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Hashimoto T, Yahiro T, Khan S, Kimitsuki K, Yoshikawa H, Nishizono A, Komiya K, Hiramatsu K. Assessing the adequacy of blood culture collection in patients aged 80 years or older. J Infect Chemother 2025; 31:102705. [PMID: 40239867 DOI: 10.1016/j.jiac.2025.102705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2025] [Revised: 03/14/2025] [Accepted: 04/11/2025] [Indexed: 04/18/2025]
Abstract
INTRODUCTION Bloodstream infections (BSIs) are common and fatal conditions in hospitalized patients. Despite higher BSI mortality rates in older adult patients, predicting BSIs in this population remains challenging. This study aimed to assess whether blood culture (BC) collection is adequate for these patients. MATERIALS AND METHODS We conducted a retrospective study of BCs collected from hospitalized patients between June 2020 and March 2024 at a tertiary care hospital in Japan. RESULTS A total of 11,674 BC sets were collected from 5837 hospitalized patients. The true-positive rate was significantly higher in patients aged ≥80 years than in those aged <80 years (13.6 % vs. 10.6 %, p < 0.001). Additionally, the contamination rate was higher in patients aged ≥80 years than in those aged <80 years (3.1 % vs. 2.2 %, p = 0.016). However, chills were less frequent in patients aged ≥80 years. Additionally, the median temperature was lower in older adult patients than in those aged <80 years. CONCLUSIONS BCs may be insufficiently collected in patients aged ≥80 years. Furthermore, a bundled intervention approach is needed for proper BC collection among patients aged ≥80 years.
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Affiliation(s)
| | - Takaaki Yahiro
- Department of Advanced Medical Sciences, Oita University Faculty of Medicine, Japan
| | - Sakirul Khan
- Department of Microbiology, Oita University Faculty of Medicine, Japan; Research Center for Global and Local Infectious Diseases, Japan
| | - Kazunori Kimitsuki
- Department of Microbiology, Oita University Faculty of Medicine, Japan; Research Center for Global and Local Infectious Diseases, Japan
| | - Hiroki Yoshikawa
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, Japan
| | - Akira Nishizono
- Department of Microbiology, Oita University Faculty of Medicine, Japan; Research Center for Global and Local Infectious Diseases, Japan
| | - Kosaku Komiya
- Department of Respiratory Medicine and Infectious Diseases, Oita University Faculty of Medicine, Japan
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Fritzenschaft L, Boehm F, Rothenbacher D, Denkinger M, Dallmeier D. Association of blood biomarkers with frailty-A mapping review. Ageing Res Rev 2025; 109:102761. [PMID: 40318768 DOI: 10.1016/j.arr.2025.102761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2024] [Revised: 04/17/2025] [Accepted: 04/28/2025] [Indexed: 05/07/2025]
Abstract
Frailty describes a geriatric syndrome characterized by an increased vulnerability. Although a variety of potential blood-based biomarkers have been discussed for its characterization, a reliable protocol considering blood-based biomarkers for this purpose is still missing. However, a comprehensive overview on these biomarkers is necessary to understand potential molecular pathways to frailty. We, therefore, performed a mapping review to identify those blood-based biomarkers most consistently associated with frailty in community-dwelling older adults as well as possible analytical gaps according to the available literature. A proposed weighted correlation index (CI) describing the direction and consistency of the association considering the number of available publications as well as the size of the study populations was calculated for each biomarker. Overall, 72 manuscripts were critically reviewed reporting on a total of 82 biomarkers. The most consistent positive association with at least 3 articles addressing the respective biomarker in unadjusted and fully adjusted models was shown for interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), neopterin, white blood cells count, glycated hemoglobin A1c (HbA1c) and sex hormone binding-globuline (SHBG) with a CI ≥ 0.7, while for negative association hemoglobin, 25-hydroxy vitamin D, free testosterone in men and albumin with a CI ≤ -0.7 were identified.
