Experimental gerontology最新文献_第9页

Less habitual knee-bent sitting and more lying time are associated with worse frailty, mobility and balance in long-term care residents 在长期护理的居民中，习惯性弯曲腿坐着和躺着的时间与更糟糕的虚弱、机动性和平衡有关。

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-11-22 DOI: 10.1016/j.exger.2025.112971

Madeline E. Shivgulam , Emily E. MacDonald , Jocelyn Waghorn , Chris Cartwright , Andrea Mayo , Derek S. Kimmerly , Kenneth Rockwood , Olga Theou , Myles W. O'Brien

The impact of habitual postures on frailty, and balance, mobility, and transfer ability, particularly among people in long-term care. We sought to characterize the time spent in detailed postures and the relationships they have with frailty and Hierarchical Assessment of Balance and Mobility (HABAM) among older adults living in long-term care. Forty-four moderate-to-severely frail long-term care residents were recruited (36 females; age: 83 ± 10 years; body mass index: 31.8 ± 7.6 kg/m²). Participants wore an activPAL on their torso, thigh, and shin for 3.6 ± 0.5 days. Frailty was determined via a 65-item index and Clinical Frailty Scale (CFS). Functional abilities were measured using the HABAM. Linear regressions, adjusted for age and body mass index, demonstrated that higher frequency of sit-to-stand transitions (18 ± 23 transitions/day), standing time (52 ± 87 min/day) and step counts (442 ± 945 steps/day) were associated with lower frailty (frailty index: 0.438 ± 0.115) and higher HABAM scores (23.2 ± 16.3/67.0; all, p ≤ 0.034). Knee-bent sitting (142 ± 228 min/day) was associated with higher HABAM and lower frailty index scores (both, p ≤ 0.002). More non-upright time (1337 ± 133 min/day) and lying time (1138 ± 372 min/day) were associated with worse frailty index and HABAM scores (all, p ≤ 0.021). There were no associations between straight-legged sitting (56 ± 227 min/day) with frailty index or HABAM scores (both, p ≥ 0.219). Overall, participant posture was mostly characterized by a horizontal thigh (sitting or lying), with ∼1 h/day upright. Intervention models promoting upright time, sit-to-stand transitions, and knee-bent sitting rather than lying are warranted for frailty and HABAM management.

习惯性姿势对虚弱、平衡、活动和转移能力的影响，特别是在长期护理的人群中。我们试图描述在长期护理的老年人中，花在具体姿势上的时间及其与脆弱性和平衡与活动等级评估（HABAM）的关系。招募44名中重度体弱长期护理居民（女性36名，年龄：83 ± 10 岁，体重指数：31.8 ± 7.6 kg/m2）。参与者在躯干、大腿和胫骨上佩戴活动pal，时间为3.6 ± 0.5 天。通过65项指标和临床虚弱量表（CFS）来确定虚弱程度。使用HABAM测量功能能力。线性回归,调整年龄和身体质量指数,证明了更高频率的sit-to-stand转换(18 ± 23转换/天),放置时间(52 ± 87 分钟/天)和步骤数量(442 ± 945步/天)相关较低的弱点(脆弱指数:0.438 ±0.115 )和更高的HABAM得分(23.2 ± 16.3/67.0;,p ≤ 0.034)。屈膝坐姿（142 ± 228 min/天）与较高的HABAM和较低的衰弱指数评分相关（p均为 ≤ 0.002）。非直立时间（1337 ± 133 min/day）和躺卧时间（1138 ± 372 min/day）越长，虚弱指数和HABAM评分越差（均p ≤ 0.021）。直腿坐姿（56 ± 227 分钟/天）与衰弱指数或HABAM评分之间没有关联（p ≥ 0.219）。总体而言，参与者的姿势主要以水平大腿（坐着或躺着）为特征，每天直立约1 h。干预模式提倡直立时间，从坐到站的转变，膝盖弯曲的坐姿而不是躺着是虚弱和HABAM管理的保证。

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引用次数: 0

Longitudinal changes of sarcopenia status and risks of cardiovascular disease and all-cause mortality 骨骼肌减少症状态与心血管疾病和全因死亡率风险的纵向变化

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-12-08 DOI: 10.1016/j.exger.2025.112989

Kaixin Zhang , Xiaowei Zheng , Tao Ma

Background and objectives

Little is known about the association between changes in sarcopenia status with cardiovascular disease (CVD) and all-cause mortality. We aimed to evaluate the associations between sarcopenia status changes and incident CVD and mortality in a large prospective cohort of middle-aged and older adults.

