Objective To examine the association between sleep quality and frailty among the oldest old(≥80 years)residing in integrated medical and long-term care institution,and to inform frailty prevention and management.Methods In a cross-sectional study conducted in Jiangsu Province Zhongshan Sanatorium from January to April 2024,130 residents aged ≥80 years were surveyed using convenience sampling.Sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index(PSQI)and objectively via a wrist-worn smart band,which captured various sleep parameters.Frailty was screened using the FRAIL Scale.Multivariable logistic regression was applied to evaluate associations between sleep-related variables and frailty.Results The prevalence rates of sleep disturbance and frailty were 56.9％(74/130)and 40.8％(53/130),respectively.Among 74 participants with sleep disturbances,39 individuals presented with frailty.Univariate analysis demonstrated that frailty group exhibited shorter nocturnal sleep duration,increased light sleep duration,and a higher frequency of daytime napping compared to non-frail group(P＜0.05).Multivariable logistic regression analysis revealed that higher PSQI score(PSQI≥5)(OR=1.392,95％CI:1.151-1.680),longer total sleep time(OR=2.431,95％CI:1.202-4.911),longer light sleep duration(OR=1.123,95％CI:1.013-1.252),and greater number of daytime naps(OR=1.680,95％CI:1.050-2.671)were independent risk factors for frailty.Conversely,longer nighttime sleep duration(OR=0.359,95％CI:0.178-0.731)was a protective factor.Conclusions Frailty among oldest old in integrated medical and long-term care institution is closely associated with poor sleep quality,impaired sleep structure and fragmented circadian rhythms,exhibiting characteristics of poor quality and fragmentation.Targeted intervention strategies need to be developed to improve sleep quality in order to mitigate the risk of frailty.
This article aims to investigate the central role of macrophage senescence in the disruption of the immune microenvironment in idiopathic pulmonary fibrosis(IPF)and to explore related therapeutic prospects.It systematically elaborates on the key mechanism by which senescent macrophages,through their unique senescence-associated secretory phenotype(SASP),disrupt immune homeostasis,promote fibroblast activation,and drive excessive extracellular matrix deposition,thereby contributing to the pathogenesis and progression of IPF.Based on this,the article further reviews therapeutic strategies,including senolysis(targeted clearance of senescent cells),SASP inhibition,and macrophage reprogramming.Finally,it emphasizes that future research should focus on elucidating the specific functions and transformation trajectories of various macrophage subpopulations at different disease stages.A shift in therapeutic paradigms toward combined targeting strategies is proposed,along with advancing the application of personalized treatment in clinical practice.
Objective To investigate the effects of long non-coding RNA AL133415.1(lncRNA AL133415.1)on cell viability,neuronal apoptosis and oxidative stress,and further explore its role in the molecular mechanism of Alzheimer's disease(AD).Methods Amyloid β-protein(Aβ)142-induced SH-SY5Y cells were selected to establish an AD cell model.The lncRNA AL133415.1 gene was regulated by plasmid transfection technology.Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the expression of lncRNA AL133415.1 and vimentin(VIM)gene in cells.Cell Counting Kit-8(CCK-8)method was used to detect the proliferation rate of cells.Flow cytometry was used to detect cell apoptosis.DCFH-DA fluorescence assay was used to detect the levels of reactive oxygen species(ROS),superoxide dismutase(SOD),and malondialdehyde(MDA)in SH-SY5Y cells.Western Blot was used to detect the expression of VIM protein in the cells.Confocal laser scanning microscopy(CLSM)was used to detect the fluorescence intensity of VIM protein.Results The viability of SH-SY5Y cells was increased and their apoptosis rate was reduced in the lncRNA AL133415.1 inhibition group,while the viability of SH-SY5Y cells was significantly decreased and their apoptosis rate was increased in the lncRNA AL133415.1 overexpression group(all P＜0.01).Down-regulation of lncRNA AL133415.1 expression could increase the intracellular SOD activity,while up-regulation would lead to a decrease in intracellular SOD activity;Down-regulation of lncRNA AL133415.1 expression could reduce the intracellular MDA and ROS activities,while up-regulation could increase the intracellular MDA and ROS activities(all P＜0.05).Inhibition of lncRNA AL133415.1 expression could promote the expression of VIM gene,while overexpression would inhibit the expression of VIM gene(P＜0.001).Conclusions Silencing of lncRNA AL133415.1 can promote the expression of VIM gene,while overexpression can inhibit the expression of VIM gene,which suggests that the expression of VIM gene can be indirectly regulated by regulating lncRNA AL133415.1,thereby reducing the incidence of AD.