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Affiliation(s)
- Lea Fritzenschaft
- Institute for Geriatric Research Ulm University Medical Center Ulm, Germany
| | - Felix Boehm
- Institute for Geriatric Research Ulm University Medical Center Ulm, Germany
| | | | - Michael Denkinger
- Institute for Geriatric Research Ulm University Medical Center Ulm, Germany; Department of Research on Ageing, AGAPLESION Bethesda Clinic Ulm, Ulm, Germany; Medical Faculty, Ulm University, Ulm, Germany
| | - Dhayana Dallmeier
- Institute for Geriatric Research Ulm University Medical Center Ulm, Germany; Department of Research on Ageing, AGAPLESION Bethesda Clinic Ulm, Ulm, Germany; Medical Faculty, Ulm University, Ulm, Germany; Department of Epidemiology, Boston University School of Public Health, Boston, USA.
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Wang X, Ji J. Explainable machine learning framework for biomarker discovery by combining biological age and frailty prediction. Sci Rep 2025; 15:13924. [PMID: 40263505 PMCID: PMC12015418 DOI: 10.1038/s41598-025-98948-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2024] [Accepted: 04/15/2025] [Indexed: 04/24/2025] Open
Abstract
Biological age (BA) and frailty represent two distinct health measures that offer valuable insights into the aging process. Comparing and analyzing blood-based biomarkers from the machine learning (ML) predictors of BA and frailty helps deepen our understanding of aging. This study aimed to develop a novel framework to identify biomarkers of aging by combining BA and frailty ML predictors with eXplainable Artificial Intelligence (XAI) techniques. We utilized data from middle-aged and older Chinese adults (≥ 45 years) in the 2011/2012 wave (n = 9702) and the 2015/2016 wave (n = 9455, as test set validation) of the China Health and Retirement Longitudinal Study (CHARLS). Sixteen blood-based biomarkers were used to predict BA and frailty. Four tree-based ML algorithms were employed in the training and validation, and performance metrics were compared to select the best models. Then, SHapley Additive exPlanations (SHAP) analysis was conducted on the selected models. CatBoost performed the best in the BA predictor, and Gradient Boosting performed the best in the frailty predictor. Traditional ML feature importance identified cystatin C and glycated hemoglobin as the major contributors for their respective models. However, subsequent SHAP analysis demonstrated that only cystatin C was the primary contributor in both models. The proposed framework can easily incorporate additional biomarkers, providing a scalable and comprehensive toolset that offers a quantitative understanding of biomarkers of aging.
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Affiliation(s)
- Xiheng Wang
- Univeristy of Michigan - Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, Shanghai, China.
| | - Jie Ji
- Network and Information Centre, Shantou University, Shantou, China
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Zhang X, Ye D, Zeng R, Xie F, Zhu W, Wang J, Zhu K, Fan T, Chen L, Zhu A, Shi M, Dou Q. Association between cardiometabolic multimorbidity, body roundness index, and frailty index in Chinese middle-aged and older adults. J Nutr Health Aging 2025; 29:100445. [PMID: 39662154 DOI: 10.1016/j.jnha.2024.100445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2024] [Accepted: 11/27/2024] [Indexed: 12/13/2024]
Affiliation(s)
- Xiaoming Zhang
- Department of Emergency, The People's Hospital of Baoan Shenzhen, Shenzhen, China.
| | - Dongmei Ye
- School of Clinical Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China
| | - Rui Zeng
- School of Clinical Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China
| | - Fayi Xie
- School of Clinical Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China
| | - Wan Zhu
- School of Clinical Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China
| | - Jiang Wang
- School of Basic Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China; Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch
| | - Ke Zhu
- School of Clinical Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China
| | - Tenghui Fan
- School of Clinical Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China
| | - Lihuan Chen
- School of Chinese Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China
| | - Aizhang Zhu
- School of Basic Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China; Online Collaborative Research Center for Evidence-Based Medicine Ministry of Education, Jinggangshan University Branch
| | - Mengxia Shi
- School of Clinical Medicine, Jinggangshan University, Ji'an, Jiangxi Province, China
| | - Qingli Dou
- Department of Emergency, The People's Hospital of Baoan Shenzhen, Shenzhen, China.
