Understanding the molecular mechanisms of aging guides the development of prevention, intervention, and treatment strategies to reduce the incidence of common age-associated diseases. Over the past decades, the proposed key features (hallmarks) of aging cells have directly or indirectly provided us clues, furthering our understanding of the causes of disease and assisting with the development of therapeutic strategies for diseases such as rare premature aging diseases like Werner syndrome and ataxia telangiectasia (A-T), as well as the common age-related diseases like dementia and sarcopenia. In this editorial, we take a closer look at three of these hallmarks including genomic instability, defective macroautophagy, and mitochondrial dysfunction, and the applications of these concepts in understanding the progress of complex diseases. Mounting studies from the laboratory, supported by emerging clinical evidence, point to the reduction of the oxidized form of nicotinamide adenine dinucleotide (NAD+) as a commonality between many of these hallmarks of aging. Intriguingly, stimulating mitochondrial autophagy (mitophagy) via improvement of NAD+ availability appears to be a promising and effective therapeutic strategy for many diseases relating to aging. Future studies on the hallmarks of aging should address their internal linkages and clinical interventions.
Objectives:Hair cortisol has been increasingly used as an important biomarker of chronic stress, as it reflects prolonged systemic exposure to cortisol over time. Such exposure has been associated with alterations in body composition; however, the associations with sarcopenia and sarcopenic obesity have still received little attention in the scientific literature on aging. The study aimed to assess the association between hair cortisol, dynapenia, sarcopenia, and sarcopenic obesity in a multicenter and multiethnic Brazilian cohort. Methods:The criterion used to classify sarcopenia was specific to the study population, and the categories used were dynapenia (reduced muscle strength), sarcopenia (reduced muscle strength and mass), and sarcopenic obesity (≥ 38% body fat plus sarcopenia). Hair cortisol levels (pg/mg) were divided into three categories: Low (< 40), normal (40 to 128), and high (> 128). Simple and multiple logistic regression analyses were used to verify the association between hair cortisol, reduced muscle strength, sarcopenia, and sarcopenic obesity. The final model was adjusted for sex, BMI, hypertension, diabetes, smoking, physical activity, and race/ethnicity, and odds ratios (OR) and 95% confidence intervals (95% CI) were calculated. Results:A total of 947 participants were included (aged 54 to 82 years, mean age 67.1 years, 63.7% women). Participants with high hair cortisol levels showed lower odds of reduced muscle strength (OR: 0.796; 95% CI: 0.504-1.255), suggesting an inverse association; this was not statistically significant. However, no significant association was seen between chronic stress and sarcopenia (OR: 1.106; 95% CI: 0.555-2.206) or sarcopenic obesity (OR: 0.607; 95% CI: 0.162-2.279). Conclusions:In a sample of Brazilian adults, hair cortisol level, a measurement technique not affected by physiological fluctuations, was not associated with reduced muscle strength, sarcopenia, or sarcopenic obesity.