Objective To explore the association between left ventricular ejection fraction(LVEF)and brain structure as well as cognitive impairment in stroke-free older adults.Methods A total of 389 stroke-free older adults undergoing health examinations were retrospectively enrolled.Participants were divided into cognitive impairment group(n=138)and non-cognitive impairment group(n=251)based on their Mini-Mental State Examination(MMSE)scores.Whole-brain morphological analysis was conducted utilizing the Computational Anatomy Toolbox 12(CAT12).After adjusting for relevant confounding factors,restricted cubic splines(RCS)were used to examine the potential nonlinear relationship between LVEF and cognitive impairment.Binary logistic regression was then employed to quantify their independent association,and mediation analysis was conducted to assess the mediating roles of gray matter volume(GMV)and white matter volume(WMV).Results RCS analysis revealed nonlinear associations between LVEF and WMV,and between cognitive scores and WMV,with linear relationships observed for all other variables.Logistic regression analysis indicated that LVEF(OR=0.951,95％CI:0.915-0.989,P=0.012),GMV(OR=0.989,95％CI:0.983-0.995,P＜0.001),WMV(OR=0.991,95％CI:0.986-0.996,P=0.001),cortical thickness(OR=0.121,95％CI:0.019-0.760,P=0.024)and white matter hyperintensity volume(WMHV)(OR=1.051,95％CI:1.010-1.094,P=0.014)were associated with the risk of cognitive impairment.Mediation analysis showed that GMV(accounting for 16.8％)and WMV(significant only when LVEF＜60％,accounting for 17.92％)partially mediated the association between LVEF and cognitive impairment.Conclusions In stroke-free older adults,reduced LVEF is significantly associated with cognitive impairment,and brain structural changes play a partial mediating role in this association.
Obstructive sleep apnea(OSA)and nocturia/nocturnal enuresis frequently co-occur in the elderly population,significantly impairing quality of life and elevating risks such as falls and fractures.This article aims to systematically review the underlying mechanisms and therapeutic strategies for this comorbidity from an integrated Traditional Chinese and Western Medicine perspective.From a pathophysiological perspective,intermittent hypoxia and intrathoracic pressure fluctuations induced by OSA collectively contribute to nocturnal polyuria and abnormal bladder storage function through multiple pathways.These include dysregulation of the neuro-humoral axis,direct renal injury,and bladder dysfunction.Traditional Chinese Medicine(TCM)posits that the core pathogenesis involves a root deficiency with superficial excess.This encompasses impaired transformation and transportation functions of the triple energizer(Sanjiao),deficiency of the lung,spleen,and kidney leading to water metabolism disorder,as well as malnourishment of the heart-spirit and emptiness of the marrow-sea,resulting in the loss of ＂ mental control＂ over urination.In terms of treatment,Western medicine employs methods such as continuous positive airway pressure,pharmacotherapy,and surgery,while TCM utilizes approaches including herbal medicine and acupuncture for holistic regulation.This article emphasizes the critical importance of screening for OSA in elderly patients presenting with nocturia and suggests that future efforts should focus on establishing an integrated diagnostic and therapeutic model combining TCM and Western medicine to optimize patient management.
As women aged and their pelvic floor support structures weaken,pelvic organ prolapse(POP)has become a major health concern for elderly women.This article systematically explores three key areas of research progress in elderly women with POP:diagnosis,conservative treatment,and surgical intervention.It particularly focuses on innovative surgical techniques and their outcomes,along with the application of novel mesh materials in surgical procedures.Finally,looking ahead to the future of POP treatment,it is necessary to combine individual needs and realize the integrated development of multiple disciplines to improve the treatment effect and prognosis.
