BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship betw...BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship between solid fuel exposure and new-onset HD in a large cohort.METHODS Multivariable logistic regression models assessed associations between cooking/heating fuel types(coal,crop residue/wood,liquefied petroleum gas,natural gas,and others)and new-onset HD.Subgroup analyses explored effect modification by age,sex,education,smoking,alcohol use,and region.RESULTS A prospective cohort study included 5915 participants,with 781 participants(13.2%)developing new-onset HD.Coal use for cooking showed an initial association with new-onset HD risk(OR=1.41,95%CI:1.06–1.86,P=0.02),which attenuated after full adjustment(OR=1.28,95%CI:0.96–1.72,P=0.10).Coal use for heating demonstrated robust associations across all models(OR=1.86,95%CI:1.42–2.43,P<0.001).Crop residue/wood burning for heating was also significant(Model 2:OR=1.40,95%CI:1.06–1.86,P=0.02).Subgroup analyses revealed stronger associations among females,non-smokers,non-drinkers,and less-educated participants.Geographic stratification showed significant associations in southern but not northern regions.CONCLUSIONS Solid fuel use,particularly coal for heating,is associated with increased new-onset HD risk.Reducing solid fuel exposure is crucial for HD prevention in low-resource settings.展开更多
Background The decline in reproductive performance of aged hens is mainly attributed to oxidative damage in reproductive organs,hepatic lipid metabolism disorders,and intestinal microbiota dysbiosis.Glycyrrhizin(GL)ha...Background The decline in reproductive performance of aged hens is mainly attributed to oxidative damage in reproductive organs,hepatic lipid metabolism disorders,and intestinal microbiota dysbiosis.Glycyrrhizin(GL)has been proven to enhance antioxidant capacity,regulate lipid metabolism and gut microbiota in mammals,but its efficacy in hens remains unclear.Hence,this study aimed to investigate whether dietary GL supplementation improves reproductive performance in hens during the late laying stage by modulating intestinal microbiota composition,hepatic lipid metabolism and ovarian antioxidant status.Results Dietary supplementation with 100 mg/kg GL significantly improved the egg production rate,egg quality,and hatching rate in aged breeder hens(P<0.05).GL supplementation also increased the serum levels of HDLC,TP and ALB,and enhanced the antioxidant capacity in both serum and ovary(P<0.05).In addition,dietary GL elevated the serum progesterone(P4)levels by enhancing the transcription level of steroid synthesis key enzymes(CYP11A1 and 3β-HSD)in the ovary(P<0.05).Dietary GL also promoted the synthesis and transport of vitellogenin(VTG)by upregulating the VTG-Ⅱ(P<0.05)and APOV1(P=0.077)expression levels in the liver,thereby increasing the number of grade follicles and small yellow follicles.Moreover,dietary GL enhanced hepatic fatty acidβ-oxidation by upregulating PPARαand CPT-I(P<0.05),and downregulating ACC expression levels(P<0.05).In agreement,liver metabolomics analysis revealed that dietary GL supplementation significantly altered hepatic metabolism,with 389 differentially identified metabolites(P<0.05).The key metabolites(e.g.,taurocholic acid,tauroursodeoxycholic acid,nicotinuric acid,glycodeoxycholic acid(hydrate))were identified,and they were mainly functionally enriched in betaalanine metabolism nicotinate,taurine and hypotaurine metabolism(P<0.05).Finally,16S rRNA gene sequencing revealed that dietary GL reversed age-induced changes in gut microbiota composition,characterized by a significant increase in Lactobacillus abundance and a decrease in Bacteroides(P<0.05).Conclusions These results collectively demonstrate that dietary supplementation with 100 mg/kg GL improved reproductive performance by reversing age-induced changes in gut microbiota,enhancing hepatic vitellogenin synthesis,and ameliorating ovarian function in aged breeder hens.This study suggests that dietary GL is a potential strategy to improve reproductive performance in broiler breeder hens during the late laying period.展开更多
Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducte...Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducted from October to December 2022 using a convenience sampling method.A total of 312 older adults were selected from 13 day service centers for older adults in Macao,China.The Advance Care Planning Acceptance Questionnaire and the Family Adaptation,Partnership,Growth,Affection,Resolve(APGAR)Scale were used to survey the older adults.Results:A total of 306 older adults completed the survey.The score for advance care planning readiness was 65.55±10.69,and 59.5%of participants(n=182)were willing to participate in ACP.The family function score was 7.24±2.51,while 70.3%of participants were from a highly functional family.The higher family function indicating a higher readiness for advance care planning(r=0.396,P<0.001).The multiple linear regression analysis indicated that the variables“age,”“knowledge of ACP,”“experience with ACP,”and“received resuscitation of yourself,relatives or friends”combined with“family function”can influence advance care planning readiness among older adults(R^(2)=0.317,F=27.898,P<0.001).Conclusions:Older adults in Macao’s day service centers were willing to engage in ACP.The importance of family involvement is highlighted in the ACP readiness.Health education and improved family communication are vital for promoting ACP,which ensures individuals receive care when they lack the capacity to make that choice.Additionally,healthcare professionals should enhance communication and education with older adults during the medical care process.展开更多
Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explo...Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used groupbased trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic regression models to analyze their risk for CVD.Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33%(OR=1.31,95%CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40%(OR=1.40,95%CI:1.06-1.84)for the high decreasing PA trajectory,and by 20%(OR=1.20,95%CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.展开更多
Background:It is still uncertain how multimorbidity patterns affect transitions between fall states among middle-aged and older Chinese.Methods:Data were obtained from China Health and Retirement Longitudinal Study(CH...Background:It is still uncertain how multimorbidity patterns affect transitions between fall states among middle-aged and older Chinese.Methods:Data were obtained from China Health and Retirement Longitudinal Study(CHARLS)2011–2018.We utilized latent class analysis to categorize baseline multimorbidity patterns,Markov multi-state model to explore the impact of multimorbidity characterized by condition counts and multimorbidity patterns on subsequent fall transitions,and Cox proportional hazard models to assess hazard ratios of each transition.Results:A total of 14,244 participants aged 45 years and older were enrolled at baseline.Among these participants,11,956(83.9%)did not have a fall history in the last 2 years,1,054(7.4%)had mild falls,and 1,234(8.7%)had severe falls.Using a multi-state model,10,967 transitions were observed during a total follow-up of 57,094 person-times,6,527 of which had worsening transitions and 4,440 had improving transitions.Among 6,711 multimorbid participants,osteocardiovascular(20.5%),pulmonary-digestive-rheumatic(30.5%),metabolic-cardiovascular(22.9%),and neuropsychiatric-sensory(26.1%)patterns were classified.Multimorbid participants had significantly higher risks of transitions compared with other participants.Among 4 multimorbidity patterns,osteocardiovascular pattern had higher transition risks than other 3 patterns.Conclusions:Multimorbidity,especially the“osteo-cardiovascular pattern”identified in this study,was associated with higher risks of fall transitions among middle-aged and older Chinese.Generally,the effect of multimorbidity is more significant in older adults than in middle-aged adults.Findings from this study provide facts and evidence for fall prevention,and offer implications for clinicians to target on vulnerable population,and for public health policymakers to allocate healthcare resources.展开更多