Alzheimer's disease (AD) and Parkinson's disease (PD) are the two most prevalent neurodegenerative disorders globally and have long been classified as clinically and pathologically distinct syndromes. AD is defined by amyloid-β (Aβ) plaques and tau-positive neurofibrillary tangles, whereas PD is characterized by α-synuclein aggregation and progressive degeneration of nigrostriatal dopaminergic neurons. However, mounting evidence has blurred the traditional boundaries between these disorders, revealing extensive overlaps in pathogenic cascades, clinical phenotypes, and epidemiological risk factors. In this review, we propose an integrated mechanistic framework in which AD and PD represent distinct yet partially overlapping disorders along a convergent neurodegenerative spectrum, unified by a core metabolic-proteinopathy axis. We highlight cerebral insulin resistance and impaired brain glucose metabolism as pivotal upstream triggers that initiate a cascade of pathological events, including mitochondrial dysfunction, energy depletion, oxidative stress, chronic neuroinflammation, and disrupted proteostasis. These disturbances collectively drive aberrant folding and aggregation of Aβ, tau, and α-synuclein, establishing a mechanistic link between systemic metabolic dysregulation and region-selective neuronal vulnerability. We synthesize evidence from molecular studies, preclinical models, clinicopathological analyses, neuroimaging, and longitudinal epidemiological surveys to delineate the extent and limitations of mechanistic convergence. We also emphasize consistent divergences between AD and PD, including distinct patterns of neuroanatomical involvement, dominant clinical presentations, pathological propagation trajectories, and genetic architectures. Epidemiological data confirm that Type 2 diabetes and insulin resistance are associated with elevated risk of both AD and PD. Moreover, antidiabetic agents such as GLP-1 receptor agonists exhibit convergent neuroprotective efficacy in preclinical and early clinical investigations, supporting metabolic modulation as a promising cross-disease therapeutic strategy. Despite shared downstream pathways and therapeutic targets, AD and PD retain unique pathological signatures and clinical progression patterns. This review provides a balanced, evidence-based interpretation of the AD-PD relationship, highlighting partial pathogenic convergence driven by metabolic dysfunction while affirming their identities as distinct disorders. The proposed metabolic-proteinopathy framework advances mechanistic understanding and informs the development of novel disease-modifying therapies targeting shared upstream pathways.
Obesity in older adults has become a prominent public health issue. Owing to age-related physiological changes and multimorbidity, obesity in this population is associated with complex clinical manifestations and markedly increased difficulty in management. Based on this, a multidisciplinary panel of obesity experts from Beijing Hospital, National Center for Gerontology, formulated this consensus after rigorous evaluation and iterative revision. The consensus emphasizes that management of obesity in older adults requires comprehensive assessment according to age and overall health status and should adopt a patient-centered, individualized, and stratified strategy. By adhering to the principles of safety first, functional improvement, and steady progress, the goals are to reduce visceral fat accumulation, maintain or increase muscle mass, protect bone health, and improve physical function and overall health. Special attention should be paid to sarcopenia in older adults. Adequate intake of high-quality protein, combined with an individualized resistance exercise program, is an effective strategy for maintaining muscle mass. Selection of weight-loss medication should be guided by evidence supporting its benefit for obesity-related complications or comorbidities, with close monitoring of adverse reactions.
Dysregulation of the renin-angiotensin-aldosterone system (RAAS) constitutes a pivotal factor in the onset and progression of various geriatric diseases, including cardiovascular diseases, diabetes, and chronic kidney disease (CKD), all closely linked to adverse cardiorenal outcomes in older patients. Excessive activation of the mineralocorticoid receptor (MR) drives inflammation, fibrosis, and oxidative stress across tissues and organs, representing a fundamental mechanism underlying systemic metabolic disorders, diabetes, cardiovascular diseases, and kidney pathologies. Emerging clinical evidence indicates that the non-steroidal mineralocorticoid receptor antagonist (ns-MRA) finerenone can block MR with high selectivity, significantly reducing cardiorenal event risks in older patients and thereby enhancing overall health status. This offers a novel therapeutic avenue for the long-term management of older patients burdened with multiple chronic comorbidities.