Objective Based on the Atrial fibrillation Better Care(ABC)pathway,this study aimed to investigate the impact of blood pressure control on ischemic stroke in elderly patients with non-valvular atrial fibrillation(NVAF)and hypertension,and to analyze the mediating role of blood pressure control in the stroke risk reduction associated with the ABC pathway.Methods A case-control study was conducted including patients aged ≥65 years with NVAF and hypertension hospitalized at Jiangsu Province Offical Hospital between August 2019 and November 2023.The case group comprised 182 patients with ischemic stroke,and the control group consisted of 364 stroke-free patients matched at a 1:2 ratio.Multivariate logistic regression was used to identify factors associated with stroke risk,and the Bootstrap method was applied to examine the mediating effect of blood pressure control.Results The proportion of patients with uncontrolled blood pressure[systolic blood pressure(SBP)≥140 mmHg]was significantly higher in the case group than that in the control group(65.40％vs 41.48％,P＜0.01),while the rate of full adherence to the ABC pathway was significantly lower in the case group(8.80％vs 28.60％,P＜0.001).Multivariate logistic analysis showed that,compared with no adherence to any component of the ABC pathway,full adherence was associated with an 89％reduction in stroke risk(OR=0.11,95％CI:0.04-0.31).Uncontrolled blood pressure(OR=2.38,95％CI:1.57-3.61)was independent risk factor for stroke.Mediation analysis indicated that 26.10％of the total effect of the ABC pathway on stroke risk was mediated through the reduction of SBP(indirect effect estimate=-0.165,Bootstrap 95％CI:-0.286 to-0.054).Conclusions In elderly patients with NVAF and hypertension,adherence to the ABC pathway and strict blood pressure control(＜140 mmHg)are crucial for reducing the risk of ischemic stroke.Blood pressure control serves not only as an independent protective factor but also as a key mediating mechanism through which the ABC pathway exerts cardiovascular protective effects.
Age-related hearing loss (ARHL), also known as presbycusis, is one of the most prevalent chronic degenerative diseases worldwide, seriously affecting the quality of life and mental health of the elderly. However, there are currently no effective preventive or therapeutic drugs in clinical practice. This review systematically summarizes the latest research progress on potential drug targets from the perspective of three core mechanisms underlying the occurrence and development of ARHL: oxidative stress, mitochondrial dysfunction, and chronic inflammation. Finally, it proposes that although drugs developed based on these targets have demonstrated potential efficacy in protecting the cochlea and delaying hearing loss in preclinical studies, there are still limitations such as most experimental models being divorced from the natural human aging process, low efficiency in targeted drug delivery to the cochlea, and insufficient validation of the long-term safety of candidate drugs and their efficacy in the elderly physiological environment.
Objective To investigate the impact of preoperative frailty on surgical site infection(SSI)after partial hepatectomy in elderly patients,and to identify associated risk factors for infection.Methods A total of 224 patients aged ≥ 60 years who were scheduled for elective partial hepatectomy at the Hepatobiliary Center of Jiangsu Province Hospital from January to December 2024 were enrolled.Preoperative frailty was assessed on admission using the FRAIL scale(frailty defined as a score≥3).Data on demographics,comorbidities,preoperative laboratory indices,and perioperative variables were collected.Patients were grouped according to the occurrence of postoperative SSI for comparison.Multivariable logistic regression analysis was used to identify independent risk factors for SSI.Results Among the 224 patients,61 were frail and 163 were non-frail,with a preoperative frailty prevalence of 27.23％.Postoperative SSI occurred in 28 patients(12.50％).The incidence rate of SSI was significantly higher in the frailty group than that in the non-frailty group(29.51％vs 6.13％,P＜0.001).Multivariable logistic regression identified that preoperative frailty(OR=7.720,95％CI:1.502-39.671,P=0.014),elevated preoperative C-reactive protein(OR=3.399,95％CI:1.971-5.861),higher platelet-to-lymphocyte ratio(OR=1.026,95％CI:1.009-1.044),and longer operative time(OR=1.019,95％CI:1.007-1.031)were independent risk factors for SSI.Conclusions Preoperative frailty significantly increases the risk of SSI in elderly patients undergoing partial hepatectomy.Routine preoperative frailty screening and risk stratification,together with targeted perioperative management incorporating inflammatory markers and operative time,may help reduce the incidence of SSI.