Advanced age impairs bone fracture healing;the underlying mechanism of this phenomenon remains unknown.We determined that apolipoprotein E(ApoE)increases with age and causes poor fracture healing.After deletion of hep...Advanced age impairs bone fracture healing;the underlying mechanism of this phenomenon remains unknown.We determined that apolipoprotein E(ApoE)increases with age and causes poor fracture healing.After deletion of hepatic ApoE expression(ΔApoE),24-month-oldΔApoE mice displayed a 95%reduction in circulating ApoE levels and significantly improved fracture healing.ApoE treatment of aged BMSCs inhibited osteoblast differentiation in tissue culture models;RNA-seq,Western blot,immunofluorescence,and RT-PCR analyses indicated that the Wnt/β-catenin pathway is the target of this inhibition.Indeed,we showed that ApoE had no effect on cultures with stabilizedβ-catenin levels.Next,we determined that Lrp4 serves as the osteoblast cell surface receptor to ApoE,as expression of Lrp4 is required in ApoE-based inhibition of Wnt/β-catenin signaling and osteoblast differentiation.Importantly,we validated this ApoE-Lrp4-Wnt/β-catenin molecular mechanism in human osteoblast differentiation.Finally,we identified an ApoE-neutralizing antibody(NAb)and used it to treat aged,wildtype mice 3 days after fracture surgery resulting in fracture calluses with 35%more bone deposition.Our work here identifies novel liver-to-bone cross-talk and a noninvasive,translatable therapeutic intervention for aged bone regeneration.展开更多
Objective: To explore the association between cardiometabolic multimorbidity and frailty among middle- aged and older adults in China. Methods: Data were derived from the 2013 wave of the China Longitudinal Healthy Lo...Objective: To explore the association between cardiometabolic multimorbidity and frailty among middle- aged and older adults in China. Methods: Data were derived from the 2013 wave of the China Longitudinal Healthy Longevity Survey, including a total of 6,179 individuals aged 45 years and above with complete follow-up records. Basic demographic information was collected, and frailty status was assessed using a physical frailty scale. Generalized linear models were employed to analyze the association between the number and combinations of cardiometabolic conditions- such as hypertension, diabetes, heart disease, and stroke-and frailty. Results: The prevalence of cardiometabolic multimorbidity among middle-aged and older adults was 14.23%. After adjusting for sociodemographic covariates, individuals with cardiometabolic multimorbidity had a significantly increased risk of frailty compared to those without such conditions (OR = 1.78, 95% CI: 1.45-2.19), along with higher frailty scale scores (β = 0.26, 95% CI: 0.19-0.34). Compared to individuals without cardiometabolic diseases, those with both hypertension and stroke (OR = 1.18, 95% CI: 1.06-1.31) and those with hypertension, heart disease, and stroke (OR = 1.46, 95% CI: 1.24-1.73) exhibited notably higher frailty risks. Conclusion: There is a significant association between cardiometabolic multimorbidity and frailty in middle- aged and older adults in China, particularly for comorbidity patterns involving hypertension. These findings provide evidence for developing targeted health interventions for aging populations.展开更多
Purpose:To describe the development of a Compendium for estimating the energy costs of activities in adults>60 years(OA Compendium).Methods:Physical activities(PAs)and their metabolic equivalent of task(MET)values ...Purpose:To describe the development of a Compendium for estimating the energy costs of activities in adults>60 years(OA Compendium).Methods:Physical activities(PAs)and their metabolic equivalent of task(MET)values were obtained from a systematic search of studies published in 4 sport and exercise databases(PubMed,Embase,SPORTDiscus(EBSCOhost),and Scopus)and a review of articles included in the 2011 Adult Compendium that measured PA in older adults.MET values were computed as the oxygen cost(VO_(2),mL/kg/min)during PA divided by 2.7 m L/kg/min(MET_(60+))to account for the lower resting metabolic rate in older adults.Results:We identified 68 articles and extracted energy expenditure data on 427 PAs.From these,we derived 99 unique Specific Activity codes with corresponding MET_(60+)values for older adults.We developed a website to present the OA Compendium MET_(60+)values:https://pacompendium.com.Conclusion:The OA Compendium uses data collected from adults>60 years for more accurate estimation of the energy cost of PAs in older adults.It is an accessible resource that will allow researchers,educators,and practitioners to find MET_(60+)values for older adults for use in PA research and practice.展开更多
Objective: Coronavirus disease 2019(COVID-19) has raised concern around the world as an epidemic or pandemic. As data on COVID-19 has grown, it has become clear that older adults have a disproportionately high rate of...Objective: Coronavirus disease 2019(COVID-19) has raised concern around the world as an epidemic or pandemic. As data on COVID-19 has grown, it has become clear that older adults have a disproportionately high rate of death from COVID-19. This study describes the early clinical characteristics of COVID-19 in patients with more than 80 years of age.Methods: Epidemiological, clinical, laboratory, radiological, and treatment data from 17 patients diagnosed with COVID-19 between January 20 and February 20, 2020 were collected and analyzed retrospectively. Treatment outcomes among subgroups of patients with non-severe and severe symptoms of COVID-19 were compared.Results: Of the 17 hospitalized patients with COVID-19, the median age was 88.0 years(interquartile range, 86.6–90.0 years;range, 80.0–100.0 years) and 12(70.6%) were men. The age distribution of patients was not significantly different between non-severe group and severe group. All patients had chronic pre-existing conditions. Hypertension and cardiovascular diseases were the most common chronic conditions in both subgroups. The most common symptoms at the onset of COVID-19 were fever(n = 13;76.5%), fatigue(n = 11;64.7%), and cough(n = 5;29.4%). Lymphopenia was observed in all patients, and lymphopenia was significantly more severe in the severe group than that in non-severe group(0.4×10~9/L vs 1.2×10~9/L, P = 0.014). The level of serum creatinine was higher in the severe group than in the non-severe group(99.0 lmol/L vs 62.5 lmol/L, P = 0.038). The most common features of chest computed tomography images were nodular foci in 10(58.8%) patients and pleural thickening in 7(41.2%) patients. All patients received antiviral therapy, while some patients also received intravenous antibiotics therapy(76.5%), Chinese medicinal preparation therapy(Lianhuaqingwen capsule, 64.7%), corticosteroids(35.3%) or immunoglobin(29.4%). Eight patients(47.1%) were transferred to the intensive care unit because of complications. Ten patients(58.8%) received intranasal oxygen, while 3(17.6%)received non-invasive mechanical ventilation, and 4(23.5%) received high-flow oxygen. As of June 20,7(41.2%) patients had been discharged and 10(58.8% of this cohort, 77.8% of severe patients) had died.Conclusion: The mortality of patients aged 80 years and older with severe COVID-19 symptoms was high.Lymphopenia was a characteristic laboratory result in these patients, and the severity of lymphopenia was indicative of the severity of COVID-19. However, the majority of patients with COVID-19 in this age cohort had atypical symptoms, and early diagnosis depends on prompt use of a viral nucleic acid test.展开更多
Given the demographic trends toward a considerably longer life expectancy,the percentage of elderly patients with prostate cancer will increase further in the upcoming decades.Therefore,the question arises,should pati...Given the demographic trends toward a considerably longer life expectancy,the percentage of elderly patients with prostate cancer will increase further in the upcoming decades.Therefore,the question arises,should patients ≥75 years old be offered radical prostatectomy and under which circumstances? For treatment decision-making,life expectancy is more important than biological age.As a result,a patient's health and mental status has to be determined and radical treatment should only be offered to those who are fit.As perioperative morbidity and mortality in these patients is increased relative to younger patients,patient selection according to comorbidities is a key issue that needs to be addressed.It is known from the literature that elderly men show notably worse tumor characteristics,leading to worse oncologic outcomes after treatment.Moreover,elderly patients also demonstrate worse postoperative recovery of continence and erectile function.As the absolute rates of both oncological and functional outcomes are still very reasonable in patients ≥75 years,a radical prostatectomy can be offered to highly selected and healthy elderly patients. Nevertheless,patients clearly need to be informed about the worse outcomes and higher perioperative risks compared to younger patients.展开更多