Objectives:Older persons are often referred to emergency departments due to acute functional decline, that is, reduced activities of daily living occurring in the days before hospitalization, frequently driven by acute medical conditions. We aimed to describe frailty in the oldest hospitalized patients presenting with acute functional decline and evaluate predictors of death, severe frailty and nursing home admission after 3-6 months. Methods:We included 119 persons with acute functional decline, aged ≥ 80 years, ≥ 5 systemic diagnoses, ≥ 5 drugs daily, from an acute geriatric ward and reassessed after 3-6 months. All were evaluated with comprehensive geriatric assessment. Severe frailty was defined as Clinical Frailty Scale 7-8. Results:Forty-one (34.4%) were free from severe frailty at baseline and 32 (48.5%) at follow-up. Male sex (adjusted OR 11.820, 95% confidence interval [CI] 3.670-38.120), Clinical Dementia Rating (CDR) ≥ 0.5 (adjusted OR 3.920, 95% CI 1.020-15.100), severe frailty at baseline (adjusted OR 6.930, 95% CI 1.830-26.210), type 2 diabetes (adjusted OR 7.460, 95% CI 2.040-27.250), and cancer (adjusted OR 5.640, 95% CI 1.040-30.690) were associated with death at follow-up. Hearing impairment (adjusted OR 7.060, 95% CI 1.430-34.760), CDR ≥ 0.5 (adjusted OR 5.390, 95% CI 1.260-23.070), and nursing home living before admission (adjusted OR 4.260, 95% CI 1.010-17.920) were associated with severe frailty at follow-up. Conclusions:Many persons with acute functional decline have severe frailty. Male sex, cognitive impairment, diabetes mellitus type 2, cancer, hearing impairment, and nursing home living seem to increase the risk of severe frailty or death and should be considered when person-centered care is planned for hospitalized older people.
China's demographic landscape is undergoing a dramatic transformation. With over 297 million people aged 60 and above-comprising 21.1% of the total population-the nation faces unprecedented challenges in providing adequate end-of-life care for its elderly citizens. It is against this backdrop that the National Health Commission of the People's Republic of China released the "Standard for Geriatric Hospice Care Wards (WS/T844-2024)" on July 24, 2024, which aims to fill the institutional gap and promote the critical transition of hospice care services from "empirical exploration" to "standardized development". This Standard specifies the configuration requirements for geriatric hospice care wards in terms of ward configuration, staffing models, age-appropriate equipment, and quality assurance mechanisms. While the WS/T 844-2024 standard establishes a much-needed framework for service standardization, its ultimate outcome will depend on how well it can be adapted to China's diverse healthcare landscape and resource constraints. This critique aims to identify both the strengths and potential limitations of the WS/T 844-2024 standard, offering insights for policymakers and healthcare providers tasked with its implementation. By doing so, the article addresses the following questions: What blueprint does the WS/T 844-2024 standard outline for geriatric hospice care in China? What key tensions may arise when this blueprint confronts the practical challenges of China's uneven distribution of medical resources, shortage of professional workforce, and cultural traditions? And how can a pragmatic implementation pathway be constructed to bridge the gap between the ideal and the reality?
Objectives:Kidney function declines with aging, leading to a high prevalence of age-related disease. Concurrently, the increasing prevalence of overweight and obesity may influence age-related kidney changes. This study aims to clarify the relationship between body mass index (BMI) and kidney function in the Chinese population, with a focus on sex differences. Methods:We conducted a retrospective cross-sectional study involving 343,040 Chinese adults, stratified by sex and age. Glomerular filtration rate (GFR) was estimated using the CKD-EPI formula based on serum creatinine. We examined trends in BMI and its distribution across age groups, as well as the patterns of estimated GFR (eGFR) decline within BMI subgroups. Multi-linear and multi-logistic regression analyses were used to assess the association between BMI and age-related kidney function. Results:BMI levels and categories varied with age, exhibiting sex-specific patterns. Overweight and obese individuals experienced a more pronounced decline in eGFR, except for females under 45. In males, BMI showed a negative correlation with eGFR, while females under 65 exhibited a positive association; older females showed a negative correlation. Significant risks for mildly reduced kidney function were noted in overweight or obese males and older females, with no risk identified in younger females. Conclusion:A normal BMI (18.5-25 kg/m2) is associated with better age-related kidney function in all-aged males and females older than 45 years, considering eGFR levels and decline rates.