Methods

A total of 7257 participants from the China Health and Retirement Longitudinal Study 2011 were included in analyses. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. Cox proportional hazards regression models were used to examine the association of changes in sarcopenia status (never, onset, remitted, and persistent) with CVD (stroke or cardiac events) and all-cause mortality.

Results

During a maximum follow-up period of 2 years, a total of 722 (9.95 %) respondents experienced CVD (303 stroke and 456 cardiac events), and 292 (4.02 %) deaths were identified. Compared to participants without any sarcopenia, those in the improved and persistent sarcopenia had an increased risk of CVD, with multiple-adjusted hazard ratios (95 % confidence intervals) of 1.37 (1.04–1.80) and 1.32 (1.03–1.69), respectively. Individuals with improved and persistent sarcopenia also had higher risk of stroke and cardiac events. Among participants with baseline possible sarcopenia, those who recovered to a non-sarcopenia status had a significantly lower risk of new-onset CVD and stroke, compared to those who remained in the possible sarcopenia status.

Conclusion

Changes in sarcopenia status are associated with varying risks of new-onset CVD risk and all-cause mortality. Monitoring long-term changes in the sarcopenia should prioritize CVD prevention strategies.

背景和目的：关于肌肉减少症与心血管疾病（CVD）和全因死亡率之间的关系，我们知之甚少。我们的目的是评估肌肉减少症状态变化与CVD事件和死亡率之间的关系，在一个大型的中老年前瞻性队列中。方法：2011年中国健康与退休纵向研究共纳入7257名参与者。肌少症状态根据2019年亚洲肌少症工作组（AWGS 2019）标准定义。使用Cox比例风险回归模型来检查肌肉减少症状态（从未、发作、缓解和持续）的变化与CVD（中风或心脏事件）和全因死亡率的关系。结果：在最长2 年的随访期间，共有722名（9.95 %）受访者经历了CVD（303例卒中和456例心脏事件），并确定了292例（4.02 %）死亡。与没有任何肌肉减少症的参与者相比，改善和持续肌肉减少症的参与者患心血管疾病的风险增加，多重校正风险比（95 %置信区间）分别为1.37（1.04-1.80）和1.32（1.03-1.69）。肌肉减少症得到改善和持续的个体也有较高的中风和心脏事件的风险。在基线可能有肌少症的参与者中，那些恢复到非肌少症状态的人与那些仍然处于可能的肌少症状态的人相比，新发心血管疾病和中风的风险显着降低。结论：肌少症状态的改变与不同的新发心血管疾病风险和全因死亡率相关。监测肌肉减少症的长期变化应优先考虑心血管疾病预防策略。

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引用次数: 0

Preserving intrinsic capacity in midlife women: A mixed-methods study of a personalized multicomponent intervention aligned with the WHO ICOPE framework 保持中年妇女的内在能力：一项符合世卫组织ICOPE框架的个性化多成分干预的混合方法研究。

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-11-21 DOI: 10.1016/j.exger.2025.112973

Ruby Yu , Cecilia Tong , Matthew Yu , Florence Ho , Angel Hui , Emily Lui , Jean Woo

Background

Intrinsic capacity (IC) preservation during midlife represents a critical yet overlooked opportunity for preventing age-related functional decline. We developed WomenWellness, a 12-week personalized multicomponent intervention aligned with the WHO Integrated Care for Older People (ICOPE) framework, and evaluated its effectiveness and scalability potential.

Methods

In a multicentre randomized controlled trial conducted in Hong Kong, we enrolled 176 women with ≥1 IC domain impairment, randomizing them to WomenWellness (n = 117) or to a control group that received a health kit containing educational materials and lifestyle tips (n = 59). The intervention integrated personalized care, multimodal exercise, and cognitive-psychosocial activities. Outcomes included IC composite scores (range 0-6, higher = worse), domain-specific impairments, anthropometrics, physical and cognitive performance, urinary incontinence prevalence, and pain severity, analysed using generalized linear mixed models adjusted for age, education, and medication use. A parallel qualitative evaluation involved 14 focus groups (8 participant groups, 6 service provider groups) exploring intervention acceptability, feasibility, and scalability through thematic analysis.