Physical activity (PA) plays a key role in the treatment of hypertension, and moderate to vigorous PA has been documented to lower the risk of developing hypertension. However, dose-response relationships between PA a...Physical activity (PA) plays a key role in the treatment of hypertension, and moderate to vigorous PA has been documented to lower the risk of developing hypertension. However, dose-response relationships between PA and hypertension are not consistent, and little is known about this relationship within the Chinese middle-aged and older people. We investigated the relationship between PA and hypertension within this population using China Health and Nutrition Survey 1991-2015 data. Physical activity was expressed in terms of the metabolic equivalent task (MET) and participants were divided into groups according to quartiles, namely, Q1 (< 32.97 METs-h/w), Q2 (32.97-60.38 METs-h/ w), Q3 (60.38-98.95 METs-h/w), and Q4 (> 98.95 METs-h/w). Compared with the Q1 group, the odds ratio of risk with hypertension (95% CIs) after adjusting for confounding factors were 0.63 (0.35, 1.12), 0.49 (0.28, 0.86), and 0.62 (0.35, 1.09) for those in Q2, Q3, and Q4, respectively. Restricted cubic spline functions were used and a U-shaped relationship between physical activity and hypertension risk was found, indicative of an optimal level of physical activity, which was found to be 112 METs-h/w. Our data suggest maintenance of optimal levels of total daily physical activity may be important for preventing hypertension in Chinese adults over the age of 40.展开更多
Purpose: We report our single-institution experience using hypofractionated radiotherapy in a patient population 75 years and older diagnosed with stage IA or IB (T1/T2 N0) Non-Small Cell Lung Carcinoma. Materials and...Purpose: We report our single-institution experience using hypofractionated radiotherapy in a patient population 75 years and older diagnosed with stage IA or IB (T1/T2 N0) Non-Small Cell Lung Carcinoma. Materials and methods: This is a single-institution, retrospective analysis examining disease free and overall survival and toxicity after hypofractionated radiation therapy in a patient population 75 years and older diagnosed with stage IA or IB (T1/T2 N0) NSCLC. Between 1991 and 2005, a total of 33 such patients were identified with a median age of 79 years. Patients were treated with a median total dose of 7000 cGy using median daily dose fractions of 250 cGy. Analysis of competing risks (local failure, distal failure or death as the first event) was performed and cumulative incidence functions (CIF) were estimated. Results: The median length of follow-up was 19.8 months (range: 4.3 - 103.8 months). Of the 33 patients treated, 21 (63.6% of total) had no evidence of disease recurrence on follow-up imaging over the course of the study. Of the 12 patients with disease recurrence, 6 (18.2% of total) had local failure as the first event and 6 (18.2% of total) had distant metastasis as the first event. Analysis of competing risks showed that at 5 years, the probability of local failure as the first detected event was 19.5% (95%CI: 7.6%, 35.6%);the probability of distal failure as the first detected event was 21.5% (95%CI: 7.9%,39.4%);and the probability of death without recording a failure was 44.1% (95%CI: 26.1%, 60.7%). There were no treatment related deaths reported. Conclusions: Elderly patients diagnosed with stage I non-small cell lung cancer may safely be offered hypofractionated radiotherapy as an effective option with curative intent.展开更多
Although eye problems can occur at any age, they are often common from the age of 40. Eye diseases with a prevalence associated with age and aging will continue to increase in the coming years. Most studies conducted ...Although eye problems can occur at any age, they are often common from the age of 40. Eye diseases with a prevalence associated with age and aging will continue to increase in the coming years. Most studies conducted on problems in middle-aged people have focused on visual disorders without taking into account all the ocular morbidities that may affect this segment of the population, hence the present study, the aim of which is to determine the proportions of different eye diseases in people aged 40 and over. Materials and Methods: This was a descriptive cross-sectional study carried out in the ophthalmology department covering the period from January 1 to December 31, 2020. Results: In total, we collected 828 patients aged 40 and over out of 1811 patients who received ophthalmological consultation during the study period, representing 45.72%. The most represented age group was 40 - 50 years, with an average age of 58.84 years and a maximum of 93 years. There were slightly more women (62.3%) than men (37.7%). The main reasons for consultation were decreased visual acuity (26.4%) and pruritus (19.9%). The main eye diseases diagnosed were cataracts (23%), allergic conjunctivitis (21.1%), and bacterial conjunctivitis (14.2%). Discussions: The predominance of cataracts in the diagnosed diseases confirms the literature data, according to which the main eye morbidities in middle-aged and elderly people are cataracts, glaucoma, and age-related macular degeneration. Conclusion: It is crucial to have a mastery of these epidemiological data of eye diseases in order to adapt the technical platforms of eye care structures to the needs of different segments of the population.展开更多
Objectives:This study aimed to develop a mobile frailty management platform for Chinese communitydwelling older adults and evaluate its effectiveness,usability and safety.Methods:Based on literature research,the resea...Objectives:This study aimed to develop a mobile frailty management platform for Chinese communitydwelling older adults and evaluate its effectiveness,usability and safety.Methods:Based on literature research,the research team combined the frailty cycle and integration models,self-determination theory,and technology acceptance models and determined the frailty interventions through expert discussion,then transformed it into multimedia resources,finally,engineers developed the mobile management platform.A cluster sampling,parallel,single-blind,controlled quasiexperimental trial was conducted.Sixty older adults from two community health service centers were recruited from March to August 2023.The control group received routine community care,while the intervention group used the mobile frailty management platform.The incidence of frailty,scores of quality of life,depression,sleep quality,and grip strength within 12 weeks were compared between the two groups,and the availability and safety of the platform were assessed.Results:A total of 52 participants completed the study,27 in the intervention group and 25 in the control group.At 12 weeks after the intervention,the frailty state of the intervention group was reversed to prefrailty.There were no significant differences in the scores of quality of life,depression,sleep quality,and grip strength between the two groups before and 4 weeks after intervention.At 8 weeks and 12 weeks after the intervention,the quality of life,depression,and grip strength of the intervention group were improved with statistical significance(P<0.05).Sleep quality was statistically significant only 12 weeks after the intervention(P<0.05).System Usability Scale score for the platform was(87.96±5.88),indicating a highly satisfactory user experience.Throughout the intervention,no adverse events were reported among the older adults.Conclusions:The mobile frailty management platform effectively improved frailty status,depressive mood,sleep quality,grip strength,and quality of life for Chinese community-dwelling older adults.It holds clinical application value and is an effective tool for strengthening frailty management among Chinese community-dwelling older adults.展开更多
BACKGROUND Older patients with liver cancer often experience impaired pulmonary function post-surgery,increasing complications and recovery challenges.AIM To investigate the effects of evidence-based stratified manage...BACKGROUND Older patients with liver cancer often experience impaired pulmonary function post-surgery,increasing complications and recovery challenges.AIM To investigate the effects of evidence-based stratified management and stepwise training in the perioperative pulmonary rehabilitation of older patients with liver cancer,providing a basis for clinical application.METHODS In total,120 older patients with liver cancer who underwent surgery at our hospital between February 2023 and February 2025 were selected and randomly divided into study and control groups,with 60 patients in each group.All the patients underwent radical hepatectomy.Postoperatively,the control group received routine nursing management and rehabilitation training,while the study group received evidence-based stratified management combined with stepwise training for a continuous intervention period of one week.Time to first ambulation,length of hospital stays,and average hospitalization costs were recorded.Oxygen saturation(SPO_(2))was measured on postoperative day 1 and day 3.The 6-minute walk distance and Borg scale scores were assessed on postoperative day 1 and day 7,respectively.The postoperative complication rates were recorded.RESULTS The study group had a significantly shorter time to first ambulation,shorter hospital stays,and lower average hospitalization costs than the control group(P<0.05).On postoperative day 1,there was no significant difference in SPO_(2)between the groups(P>0.05);however,on postoperative day 3,the study group had significantly higher SPO_(2)(P<0.05).On postoperative day 7,the study group showed a significantly longer 6-minute walk distance and lower Borg scores than the control group(P<0.05).The incidence of postoperative complications in the study group was 3.33%,which was significantly lower than that in the control group(13.33%;P<0.05).CONCLUSION Implementing evidence-based stratified management combined with stepwise training in the perioperative pulmonary rehabilitation of older patients with liver cancer is improves lung function,reduces complications,and promotes effective recovery,demonstrating significant clinical value.展开更多