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Wen S, Cai Y, Zhang Q, Qiu B, Zeng Y, Zheng S, Ling Z, Xiao Y, Lu P, Zheng P, Chen N, Huang G, Zeng Q, Zou J. Immunological Insights into the Causal Link Between Arthritis, Osteoarthritis, and Frailty: An Integrated Analytical Study. Int J Med Sci 2025; 22:616-629. [PMID: 39898240 PMCID: PMC11783077 DOI: 10.7150/ijms.104476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2024] [Accepted: 12/09/2024] [Indexed: 02/04/2025] Open
Abstract
Background: Previous observational studies have observed associations between rheumatoid arthritis (RA), knee osteoarthritis (KOA), hip osteoarthritis (HOA), and frailty, but the causal relationships remain unestablished. Objective: This study aimed to evaluate the causal relationships between RA, KOA, HOA, KneeHipOA, and frailty using Mendelian randomization (MR) and bioinformatics analysis. Methods: We performed two-sample MR to test for causality between RA, KOA, HOA, KneeHipOA, and frailty. Subsequently, we combined our results in a meta-analysis and conducted multiple sensitivity analyses (MR-Egger, weighted median, constrained maximum likelihood and model averaging (cML-MA), and Bayesian weighted MR (BWMR)). We further explored the role of circulating immune cells and the effects of RA and OA-related gene expression on frailty. Results: Genetically determined RA, KOA, HOA, and KneeHipOA were correlated with a higher risk of frailty. The results of multivariate MR analyses were consistent with those of two-sample MR. Gene Ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes analysis indicated that RA and OA-related genes were primarily enriched in various immune responses. Our findings suggested that increases in monocyte cell AC, eosinophil cell AC, and neutrophil cell AC were associated with a higher risk of frailty. Conclusion: This research provides evidence supporting the associations between RA, KOA, HOA, KneeHipOA, and frailty. It also highlights the significant role of circulating immune cells in the development of frailty, indicating the importance of frailty management from an immunological perspective.
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MESH Headings
- Humans
- Frailty/immunology
- Frailty/genetics
- Frailty/epidemiology
- Mendelian Randomization Analysis
- Arthritis, Rheumatoid/immunology
- Arthritis, Rheumatoid/genetics
- Arthritis, Rheumatoid/epidemiology
- Osteoarthritis, Knee/immunology
- Osteoarthritis, Knee/genetics
- Osteoarthritis, Knee/epidemiology
- Osteoarthritis, Hip/immunology
- Osteoarthritis, Hip/genetics
- Osteoarthritis, Hip/epidemiology
- Computational Biology
- Polymorphism, Single Nucleotide
- Genetic Predisposition to Disease
- Male
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Affiliation(s)
- Shuyang Wen
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yuxin Cai
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Qi Zhang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Baizhi Qiu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yuting Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Shuqi Zheng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Zhishan Ling
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Yupeng Xiao
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Pengcheng Lu
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Peng Zheng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Na Chen
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Guozhi Huang
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Nursing, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Qing Zeng
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
| | - Jihua Zou
- Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, China
- School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China
- Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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Guo X, Zhou R, Tian G, Shi W, Lu J, Li R. Genetic insights into the causal linkage between systemic inflammatory regulators and frailty. Cytokine 2024; 184:156791. [PMID: 39447338 DOI: 10.1016/j.cyto.2024.156791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2024] [Revised: 09/30/2024] [Accepted: 10/18/2024] [Indexed: 10/26/2024]
Abstract