Results

Participants (mean age 61.5 ± 3.6 years) receiving WomenWellness showed significantly greater reductions in IC composite scores than controls (β = 0.39, 95 % CI = 0.03-0.75, p = .032), with domain-specific benefits including reduced chair stand times (β = 1.57, 95 % CI = 0.51-2.63, p = .004), ASMI preservation (β = −0.32, 95 % CI = −0.60-−0.04, p = .027), cardiorespiratory fitness gains (β = −11.47, 95 % CI = −16.89-−6.04, p < .001), lower malnutrition risk (OR = 0.26, 95 % CI = 0.08-0.84, p = .025), and reduced visual impairment (OR = 0.28, 95 % CI = 0.12–0.65, p = .003). Qualitative findings revealed high acceptability, with participants valuing the integrated approach and service providers emphasizing its adaptability to community settings.

Conclusion

WomenWellness effectively enhanced IC in midlife women, demonstrating high acceptability, feasibility, and adaptive fidelity, thereby supporting the integration of such programs into routine midlife healthcare services.

背景：内在能力（IC）保存在中年代表了一个关键的，但未充分利用的机会，以防止年龄相关的功能衰退。我们根据世卫组织老年人综合护理（ICOPE）框架开发了为期12周的个性化多成分干预ANONYMOUS，并评估了其有效性和可扩展性潜力。方法：在香港18个地区进行的一项多中心随机对照试验中，我们招募了176名IC结构域损伤≥1的女性，将她们随机分为匿名组（n = 117）和对照组（n = 59），对照组接受包含教育材料和生活方式提示的健康包。干预包括个性化的多学科护理、多模式锻炼和认知-社会心理活动。结果包括IC综合评分（范围0-6， 越高= 越差）、领域特异性损伤、人体测量学、身体和认知表现、尿失禁患病率和疼痛严重程度，使用线性混合效应模型对年龄、教育程度和药物使用进行了调整。平行定性评估涉及14个焦点小组（8名参与者，6名服务提供者），通过专题分析探讨干预的可接受性、可行性和可扩展性。结果:参与者 (平均年龄61.5±3.6  年)收到匿名显示显著减少集成电路综合得分大于控件(β = 0.39,95 % CI = 0.03 - -0.75,p = 。032)，具有特定领域的好处，包括更快的椅子站立时间（β = 1.57,95 %CI = 0.51-2.63,p = ）。004), ASMI保存(β = -0.32,95 CI  % = -0.60——0.04,p = 。027)，心肺功能增强（β = -11.47,95% %CI = -16.89 - -6.04,p ）结论：ANONYMOUS有效增强了中年女性的IC，具有较高的可接受性、可行性和适应性保真度，支持将此类项目纳入日常中年医疗保健服务。

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引用次数: 0

Chronotype, serum metabolome, and nonalcoholic fatty liver disease in middle-aged and older adults: Association and potential mediation analyses 中老年人的时间型、血清代谢组和非酒精性脂肪肝：关联和潜在的中介分析

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-12-16 DOI: 10.1016/j.exger.2025.112998

Ming-Jun Hu , Xiao-Min Dong , Xue-Li Wang, Bei Yao, Fu Yu, Dan Su, Lu Li, Yong-Liang Zhang, Xin-Min Chu

Objective

Chronotype represents individual's circadian preference in behavioral and circadian rhythm. This study aimed to investigate association between chronotype and nonalcoholic fatty liver disease (NAFLD) and underlying metabolic mechanisms in middle-aged and older adults.

Methods

This cross-sectional study included 744 general middle-aged and older adults. Chronotype was assessed using the Morningness-Eveningness Questionnaire. Untargeted metabolomic profiling was identified using liquid chromatography with high-resolution mass spectrometry. Logistic regression model was used to evaluate association between chronotype and NAFLD. A metabolome-wide association study coupled with mediation analysis was conducted to assess metabolic dysregulation related with chronotype and NAFLD.