Chronic respiratory diseases pose a serious threat to the health of the population due to their high incidence, high disability rate, and poor prognosis. It is necessary to improve the prevention and treatment status of chronic respiratory diseases. Vaccination against influenza and pneumococcal infections can reduce the risk of respiratory infections, lower hospitalization and mortality rates, and alleviate disease burden in individuals with chronic respiratory diseases. However, insufficient public awareness of influenza and pneumococcal vaccines and the lack of recommendation by medical personnel have led to the low actual vaccination rate of influenza and pneumococcal vaccines in elderly people with chronic respiratory diseases in China. Based on existing research evidence both domestically and internationally, this consensus describes the burden of influenza and pneumococcal diseases in elderly people with chronic respiratory diseases, the protective effect and safety of influenza and pneumococcal vaccines, and vaccination recommendations, aiming to promote the vaccination rate of elderly people with chronic respiratory diseases, better play the role of vaccines in preventing influenza and pneumococcal diseases, and reduce the occurrence of respiratory infections and related serious complications in the population with chronic respiratory diseases.
Objectives:This study aims to evaluate the Scientific, Transparent, and Applicable Rankings (STAR) of guidelines and consensus published in Chinese geriatric medicine journals in 2023. Methods:The working group conducted a systematic search in eight major Chinese and English databases for guidelines and consensuses published by Chinese scholars in the field of geriatric medicine in 2023. The selected guidelines and consensuses were rated using the STAR rating tool, and the rating results were analyzed. Results:A total of 10 guidelines and 20 expert consensus documents were included. The STAR scores ranged from 9.4 to 55.7 with a mean of 29.3 ± 11.2. The STAR scores of 10 guidelines ranged from 16.1 and 55.7 with an average of 35.5 ± 13.1. The STAR scores of 20 consensus ranged from 9.4 and 48.5 with an average of 26.2 ± 8.9. Conclusion:Guidelines and consensus in geriatric medicine have shown significant improvements in 2023 compared to 2022 across registration, consensus methodology, working groups, and accessibility. However, areas such as protocol development, funding, and clinical issues require further refinement by the authors.
ABSTRACT Objectives Sarcopenia, an age‐related muscle disease, is influenced by a variety of factors, making it essential to explore the associations of physical activity, psychological health, employment, and exercise with this condition in a healthy, well‐nourished population. Method This study was conducted with 766 healthy adults to assess these relationships based on EWGSOP2. Participants completed the IPAQ and provided a work and exercise history. Mental health was evaluated using BDI‐13 and DASS‐21. Result Physical activity, both current and past, was significanly associated with a lower odds of sarcopenia. Employment status and type of work were also associated with odds of sarcopenia. Participation in sports and exercise duration were linked to decreased odds (OR = 0.687 (95% CI = 0.600–0.787), p < 0.005), with specific activities like swimming and certain traditional Iranian sports showing strong associations. Psychological factors such as scores of depression (OR = 1.149 (95% CI = 1.112–1.189), p < 0.005), anxiety (OR = 1.233 (95% CI = 1.176–1.293), p < 0.005), and stress (OR = 1.084 (95% CI = 1.056–1.114), p < 0.005) were associated with an increased odds of sarcopenia. The multivariable analyses confirmed the independent relationships of physical activity and some mental health components with sarcopenia. Predictive models highlighted the importance of physical activity, exercise, and employment status as key variables associated with sarcopenia. Conclusion This study revealed that higher work engagement, better mental health components (including lower stress, depression, and anxiety), higher levels of physical activity and, longer duration of exercise, and engaging in specific types of exercise may be related to lower odds of sarcopenia.
