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Development and validation of a machine learning model for frailty screening using claims data in Japan: the Longevity Improvement & Fair Evidence Study 使用日本索赔数据开发和验证用于虚弱筛查的机器学习模型:寿命改善和公平证据研究
IF 4.3 Pub Date : 2026-01-26 DOI: 10.1016/j.exger.2026.113050
Kengo Kawaguchi , Megumi Maeda , Futoshi Oda , Yasuharu Nakashima , Haruhisa Fukuda

Background

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.
背景:虚弱是一种与老龄化相关的多维状况,与较高的长期护理(LTC)需求、医疗保健支出和死亡率有关。在日本,老年人体检问卷(QMCOO)用于评估老年人的脆弱性,但其实施需要耗费大量资源。基于索赔的预测模型可能为早期脆弱识别提供可扩展的替代方案。方法:我们开发了一个机器学习模型,使用来自老年人的行政索赔数据来预测QMCOO定义的虚弱状态。在第一阶段,使用来自单个城市的数据对模型进行训练和验证。在第二阶段,使用来自其他七个城市的数据评估了该模型预测全因死亡率的预后效用。我们应用了极端梯度增强算法,结合了人口统计变量、LTC使用、合并症、手术过程和医疗设备使用。模型性能的评价主要采用接收人工作特征曲线下面积(ROC-AUC)。采用Kaplan-Meier法和Cox回归模型估计死亡风险。结果第一阶段共纳入74,148例患者(开发队列:60,930,验证队列:13,218)。模型内部验证的ROC-AUC为0.780,外部验证的ROC-AUC为0.728。在第二阶段,外部验证在354,815人的新队列中进行。在发展组(风险比:7.03,95%可信区间:6.47-7.63)和验证组(6.75,6.62-6.89)中,虚弱分类与较高的死亡率相关。结论基于索赔的衰弱预测模型性能合理,具有一定的预后价值。在基于问卷的评估不切实际的情况下,它可能支持有效的、人口层面的脆弱性筛查。
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引用次数: 0
Age-related diversity of the oral and gut microbiome and its correlation with systemic fatty acids and cytokine profiles in healthy subjects. 健康受试者口腔和肠道微生物组的年龄相关多样性及其与全身脂肪酸和细胞因子谱的相关性
IF 4.3 Pub Date : 2026-01-25 DOI: 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.

背景与目的:人类微生物组研究的进展突出了其对宿主健康的影响。本研究旨在描述口腔微生物组(OM)和肠道微生物组(GM)的特征,并研究它们与不同年龄组健康成年人全身脂肪酸和细胞因子谱的关系。方法:年龄在18-76岁 ,未确诊疾病的参与者分为青年(18-29 岁)、中年(30-49 岁)和老年人(≥50 岁)。采集血液、牙菌斑和粪便样本。采用16rrna测序法测定OM和GM的组成。循环游离脂肪酸(FFAs)采用气相色谱-质谱法定量,血清细胞因子采用流式细胞术测定。结果:在OM中,青壮年以梭杆菌和嗜血杆菌为主,中年人以嗜血杆菌和奈瑟菌为主。在老年人中,奈瑟菌和嗜碳细胞噬菌是最常见的口腔属。在转基因中,拟杆菌属是所有年龄组中最普遍的属,其次是粪杆菌属、蓝杆菌属和普雷沃氏菌属。此外,与其他年龄组相比,年轻人循环中的癸酸、十六酸和十八酸以及细胞因子IP-10水平更高。结论:据我们所知,这项研究首次在健康成人队列中描述了OM和GM的多样性与全身FFA和细胞因子谱的相关性,并强调了年龄在塑造微生物组组成和相关代谢物方面的关键作用。将微生物群分析与血清FFA和细胞因子测量相结合,增强了我们对微生物群如何影响成人一生的健康和疾病风险的理解。
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引用次数: 0
Association of accelerometer-measured rest-activity rhythm patterns and parameters with cardiovascular and all-cause mortality in older adults: Population-based cohort study 加速度计测量的静息-活动节律模式和参数与老年人心血管和全因死亡率的关联:基于人群的队列研究
IF 4.3 Pub Date : 2026-01-23 DOI: 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.