OBJECTIVES Previous studies have suggested the associations between systemic inflammation and the risk of frailty, but causal relationships between them remain not well established. We conducted a bi-directional Mendelian randomization (MR) analysis to investigate the causal links between systemic inflammatory regulators and frailty. METHODS Genetic variants associated with systemic inflammatory regulators were obtained from a comprehensive genetic study on 41 circulating cytokines, such as interleukin-4 (IL-4), eotaxin, and macrophage inflammatory protein-1β (MIP1β). We integrated summary-level data on frailty from two independent genetic studies on frailty index (FI) and Fried frailty score (FFS). The inverse-variance weighted method was used to assess the causal estimate. Sensitivity and heterogeneity analysis was performed to evaluate the stability of the estimates. The false discovery rate (FDR) method was used for P value adjustment of multiple comparisons. RESULTS Genetically elevated levels of MIP1β and decreased levels of eotaxin were suggestively associated with increased FI (MIP1β: β = 0.016, Praw = 0.006, PFDR = 0.083; eotaxin: β = -0.030, Praw = 0.007, PFDR = 0.083) and FFS (MIP1β: β = 0.008, Praw = 0.027, PFDR = 0.247; eotaxin: β = -0.015, Praw = 0.014, PFDR = 0.247). In contrast, genetically predicted FI was suggestively associated with decreased levels of IL-4 (β = -0.395, Praw = 0.040, PFDR = 0.638) and platelet-derived growth factor BB (PDGF-BB, β = -0.385, Praw = 0.047, PFDR = 0.638) and increased levels of stem cell factor (SCF, β = 0.527, Praw = 0.005, PFDR = 0.204). Similar results were obtained from different sensitivity analysis. CONCLUSIONS The present study demonstrates that increased MIP-1β levels and decreased eotaxin levels might lead to a higher risk of frailty, whereas frailty might reduce the levels of IL-4 and PDGF-BB and increase the levels of SCF.
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Affiliation(s)
- Xingzhi Guo
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China; Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an 710068, Shaanxi, China; Xi'an Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Medical Research, Northwestern Polytechnical University, Xi'an 710072, Shaanxi, China
| | - Rong Zhou
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China; Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an 710068, Shaanxi, China
| | - Ge Tian
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China; Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an 710068, Shaanxi, China
| | - Wenzhi Shi
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China; Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an 710068, Shaanxi, China
| | - JuanJuan Lu
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China; Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an 710068, Shaanxi, China
| | - Rui Li
- Department of Geriatric Neurology, Shaanxi Provincial People's Hospital, Xi'an 710068, Shaanxi, China; Shaanxi Provincial Clinical Research Center for Geriatric Medicine, Xi'an 710068, Shaanxi, China; Xi'an Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Medical Research, Northwestern Polytechnical University, Xi'an 710072, Shaanxi, China.
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He L, Yang J, Fang Y. Longitudinal analysis on inflammatory markers and frailty progression: based on the English longitudinal study of aging. Eur Geriatr Med 2024; 15:1323-1330. [PMID: 38987423 DOI: 10.1007/s41999-024-00998-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 05/17/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE Frailty is a common health state that is closely linked to adverse health outcomes in aging society. Although many inflammatory biomarkers have been cross-sectionally associated with frailty, knowledge on the longitudinal association is still limited. This study investigated the associations between inflammatory factors in clinical practice and frailty progression over time. METHODS To investigate the associations of three common inflammatory markers (hypersensitive C-reactive protein [hsCRP], white blood cell [WBC] and fibrinogen) with the progression of frailty. METHODS Data of 2316 participants (age 67.9 ± 6.1 years) were obtained from the English longitudinal study of aging (wave 4, 6 and 8) over an 8-year follow-up. The frailty index (FI) was calculated from 52 items. Mixed-effects models and Cox proportional hazards (Cox-PH) models were used to analyze the associations of hsCRP, WBC and fibrinogen with frailty progression. Values of inflammatory biomarkers were log-transformed. Age, sex and gross wealth were controlled. RESULTS Mixed-effects models showed that at a cross-sectional level, higher levels of hsCRP (β: 0.007, 95% CI 0.004-0.010), WBC (β: 0.021, 95% CI 0.010-0.032) and fibrinogen (β: 0.022, 95% CI 0.005-0.038) were associated with greater FI values while no significant time interaction was found. Cox-PH models showed that higher baseline levels of hsCRP (HR: 1.10, 95% CI 1.03-1.17) and WBC (HR: 1.23, 95% CI 1.10-1.37) were linked to a greater risk of developing frailty within 8 years. CONCLUSIONS We concluded that hsCRP, WBC and fibrinogen can reflect frailty status at a cross-sectional level while only hsCRP and WBC are associated with frailty progression over an 8-year period.
