally injecting IL-1β into the footpads of mice. The results demonstrated suppressed ESG function, structural loosening of ESG tissues, and a marked reduction of type I and type II collagen surrounding the ESGs. In summary, this study reveals that type I and type II collagen are distributed around ESGs, providing structural and functional support. The activation of the IL-1β–MMP-1 inflammatory pathway in aging may contribute to ESG dysfunction and structural disruption by degrading the collagen around ESGs.
{"title":"The effects of extracellular matrix degradation mediated by chronic inflammation in aged skin on the structure and function of eccrine sweat glands","authors":"Xiaohan Liu , Guihong Yang , Yuanli Ye , Weifei Wang , Yongpeng Su , Jianxin Wu , Yiting Feng , Mingdi He , Zhenglin Li , Lingbo Li , Lingfei Li , Yi Liang , Mingxing Lei , Xia Lei","doi":"10.1016/j.exger.2026.113048","DOIUrl":"10.1016/j.exger.2026.113048","url":null,"abstract":"<div><div>Eccrine sweat glands (ESGs) are critical organs for human thermoregulation, yet their function progressively declines with aging. This study aims to investigate the underlying mechanisms responsible for the age-related impairment of ESG function. Through comparative analysis between skin tissues from young and aged mice/human, we observed structural loosening of aged ESG and a significant reduction in the expression of extracellular matrix (ECM) components—type I and type II collagen. Further investigation revealed a significant upregulation of the inflammatory cytokine interleukin (IL)-1β and matrix metalloproteinases and proteases (MMP)-1 in aged tissues, which can modulate the collagen degradation, suggesting that ECM degradation may be regulated by an inflammatory microenvironment. To validate this hypothesis, we established a model of chronic inflammation by intradermally injecting IL-1β into the footpads of mice. The results demonstrated suppressed ESG function, structural loosening of ESG tissues, and a marked reduction of type I and type II collagen surrounding the ESGs. In summary, this study reveals that type I and type II collagen are distributed around ESGs, providing structural and functional support. The activation of the IL-1β–MMP-1 inflammatory pathway in aging may contribute to ESG dysfunction and structural disruption by degrading the collagen around ESGs.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"215 ","pages":"Article 113048"},"PeriodicalIF":4.3,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
High-fat diet (HFD) intake is a potent inducer of oxidative stress, promoting metabolic dysfunction and accelerated ageing. Identifying interventions capable of mitigating this persistent redox burden is therefore essential. This study investigated the combined efficacy of α-lipoic acid (LA) supplementation and a daily climbing regimen in counteracting HFD-induced oxidative stress across different life stages and mating statuses in Drosophila melanogaster. Flies were maintained on an HFD and subjected to LA (2 mM or 2.5 mM), climbing exercise, or their combination during early, mid, or late life. Oxidative stress resistance was evaluated using hydrogen peroxide challenge assays, and peroxide accumulation was quantified via the FOX method. Combined LA and climbing treatment significantly enhanced stress resistance and reduced peroxide levels in early- and mid-life flies, outperforming either intervention alone. This benefit was most pronounced in unmated flies, indicating that physiological costs associated with mating diminish adaptive responsiveness. Notably, while LA alone reduced fecundity, its combination with climbing restored reproductive output, suggesting exercise-mediated alleviation of resource-allocation trade-offs. In late-life groups, the interventions produced only modest biochemical improvements without corresponding lifespan extension, highlighting age-related loss of physiological plasticity and the limited reversibility of cumulative oxidative damage. Overall, the findings demonstrated that integrating antioxidant supplementation with hormetic exercise elicited superior protection against HFD-induced oxidative stress, but the magnitude of benefit depended strongly on age and reproductive status. These results underscore the importance of early, multifaceted interventions to maintain redox balance and physiological resilience.