ABSTRACT Objectives Frailty, a common condition in the elderly, is characterized by a decline in physiological reserves and an increased vulnerability to stressors, leading to negative health outcomes such as falls, fractures, and prolonged recovery from illness. Despite its clinical significance, the relationship between frailty and cerebral health, particularly the correlation of frailty evaluation scales with brain structural integrity changes, is not well‐defined. The study aims to investigate the associations between frailty and brain structure, focusing on the relationship between various frailty scales and brain volumetric and relaxometric changes as identified by synthetic MRI neuroimaging techniques. Methods This prospective study initially enrolled 109 participants from the neurology ward. After applying exclusion criteria, 41 participants were included in the final analysis. Data on demographics, medical history, and physical examinations were collected. Synthetic MRI was conducted using a MAGnetic resonance image Compilation (MAGiC) with images processed using SyMRI 8.0 and SPM12 software for volumetric and relaxometric analyses. Frailty was assessed using the Clinical Frailty Scale (CFS), Fried scale, FRAIL scale, and Edmonton Frailty Scale (EFS). Statistical analysis was performed by partial correlation analysis, adjusting for age, gender, and history of stroke, to examine the relationships between global and regional brain volumetric and relaxometry parameters with frailty scales. To control for multiple comparisons, the false discovery rate (FDR) method was applied, with statistical significance set at FDR‐adjusted p value < 0.05. Results Compared to non‐frail participants, frail individuals exhibited significantly lower gray matter volumes in the cerebellum, hippocampus, and thalamus, as well as reduced white matter volumes globally and in the temporal and parietal lobes. Brain relaxometry revealed higher hippocampal and thalamic T1 and T2 values in the frail group. The CFS and EFS were significantly correlated with global and regional gray and white matter volumes, indicating a link between frailty severity and brain structural integrity. Conclusions This study highlights significant correlations between frailty scales, particularly CFS and EFS, and changes in brain volumetry and relaxometry in specific brain regions. These findings suggest that the CFS and EFS may serve as sensitive frailty scales for assessing the impact of frailty on brain structure. Synthetic MRI holds promise as a valuable neuroimaging tool for diagnosing and evaluating frailty. Further research is needed to confirm these findings and enhance clinical strategies for frailty assessment and intervention.
ABSTRACT Objective To investigate the relevant factors of augmented vertebrae recollapse after percutaneous vertebral augmentation (PVA) for the treatment of osteoporotic vertebral compression fractures (OVCFs). Method A prospective study was performed on 116 patients who were diagnosed with osteoporotic compression fractures in which the anterior height loss of the vertebral body was greater than 1/3. All patients underwent percutaneous vertebral augmentation (PKP or PVP). Possible risk factors for augmented vertebral height decrease, such as age, sex, body mass index, surgical approach, fracture location, cement leakage, patterns of vertebral fractures, Vertebral height restoration (VHR), and intervertebral cleft (IVC), were analyzed. Results The radiography follow‐up period was 1 year. Ninety‐five patients completed the trial. Twenty‐four patients suffered postoperative recollapse. Preoperative magnetic resonance imaging showed that the incidence of IVC in the recollapse group was significantly higher than that in the no‐recollapse group (p < 0.050). The OR value (157.891) indicates that the presence of IVC before surgery significantly exacerbates the incidence of postoperative recollapse. The surgical approaches of the recollapse group and the no‐recollapse group were statistically significant (p < 0.050), and the risk of recollapse in the PKP group was lower compared to the PVP group (OR = 0.094). Conclusion Intervertebral cleft (IVC) and those with PVP intervention are at higher risk of recollapse. Patients with osteoporotic compression fractures with anterior vertebral height loss greater than 1/3, especially those with IVC, should be concerned and taken seriously, and PVP should be carefully selected to prevent their clinical course from worsening.