Results

Chronotype was categorized as morning in 33.1 % of participants, intermediate in 46.8 %, and evening in 20.1 %. After adjustment for covariates, evening chronotype was significantly associated with higher NAFLD risk (OR = 1.70, 95 % CI: 1.03, 2.81) compared to morning chronotype. We identified 81 metabolite features that were significantly associated with chronotype. The comparison between NAFLD and non-NAFLD revealed 251 metabolic differences, implicating 5 metabolic pathways: Arginine biosynthesis, Histidine metabolism, Alanine, aspartate and glutamate metabolism, Arginine and proline metabolism, and beta-Alanine metabolism. Mediation analyses suggested that 7 metabolites (such as Asparaginyl-Proline and DG(11D3/11D5/0:0)) might be potential mediators in association of chronotype with NAFLD, with mediated proportions ranging from 12.1 % to 20.6 %.

Conclusion

Evening chronotype was associated with increased risk of NAFLD in middle-aged and older adults. Chronotype-related metabolomic alterations, including Asparaginyl-Proline and some lipid metabolites, might represent an associative pathway between chronotype and NAFLD. This highlighted the importance of maintaining circadian rhythms for metabolic health.

目的：时间型反映了个体在行为和昼夜节律方面的生理偏好。本研究旨在探讨中老年人睡眠类型与非酒精性脂肪性肝病（NAFLD）之间的关系及其潜在的代谢机制。方法：本横断面研究纳入744名普通中老年人。时间类型评估使用晨醒性问卷。使用液相色谱和高分辨率质谱法鉴定非靶向代谢组学分析。采用Logistic回归模型评价睡眠类型与NAFLD的相关性。一项代谢组关联研究结合中介分析来评估代谢失调与时间型和NAFLD的关系。结果：33.1% %的参与者的睡眠类型为早晨，46.8% %的参与者为中间，20.1% %的参与者为晚上。调整协变量后，与晨起型相比，晚睡型与NAFLD风险显著相关（OR = 1.70,95 % CI: 1.03, 2.81）。我们确定了81个与时间型显著相关的代谢物特征。NAFLD与非NAFLD的比较发现了251种代谢差异，涉及5种代谢途径：精氨酸生物合成、组氨酸代谢、丙氨酸、天冬氨酸和谷氨酸代谢、精氨酸和脯氨酸代谢、β -丙氨酸代谢。中介分析表明，7种代谢物（如天冬酰胺脯氨酸和DG(11D3/11D5/0:0)）可能是与NAFLD相关的潜在中介，介导比例在12.1 %至20.6 %之间。结论：夜间睡眠类型与中老年人NAFLD风险增加有关。时间型相关的代谢组学改变，包括天冬酰胺脯氨酸和一些脂质代谢物，可能代表了时间型和NAFLD之间的关联途径。这突出了维持昼夜节律对代谢健康的重要性。

{"title":"Chronotype, serum metabolome, and nonalcoholic fatty liver disease in middle-aged and older adults: Association and potential mediation analyses","authors":"Ming-Jun Hu , Xiao-Min Dong , Xue-Li Wang, Bei Yao, Fu Yu, Dan Su, Lu Li, Yong-Liang Zhang, Xin-Min Chu","doi":"10.1016/j.exger.2025.112998","DOIUrl":"10.1016/j.exger.2025.112998","url":null,"abstract":"<div><h3>Objective</h3><div>Chronotype represents individual's circadian preference in behavioral and circadian rhythm. This study aimed to investigate association between chronotype and nonalcoholic fatty liver disease (NAFLD) and underlying metabolic mechanisms in middle-aged and older adults.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 744 general middle-aged and older adults. Chronotype was assessed using the Morningness-Eveningness Questionnaire. Untargeted metabolomic profiling was identified using liquid chromatography with high-resolution mass spectrometry. Logistic regression model was used to evaluate association between chronotype and NAFLD. A metabolome-wide association study coupled with mediation analysis was conducted to assess metabolic dysregulation related with chronotype and NAFLD.</div></div><div><h3>Results</h3><div>Chronotype was categorized as morning in 33.1 % of participants, intermediate in 46.8 %, and evening in 20.1 %. After adjustment for covariates, evening chronotype was significantly associated with higher NAFLD risk (OR = 1.70, 95 % CI: 1.03, 2.81) compared to morning chronotype. We identified 81 metabolite features that were significantly associated with chronotype. The comparison between NAFLD and non-NAFLD revealed 251 metabolic differences, implicating 5 metabolic pathways: Arginine biosynthesis, Histidine metabolism, Alanine, aspartate and glutamate metabolism, Arginine and proline metabolism, and beta-Alanine metabolism. Mediation analyses suggested that 7 metabolites (such as Asparaginyl-Proline and DG(11D3/11D5/0:0)) might be potential mediators in association of chronotype with NAFLD, with mediated proportions ranging from 12.1 % to 20.6 %.</div></div><div><h3>Conclusion</h3><div>Evening chronotype was associated with increased risk of NAFLD in middle-aged and older adults. Chronotype-related metabolomic alterations, including Asparaginyl-Proline and some lipid metabolites, might represent an associative pathway between chronotype and NAFLD. This highlighted the importance of maintaining circadian rhythms for metabolic health.</div></div>","PeriodicalId":94003,"journal":{"name":"Experimental gerontology","volume":"213 ","pages":"Article 112998"},"PeriodicalIF":4.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145784103","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