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Affiliation(s)
- Lingxiao He
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Jinzhu Yang
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Ya Fang
- Center for Aging and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
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Yang F, Guo Y. Does Medical Insurance Integration Reduce Frailty Risk? Evidence From Rural Older Adults in China. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae112. [PMID: 38887098 DOI: 10.1093/geronb/gbae112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVES This study aimed to assess the impacts of China's health insurance integration reform on frailty among rural older adults. METHODS Nationally representative longitudinal data with 2,751 adults aged ≥60 years were analyzed from the China Health and Retirement Longitudinal Study 2011-2015. The integration of the rural New Cooperative Medical Scheme and urban Resident Basic Medical Insurance into the unified Urban and Rural Resident Basic Medical Insurance (URRBMI). Frailty Index (FI) summarizes 32 health deficits, quantifying frailty severity with a range of 0-1. Frailty is defined as FI ≥ 0.25, prefrailty as FI: 0.10-0.25, and robustness as FI < 0.10. Frailty worsening, stability, and improvement from 2011 to 2015 were assessed. Difference-in-differences and propensity score matched difference-in-differences models assessed URRBMI integration effects on frailty severity and risk (FI ≥ 0.25) among rural older adults. RESULTS URRBMI integration significantly reduced frailty severity by 15.16% and risk by 9.60% points among rural older adults. Reductions were greatest among initially prefrail individuals, with 27.49% lower frailty severity and a 17.62% point reduction in subsequent frailty onset risk after URRBMI integration. In contrast, no significant benefits were observed for initially robust or frail subgroups following integration. Analyses of frailty transitions corroborated selective benefits, with URRBMI integration lowering the risks of worsening frailty among prefrail but no significant reversal of frailty status among those initially frail or prefrail. DISCUSSION China's URRBMI integration selectively ameliorated frailty progression among rural older adults with prefrail status. Targeting integrated medical insurance policies toward high-risk populations may optimize frailty prevention effects.