Vascular aging is closely associated with the onset and progression of cardiovascular diseases such as hypertension and atherosclerosis.The underlying mechanisms are complex and involve multiple molecular pathways.Acetylation modification regulates multiple biological processes including lipid synthesis,DNA damage repair,glycolysis,and cell cycle progression by modulating protein stability,enzyme activity,and subcellular localization.This review summarizes the acetylation regulatory mechanisms in vascular aging,including histone acetylation regulation and non-histone acetylation regulation,and discusses potential therapeutic targets to provide new ideas for the prevention and treatment of vascular aging-related diseases.
Objective To construct a health-related behavior intervention program based on Fogg behavior model and to explore its application effect.Methods A research team was established to consult relevant literature,construct a health-related behavioral intervention program for elderly patients with cirrhosis based on Fogg behavior model,and 152 elderly patients with cirrhosis were selected to carry out a randomized controlled study to explore its application effect.Results After 2 rounds of letter inquiry,a health-related behavior intervention program based on Fogg behavior model was formed,including 10 intervention items in 3 intervention stages.The Cr value of the two rounds of expert correspondence letters was 0.895 and 0.930,respectively.The application results showed that after the intervention,the self-management behavior score in the study group was 82.19±8.97,compared with 74.16±9.86 in the control group(P＜0.05),and the self-efficacy score in the study group was 32.87±3.28,compared with 28.43±5.11 in the control group(P＜0.05).Conclusions The health-related behavior intervention program based on Fogg behavior model can significantly improve patients' self-management behavior and self-efficacy.
Global population aging underscores the urgent need to advance healthy aging as a public health priority.Physical resilience, as the core capacity of older adults to maintain or restore functional stability when exposed to physiological stressors such as surgery, infection, or acute illness, offers a new perspective for assessing and promoting healthy aging.This paper systematically elaborates on the conceptual framework and assessment system of physical resilience, examines its intrinsic association with healthy aging, and explores its application value and future directions in clinical practice and public health.
Alzheimer's disease(AD)is a major neurodegenerative disorder characterized by progressive cognitive decline and functional impairment.Its prolonged and insidious progression highlights the urgent need for effective disease-modifying therapies(DMTs).Lecanemab,a humanized monoclonal antibody that selectively targets soluble amyloid-β(Aβ)oligomers and protofibrils,is among the first DMTs approved by international regulatory agencies for the treatment of early-stage AD.In recent years,accumulating evidences from randomized clinical trials,long-term extension studies,and multiple real-world cohorts have provided a clearer understanding of its efficacy and safety.This review summarizes the pharmacological characteristics of lecanemab,key clinical findings,biomarker responses,adverse event profiles,and management strategies.Furthermore,drawing on emerging real-world data from China,we discuss its potential implications for clinical practice and explore future directions by addressing curr-ent research controversies and cutting-edge advancements to support the standardized management of cognitive impairment in older adults.
Inflammatory bowel disease (IBD) and sarcopenia are two common diseases that seriously affect the quality of life of elderly patients. Recent studies have shown that there is a close connection between the two diseases in terms of pathological mechanisms. The gut microbiota-brain-muscle axis, as an important regulatory pathway connecting the intestinal microecology, nervous system, and muscle function, provides a new perspective for revealing the comorbidity mechanism of IBD and sarcopenia. This article systematically reviews how gut microbiota dysbiosis affects brain function and muscle metabolism through neuroimmune regulation, thereby promoting the occurrence and development of these two diseases. It focuses on key links such as inflammatory responses, neuroendocrine regulation, and metabolic abnormalities. Combining the latest basic and clinical research results, it explores potential therapeutic targets and intervention strategies, providing theoretical basis and direction guidance for future research and clinical treatment.