Sarcopenia, obesity, and functional decline: converging mechanisms and emerging diagnostic frontiers 肌肉减少症、肥胖和功能衰退：趋同机制和新兴诊断前沿。

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI: 10.1016/j.exger.2025.112993

Andrea P. Rossi , Lin Kang , Ming Yang

引用次数: 0

The impact of adapted tango dance on cognitive and executive function in older adults: A randomized controlled trial 适应性探戈舞对老年人认知和执行功能的影响：一项随机对照试验。

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-12-22 DOI: 10.1016/j.exger.2025.113012

Yuexin Zhang , Hongli Zhang , Hongtao Ma

Purpose

This study aimed to evaluate the effects of a 12-week adapted tango program on executive and cognitive function in older adults.

Methods

In this randomized controlled trial, fifty Chinese older adults (aged 60–69 years) were randomly assigned to either an adapted tango intervention group (n = 25) or a control group (n = 25) maintaining usual daily habits. The intervention group completed a 12-week adapted tango program (twice weekly, 60 min per session). Executive function was assessed using the Flanker task, Dimensional Change Card Sort (DCCS) task, and N-back task, while global cognition was measured with the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). A two-way repeated-measures ANOVA was performed to examine group × time interactions, followed by Bonferroni-adjusted post-hoc comparisons. Effect sizes were calculated using Cohen's d.

Results

Significant group × time interactions were found for Flanker reaction time (RT) and accuracy (p = 0.002 and p < 0.001), with improvements in the tango group but no changes in the control group. DCCS RT and accuracy also showed significant improvements (p < 0.001), while the control group exhibited no changes. Significant improvements were noted in N-back RT and accuracy (p = 0.008 and p < 0.001), with no changes observed in the control group. Additionally, MMSE total and subdomains (e.g., orientation) significantly improved (p < 0.001), with no changes in the controls. MoCA total and subdomains (e.g., visuospatial/executive) significantly improved (p < 0.001), while no changes were found in the control group.

Conclusion

The findings suggest that adapted tango may be an effective non-pharmacological intervention for enhancing executive and cognitive functions in older adults, with potential implications for promoting cognitive health in aging populations.

目的：本研究旨在评估一项为期12周的适应性探戈计划对老年人执行和认知功能的影响。方法：在这项随机对照试验中，50名中国老年人（60-69岁 ）被随机分配到适应性探戈干预组（n = 25）和对照组（n = 25），保持正常的日常习惯。干预组完成了一个为期12周的适应探戈项目（每周两次，每次60 分钟）。执行功能采用侧卫任务、维度变化卡排序（DCCS）任务和N-back任务进行评估，整体认知采用迷你精神状态检查（MMSE）和蒙特利尔认知评估（MoCA）进行评估。采用双向重复测量方差分析来检查组与时间的相互作用，然后进行bonferroni调整后的事后比较。结果：发现Flanker反应时间（RT）和准确性之间存在显著的组×时间相互作用（p = 0.002和p ）。结论：研究结果表明，适应性探戈可能是一种有效的非药物干预措施，可增强老年人的执行和认知功能，对促进老年人的认知健康具有潜在的意义。