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Affiliation(s)
- Fan Yang
- School of Public Health, Fudan University, Shanghai, People's Republic of China
- National Health Commission Key Lab of Health Technology Assessment, Fudan University, Shanghai, People's Republic of China
| | - Yujia Guo
- School of Health Policy & Management, Nanjing Medical University, Nanjing, People's Republic of China
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Naito Y, Yasuda T, Kitae H, Takagi T, Mizushima K, Koyoma T, Inoue R, Ouchi N, Adachi A, Kamitani T, Matoba S. A cross-sectional study on the relationship between nutrient/food intake and gut microbiota in frailty among older community residents: The Kyotango study. J Clin Biochem Nutr 2024; 75:161-173. [PMID: 39345290 PMCID: PMC11425074 DOI: 10.3164/jcbn.24-93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 06/25/2024] [Indexed: 10/01/2024] Open
Abstract
In strategies to extend a healthy lifespan, early detection and prevention of frailty are critical. The purpose of this study was to analyze the current state and clinical risk factors of frailty among community-dwelling older to conduct a cross-sectional analysis of the individuals, correlation between frailty and nutrient intake, dietary diversity, and dietary patterns, and to elucidate the correlation between frailty-related dietary factors and the gut microbiota. The study included 786 participants aged ≥65 years from the Kyotango Multipurpose Cohort Study who had available data on their gut microbiota. Frailty was quantitatively assessed by selecting 32 items from the previously reported frailty index, with those scoring ≥0.21 classified as frailty (n = 119) and those with scores <0.21 as non-frailty (n = 667), followed by group comparisons. The frailty group had significantly higher values and rates than the non-frailty group for the following items: age, obesity (in females only), diabetes, hypertension, history of cancer treatment, polypharmacy, disturbed sleep quality, low physical activity, serum insulin levels, and high-sensitivity C-reactive protein. The frailty group had significantly lower levels of nutrients, including plant proteins, potassium (K), magnesium (Mg), iron (Fe), copper (Cu), vitamins B and C, folic acid, and total, soluble, and insoluble dietary fiber. When analyzed by food groups of dietary fiber, the frailty group had significantly lower intakes of soy products and non-green-yellow vegetables, specifically. The Japanese Diet Index score (rJDI12) was significantly lower in the frailty group, with significant deficiencies in soy products and mushrooms included in the rJDI12. Cluster analysis of the Spearman correlation values between nutrient intake related to frailty and the gut microbiota abundance revealed a positive correlation between the cluster containing dietary fiber and the abundance of the phylum Bacillota, including the [Eubacterium]_eligens_group. In conclusion, our findings clarify the current state of frailty among older community residents and suggest the importance of a diverse range of plant-based foods, including soy products and non-green yellow vegetables, through correlation analysis with nutrients and food groups, and partially reveal the involvement of the gut microbiota.
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Affiliation(s)
- Yuji Naito
- Human Immunology and Nutrition Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Takeshi Yasuda
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Hiroaki Kitae
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Tomohisa Takagi
- Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department for Medical Innovation Translational Medical Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Katsura Mizushima
- Human Immunology and Nutrition Science, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Teruhide Koyoma
- Epidemiology for Community Health and Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Ryo Inoue
- Laboratory of Animal Science, Department of Applied Biological Sciences, Faculty of Agriculture, Setsunan University, Hirakata, Japan
| | - Norihiro Ouchi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Longevity and Community Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Kyotango City Yasaka Hospital, Kyotango, Japan
| | - Atsuo Adachi
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Longevity and Community Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Kyotango City Yasaka Hospital, Kyotango, Japan
| | - Tadaaki Kamitani
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Longevity and Community Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Kyotango City Yasaka Hospital, Kyotango, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
- Department of Longevity and Community Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
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He L, Yang J, Lin S, Shi K, Fang Y. Frailty detection with routine blood tests using data from the english longitudinal study of ageing (ELSA). Eur Geriatr Med 2024:10.1007/s41999-024-01038-2. [PMID: 39190227 DOI: 10.1007/s41999-024-01038-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE Frailty is a rising global health issue in ageing society. Easily accessible and sensitive tools are needed for frailty monitoring while routine blood factors can be potential candidates. METHODS Data from 1907 participants (aged 60 years or above) were collected from the 4th to 9th wave of the English longitudinal study of ageing. 14 blood factors obtained from blood tests were included in the analysis. A 52-item frailty index (FI) was calculated for frailty evaluation. Logistic regression and Cox proportional hazards analysis were used to explore the relationships between baseline blood factors and the incidence of frailty over time respectively. All analyses were controlled for age and sex. RESULTS The mean age of participants was 67.3 years and 47.2% of them were male. Our study identified that 8 blood factors (mean corpuscular haemoglobin, HDL, triglyceride, ferritin, hsCRP, dehydroepiandrosterone, haemoglobin, and WBC) involved in inflammatory, nutritional and metabolic processes were associated with frailty. The combined model with these 8 blood factors had an AUC of 0.758 at cross-sectional level. In the Cox proportional hazards analysis, higher triglyceride (HR: 1.30, 95%CI: 1.07 ~ 1.59), WBC (HR: 1.16, 95%CI: 1.05 ~ 1.28), and lower HDL (HR: 0.58, 95%CI: 0.38 ~ 0.90) at baseline were linked to greater risk of developing frailty within 10 years. Compared to adults without abnormal blood factors at baseline, the hazard ratios of participants with two or more abnormal blood factors were almost twofold higher in developing frailty over time. CONCLUSIONS Routine blood factors, particularly triglyceride, HDL and WBC, could be used for frailty screening in clinical practice and estimate the development of frailty over time.