背景:休息-活动节律(RAR)是与年龄相关的昼夜节律系统恶化的基本生物标志物。然而,RAR模式对老年人死亡率的长期影响尚不清楚。方法:分析2011-2014年全国健康与营养检查调查资料。基于腕部加速度计的RAR参数,利用高斯混合模型进行聚类分析,识别出4种模式。采用Cox模型比较不同RAR参数和模式的受试者死亡率的风险比(HR)和95%置信区间(CI)。结果:本研究纳入1710名年龄≥60 岁的参与者。中位随访时间为6.67 年。随访期间共发生269例全因死亡和77例心血管死亡。研究发现了四种RAR模式:“早晨型”、“较早型”、“延迟型”和“晚上型”。与“早睡型”的人相比,“晚睡型”的人患心血管疾病的风险更高(HR: 12.16, 95% CI: 4.02-36.82),全因死亡率更高(HR: 3.31, 95% CI: 1.91-5.72)。较高的日间稳定性与较低的心血管风险(HR: 0.67, 95% CI: 0.55-0.81)和全因死亡率(HR: 0.86, 95% CI: 0.74-1.00)相关。较高的相对振幅与较低的心血管风险(HR: 0.61, 95% CI: 0.49-0.75)和全因死亡率(HR: 0.70, 95% CI: 0.60-0.81)相关。相反,较高的每日变异性与心血管风险增加(HR: 1.30, 95% CI: 1.15-1.46)和全因死亡率(HR: 1.19, 95% CI: 1.10-1.30)相关。结论:RAR模式和参数与老年人心血管和全因死亡率显著相关。早期识别和干预不良RAR模式可能有助于改善长期健康结果。
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引用次数: 0
Muscle–brain axis mechanisms linking community-based exercise to cognitive function in older adults: A five-arm randomized controlled trial 老年人社区运动与认知功能之间的肌脑轴机制:一项五组随机对照试验
IF 4.3 Pub Date : 2026-01-22 DOI: 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.
目的比较社区可行运动对老年人认知能力的影响,探讨老年人肌脑轴运动的机制。方法在这项单盲、五组随机对照试验中,参与者被分配参加12组陈式太极拳(CTC12)、24组阳式太极拳(TC24)、广场舞(SD)、散步或对照组,为期12周(两组/周)。采用北京汉语MoCA进行全局认知评价。采用多频生物阻抗法评价身体组成:骨骼肌质量(SMM)、脂肪质量(FM)、全身水分、蛋白质质量和基础代谢率(BMR)。采用短物理性能电池(SPPB)、最大握力(HGS)评估物理性能。空腹白介素-6 (IL-6)水平和其他血液生物标志物也被测量。结果113名参与者完成干预,平均年龄62.3岁,女性79.6%。训练12周后,CTC12组(n = 22, Δ = +0.46, p = 0.0045)和SD组(n = 22, Δ = +0.50, p = 0.0046) MoCA评分均有改善,而TC24组(n = 23)、步行组(n = 23)和对照组(n = 23) MoCA评分无变化。生理上,CTC12组增加SMM和BMR, SPPB/HGS增加较小,IL-6水平显著降低;SD组降低BMI和FM,提高BMR和SPPB;TC24组仅增加BMR;步行没有显示出可测量的变化。在相关分析中,ΔMoCA与CTC12组的ΔSMM (p = 0.014)和ΔBMR (p = 0.004)呈正相关,与SD组的ΔBMI (p = 0.002)和ΔFM (p = 0.002)负相关。结论sctc12、SD与适度的认知增益和可能与肌脑轴相关的独特生理模式相关,这可能有助于指导老年人的运动选择。
{"title":"Muscle–brain axis mechanisms linking community-based exercise to cognitive function in older adults: A five-arm randomized controlled trial","authors":"Jiadong Qiu ,&nbsp;Xiongying Song ,&nbsp;Jian Wang ,&nbsp;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}
引用次数: 0
Comprehensive evaluation of appendicular lean mass and sarcopenia on human health: evidence from the NHANES program 阑尾瘦质量和肌肉减少症对人类健康的综合评价:来自NHANES项目的证据
IF 4.3 Pub Date : 2026-01-22 DOI: 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.