{"title":"Age and mating status modulate combined efficacy of α-lipoic acid and climbing to mitigate high-fat diet-induced oxidative stress in Drosophila melanogaster","authors":"Madappa Machamada Bheemaiah , Debarati Chattopadhyay","doi":"10.1016/j.exger.2026.113045","DOIUrl":"10.1016/j.exger.2026.113045","url":null,"abstract":"<div><div>High-fat diet (HFD) intake is a potent inducer of oxidative stress, promoting metabolic dysfunction and accelerated ageing. Identifying interventions capable of mitigating this persistent redox burden is therefore essential. This study investigated the combined efficacy of α-lipoic acid (LA) supplementation and a daily climbing regimen in counteracting HFD-induced oxidative stress across different life stages and mating statuses in <em>Drosophila melanogaster</em>. Flies were maintained on an HFD and subjected to LA (2 mM or 2.5 mM), climbing exercise, or their combination during early, mid, or late life. Oxidative stress resistance was evaluated using hydrogen peroxide challenge assays, and peroxide accumulation was quantified via the FOX method. Combined LA and climbing treatment significantly enhanced stress resistance and reduced peroxide levels in early- and mid-life flies, outperforming either intervention alone. This benefit was most pronounced in unmated flies, indicating that physiological costs associated with mating diminish adaptive responsiveness. Notably, while LA alone reduced fecundity, its combination with climbing restored reproductive output, suggesting exercise-mediated alleviation of resource-allocation trade-offs. In late-life groups, the interventions produced only modest biochemical improvements without corresponding lifespan extension, highlighting age-related loss of physiological plasticity and the limited reversibility of cumulative oxidative damage. Overall, the findings demonstrated that integrating antioxidant supplementation with hormetic exercise elicited superior protection against HFD-induced oxidative stress, but the magnitude of benefit depended strongly on age and reproductive status. These results underscore the importance of early, multifaceted interventions to maintain redox balance and physiological resilience.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"214 ","pages":"Article 113045"},"PeriodicalIF":4.3,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-21DOI: 10.1016/j.exger.2026.113044
Xiaorong Ye , Dingqi Shi , Ruixuan Li , Yuxin Li , Luwen Zhang , Lei Shi , Yao Xiao
<div><h3>Background</h3><div>The burden of chronic diseases is known to be significantly increased by obesity, yet conventional measures like waist circumference (WC) and body mass index (BMI) do not accurately capture central adiposity. The Weight-Adjusted Waist Index (WWI), calculated as waist circumference (cm)/√weight (kg), has been proposed to assess abdominal fat distribution independent of overall body size and may theoretically outperform BMI and WC by reducing muscle-mass–related misclassification. Evidence regarding its association with multimorbidity remains limited. This study sought to elucidate these associations using nationally representative NHANES data and to verify the results in a prospective Chinese cohort (CHARLS).</div></div><div><h3>Method</h3><div>Adults ≥20 years in NHANES 2017–2023 were included, applying sampling weights. Multimorbidity was defined as the coexistence of ≥2 chronic conditions, identified based on self-reported physician-diagnosed diseases in both NHANES and CHARLS. In NHANES, multivariable logistic regression, RCS, GAM, interaction analysis and Sensitivity analyses were performed, adjusting for demographics, socioeconomic status, lifestyle behaviors, and dietary factors. ROC curve analysis was then performed to evaluate and compare the predictive performance of WWI, BMI, and WC. WWI, BMI, and WC were analyzed in separate regression models to avoid multicollinearity interference when comparing predictive performance. External validation was conducted using Cox regression and RCS in CHARLS 2011–2028, adjusting for demographic, socioeconomic, and lifestyle variables.</div></div><div><h3>Result</h3><div>In NHANES, WWI was significantly positively associated with multimorbidity (OR = 1.74; 95% CI: 1.59–1.90; <em>P</em> < 0.001). Participants in the highest quartile of WWI had over threefold higher odds of multimorbidity compared with those in the lowest quartile (OR = 3.04; 95% CI: 2.94–3.73; P < 0.001). RCS indicated a predominantly linear association, while GAM suggested a modest J-shaped pattern. Sex significantly modified the association (P for interaction <0.05). Sensitivity analysis in adults ≥45 years yielded consistent results. In the CHARLS cohort (<em>n</em> = 2985), higher WWI significantly predicted incident multimorbidity (HR = 1.14; 95% CI: 1.06–1.22). WWI showed the highest discriminative ability for multimorbidity (AUC = 0.709) compared with BMI and WC.</div></div><div><h3>Conclusions</h3><div>WWI remained a significant and consistent predictor of multimorbidity, demonstrating greater discriminatory ability than BMI or WC. While RCS suggested a predominantly linear association, GAM revealed potential non-linearity at extreme WWI levels, indicating that dose-response patterns warrant further confirmation. Validation in the CHARLS cohort supports temporal association, offering greater causal plausibility. Collectively, these results highlight WWI as a practical marker for identifying h