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引用次数: 0

Accelerated intermittent theta burst stimulation combined with cognitive training modulates cortical plasticity and brain activation in patients with amnestic mild cognitive impairment 加速间歇性θ波爆发刺激联合认知训练可调节健忘轻度认知障碍患者的皮质可塑性和大脑激活。

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-12-19 DOI: 10.1016/j.exger.2025.113009

Jiali Luo , Zefeng Tan , Pan Shang , Shuyun Huang , Yajing Liu , Yukai Wang , Haiqun Xie , Qi Chen

Amnestic mild cognitive impairment (aMCI) is the prodromal period of Alzheimer's disease without effective treatment. This research aimed to investigate the effects of accelerated intermittent theta burst stimulation (iTBS) combined with adaptive cognitive training (COG) on cognitive function in aMCI patients and explore the underlying neural mechanisms. Twenty-four aMCI patients participated in either the real (n = 12) or sham (n = 12) stimulation group. Both groups received adaptive COG, which comprised three sessions of real or sham iTBS delivered on the left dorsolateral prefrontal cortex (DLPFC) once a day for 14 days. The primary outcomes were the Montreal Cognitive Assessment (MoCA) and Alzheimer's Disease Assessment Scale–Cognitive Subscale (ADAS-Cog) scores. Secondary outcomes were changes in cortical plasticity measured by transcranial magnetic stimulation and brain activation monitored by functional near-infrared spectroscopy (fNIRS). Patients were evaluated before and after the intervention. Patients with aMCI who received iTBS combined with COG had a significant improvement in cognitive performance, as assessed by the ADAS-Cog and N-back. In the iTBS+COG group, cortical plasticity measured 30 min post-intervention correlated with ADAS-Cog changes (r = −0.59, p = 0.043). Furthermore, this plasticity was associated with 1-back activation (r = −0.58, p = 0.050), and 2-back activation correlated with ADAS-Cog changes (r = −0.59, p = 0.042). Accelerated iTBS targeted to the left DLPFC combined with adaptive COG promoted cognitive improvement in aMCI patients more effectively by modulating cortical plasticity and brain activation. Cortical plasticity and brain activation might be valuable measurements for understanding cognitive function (Chinese Clinical Trial Registry: ChiCTR2400087943).

遗忘性轻度认知障碍（aMCI）是阿尔茨海默病的前驱期，没有有效的治疗。本研究旨在探讨加速间歇性θ波爆发刺激（iTBS）联合适应性认知训练（COG）对aMCI患者认知功能的影响，并探讨其潜在的神经机制。24例aMCI患者分为真实刺激组（n = 12）和假刺激组（n = 12）。两组均接受适应性COG，包括三次真实或假iTBS，每天一次，持续14 天。主要结果是蒙特利尔认知评估（MoCA）和阿尔茨海默病评估量表-认知亚量表（ADAS-Cog）得分。次要结果是经颅磁刺激测量的皮质可塑性变化和功能近红外光谱（fNIRS）监测的脑激活。在干预前后对患者进行评估。根据ADAS-Cog和N-back评估，接受iTBS联合COG的aMCI患者认知能力有显著改善。在iTBS+COG组中，干预后30 min测量的皮质可塑性与ADAS-Cog变化相关（r = -0.59,p = 0.043）。此外，这种可塑性与1-back激活相关（r = -0.58,p = 0.050），2-back激活与ADAS-Cog变化相关（r = -0.59,p = 0.042）。针对左侧DLPFC的加速iTBS联合适应性COG通过调节皮质可塑性和大脑激活更有效地促进aMCI患者的认知改善。皮质可塑性和大脑激活可能是理解认知功能的有价值的测量（中国临床试验注册：ChiCTR2400087943）。

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引用次数: 0

Causal association and potential mediators between obstructive sleep apnea and diabetic nephropathy: A Mendelian randomization study 阻塞性睡眠呼吸暂停和糖尿病肾病之间的因果关系和潜在介质：孟德尔随机研究。

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-11-27 DOI: 10.1016/j.exger.2025.112980

Yonghang He , Junxiang Wang , Yun Wen , Bo Yi , Yong Wang

Background

Previous observational studies have reported the association between obstructive sleep apnea (OSA) and diabetic nephropathy. However, it remains to be confirmed whether this association is causal. This study aimed to investigate the causal association of OSA with diabetic nephropathy and the mediating effect of common risk factors using Mendelian randomization (MR) design.