虽然积累点已经指出了肌肉功能的重要性,但很少有临床或流行病学证据提供。本研究旨在基于国家健康与营养检查调查(NHANES)计划,为肌肉质量对健康状况的系统性影响提供新的证据。方法采用NHANES项目1999-2020年11个调查周期的数据。参与者的死亡率信息来源于国家死亡指数(NDI)网站。参与者的疾病状况通过问卷调查获得。从检查资料中得出代谢相关指标。关联分析采用多元回归方法、光滑曲线拟合和阈值效应模型。结果在这项包含46,733名参与者的大规模研究中,阑尾瘦质量(ALM)与多种健康结局有显著关联:ALM与高尿酸血症和恶性肿瘤呈l型相关,与哮喘、慢性阻塞性肺疾病(COPD)、类风湿关节炎(RA)、肾结石、抑郁症和癌症死亡率呈负相关,与骨密度(BMD)呈正相关,特别是对骨关节炎(OA)、全因死亡率和心血管(CVD)原因死亡率具有保护性饱和作用。骨骼肌减少症与骨密度呈显著负相关,而骨骼肌减少症与COPD、哮喘、OA、抑郁症和全因死亡率呈正相关。在本研究中,我们探讨了ALM或肌肉减少症与多种健康结局之间的关系,强调了ALM对全身健康状况的广泛影响。这些发现为ALM或肌肉减少症如何影响美国人群的健康状况提供了新的流行病学证据。
{"title":"Comprehensive evaluation of appendicular lean mass and sarcopenia on human health: evidence from the NHANES program","authors":"Xiao Long ,&nbsp;Ruizhi Chen ,&nbsp;Yanmin Lu ,&nbsp;Binbin Ma ,&nbsp;Yuxin Chang ,&nbsp;Zichao Jiang ,&nbsp;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}
引用次数: 0
Remnant cholesterol associated with all-cause mortality in oldest-old acute coronary syndrome patients: A cohort study 老年急性冠状动脉综合征患者残余胆固醇与全因死亡率相关:一项队列研究
IF 4.3 Pub Date : 2026-01-21 DOI: 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.
以往的研究表明,残余胆固醇(RC)部分解释了心血管疾病的残余风险。我们试图验证残余胆固醇是高龄(80岁)急性冠脉综合征(ACS)患者全因死亡率和心血管(CV)死亡率的危险因素这一假设。方法选择699例高龄ACS行冠状动脉造影(CAG)的患者作为研究对象。RC由空腹总胆固醇(TC)减去低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDLC)计算。最长随访时间为10年,失访37例,最终有662例可供统计分析。采用Pearson相关检验评估RC与临床参数的相关性。采用多变量Cox回归分析确定RC与全因死亡率之间的关系。Nelson-Aalen累积风险曲线和Fine-Gray图用于评估RC与临床结果之间的关系,包括全因死亡率、主要不良心血管事件(mace)、心血管(CV)死亡率和非CV死亡率。采用受试者工作特征(ROC)曲线比较RC、TC、HDL-C和LDL-C预测全因死亡率的判别能力。结果662例高龄患者中,92.90%接受他汀类药物治疗。平均年龄81.87±2.14岁。Nelson-Aalen累积风险曲线显示,高碳水化合物三分之一的全因死亡率和mace累积风险均高于中、低碳水化合物三分之一。在全校正Cox回归模型中,RC每增加一个标准差(SD),全因死亡率的风险比(HR)[95%置信区间(CI)]为1.17(1.01,1.44)。与RC ttile 1相比,RC ttile 3与全因死亡率增加94%相关(HR:1.94; 95%CI: 1.22-3.10)。从1级到3级的全因死亡风险增加具有统计学意义。Fine-Gray检验显示,在CV死亡率方面,3个RC组的累积发病率差异有统计学意义(P = 0.054)。对于非cv死亡率,三组间的差异有统计学意义(P = 0.026)。亚组分析证实了RC与全因死亡率之间的显著相关性。ROC曲线显示,RC在预测全因死亡率方面具有较好的判别能力(AUC (95% CI): 0.621(0.575 ~ 0.666)),并提高了Gensini评分联合左室射血分数(LVEF)的预后价值。结论在长期随访中,残余胆固醇与老年ACS患者的全因死亡率相关。
{"title":"Remnant cholesterol associated with all-cause mortality in oldest-old acute coronary syndrome patients: A cohort study","authors":"Zijie Dang ,&nbsp;Boning Zhou ,&nbsp;Yongkang Su ,&nbsp;Haocheng Huang ,&nbsp;Xin Zhang ,&nbsp;Yang Jiao ,&nbsp;Jian Wang ,&nbsp;Xiaoling Hou ,&nbsp;Yanru Yang ,&nbsp;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(&gt;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}
引用次数: 0
The effects of extracellular matrix degradation mediated by chronic inflammation in aged skin on the structure and function of eccrine sweat glands 衰老皮肤慢性炎症介导的细胞外基质降解对汗腺结构和功能的影响。
IF 4.3 Pub Date : 2026-01-21 DOI: 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.
