ABSTRACT 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.
Objective:To investigate alterations in brain function among elderly patients with interstitial cystitis/bladder pain syndrome(IC/BPS)during the resting state.Methods:We prospectively recruited seven elderly patients with IC/BPS admitted to the Urology Department of Beijing Hospital from December 2023 to May 2024 as the experimental group, and concurrently selected twelve elderly healthy individuals as the control group.After enrollment, all participants underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans.General clinical data, including age and gender, as well as standardized assessment scores from the Interstitial Cystitis Symptom Index(ICSI), Interstitial Cystitis Problem Index(ICPI), Visual Analogue Scale(VAS), Self-Rating Anxiety Scale(SAS), and Self-Rating Depression Scale(SDS), were collected.The data were processed using Matlab.This study employed a paired sample t-test to analyze the differences in gray matter volume between the two groups.The functional activities of the subjects' brains were analyzed using regional homogeneity(ReHo)and low-frequency amplitude(ALFF)algorithms.Based on the identified abnormal brain regions, further functional connectivity(FC)analysis was conducted to explore the connectivity patterns among the functional brain regions.Results:No significant differences were observed in age( t=-0.68, P=0.536)or gender( χ2=0.019, P=0.891)between the experimental group and the control group.The scores of SAS and SDS in the experimental group were significantly higher than those in the control group( P<0.001).No significant difference was observed in cerebral gray matter volume between the two subject groups.In contrast to the control group, the ALFF value of the left superior parietal lobe(MNI: x, y, z=-21, -66, 60; t=12.530 5)was elevated in elderly patients with IC/BPS, and the ReHo value of the left precuneus(MNI: x, y, z=-9, -54, 63; t=9.410 3)was also increased.Through FC analysis, it was revealed that elderly IC/BPS patients exhibited significantly lower FC values between the left superior parietal lobule and the central sulcus(MNI: x, y, z=21, 15, 3; t=-27.835 6), as well as between the left anterior cingulate and the left posterior cingulate gyrus(MNI: x, y, z=-12, 0, 42; t=-8.738 9)in comparison with the control group. Conclusions:In contrast to normal individuals, elderly IC/BPS patients demonstrate functional aberrations in the left superior parietal lobule and the left precuneus.Moreover, a decrease in functional connectivity is observed between the left superior parietal lobule and the central sulcus, as well as between the left precuneus and the left posterior cingulate gyrus.These abnormal functional alterations in the brain may be implicated in the maintenance and development of symptoms in IC/BPS patients.This study conducted research from the perspective of central nervous system regulation, presenting possible directions for further exploration of the pathophysiological mechanisms of IC/BPS.
Objective To compare the performance of 11 glomerular filtration rate(GFR)equations in Chinese elderly hospitalized patients using dynamic renal imaging as the reference standard.Methods The retrospective study involved patients aged 60 years and older who were admitted to Beijing Hospital between January,2017,and January 2020.Glomerular filtration rate(GFR)was assessed through dynamic renal imaging for all participants.Estimated GFR(eGFR)was calculated using various equations based on serum creatinine and/or cystatin C levels,including All Age Spectrum(FAS),Berlin Initiative Study(BIS),Chronic Kidney Disease Epidemiology Collaboration(CKD-EPI),Modification of Diet in Renal Disease Study(MDRD),MDRD in China(MDRDc),and Xiangya..Results A total of 691 patients,of which 383 were males,with an age range of 60 to 90 years(mean age 71.9±7.7 years),were included in the study.Among the different equations used to estimate glomerular filtration rate(GFR)in ml·min-1·1.73m-2,the smallest deviations were observed with FAScys(2.48),FAScr-cys(3.07),CKD-EPIcys(4.20),and BIScr-cys(7.42).Conversely,the most accurate estimations were found with BIScr-cys(10.38),FAScr-cys(11.94),FAScys(12.08),CKD-EPIcr-cys(13.21),and CKD-EPIcys(13.51).The highest P30 values,indicating the proportion of estimates within 30％of the true GFR,were achieved by FAScr-cys(68.97％),FAScys(68.96％),CKD-EPIcys(63.22％),and BIScr-cys(61.67％).The equations with the lowest root mean square errors were BIScr-cys(9.73),CKD-EPIcr-cys(10.98),FAScr-cys(11.27),CKD-EPIcys(11.52),and FAScys(11.53).Specifically,the FAS equation showed higher accuracy in men,while BIScr-cys and CKD-EPIcys were more accurate in women.Among patients with chronic kidney disease(CKD),the P30 values for BIScr-cys,FAScys,and FAScr-cys were 86.96％,83.33％,and 80.95％respectively.Notably,for patients with mGFR ≥ 30 ml/min,MDRDc overestimated GFR the most,whereas for patients with mGFR＜30 ml/min,Xiangya exhibited the most significant overestimation of GFR.Conclusions Among the equations tested,BIScr-cys,FAScys,and FAScr-cys demonstrated the highest accuracy and are therefore recommended for use in Chinese elderly hospitalized patients.
Sarcopenia is an age-related disorder that influences the daily living ability of older adults and interacts with various chronic diseases. Older adults with sarcopenia typically experience a deterioration in their quality of life and healthy lifespan. The number of Chinese persons with sarcopenia is considerable, and the burden of sarcopenia is substantial; however, the specific sarcopenia clinics available for outpatients are insufficient. The promotion of sarcopenia clinics is beneficial for the early identification, standardized diagnosis, and treatment of older adults with sarcopenia, thereby helping to enhance their physical function and quality of life. This consensus incorporates the professional recommendations of Chinese geriatrics experts, synthesizes existing Chinese experiences in establishing sarcopenia clinics, offers guidance for managing sarcopenia clinics, and advocates for early identification, diagnosis, and intervention of sarcopenia in older adults.
With the deepening of aging in China,the prevalence of diabetes in older people has in-creased noticeably,and standardized diabetes management is critical for improving clinical outcomes of diabetes in older people.In 2021,the National Center of Gerontology,Chinese Society of Geriatrics,and Diabetes Pro-fessional Committee of Chinese Aging Well Association organized experts to write the first guideline for diabetes diagnosis and treatment in older people in China,the Guideline for the Management of Diabetes Mellitus in the Elderly in China(2021 edition).The guideline emphasizes that older patients with diabetes are a highly hetero-geneous group requiring comprehensive assessment and stratified and individualized management strategies.The guideline proposes simple treatments and de-intensified treatment strategies for older patients with diabetes.This edition of the guideline provides clinicians with practical and operable clinical guidance,thus greatly contribu-ting to the comprehensive and full-cycle standardized management of older patients with diabetes in China and promoting the extensive development of clinical and basic research on diabetes in older people and related fields.In the past 3 years,evidence-based medicine for older patients with diabetes and related fields has fur-ther advanced,and new treatment concepts,drugs,and technologies have been developed.The guideline edito-rial committee promptly updated the first edition of the guideline and compiled the Guideline for the Management of Diabetes Mellitus in the Elderly in China(2024 edition).More precise management paths for older patients with diabetes are proposed,for achieving continued standardization of the management of older Chinese patients with diabetes and improving their clinical outcomes.