Background:Falls are a significant public health concern among older adults,often leading to severe injuries and decreased quality of life.Fall prevention self-management behaviors are critical in reducing fall risk.H...Background:Falls are a significant public health concern among older adults,often leading to severe injuries and decreased quality of life.Fall prevention self-management behaviors are critical in reducing fall risk.However,the status and influencing factors of these behaviors among community-dwelling older adults in China remain poorly understood.This study aimed to investigate fall prevention self-management behaviors and their influencing factors among community-dwelling older adults in Fuzhou,China.Methods:From June to December 2022,we used multi-stage cluster random sampling and invited 675 community-dwelling older adults from Fujian as participants.We conducted a questionnaire survey using the general information questionnaire,Fall Prevention Self-management Behavior among Older Adults Questionnaire,Questionnaire on Knowledge,Belief,and Practice of Falls Prevention among Older Adults in Community,Modified Falls Efficacy Scale,Social Support Rating Scale,and Chinese Version of the Self-Assessment Fall Risk Scale for Older Adults.Multivariate linear regression was used to identify the factors influencing fall prevention self-management behavior among older adults.Results:The overall score of fall prevention self-management behaviors was 146.81±34.22,indicating a moderate level.Key influencing factors included education level,pre-retirement occupation,income,medication type,self-assessed physical condition,fear of falling,knowledge and practices in fall prevention,social support,and fall risk.These factors collectively explained 34.3%of the variance in self-management behaviors.Conclusion:The findings highlight the need for targeted interventions to enhance fall prevention self-management among community-dwelling older adults.Interventions should focus on improving knowledge,strengthening social support,and addressing psychological barriers such as fear of falling.This study provides valuable insights for developing community-based strategies to reduce fall risks and promote healthy aging.展开更多
Icariin is a natural product that possesses numerous pharmaceutical properties.Thus,this study aimed to investigate the molecular mechanism by which icariin prevents ferroptosis in aged-related osteoporosis.Firstly,mR...Icariin is a natural product that possesses numerous pharmaceutical properties.Thus,this study aimed to investigate the molecular mechanism by which icariin prevents ferroptosis in aged-related osteoporosis.Firstly,mRNA transcriptomics was used to analyze differentially expressed genes and ferroptosis markers.Next,a weighted correlation network analysis was conducted on these genes.Then,common genes among ferroptosis,Yinyanghuo,and differentially expressed genes were identified as target genes.Single-cell and spatial transcriptomics were analyzed to evaluate expression changes of target genes in bone marrow.Furthermore,to validate the results of bioinformatics analysis,MC3T3-E1 cells were used to model the preventive effects of icariin in vitro,and ferroptosis markers and mitochondrial function were both examined.In vivo,4-month-old mice were fed a diet containing icariin for 14 months,following which bone proteomics was assessed to identify essential proteins.Hematoxylin-eosin staining and immunohistochemistry assays were performed on mouse femurs.Finally,Western blot and polymerase chain reaction(PCR)analyses were performed to analyze the effects of icariin on ferroptosis target biomarkers.Ptgs2 and Hmox1 were identified as target genes related to both icariin and ferroptosis.The expression of ferroptosis-related genes was up-regulated with age.Moreover,single-cell and spatial transcriptomics analyses revealed that up-regulation of these two genes inhibited osteogenic capability.The results of the in vitro experiments indicated that icariin mitigated the accumulation of reactive oxygen species and β-galactosidase.Similarly,icariin prevented aberrant changes in the levels of ferroptosis-related proteins,consistent with the results of the in vivo experiments.Specifically,10 mg/(kg·day)of icariin inhibited ferroptosis and osteoporosis in aged mice.Overall,this study revealed that icariin could serve as a dietary supplement to prevent age-induced osteoporosis.Furthermore,Ptgs2 and Hmox1 were identified as ferroptosis-related targets through which icariin exerts its protective effects.展开更多
BACKGROUND According to the guidelines in the United States,individuals with a family history of colorectal cancer should be screened at the age of 40 years.Data on the prevalence of adenomas and sessile serrated lesi...BACKGROUND According to the guidelines in the United States,individuals with a family history of colorectal cancer should be screened at the age of 40 years.Data on the prevalence of adenomas and sessile serrated lesions(SSLs)in individuals aged 40-49 years in Japan are lacking.AIM To investigate the effect of family history on the detection of adenomas and SSLs during colonoscopy in Japan.METHODS This retrospective,single-center cohort study included individuals aged 40-79 years who underwent colonoscopy by expert endoscopists with an adenoma detection rate(ADR)≥40%between 2021 and 2024.The ADR and adenoma plus SSL detection rate(ASDR)were investigated according to age.Multivariable analyses were performed to examine the effects of first-degree family history of colorectal cancer,fecal immunochemical test,and sex on the ADR and ASDR for each age group.A binomial logistic regression model was used.RESULTS In 10248 participants,the overall ADR and ASDR were 53.6%and 59.1%,respectively.The ADR and ASDR increased with age.Among 2317 participants aged 40-49 years,the presence of a family history significantly increased the ADR(47.6%vs 38.2%).The odds ratio of a family history for the ADR adjusted by sex and fecal immunochemical test was 1.59(95%confidence interval:1.13-2.25).In contrast,there was no significant association between the ADR and family history in participants aged 50-59,60-69,and 70-79 years.Similarly,a family history significantly increased the ASDR(58.0%vs 43.7%)in participants aged 40-49 years.The odds ratio of a family history for the ASDR was 1.92(95%confidence interval:1.36-2.71).CONCLUSION Participants with a family history exhibited significantly elevated ADR(47.6%)and ASDR(58.0%),in their 40s.Individuals with a family history should initiate colonoscopy at 40 years old.展开更多
基金supported by the Sichuan Provincial Cadre Health Research Project(ZH2024-101)the Key Natural Science Foundation of Sichuan Province(No.2025 ZNSFSC0053)。
文摘BACKGROUND Solid fuel use for cooking and heating is a major environmental risk factor,yet its association with new-onset heart disease(HD)remains unclear.The aim of this study was to investigate the relationship between solid fuel exposure and new-onset HD in a large cohort.METHODS Multivariable logistic regression models assessed associations between cooking/heating fuel types(coal,crop residue/wood,liquefied petroleum gas,natural gas,and others)and new-onset HD.Subgroup analyses explored effect modification by age,sex,education,smoking,alcohol use,and region.RESULTS A prospective cohort study included 5915 participants,with 781 participants(13.2%)developing new-onset HD.Coal use for cooking showed an initial association with new-onset HD risk(OR=1.41,95%CI:1.06–1.86,P=0.02),which attenuated after full adjustment(OR=1.28,95%CI:0.96–1.72,P=0.10).Coal use for heating demonstrated robust associations across all models(OR=1.86,95%CI:1.42–2.43,P<0.001).Crop residue/wood burning for heating was also significant(Model 2:OR=1.40,95%CI:1.06–1.86,P=0.02).Subgroup analyses revealed stronger associations among females,non-smokers,non-drinkers,and less-educated participants.Geographic stratification showed significant associations in southern but not northern regions.CONCLUSIONS Solid fuel use,particularly coal for heating,is associated with increased new-onset HD risk.Reducing solid fuel exposure is crucial for HD prevention in low-resource settings.