Objective To explore the symptom experience and management needs of opioid-induced nausea and vomiting(OINV)in the elderly patients with cancer pain.Methods A phenomenological research method was adopted.From January to March 2025,18 elderly patients with cancer pain who experienced nausea and vomiting after using opioids in Jiangsu Cancer Hospital were interviewed using purposive sampling.Colaizzi method was used for thematic analysis.Results Four main themes were extracted,including limited symptom awareness and attribution bias,somatic-functional interaction and multiple frailty risks,constrained self-management strategies and reliance on family/healthcare support,the application status and dilemmas of management strategies.Conclusions It is urgent to construct a whole-process management system of OINV centered on elderly patients,including dynamic assessment,personalized education,multidimensional interventions and support network reconstruction.
Pelvic floor dysfunction in elderly women is a prevalent condition that significantly affects patients' quality of life.Clinical manifestations primarily include urinary incontinence,pelvic organ prolapse,and anal dysfunction.With the accelerating global aging trend,research on its diagnosis and treatment has become a critical focus in medical science.Although multiple diagnostic techniques are now widely adopted,diagnostic accuracy remains suboptimal.This review systematicly examines the pathogenesis of pelvic floor dysfunction in elderly women,with particular emphasis on advanced diagnostic technologies developed in recent years.
Older adults frequently experience varying degrees of functional decline and incomplete recovery following acute stressors such as surgery and infection, representing a critical turning point toward disability. Physical resilience (PR) refers to an individual’s ability to maintain or restore physical function through dynamic regulation after exposure to acute stress and has emerged as an important perspective for predicting functional prognosis in the acute phase of aging. This review focuses on the conceptual framework and theoretical foundations of PR, systematically summarizes its assessment tools and the patterns of functional recovery following acute stress, analyzes the key physiological mechanisms and multidimensional regulatory factors influencing the recovery process, and discusses its clinical applications and intervention strategies across different settings.
Alzheimer's disease(AD)is often accompanied by a spectrum of neuropsychiatric symptoms(NPS),which accelerate disease progression,reduce the quality of life of patients,and increase the caregiving burden.However,early identification and effective intervention for AD-related NPS currently face significant challenges.This review summarizes the clinical manifestations,assessment methods,and intervention strategies for AD with NPS,aiming to provide references for the early identification and clinical management of NPS.
Objective To explore the effects of 12-week Otago exercise program(OEP)on frailty degree,fall risk,balance ability,gait function,lower limb function,and body composition in the elderly inpatients with frailty or pre-frailty.Methods A total of 110 elderly patients with frailty and pre-frailty who were hospitalized in West China Hospital of Sichuan University were enrolled in the study.They were randomly divided into an observation group and a control group,with 55 cases in each group.The control group received routine nursing care and health education;the observation group underwent 12 weeks of OEP in addition to routine nursing care.The scores of FRAIL scale,fall risk score,Tinetti score,Simple Physical Performance Bureau(SPPB)score and body composition index were observed and compared between the two groups before and after 12 weeks of intervention.Results After 12 weeks of intervention,the scores of FRAIL scale and fall risk and the fat content of the body in the observation group were significantly lower than those in the control group(P<0.05);The Tinetti score,SPPB score,and skeletal muscle mass in the observation group were higher than those in the control group(P<0.05).Conclusions OEP can effectively improve the frailty status of elderly patients with frailty or pre-frailty,reduce the risk of falls,and enhance balance ability and muscle mass,which is an effective comprehensive strategy for optimizing the management of frail elderly inpatients.
This review systematically outlines recent advances in understanding hematological disorders combined with respiratory viral infections in the elderly.It summarizes core hematological abnormalities-including leukocyte irregularities,thrombocytopenia,anemia,and progressive coagulation dysfunction-induced by influenza virus,respiratory syncytial virus,and SARS-CoV-2,and analyzes their relationships with immunosenescence and chronic inflammatory states.These hematologic alterations do not occur in isolation;rather,in concert with cytokine storm,they can rapidly evolve into disseminated intravascular coagulation or even trigger fatal complications such as secondary hemophagocytic lymphohistiocytosis.Finally,it emphasizes that early and dynamic hematological monitoring should be established as a clinical priority in the management of elderly patients with respiratory viral infections.Future research should focus on elucidating the specific mechanisms of virus-immunosenescence interactions to facilitate the development of stratified management and personalized treatment strategies for the aging population.