ABSTRACT Objective To investigate the longitudinal pathological changes in the spectrum of biopsy‐proven renal diseases among elderly patients over the past 20 years at a single center in China. Methods We retrospectively enrolled patients aged ≥ 60 years who underwent renal biopsy at Beijing Hospital between January 2005 and December 2024. Patients were stratified into four 5‐year periods (2005–2009, 2010–2014, 2015–2019, and 2020–2024) based on biopsy date. The frequency and distribution of biopsy‐proven renal diseases across these periods were analyzed. Results A total of 594 elderly patients were included, accounting for 29.2% of all native biopsies in our cohort. The mean age was 67.9 ± 5.7 years, with a male‐to‐female ratio of 1.4:1. The proportion of elderly patients undergoing renal biopsy increased significantly across the four periods (19.1%, 22.5%, 33.9%, 38.9%; χ2 = 60.160, p < 0.01). Nephrotic syndrome (NS) was the most common indication for biopsy, although its proportion declined over time. In contrast, the proportion of biopsies performed for chronic kidney disease (CKD) increased substantially. Primary glomerular nephropathy (PGN), secondary glomerular nephropathy (SGN), and tubulointerstitial nephropathy (TIN) accounted for 54%, 39.9%, and 6.1% of all cases, respectively. The most prevalent cause of PGN was membranous nephropathy (MN), and the leading pathological types of SGN included diabetic nephropathy (DN), antineutrophil cytoplasmic antibody‐associated vasculitis (AAV), and hypertensive nephropathy (HTN). Throughout the study period, the proportion of PGN decreased significantly (64.6%, 64.9%, 54.1%, 42.6%; χ2 = 18.5, p < 0.001), driven by a decline in MN (34.1%, 39.6%, 32.6%, 23%; χ2 = 10.015, p = 0.018). Conversely, the proportion of SGN increased markedly (29.3%, 32.4%, 39.4%, and 49.2%; χ2 = 13.0, p = 0.004), primarily due to rising trends in DN and HTN. Notably, during the period 2020–2024, SGN surpassed PGN as the predominant form of biopsy‐proven renal diseases among elderly individuals. Conclusions The utilization of renal biopsy in elderly patients has increased significantly over the past two decades. While NS remains the most common indication, a notable rise in biopsies for CKD has been observed. The pathological spectrum has undergone a significant shift, characterized by a dramatic decrease in PGN (especially MN) and a continuous increase in SGN (predominantly DN and HTN). The predominance shifted to SGN over PGN in biopsy‐proven renal diseases among the elderly in the most recent period.
ABSTRACT Objective Morbidity is a prevalent public health issue especially among the aging population worldwide. As the risks of morbidity increase with age, aging populations increasingly become a socioeconomic burden on their families. However, studies on morbidity among aging populations in Bangladesh remain limited and under‐documented. This study aims to determine the prevalence of morbidity and identify the associated factors among aging populations in Northern Bangladesh. Methods The cross‐sectional study was conducted in the northern part of Bangladesh. Data were collected from 540 aging people; they were selected using multistage random sampling. Face‐to‐face interviews were conducted by 12 trained interviewers for collecting data, and it was done from June 5, 2022 to August 18, 2022. The outcome variable morbidity was measured by a question, “are you suffering from chronic diseases?” Based on the answer, the respondents were classified into three classes; (i) did not have any disease (0 = No), (ii) having only one disease (1 = single), and (iii) having more than one disease (2 = morbidity). Finally, (iii) was considered as morbidity (Yes, code 1), and (i) and (ii) together were considered did not have morbidity (No, code 0). According to the objectives of the study, we used descriptive statistics, the χ2 test, and multivariate logistic regression to determine the prevalence and to assess the factors influencing morbidity respectively. Results The study revealed that the prevalence of morbidity was found 75.74% [95% CI: 0.719–0.793] among people. The significantly associated factors of morbidity included being male [AOR = 1.717; 95% CI = 1.109–2.657; p = 0.015], living in a rural area [AOR = 1.758; 95% CI = 1.082–2.856; p = 0.023], age above 70 [AOR = 1.926; 95% CI = 1.178–3.150; p = 0.009], having prior disability [AOR = 1.932; 95% CI = 1.126–3.315; p = 0.017], being underweight [AOR = 4.045; 95% CI = 1.568–10.438; p = 0.004], and overweight [AOR = 1.957; 95% CI = 1.223–3.132; p = 0.005]. Conclusions Morbidity is highly prevalent among aging populations, with over nourished individuals aged 70 and above, particularly those living in rural areas, being the most significantly affected. Targeted interventions should focus on improving nutritional status and raising awareness, particularly in rural areas, to help reduce the burden of morbidity among aging populations.