基金supported and funded by the National Key Research and Development Program of China(2023YFD1300801)the Agricultural Science and Technology Innovation Program in Chinese Academy of Agricultural Sciences(ASTIP-IAS-08)。
文摘Background The decline in reproductive performance of aged hens is mainly attributed to oxidative damage in reproductive organs,hepatic lipid metabolism disorders,and intestinal microbiota dysbiosis.Glycyrrhizin(GL)has been proven to enhance antioxidant capacity,regulate lipid metabolism and gut microbiota in mammals,but its efficacy in hens remains unclear.Hence,this study aimed to investigate whether dietary GL supplementation improves reproductive performance in hens during the late laying stage by modulating intestinal microbiota composition,hepatic lipid metabolism and ovarian antioxidant status.Results Dietary supplementation with 100 mg/kg GL significantly improved the egg production rate,egg quality,and hatching rate in aged breeder hens(P<0.05).GL supplementation also increased the serum levels of HDLC,TP and ALB,and enhanced the antioxidant capacity in both serum and ovary(P<0.05).In addition,dietary GL elevated the serum progesterone(P4)levels by enhancing the transcription level of steroid synthesis key enzymes(CYP11A1 and 3β-HSD)in the ovary(P<0.05).Dietary GL also promoted the synthesis and transport of vitellogenin(VTG)by upregulating the VTG-Ⅱ(P<0.05)and APOV1(P=0.077)expression levels in the liver,thereby increasing the number of grade follicles and small yellow follicles.Moreover,dietary GL enhanced hepatic fatty acidβ-oxidation by upregulating PPARαand CPT-I(P<0.05),and downregulating ACC expression levels(P<0.05).In agreement,liver metabolomics analysis revealed that dietary GL supplementation significantly altered hepatic metabolism,with 389 differentially identified metabolites(P<0.05).The key metabolites(e.g.,taurocholic acid,tauroursodeoxycholic acid,nicotinuric acid,glycodeoxycholic acid(hydrate))were identified,and they were mainly functionally enriched in betaalanine metabolism nicotinate,taurine and hypotaurine metabolism(P<0.05).Finally,16S rRNA gene sequencing revealed that dietary GL reversed age-induced changes in gut microbiota composition,characterized by a significant increase in Lactobacillus abundance and a decrease in Bacteroides(P<0.05).Conclusions These results collectively demonstrate that dietary supplementation with 100 mg/kg GL improved reproductive performance by reversing age-induced changes in gut microbiota,enhancing hepatic vitellogenin synthesis,and ameliorating ovarian function in aged breeder hens.This study suggests that dietary GL is a potential strategy to improve reproductive performance in broiler breeder hens during the late laying period.
文摘Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducted from October to December 2022 using a convenience sampling method.A total of 312 older adults were selected from 13 day service centers for older adults in Macao,China.The Advance Care Planning Acceptance Questionnaire and the Family Adaptation,Partnership,Growth,Affection,Resolve(APGAR)Scale were used to survey the older adults.Results:A total of 306 older adults completed the survey.The score for advance care planning readiness was 65.55±10.69,and 59.5%of participants(n=182)were willing to participate in ACP.The family function score was 7.24±2.51,while 70.3%of participants were from a highly functional family.The higher family function indicating a higher readiness for advance care planning(r=0.396,P<0.001).The multiple linear regression analysis indicated that the variables“age,”“knowledge of ACP,”“experience with ACP,”and“received resuscitation of yourself,relatives or friends”combined with“family function”can influence advance care planning readiness among older adults(R^(2)=0.317,F=27.898,P<0.001).Conclusions:Older adults in Macao’s day service centers were willing to engage in ACP.The importance of family involvement is highlighted in the ACP readiness.Health education and improved family communication are vital for promoting ACP,which ensures individuals receive care when they lack the capacity to make that choice.Additionally,healthcare professionals should enhance communication and education with older adults during the medical care process.
基金supported by Peking University,the National Natural Science Foundation of China,the National Institute on Aging and the World Bank。
文摘Background It remains unclear whether sleep duration and physical activity(PA)trajectories in middle-aged and older adults are associated with different risks of cardiovascular diseases(CVDs).This study aimed to explore the trajectories of total sleep duration and PA among middle-aged and older Chinese adults and their impact on CVD risk.Methods This study was based on the China Health and Retirement Longitudinal Study.12009 adults aged 45 years and older from five waves were included.CVD events were measured by self-reports of heart disease and stroke.We first used groupbased trajectory modeling to identify total sleep duration and PA trajectories from 2011 to 2020,and then employed logistic regression models to analyze their risk for CVD.Results We identified three sleep duration and PA trajectories.The risk of heart disease increased by 33%(OR=1.31,95%CI:1.12-1.53)for the short sleep duration trajectory(vs.moderate sleep duration trajectory),by 40%(OR=1.40,95%CI:1.06-1.84)for the high decreasing PA trajectory,and by 20%(OR=1.20,95%CI:1.01-1.42)for the low stable PA trajectory(vs.high stable PA trajectory),respectively.Similar results for stroke and CVD as the outcomes were also observed,but the higher risk of stroke in the high decreasing PA trajectory group was not statistically significant.The joint effects of sleep and PA showed lower risks of heart disease and stroke in trajectories with moderate or long sleep duration and high stable PA compared with short sleep duration and a low stable PA trajectory.Conclusions Short total sleep duration,high decreasing PA,and low stable PA trajectories could increase the risk of CVDs among middle-aged and older adults.Long-term moderate to long total sleep durations and high stable PA trajectories might be optimal for preventing CVDs.
基金funded by the National Key R&D Program of China(2023YFB4603200 and 2023YFC3606400)National Natural Science Foundation of China(72374013)Capital’s Funds for Health Improvement and Research(CFH 2024-1G-3014).