Method

The study data were sourced from genome-wide association studies (GWAS). Bidirectional two-sample MR and multivariable MR analyses were conducted to assess causal relationships between OSA and diabetic nephropathy. Potential mediation by common risk factors was evaluated through two-step MR. In addition, the MR results were supported by various sensitivity and validation analyses.

Results

We presented genetic evidence that OSA could unidirectionally increase the risk of diabetic nephropathy (OR = 1.30; 95 % CI: 1.13, 1.50; p = 2.51 × 10⁻⁴). After adjusting for BMI, high blood pressure, blood glucose levels, glycated hemoglobin levels, severe insulin resistance, years of schooling, nap during day, processed meat consumption, and coffee intake, the causal effect of OSA on diabetic nephropathy remained statistically significant. Further mediation MR analysis showed that BMI and high blood pressure may mediate the causal relationship between OSA and diabetic nephropathy, with a mediation effect of 26.35 % and 9.91 %, respectively.

Conclusion

Our findings suggest that genetically predicted OSA is associated with a higher risk of diabetic nephropathy. Additionally, BMI and high blood pressure are involved in the mechanism of OSA-induced diabetic nephropathy.

背景：先前的观察性研究已经报道了阻塞性睡眠呼吸暂停（OSA）与糖尿病肾病之间的关联。然而，这种联系是否有因果关系还有待证实。本研究采用孟德尔随机化（Mendelian randomization， MR）设计，探讨OSA与糖尿病肾病的因果关系及常见危险因素的中介作用。方法：研究数据来源于全基因组关联研究（GWAS）。进行双向双样本MR和多变量MR分析，以评估OSA与糖尿病肾病之间的因果关系。通过两步MR评估常见危险因素的潜在中介作用。此外，MR结果得到了各种敏感性和验证性分析的支持。结果：我们提供了遗传证据，OSA可单向增加糖尿病肾病的风险（OR = 1.30;95 % CI: 1.13, 1.50; p = 2.51 × 10-4）。在调整BMI、高血压、血糖水平、糖化血红蛋白水平、严重胰岛素抵抗、上学年限、白天午睡、加工肉类消费和咖啡摄入等因素后，OSA对糖尿病肾病的因果影响仍然具有统计学意义。进一步的中介MR分析表明，BMI和高血压可能介导OSA与糖尿病肾病的因果关系，其中介效应分别为26.35 %和9.91 %。结论：我们的研究结果表明，基因预测的OSA与糖尿病肾病的高风险相关。此外，BMI和高血压参与了osa诱导的糖尿病肾病的发生机制。

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引用次数: 0

A subtle association raising bigger questions: Implicit and explicit ageism in the Dutch age IAT 一个微妙的联系引发了更大的问题：荷兰时代的隐性和显性年龄歧视。

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-12-08 DOI: 10.1016/j.exger.2025.112988

Belia Schuurman , Jolanda Lindenberg , Tineke A. Abma , Wilco P. Achterberg

This study presents the first baseline analysis of the Dutch Age Implicit Association Test (IAT) data, examining both implicit and explicit ageism measures in the Netherlands. Analyzing data from 8680 participants over a range of 12 years, we investigated implicit ageism scores, their association with explicit ageism measures, and associations with demographic characteristics. Results position the Netherlands in the international midfield for implicit ageism. Significant gender differences emerged, with men showing higher implicit ageism scores than women. We found no significant relationship between age and implicit ageism. The study revealed small to moderate yet significant correlations between implicit and explicit ageism measures, suggesting these are subtly related yet distinct constructs. These findings contribute to the international comparative literature on ageism by establishing a Dutch baseline and emphasize the need for further research into the association between implicit and explicit ageism. To tackle the prevalence and consequences of ageism in our social lives and institutions, the mechanisms underlying age-related biases across different contexts need to be investigated further.