ABSTRACT Objectives To evaluate the efficacy of lactulose in the treatment of elderly constipation patients with chronic renal insufficiency and its influence on renal function. Methods They were divided into the lactulose group (n = 30) and polyethyleneglycol (PEG) group (n = 26). The lactulose group was given 15 mL oral lactulose qd × 4 weeks, and the PEG group was given PEG 4000 powder 10 g qd × 4 weeks. Wexner constipation score and Bristol stool type were recorded before and after the intervention. To evaluate the efficacy of lactulose and PEG in improving constipation in elderly patients with chronic constipation with renal insufficiency. Results Both lactulose and PEG could improve the symptoms of constipation, and no significant difference was observed (p = 0.995). After lactulose treatment for 4 weeks, the serum levels of creatinine, uric acid, and IL‐6 reduced significantly (p < 0.050), but they remained unchanged after treatment with PEG for 4 weeks (p > 0.050). At the genus level, the abundance of Anaerofustis stercorihominis (related to the production of short‐chain fatty acids) increased markedly (p < 0.050), and the abundance of Halomonadaceae (related to the production of uremic toxins), Eikenella (one of the opportunistic pathogenic bacteria), and Sphingomonas (related to nitrogen metabolism) reduced significantly after lactulose treatment. Conclusion Lactulose can improve renal function, mild inflammation, and gut microbiota in these patients. We speculate that the improvement of renal function after lactulose treatment may be related to the improvement of gut microbiota and systemic mild inflammation.
ABSTRACT Objectives To investigate the impact of early postoperative blood pressure variability (BPV) on 90‐day functional outcomes in patients with acute ischemic stroke due to large vessel occlusion (AIS‐LVO) undergoing mechanical thrombectomy, and to assess its interaction with pre‐existing hypertension. Methods This retrospective cohort study included 144 AIS‐LVO patients treated with mechanical thrombectomy between January 2022 and September 2024. Systolic blood pressure was recorded hourly during the first 24 h post‐procedure, and BPV was calculated as the standard deviation of systolic BP. Patients were divided into low and high BPV groups according to the median BPV value. Functional outcome at 90 days was assessed using the modified Rankin Scale (mRS), with 0–2 defined as favorable. Subgroup analyses were performed according to hypertension status. Results Patients in the high BPV group had significantly higher baseline NIHSS and worse 90‐day mRS scores (p = 0.021 and p = 0.007, respectively). Favorable outcomes were achieved in 29.5% of high BPV patients compared with 60% of low BPV patients (p = 0.007). ROC analysis showed moderate predictive ability of BPV for favorable outcomes (AUC = 0.743, 95% CI: 0.662–0.840). The detrimental effect of elevated BPV was more pronounced among patients with pre‐existing hypertension. Conclusions Elevated early postoperative BPV is independently associated with worse 90‐day functional outcomes in AIS‐LVO patients undergoing thrombectomy, particularly in those with hypertension. These findings suggest that maintaining stable blood pressure during the early postoperative period may help optimize recovery in this high‐risk population.
ABSTRACT Objectives Sarcopenia, characterized by age‐related muscle loss, worsens in diabetes due to anabolic resistance. Ursolic acid (UA), a natural compound with anabolic and anti‐catabolic effects, may mitigate sarcopenia by enhancing anabolic pathways. This study examined the effects of 8 weeks of resistance training and UA supplementation on PI3K‐AKT‐mTORC1 pathway proteins in muscle tissue of aged diabetic rats. Methods Fifty 21‐month‐old Wistar rats were divided into five groups: healthy control, diabetic control, diabetic + resistance training, diabetic + UA, and diabetic + resistance training + UA. Type 2 diabetes was induced using a high‐fat diet and low‐dose STZ. Resistance training consisted of 8 weeks of ladder climbing at 60% MVCC, 5 days per week. UA was administered daily to the UA and combination groups. Protein expression was analyzed using Western blot. Results AKT and mTORC1 or phosphorylated AKT levels did not differ significantly across groups. However, dephosphorylated PI3K (p = 0.011) and phosphorylated mTORC1 (p = 0.026) showed significant changes. PI3K expression decreased in diabetic, resistance training, and UA groups compared to controls, but not in the combination group. Phosphorylated mTORC1 was reduced in diabetic controls but maintained in the training, UA, and combination groups. Conclusion Diabetes reduces PI3K and mTORC1 protein expression. Resistance training or UA alone improved mTORC1 expression, while their combination enhanced both PI3K and mTORC1, suggesting synergistic anabolic benefits. Combining UA with resistance training may counteract diabetes‐induced muscle loss.