文摘Background:It is still uncertain how multimorbidity patterns affect transitions between fall states among middle-aged and older Chinese.Methods:Data were obtained from China Health and Retirement Longitudinal Study(CHARLS)2011–2018.We utilized latent class analysis to categorize baseline multimorbidity patterns,Markov multi-state model to explore the impact of multimorbidity characterized by condition counts and multimorbidity patterns on subsequent fall transitions,and Cox proportional hazard models to assess hazard ratios of each transition.Results:A total of 14,244 participants aged 45 years and older were enrolled at baseline.Among these participants,11,956(83.9%)did not have a fall history in the last 2 years,1,054(7.4%)had mild falls,and 1,234(8.7%)had severe falls.Using a multi-state model,10,967 transitions were observed during a total follow-up of 57,094 person-times,6,527 of which had worsening transitions and 4,440 had improving transitions.Among 6,711 multimorbid participants,osteocardiovascular(20.5%),pulmonary-digestive-rheumatic(30.5%),metabolic-cardiovascular(22.9%),and neuropsychiatric-sensory(26.1%)patterns were classified.Multimorbid participants had significantly higher risks of transitions compared with other participants.Among 4 multimorbidity patterns,osteocardiovascular pattern had higher transition risks than other 3 patterns.Conclusions:Multimorbidity,especially the“osteo-cardiovascular pattern”identified in this study,was associated with higher risks of fall transitions among middle-aged and older Chinese.Generally,the effect of multimorbidity is more significant in older adults than in middle-aged adults.Findings from this study provide facts and evidence for fall prevention,and offer implications for clinicians to target on vulnerable population,and for public health policymakers to allocate healthcare resources.
基金supported by a Borden Scholars awardDuke Claude D.Pepper Older Americans Independence Center Pilot Award(P30AG028716)by the NIH/NIA(R01AG081393)。
文摘Advanced age impairs bone fracture healing;the underlying mechanism of this phenomenon remains unknown.We determined that apolipoprotein E(ApoE)increases with age and causes poor fracture healing.After deletion of hepatic ApoE expression(ΔApoE),24-month-oldΔApoE mice displayed a 95%reduction in circulating ApoE levels and significantly improved fracture healing.ApoE treatment of aged BMSCs inhibited osteoblast differentiation in tissue culture models;RNA-seq,Western blot,immunofluorescence,and RT-PCR analyses indicated that the Wnt/β-catenin pathway is the target of this inhibition.Indeed,we showed that ApoE had no effect on cultures with stabilizedβ-catenin levels.Next,we determined that Lrp4 serves as the osteoblast cell surface receptor to ApoE,as expression of Lrp4 is required in ApoE-based inhibition of Wnt/β-catenin signaling and osteoblast differentiation.Importantly,we validated this ApoE-Lrp4-Wnt/β-catenin molecular mechanism in human osteoblast differentiation.Finally,we identified an ApoE-neutralizing antibody(NAb)and used it to treat aged,wildtype mice 3 days after fracture surgery resulting in fracture calluses with 35%more bone deposition.Our work here identifies novel liver-to-bone cross-talk and a noninvasive,translatable therapeutic intervention for aged bone regeneration.
文摘Objective: To explore the association between cardiometabolic multimorbidity and frailty among middle- aged and older adults in China. Methods: Data were derived from the 2013 wave of the China Longitudinal Healthy Longevity Survey, including a total of 6,179 individuals aged 45 years and above with complete follow-up records. Basic demographic information was collected, and frailty status was assessed using a physical frailty scale. Generalized linear models were employed to analyze the association between the number and combinations of cardiometabolic conditions- such as hypertension, diabetes, heart disease, and stroke-and frailty. Results: The prevalence of cardiometabolic multimorbidity among middle-aged and older adults was 14.23%. After adjusting for sociodemographic covariates, individuals with cardiometabolic multimorbidity had a significantly increased risk of frailty compared to those without such conditions (OR = 1.78, 95% CI: 1.45-2.19), along with higher frailty scale scores (β = 0.26, 95% CI: 0.19-0.34). Compared to individuals without cardiometabolic diseases, those with both hypertension and stroke (OR = 1.18, 95% CI: 1.06-1.31) and those with hypertension, heart disease, and stroke (OR = 1.46, 95% CI: 1.24-1.73) exhibited notably higher frailty risks. Conclusion: There is a significant association between cardiometabolic multimorbidity and frailty in middle- aged and older adults in China, particularly for comorbidity patterns involving hypertension. These findings provide evidence for developing targeted health interventions for aging populations.
文摘Purpose:To describe the development of a Compendium for estimating the energy costs of activities in adults>60 years(OA Compendium).Methods:Physical activities(PAs)and their metabolic equivalent of task(MET)values were obtained from a systematic search of studies published in 4 sport and exercise databases(PubMed,Embase,SPORTDiscus(EBSCOhost),and Scopus)and a review of articles included in the 2011 Adult Compendium that measured PA in older adults.MET values were computed as the oxygen cost(VO_(2),mL/kg/min)during PA divided by 2.7 m L/kg/min(MET_(60+))to account for the lower resting metabolic rate in older adults.Results:We identified 68 articles and extracted energy expenditure data on 427 PAs.From these,we derived 99 unique Specific Activity codes with corresponding MET_(60+)values for older adults.We developed a website to present the OA Compendium MET_(60+)values:https://pacompendium.com.Conclusion:The OA Compendium uses data collected from adults>60 years for more accurate estimation of the energy cost of PAs in older adults.It is an accessible resource that will allow researchers,educators,and practitioners to find MET_(60+)values for older adults for use in PA research and practice.
基金supported by grant from the National Nature Sciences Foundation of China (No. 81500639)。
文摘Objective: Coronavirus disease 2019(COVID-19) has raised concern around the world as an epidemic or pandemic. As data on COVID-19 has grown, it has become clear that older adults have a disproportionately high rate of death from COVID-19. This study describes the early clinical characteristics of COVID-19 in patients with more than 80 years of age.Methods: Epidemiological, clinical, laboratory, radiological, and treatment data from 17 patients diagnosed with COVID-19 between January 20 and February 20, 2020 were collected and analyzed retrospectively. Treatment outcomes among subgroups of patients with non-severe and severe symptoms of COVID-19 were compared.Results: Of the 17 hospitalized patients with COVID-19, the median age was 88.0 years(interquartile range, 86.6–90.0 years;range, 80.0–100.0 years) and 12(70.6%) were men. The age distribution of patients was not significantly different between non-severe group and severe group. All patients had chronic pre-existing conditions. Hypertension and cardiovascular diseases were the most common chronic conditions in both subgroups. The most common symptoms at the onset of COVID-19 were fever(n = 13;76.5%), fatigue(n = 11;64.7%), and cough(n = 5;29.4%). Lymphopenia was observed in all patients, and lymphopenia was significantly more severe in the severe group than that in non-severe group(0.4×10~9/L vs 1.2×10~9/L, P = 0.014). The level of serum creatinine was higher in the severe group than in the non-severe group(99.0 lmol/L vs 62.5 lmol/L, P = 0.038). The most common features of chest computed tomography images were nodular foci in 10(58.8%) patients and pleural thickening in 7(41.2%) patients. All patients received antiviral therapy, while some patients also received intravenous antibiotics therapy(76.5%), Chinese medicinal preparation therapy(Lianhuaqingwen capsule, 64.7%), corticosteroids(35.3%) or immunoglobin(29.4%). Eight patients(47.1%) were transferred to the intensive care unit because of complications. Ten patients(58.8%) received intranasal oxygen, while 3(17.6%)received non-invasive mechanical ventilation, and 4(23.5%) received high-flow oxygen. As of June 20,7(41.2%) patients had been discharged and 10(58.8% of this cohort, 77.8% of severe patients) had died.Conclusion: The mortality of patients aged 80 years and older with severe COVID-19 symptoms was high.Lymphopenia was a characteristic laboratory result in these patients, and the severity of lymphopenia was indicative of the severity of COVID-19. However, the majority of patients with COVID-19 in this age cohort had atypical symptoms, and early diagnosis depends on prompt use of a viral nucleic acid test.