本研究提出了荷兰年龄内隐联想测试（IAT）数据的第一个基线分析，检查了荷兰的内隐和外显年龄歧视措施。我们分析了8680名参与者在12 年的时间里的数据，研究了内隐年龄歧视评分、它们与外显年龄歧视措施的关系，以及它们与人口统计学特征的关系。结果显示，荷兰队因隐性年龄歧视而处于国际中场位置。显著的性别差异出现了，男性的隐性年龄歧视得分高于女性。我们发现年龄与隐性年龄歧视之间没有显著的关系。该研究揭示了内隐和外显年龄歧视测量之间的小到中度但显著的相关性，表明它们是微妙相关但不同的结构。这些发现通过建立荷兰基线，为年龄歧视的国际比较文献做出了贡献，并强调了对内隐和外显年龄歧视之间关系的进一步研究的必要性。为了解决在我们的社会生活和机构中普遍存在的年龄歧视及其后果，需要进一步研究不同背景下与年龄相关的偏见的潜在机制。

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引用次数: 0

Prognostic assessment of sepsis-induced acute respiratory distress syndrome in older patients using clinical and CT-based radiomic features 使用临床和基于ct的放射学特征评估败血症引起的老年患者急性呼吸窘迫综合征的预后。

IF 4.3

Experimental gerontology

Pub Date : 2026-01-01 Epub Date: 2025-12-05 DOI: 10.1016/j.exger.2025.112987

Xiya Wang , Bowen Zhang , Ying Chen , Xinzhen Gao , Yongshen Bai , Shuxing Wei , Shubin Guo , Xue Mei

Background

Sepsis-induced acute respiratory distress syndrome (SI-ARDS) is associated with high mortality rates, necessitating early risk stratification. This study aimed to develop and validate a radiomics-based nomogram integrating computed tomography (CT) features and clinical parameters to predict 28-day mortality in older patients with SI-ARDS.

Methods

In this retrospective cohort study, 302 older patients (≥60 years) diagnosed with SI-ARDS between January 2019 and December 2023 were enrolled. Radiomic features were extracted from admission chest CT images. Patients were randomly allocated to training (n = 242) and validation (n = 60) cohorts. Three predictive models—radiomic, clinical, and combined—were constructed using Maximum Relevance Minimum Redundancy (MRMR) algorithm and Least Absolute Shrinkage and Selection Operator (LASSO) regression. Model performance was assessed using the concordance index (C-index), calibration curves, and decision curve analysis. A nomogram was developed based on the optimal model for clinical application.

Results

The fusion model achieved superior discrimination compared with the radiomic model, clinical model, and Sequential Organ Failure Assessment score in both cohorts (C-index: training, 0.850 vs. 0.798, 0.781, and 0.654; validation, 0.839 vs. 0.768, 0.779, and 0.696; all p < 0.001). The model demonstrated excellent calibration and provided greater net clinical benefit across threshold probabilities of 10 %–90 %. Risk stratification using the nomogram identified distinct prognostic groups with significantly different 28-day survival (log-rank p < 0.001).

Conclusion

The nomogram developed from the fusion model demonstrated superior predictive performance for 28-day mortality in older patients with SI-ARDS compared to conventional scoring systems, though multicenter validation is required to confirm clinical utility.

背景：败血症引起的急性呼吸窘迫综合征（SI-ARDS）死亡率高，需要进行早期风险分层。本研究旨在开发和验证一种基于放射组学的图，结合计算机断层扫描（CT）特征和临床参数来预测老年SI-ARDS患者的28天死亡率。方法：在这项回顾性队列研究中，纳入了2019年1月至2023年12月期间诊断为SI-ARDS的302例老年患者（≥60 岁）。从入院胸部CT图像中提取放射学特征。患者被随机分配到训练组（n = 242）和验证组（n = 60）。使用最大相关最小冗余（MRMR）算法和最小绝对收缩和选择算子（LASSO）回归构建了放射学、临床和组合三种预测模型。采用一致性指数（C-index）、校准曲线和决策曲线分析来评估模型的性能。在此基础上建立了一种适合临床应用的模式图。结果：在两个队列中，与放射学模型、临床模型和序贯器官衰竭评估评分相比，融合模型取得了更好的识别效果(c指数：训练，0.850比0.798、0.781和0.654；验证，0.839比0.768、0.779和0.696；结论：与传统评分系统相比，融合模型开发的nomogram对SI-ARDS老年患者28天死亡率的预测能力更强，但需要多中心验证来证实其临床实用性。

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引用次数: 0