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Affiliation(s)
- Lingxiao He
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Jinzhu Yang
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Shujing Lin
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Kanglin Shi
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China
| | - Ya Fang
- Center for Ageing and Health Research, School of Public Health, Xiamen University, Xiang'an South Road, Xiamen, 361102, China.
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11
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Liu M, Zeeshan M, Sun T, Hu X, Nie Z, Dong H, Dong G, Ou Y. Association of Air Quality Improvement and Frailty Progression: A National Study across China. TOXICS 2024; 12:464. [PMID: 39058116 PMCID: PMC11280498 DOI: 10.3390/toxics12070464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 06/22/2024] [Accepted: 06/23/2024] [Indexed: 07/28/2024]
Abstract
Accumulating evidence strongly suggests that exposure to ambient air pollution is linked with increased frailty. However, little is known about the effect of improved air quality on frailty progression. We aimed to investigate whether improvements in air quality (PM1, PM2.5, PM10, NO2, and O3) can alleviate frailty progression, particularly in the aftermath of implementation of the "Clean Air Action" policy in China. The study involved 12,891 participants with geocoded environmental data from the nationwide China Health and Retirement Longitudinal Study (CHARLS) during the period from May 2011 to August 2015. Multivariate logistic regression models were used to analyze the association of air pollution improvements and frailty progression. The protective effects were noted for PM1, PM2.5, PM10, and NO2 indices, with an aOR (adjusted odds ratio) ranging from 0.72 to 0.79. Air quality improvement in PM1, PM2.5, PM10, and NO2 could alleviate the progression of frailty. The study is the first to examine the association between the improvement of air quality and the progression of frailty, setting a precedent for the importance of a nationwide clean air policy and its impact on healthy ageing.
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Affiliation(s)
- Mingqin Liu
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China;
| | - Mohammed Zeeshan
- Department of Biochemistry and Structural Biology, University of Texas Health San Antonio, San Antonio, TX 78229, USA;
| | - Tiantian Sun
- Department of Hematology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518000, China;
| | - Xiangming Hu
- Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, China; (X.H.); (Z.N.); (H.D.)
| | - Zhiqiang Nie
- Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, China; (X.H.); (Z.N.); (H.D.)
| | - Haojian Dong
- Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, China; (X.H.); (Z.N.); (H.D.)