文摘Given the demographic trends toward a considerably longer life expectancy,the percentage of elderly patients with prostate cancer will increase further in the upcoming decades.Therefore,the question arises,should patients ≥75 years old be offered radical prostatectomy and under which circumstances? For treatment decision-making,life expectancy is more important than biological age.As a result,a patient's health and mental status has to be determined and radical treatment should only be offered to those who are fit.As perioperative morbidity and mortality in these patients is increased relative to younger patients,patient selection according to comorbidities is a key issue that needs to be addressed.It is known from the literature that elderly men show notably worse tumor characteristics,leading to worse oncologic outcomes after treatment.Moreover,elderly patients also demonstrate worse postoperative recovery of continence and erectile function.As the absolute rates of both oncological and functional outcomes are still very reasonable in patients ≥75 years,a radical prostatectomy can be offered to highly selected and healthy elderly patients. Nevertheless,patients clearly need to be informed about the worse outcomes and higher perioperative risks compared to younger patients.
基金The National Key Research and Development Program of China,Scientific Fitness Guidance Service System Research(2020YFC2006904)。
文摘Physical activity (PA) plays a key role in the treatment of hypertension, and moderate to vigorous PA has been documented to lower the risk of developing hypertension. However, dose-response relationships between PA and hypertension are not consistent, and little is known about this relationship within the Chinese middle-aged and older people. We investigated the relationship between PA and hypertension within this population using China Health and Nutrition Survey 1991-2015 data. Physical activity was expressed in terms of the metabolic equivalent task (MET) and participants were divided into groups according to quartiles, namely, Q1 (< 32.97 METs-h/w), Q2 (32.97-60.38 METs-h/ w), Q3 (60.38-98.95 METs-h/w), and Q4 (> 98.95 METs-h/w). Compared with the Q1 group, the odds ratio of risk with hypertension (95% CIs) after adjusting for confounding factors were 0.63 (0.35, 1.12), 0.49 (0.28, 0.86), and 0.62 (0.35, 1.09) for those in Q2, Q3, and Q4, respectively. Restricted cubic spline functions were used and a U-shaped relationship between physical activity and hypertension risk was found, indicative of an optimal level of physical activity, which was found to be 112 METs-h/w. Our data suggest maintenance of optimal levels of total daily physical activity may be important for preventing hypertension in Chinese adults over the age of 40.
文摘Purpose: We report our single-institution experience using hypofractionated radiotherapy in a patient population 75 years and older diagnosed with stage IA or IB (T1/T2 N0) Non-Small Cell Lung Carcinoma. Materials and methods: This is a single-institution, retrospective analysis examining disease free and overall survival and toxicity after hypofractionated radiation therapy in a patient population 75 years and older diagnosed with stage IA or IB (T1/T2 N0) NSCLC. Between 1991 and 2005, a total of 33 such patients were identified with a median age of 79 years. Patients were treated with a median total dose of 7000 cGy using median daily dose fractions of 250 cGy. Analysis of competing risks (local failure, distal failure or death as the first event) was performed and cumulative incidence functions (CIF) were estimated. Results: The median length of follow-up was 19.8 months (range: 4.3 - 103.8 months). Of the 33 patients treated, 21 (63.6% of total) had no evidence of disease recurrence on follow-up imaging over the course of the study. Of the 12 patients with disease recurrence, 6 (18.2% of total) had local failure as the first event and 6 (18.2% of total) had distant metastasis as the first event. Analysis of competing risks showed that at 5 years, the probability of local failure as the first detected event was 19.5% (95%CI: 7.6%, 35.6%);the probability of distal failure as the first detected event was 21.5% (95%CI: 7.9%,39.4%);and the probability of death without recording a failure was 44.1% (95%CI: 26.1%, 60.7%). There were no treatment related deaths reported. Conclusions: Elderly patients diagnosed with stage I non-small cell lung cancer may safely be offered hypofractionated radiotherapy as an effective option with curative intent.
文摘Although eye problems can occur at any age, they are often common from the age of 40. Eye diseases with a prevalence associated with age and aging will continue to increase in the coming years. Most studies conducted on problems in middle-aged people have focused on visual disorders without taking into account all the ocular morbidities that may affect this segment of the population, hence the present study, the aim of which is to determine the proportions of different eye diseases in people aged 40 and over. Materials and Methods: This was a descriptive cross-sectional study carried out in the ophthalmology department covering the period from January 1 to December 31, 2020. Results: In total, we collected 828 patients aged 40 and over out of 1811 patients who received ophthalmological consultation during the study period, representing 45.72%. The most represented age group was 40 - 50 years, with an average age of 58.84 years and a maximum of 93 years. There were slightly more women (62.3%) than men (37.7%). The main reasons for consultation were decreased visual acuity (26.4%) and pruritus (19.9%). The main eye diseases diagnosed were cataracts (23%), allergic conjunctivitis (21.1%), and bacterial conjunctivitis (14.2%). Discussions: The predominance of cataracts in the diagnosed diseases confirms the literature data, according to which the main eye morbidities in middle-aged and elderly people are cataracts, glaucoma, and age-related macular degeneration. Conclusion: It is crucial to have a mastery of these epidemiological data of eye diseases in order to adapt the technical platforms of eye care structures to the needs of different segments of the population.
文摘Objectives:This study aimed to develop a mobile frailty management platform for Chinese communitydwelling older adults and evaluate its effectiveness,usability and safety.Methods:Based on literature research,the research team combined the frailty cycle and integration models,self-determination theory,and technology acceptance models and determined the frailty interventions through expert discussion,then transformed it into multimedia resources,finally,engineers developed the mobile management platform.A cluster sampling,parallel,single-blind,controlled quasiexperimental trial was conducted.Sixty older adults from two community health service centers were recruited from March to August 2023.The control group received routine community care,while the intervention group used the mobile frailty management platform.The incidence of frailty,scores of quality of life,depression,sleep quality,and grip strength within 12 weeks were compared between the two groups,and the availability and safety of the platform were assessed.Results:A total of 52 participants completed the study,27 in the intervention group and 25 in the control group.At 12 weeks after the intervention,the frailty state of the intervention group was reversed to prefrailty.There were no significant differences in the scores of quality of life,depression,sleep quality,and grip strength between the two groups before and 4 weeks after intervention.At 8 weeks and 12 weeks after the intervention,the quality of life,depression,and grip strength of the intervention group were improved with statistical significance(P<0.05).Sleep quality was statistically significant only 12 weeks after the intervention(P<0.05).System Usability Scale score for the platform was(87.96±5.88),indicating a highly satisfactory user experience.Throughout the intervention,no adverse events were reported among the older adults.Conclusions:The mobile frailty management platform effectively improved frailty status,depressive mood,sleep quality,grip strength,and quality of life for Chinese community-dwelling older adults.It holds clinical application value and is an effective tool for strengthening frailty management among Chinese community-dwelling older adults.
