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.