内分泌汗腺(esg)是人体体温调节的重要器官,但其功能随着年龄的增长而逐渐下降。本研究旨在探讨与年龄相关的ESG功能损伤的潜在机制。通过对年轻和老年小鼠/人皮肤组织的比较分析,我们观察到老年ESG结构松动,细胞外基质(ECM)成分- I型和II型胶原蛋白的表达显著减少。进一步研究发现,炎症细胞因子白细胞介素(IL)-1β和基质金属蛋白酶和蛋白酶(MMP)-1在衰老组织中显著上调,可调节胶原降解,提示ECM降解可能受到炎症微环境的调节。为了验证这一假设,我们通过向小鼠脚垫皮下注射IL-1β建立了慢性炎症模型。结果显示ESG功能受到抑制,ESG组织结构松动,ESG周围I型和II型胶原蛋白明显减少。综上所述,本研究揭示了I型和II型胶原分布在esg周围,提供结构和功能支持。衰老过程中IL-1β-MMP-1炎症通路的激活可能通过降解ESG周围的胶原蛋白导致ESG功能障碍和结构破坏。
{"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 ,&nbsp;Guihong Yang ,&nbsp;Yuanli Ye ,&nbsp;Weifei Wang ,&nbsp;Yongpeng Su ,&nbsp;Jianxin Wu ,&nbsp;Yiting Feng ,&nbsp;Mingdi He ,&nbsp;Zhenglin Li ,&nbsp;Lingbo Li ,&nbsp;Lingfei Li ,&nbsp;Yi Liang ,&nbsp;Mingxing Lei ,&nbsp;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}
引用次数: 0
Age and mating status modulate combined efficacy of α-lipoic acid and climbing to mitigate high-fat diet-induced oxidative stress in Drosophila melanogaster 年龄和交配状态调节α-硫辛酸和攀爬对黑腹果蝇高脂肪饮食诱导的氧化应激的联合作用
IF 4.3 Pub Date : 2026-01-21 DOI: 10.1016/j.exger.2026.113045
Madappa Machamada Bheemaiah , Debarati Chattopadhyay
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.
高脂肪饮食(HFD)的摄入是一种有效的诱导氧化应激,促进代谢功能障碍和加速衰老。因此,确定能够减轻这种持续氧化还原负担的干预措施至关重要。本研究探讨了α-硫辛酸(LA)补充和每日攀爬方案对黑腹果蝇不同生命阶段和交配状态下hfd诱导的氧化应激的联合作用。在果蝇的早期、中期或晚期,果蝇被保持在高热量食物上,并接受LA(2毫米或2.5毫米)、攀爬运动或它们的组合。通过过氧化氢激发法评估抗氧化应激能力,并通过FOX方法量化过氧化氢积累。LA和攀爬联合处理显著提高了早期和中期果蝇的抗逆性,降低了过氧化氢水平,优于单独干预。这种好处在未交配的果蝇中最为明显,这表明与交配相关的生理成本降低了适应性反应。值得注意的是,虽然LA单独降低了繁殖力,但它与攀爬的结合恢复了生殖产出,这表明运动介导的资源分配权衡的缓解。在老年组中,干预措施只产生了适度的生化改善,没有相应的寿命延长,突出了与年龄相关的生理可塑性丧失和累积氧化损伤的有限可逆性。总的来说,研究结果表明,将抗氧化剂补充与有氧运动结合起来,可以更好地防止hfd诱导的氧化应激,但益处的大小在很大程度上取决于年龄和生殖状态。这些结果强调了早期、多方面干预对维持氧化还原平衡和生理弹性的重要性。
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引用次数: 0
Association between weight-adjusted waist index (WWI) and multimorbidity: Evidence from NHANES and prospective validation in CHARLS 体重调整腰围指数(WWI)与多病之间的关系:来自NHANES的证据和CHARLS的前瞻性验证。
IF 4.3 Pub Date : 2026-01-21 DOI: 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。
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引用次数: 0
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 较高的开放性和尽责性与较低的长期护理需求风险相关:对日本社区居住的老年人进行22年随访
IF 4.3 Pub Date : 2026-01-20 DOI: 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。
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引用次数: 0
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Experimental gerontology
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