文摘BACKGROUND Older patients with liver cancer often experience impaired pulmonary function post-surgery,increasing complications and recovery challenges.AIM To investigate the effects of evidence-based stratified management and stepwise training in the perioperative pulmonary rehabilitation of older patients with liver cancer,providing a basis for clinical application.METHODS In total,120 older patients with liver cancer who underwent surgery at our hospital between February 2023 and February 2025 were selected and randomly divided into study and control groups,with 60 patients in each group.All the patients underwent radical hepatectomy.Postoperatively,the control group received routine nursing management and rehabilitation training,while the study group received evidence-based stratified management combined with stepwise training for a continuous intervention period of one week.Time to first ambulation,length of hospital stays,and average hospitalization costs were recorded.Oxygen saturation(SPO_(2))was measured on postoperative day 1 and day 3.The 6-minute walk distance and Borg scale scores were assessed on postoperative day 1 and day 7,respectively.The postoperative complication rates were recorded.RESULTS The study group had a significantly shorter time to first ambulation,shorter hospital stays,and lower average hospitalization costs than the control group(P<0.05).On postoperative day 1,there was no significant difference in SPO_(2)between the groups(P>0.05);however,on postoperative day 3,the study group had significantly higher SPO_(2)(P<0.05).On postoperative day 7,the study group showed a significantly longer 6-minute walk distance and lower Borg scores than the control group(P<0.05).The incidence of postoperative complications in the study group was 3.33%,which was significantly lower than that in the control group(13.33%;P<0.05).CONCLUSION Implementing evidence-based stratified management combined with stepwise training in the perioperative pulmonary rehabilitation of older patients with liver cancer is improves lung function,reduces complications,and promotes effective recovery,demonstrating significant clinical value.
基金the community of older adults who participated in this study.Ministry of Education Science and Technology Industry-University Co-operation Collaborative Education Project(230806630292310).
文摘Background:Falls are a significant public health concern among older adults,often leading to severe injuries and decreased quality of life.Fall prevention self-management behaviors are critical in reducing fall risk.However,the status and influencing factors of these behaviors among community-dwelling older adults in China remain poorly understood.This study aimed to investigate fall prevention self-management behaviors and their influencing factors among community-dwelling older adults in Fuzhou,China.Methods:From June to December 2022,we used multi-stage cluster random sampling and invited 675 community-dwelling older adults from Fujian as participants.We conducted a questionnaire survey using the general information questionnaire,Fall Prevention Self-management Behavior among Older Adults Questionnaire,Questionnaire on Knowledge,Belief,and Practice of Falls Prevention among Older Adults in Community,Modified Falls Efficacy Scale,Social Support Rating Scale,and Chinese Version of the Self-Assessment Fall Risk Scale for Older Adults.Multivariate linear regression was used to identify the factors influencing fall prevention self-management behavior among older adults.Results:The overall score of fall prevention self-management behaviors was 146.81±34.22,indicating a moderate level.Key influencing factors included education level,pre-retirement occupation,income,medication type,self-assessed physical condition,fear of falling,knowledge and practices in fall prevention,social support,and fall risk.These factors collectively explained 34.3%of the variance in self-management behaviors.Conclusion:The findings highlight the need for targeted interventions to enhance fall prevention self-management among community-dwelling older adults.Interventions should focus on improving knowledge,strengthening social support,and addressing psychological barriers such as fear of falling.This study provides valuable insights for developing community-based strategies to reduce fall risks and promote healthy aging.
基金funded by the Natural Science Foundation of Hubei Province(2021CFB414)Scientific Research Program of Traditional Chinese Medicine of Hubei Provincial Health and Wellness Commission(ZY2021M074).
文摘Icariin is a natural product that possesses numerous pharmaceutical properties.Thus,this study aimed to investigate the molecular mechanism by which icariin prevents ferroptosis in aged-related osteoporosis.Firstly,mRNA transcriptomics was used to analyze differentially expressed genes and ferroptosis markers.Next,a weighted correlation network analysis was conducted on these genes.Then,common genes among ferroptosis,Yinyanghuo,and differentially expressed genes were identified as target genes.Single-cell and spatial transcriptomics were analyzed to evaluate expression changes of target genes in bone marrow.Furthermore,to validate the results of bioinformatics analysis,MC3T3-E1 cells were used to model the preventive effects of icariin in vitro,and ferroptosis markers and mitochondrial function were both examined.In vivo,4-month-old mice were fed a diet containing icariin for 14 months,following which bone proteomics was assessed to identify essential proteins.Hematoxylin-eosin staining and immunohistochemistry assays were performed on mouse femurs.Finally,Western blot and polymerase chain reaction(PCR)analyses were performed to analyze the effects of icariin on ferroptosis target biomarkers.Ptgs2 and Hmox1 were identified as target genes related to both icariin and ferroptosis.The expression of ferroptosis-related genes was up-regulated with age.Moreover,single-cell and spatial transcriptomics analyses revealed that up-regulation of these two genes inhibited osteogenic capability.The results of the in vitro experiments indicated that icariin mitigated the accumulation of reactive oxygen species and β-galactosidase.Similarly,icariin prevented aberrant changes in the levels of ferroptosis-related proteins,consistent with the results of the in vivo experiments.Specifically,10 mg/(kg·day)of icariin inhibited ferroptosis and osteoporosis in aged mice.Overall,this study revealed that icariin could serve as a dietary supplement to prevent age-induced osteoporosis.Furthermore,Ptgs2 and Hmox1 were identified as ferroptosis-related targets through which icariin exerts its protective effects.
文摘BACKGROUND According to the guidelines in the United States,individuals with a family history of colorectal cancer should be screened at the age of 40 years.Data on the prevalence of adenomas and sessile serrated lesions(SSLs)in individuals aged 40-49 years in Japan are lacking.AIM To investigate the effect of family history on the detection of adenomas and SSLs during colonoscopy in Japan.METHODS This retrospective,single-center cohort study included individuals aged 40-79 years who underwent colonoscopy by expert endoscopists with an adenoma detection rate(ADR)≥40%between 2021 and 2024.The ADR and adenoma plus SSL detection rate(ASDR)were investigated according to age.Multivariable analyses were performed to examine the effects of first-degree family history of colorectal cancer,fecal immunochemical test,and sex on the ADR and ASDR for each age group.A binomial logistic regression model was used.RESULTS In 10248 participants,the overall ADR and ASDR were 53.6%and 59.1%,respectively.The ADR and ASDR increased with age.Among 2317 participants aged 40-49 years,the presence of a family history significantly increased the ADR(47.6%vs 38.2%).The odds ratio of a family history for the ADR adjusted by sex and fecal immunochemical test was 1.59(95%confidence interval:1.13-2.25).In contrast,there was no significant association between the ADR and family history in participants aged 50-59,60-69,and 70-79 years.Similarly,a family history significantly increased the ASDR(58.0%vs 43.7%)in participants aged 40-49 years.The odds ratio of a family history for the ASDR was 1.92(95%confidence interval:1.36-2.71).CONCLUSION Participants with a family history exhibited significantly elevated ADR(47.6%)and ASDR(58.0%),in their 40s.Individuals with a family history should initiate colonoscopy at 40 years old.