背景：众所周知，慢性疾病的负担会因肥胖而显著增加，但传统的测量方法如腰围（WC）和体重指数（BMI）并不能准确地捕捉到中心性肥胖。体重调整腰围指数（WWI），以腰围(cm)/体重（kg）计算，已被提出用于评估腹部脂肪分布独立于整体体型，理论上可能通过减少与肌肉质量相关的错误分类而优于BMI和WC。关于其与多病相关的证据仍然有限。本研究试图利用具有全国代表性的NHANES数据阐明这些关联，并在一个前瞻性的中国队列（CHARLS）中验证结果。方法：纳入NHANES 2017-2023中≥20 岁的成年人，应用抽样权。多病被定义为共存≥2种慢性疾病，根据NHANES和CHARLS中自我报告的医生诊断疾病来确定。在NHANES中，进行了多变量logistic回归、RCS、GAM、相互作用分析和敏感性分析，调整了人口统计学、社会经济地位、生活方式行为和饮食因素。然后进行ROC曲线分析，评价和比较WWI、BMI和WC的预测性能。WWI、BMI和WC在单独的回归模型中进行分析，以避免在比较预测性能时的多重共线性干扰。在CHARLS 2011-2028中使用Cox回归和RCS进行外部验证，调整人口统计学、社会经济和生活方式变量。结果：在NHANES中，WWI与多发病显著正相关（OR = 1.74;95% CI: 1.59-1.90; P ）结论：WWI仍然是多发病的显著且一致的预测因子，表现出比BMI或WC更强的区分能力。虽然RCS显示了主要的线性关联，但GAM显示了在极端WWI水平下潜在的非线性，表明剂量-反应模式有待进一步证实。CHARLS队列验证支持时间关联，提供更大的因果合理性。总的来说，这些结果突出了一战作为识别高风险个体和指导早期预防策略的实用标记。
{"title":"Association between weight-adjusted waist index (WWI) and multimorbidity: Evidence from NHANES and prospective validation in CHARLS","authors":"Xiaorong Ye , Dingqi Shi , Ruixuan Li , Yuxin Li , Luwen Zhang , Lei Shi , Yao Xiao","doi":"10.1016/j.exger.2026.113044","DOIUrl":"10.1016/j.exger.2026.113044","url":null,"abstract":"<div><h3>Background</h3><div>The burden of chronic diseases is known to be significantly increased by obesity, yet conventional measures like waist circumference (WC) and body mass index (BMI) do not accurately capture central adiposity. The Weight-Adjusted Waist Index (WWI), calculated as waist circumference (cm)/√weight (kg), has been proposed to assess abdominal fat distribution independent of overall body size and may theoretically outperform BMI and WC by reducing muscle-mass–related misclassification. Evidence regarding its association with multimorbidity remains limited. This study sought to elucidate these associations using nationally representative NHANES data and to verify the results in a prospective Chinese cohort (CHARLS).</div></div><div><h3>Method</h3><div>Adults ≥20 years in NHANES 2017–2023 were included, applying sampling weights. Multimorbidity was defined as the coexistence of ≥2 chronic conditions, identified based on self-reported physician-diagnosed diseases in both NHANES and CHARLS. In NHANES, multivariable logistic regression, RCS, GAM, interaction analysis and Sensitivity analyses were performed, adjusting for demographics, socioeconomic status, lifestyle behaviors, and dietary factors. ROC curve analysis was then performed to evaluate and compare the predictive performance of WWI, BMI, and WC. WWI, BMI, and WC were analyzed in separate regression models to avoid multicollinearity interference when comparing predictive performance. External validation was conducted using Cox regression and RCS in CHARLS 2011–2028, adjusting for demographic, socioeconomic, and lifestyle variables.</div></div><div><h3>Result</h3><div>In NHANES, WWI was significantly positively associated with multimorbidity (OR = 1.74; 95% CI: 1.59–1.90; <em>P</em> < 0.001). Participants in the highest quartile of WWI had over threefold higher odds of multimorbidity compared with those in the lowest quartile (OR = 3.04; 95% CI: 2.94–3.73; P < 0.001). RCS indicated a predominantly linear association, while GAM suggested a modest J-shaped pattern. Sex significantly modified the association (P for interaction <0.05). Sensitivity analysis in adults ≥45 years yielded consistent results. In the CHARLS cohort (<em>n</em> = 2985), higher WWI significantly predicted incident multimorbidity (HR = 1.14; 95% CI: 1.06–1.22). WWI showed the highest discriminative ability for multimorbidity (AUC = 0.709) compared with BMI and WC.</div></div><div><h3>Conclusions</h3><div>WWI remained a significant and consistent predictor of multimorbidity, demonstrating greater discriminatory ability than BMI or WC. While RCS suggested a predominantly linear association, GAM revealed potential non-linearity at extreme WWI levels, indicating that dose-response patterns warrant further confirmation. Validation in the CHARLS cohort supports temporal association, offering greater causal plausibility. Collectively, these results highlight WWI as a practical marker for identifying h","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"215 ","pages":"Article 113044"},"PeriodicalIF":4.3,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146042325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1016/j.exger.2026.113040
Yukiko Nishita , Chikako Tange , Sayaka Kubota , Shu Zhang , Mana Tateishi , Fujiko Ando , Hiroshi Shimokata , Rei Otsuka
Background
Personality traits have been associated with physical and mental health outcomes, yet their relationship with long-term care (LTC) needs remains understudied.
Objective
To examine the longitudinal effect of personality traits on the incidence of LTC needs among community-dwelling older adults in Japan.