ABSTRACT Objectives Urinary incontinence (UI) significantly deteriorates the quality of life in the elderly, with a disproportionately higher burden among women. With populations aging in the USA and the UK, understanding the gender‐specific prevalence, determinants, and future care needs in UI is critical for shaping gender‐responsive health policies and care strategies. Methods Data from the Health and Retirement Study (HRS, 2010–2020) and the English Longitudinal Study of Aging (ELSA, 2009–2019) involving participants aged 50 and older were analyzed. UI was assessed through self‐reported urinary leakage during the last 12 months. The prevalence, determinants, and future care needs were estimated by gender. Results The analysis included 111,049 and 52,972 observations from HRS and ELSA, respectively. The findings revealed a steady increase in UI prevalence during the 2010s in males (HRS 11.2%–15.1%, ELSA 7.2%–12.0%) and females (HRS 31.4%–36.3%, ELSA 21.0%–28.1%). Contributory factors included aging, higher education levels, and comorbidities. Projections indicate a rise in UI‐related care needs in the USA (HRS Female: from 22.1 to 25.7 million, Male: from 7.8 to 9.8 million) and the UK (ELSA Female: from 3.6 to 4.2 million, Male: from 1.4 to 1.6 million) during the 2020s, with women accounting for 65% of this growth, among which the fastest growth was among those aged 80 and over. Conclusions The rising prevalence of UI, particularly among women, alongside population aging in the USA and UK necessitates an escalation in gender‐responsive expansion of care services. Gender‐sensitive counseling on tailored prevention strategies and care services such as weight loss and Kegel exercises should be provided to support quality of life and healthy aging, especially in women.
ABSTRACT Objectives Limited data exist on real‐world treatment strategies and their impact on survival in Australian patients with NSCLC. THASSOS‐INL (NCT04808050) evaluated the treatment patterns and survival outcomes in patients with early‐stage NSCLC. Methods Australia cohort of THASSOS‐INTL, non‐interventional, multicenter, retrospective study enrolled patients aged ≥ 18 years diagnosed with stage IA‐IIIB resectable NSCLC between January 2013 and December 2017. The primary outcomes included treatment patterns and associated 3‐year survival rates. Secondary endpoints included clinico‐demographic characteristics and their association with overall survival (OS). Results Of 199 patients recruited (median [range] age: 67.0 [35.0–88.0] years), 53.8% were males, 87.4% were current smokers/ex‐smokers, and 52.2% had an ECOG score of ≤ 1. A total of 42.2% patients had stage I, 28.1% had stage II, and 29.6% had stage III NSCLC. Adenocarcinoma was the predominant (56.8%) histological subtype. Overall, 97.0% patients underwent surgery. Neoadjuvant therapy was reported in 9.5%; adjuvant therapy was reported in 39.2%. The overall median OS was 6.0 years (95% CI: 5.200 NE) with a median 3 year survival probability rate of 70.5% (95% CI: 64.4%–77.2%). Age, increasing stages of NSCLC, disease progression, and EGFR mutations were associated with significant worsening of OS. Conclusions The study underscores the diverse treatment approaches prior to approval of immuno‐targeted therapy, showing that fewer than half of the patients received AT with only a quarter of those receiving adjuvant ST. The study highlights the need for integrating molecular diagnostics, improving access to novel therapies, and a multidisciplinary team approach to improve survival in these patients.