Methods
Data were drawn from the National Institute for Longevity Sciences–Longitudinal Study of Aging (NILS-LSA), involving 1003 older adults (≥65 years; mean age 73.0 ± 4.4; 48.6% male), who had no certification of LTC needs prior to baseline or within two years after baseline to prevent reverse causality. Personality traits were assessed at baseline using the Japanese version of the NEO Five-Factor Inventory. Participants were followed for up to 21.8 years (mean ± SD: 12.2 ± 5.7 years) to determine the incidences of long-term care (LTC) needs by the LTC Insurance System certificate. Cox proportional hazards models were used to estimate hazard ratios for the incidence of long-term care (LTC) needs per one standard deviation (1-SD) increase in each personality trait score, adjusting for relevant covariates.
Results
During follow-up, 583 individuals (58.1%) were newly certified for LTC needs. Higher levels of openness and conscientiousness were associated with reduced LTC needs incidence (HR [95% CI] 0.88 [0.81–0.95], p = 0.002; 0.91 [0.84–0.99], p = 0.030, respectively). No significant associations were found for neuroticism, extraversion, or agreeableness.
Conclusion
Among older adults living in the community, higher openness and conscientiousness were protective against future LTC needs. These findings highlight the potential role of psychological traits in promoting autonomy and healthy aging.
人格特质与身心健康结果相关，但其与长期护理（LTC）需求的关系仍未得到充分研究。目的探讨人格特质对日本社区老年人LTC需求发生率的纵向影响。方法数据来自美国国家长寿科学研究所-老龄化纵向研究（nls - lsa），涉及1003名老年人（≥65岁，平均年龄73.0±4.4岁，48.6%男性），在基线前或基线后两年内没有LTC需求证明，以防止反向因果关系。在基线上使用日本版NEO五因素量表评估人格特征。随访时间长达21.8年（mean±SD: 12.2±5.7年），通过LTC保险系统证书确定长期护理（LTC）需求的发生率。Cox比例风险模型用于估计每个人格特质评分每增加一个标准差（1-SD）长期护理（LTC）需求发生率的风险比，并对相关协变量进行调整。结果随访期间，583人（58.1%）获得LTC需求新认证。较高水平的开放性和严谨性与较低的LTC需求发生率相关（HR [95% CI] 0.88 [0.81-0.95], p = 0.002; 0.91 [0.84-0.99], p = 0.030）。在神经质、外向性或宜人性方面没有发现显著的关联。结论在社区生活的老年人中，较高的开放性和自觉性对未来的LTC需求具有保护作用。这些发现强调了心理特征在促进自主和健康老龄化方面的潜在作用。
{"title":"Higher openness and conscientiousness are associated with lower risk of long-term care needs: A 22-year follow-up of community-dwelling older adults in Japan","authors":"Yukiko Nishita , Chikako Tange , Sayaka Kubota , Shu Zhang , Mana Tateishi , Fujiko Ando , Hiroshi Shimokata , Rei Otsuka","doi":"10.1016/j.exger.2026.113040","DOIUrl":"10.1016/j.exger.2026.113040","url":null,"abstract":"<div><h3>Background</h3><div>Personality traits have been associated with physical and mental health outcomes, yet their relationship with long-term care (LTC) needs remains understudied.</div></div><div><h3>Objective</h3><div>To examine the longitudinal effect of personality traits on the incidence of LTC needs among community-dwelling older adults in Japan.</div></div><div><h3>Methods</h3><div>Data were drawn from the National Institute for Longevity Sciences–Longitudinal Study of Aging (NILS-LSA), involving 1003 older adults (≥65 years; mean age 73.0 ± 4.4; 48.6% male), who had no certification of LTC needs prior to baseline or within two years after baseline to prevent reverse causality. Personality traits were assessed at baseline using the Japanese version of the NEO Five-Factor Inventory. Participants were followed for up to 21.8 years (mean ± SD: 12.2 ± 5.7 years) to determine the incidences of long-term care (LTC) needs by the LTC Insurance System certificate. Cox proportional hazards models were used to estimate hazard ratios for the incidence of long-term care (LTC) needs per one standard deviation (1-SD) increase in each personality trait score, adjusting for relevant covariates.</div></div><div><h3>Results</h3><div>During follow-up, 583 individuals (58.1%) were newly certified for LTC needs. Higher levels of openness and conscientiousness were associated with reduced LTC needs incidence (HR [95% CI] 0.88 [0.81–0.95], <em>p</em> = 0.002; 0.91 [0.84–0.99], <em>p</em> = 0.030, respectively). No significant associations were found for neuroticism, extraversion, or agreeableness.</div></div><div><h3>Conclusion</h3><div>Among older adults living in the community, higher openness and conscientiousness were protective against future LTC needs. These findings highlight the potential role of psychological traits in promoting autonomy and healthy aging.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"214 ","pages":"Article 113040"},"PeriodicalIF":4.3,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146023517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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