| | - Guanghui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yanqiu Ou
- Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China;
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12
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Guven DC, Martinez-Cannon BA, Testa GD, Martins JC, Velasco RN, Kalsi T, Gomes F. Immunotherapy use in older adults with cancer with frailty: A young SIOG review paper. J Geriatr Oncol 2024; 15:101742. [PMID: 38472009 DOI: 10.1016/j.jgo.2024.101742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/04/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Abstract
Immune checkpoint inhibitors (ICIs) became a treatment option in most tumor types and improved survival in patients with cancer in the last decade. Older patients with cancer are underrepresented in the pivotal clinical trials with ICIs. Older patients with cancer often have significant comorbidities and geriatric syndromes like frailty, which can complicate cancer care and treatment decisions. Frailty is among the most prevalent geriatric syndromes in patients with cancer and could lead to inferior survival and a higher risk of complications in patients treated with chemotherapy. However, the effect of frailty on the efficacy and safety of ICIs is understudied. This review focuses on the available evidence regarding the association between frailty and ICI efficacy and safety. Although the survival benefits of ICIs have generally been shown to be independent of age, the available real-world data has generally suggested higher rates of immune-related adverse events (irAEs) and treatment discontinuation in older patients. While international organizations recommend conducting a comprehensive geriatric assessment CGA to assess and address frailty before the start of anti-cancer therapies, an Eastern Cooperative Oncology Group (ECOG) performance status of 2 or higher is frequently used in clinical practice as synonymous with frailty, albeit with significant limitations. The available data has generally demonstrated diminished ICI efficacy in patients with an ECOG 2 or higher compared to patients with better performance status, while the incidence of high-grade irAEs were similar. Whilst evidence regarding outcomes with ICI in older patients and in those with sub-optimal performance status is growing, there is very limited data specifically evaluating the role of frailty with ICIs. These studies found a shortened overall survival, yet no evidence of a lower response rate to ICIs. These patients experienced more AEs, but they did not necessarily have a higher incidence of irAEs.
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Affiliation(s)
- Deniz Can Guven
- Medical Oncology Clinic, Health Sciences University, Elazig City Hospital, Elazig, Turkey.
| | | | - Giuseppe Dario Testa
- Division of Geriatric and Intensive Care Medicine, University of Florence and Azienda Ospedaliero Universitaria Careggi, Largo Brambilla 3, 50139 Florence, Italy
| | | | - Rogelio N Velasco
- Clinical Trial and Research Division, Philippine Heart Center, Quezon City, Philippines
| | - Tania Kalsi
- Department of Ageing and Health, Guys and St Thomas' NHS Foundation Trust, London, UK
| | - Fabio Gomes
- Medical Oncology Department, The Christie NHS Foundation Trust, Manchester, UK
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13
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Yu BY, Hu XM, Matala R, Mo YH, Liu JL, Jin JG, Zhang SH, Ou YQ, Yang Y, Dong HJ. Association between trajectories of systolic blood pressure and frailty outcome in middle-aged and older adults. J Nutr Health Aging 2024; 28:100202. [PMID: 38460319 DOI: 10.1016/j.jnha.2024.100202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/06/2024] [Accepted: 02/11/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES The association between blood pressure and frailty outcome in the middle-aged and older population remains controversial. This study aimed to examine the relationship between trajectories of systolic blood pressure (SBP) and new-onset frailty. DESIGN Cohort study with a 7-year follow-up. SETTING AND PARTICIPANTS Data were derived from 4 waves (2011, 2013, 2015 and 2018) of the China Health and Retirement Longitudinal Study and 6168 participants aged ≥45 years were included in the study. METHODS The frailty index (FI) was constructed based on 40 scored items, with FI ≥ 0.25 defined as frailty. We identified the 5-year trajectory of SBP by latent class trajectory modeling. The association between SBP trajectories and frailty was explored based on hazard ratios (HR) by four Cox proportional hazards models. Furthermore, we also investigated the relationship between mean SBP and systolic blood pressure variability (SBPV) and frailty. RESULTS 6168 participants were included in this study with a mean age of 59 years. We identified five trajectories based on SBP, which are maintained low-stable SBP (T0), moderate-stable SBP (T1), remitting then increasing SBP (T2), increasing then remitting SBP (T3), and remaining stable at high SBP levels (T4). During the 7-year follow-up period, frailty outcome occurred in 1415 participants. After adjusting for other confounders, the two trajectories labeled "T2" and "T4" were associated with a higher risk of frailty compared with T0. In addition, elevated SBP and increased SBPV were associated with risk of frailty. CONCLUSIONS Higher risk of frailty occurred in two trajectories, remitting then increasing and remaining stable at high SBP levels, were associated with a relatively higher risk of frailty.
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Affiliation(s)
- B Y Yu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - X M Hu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - R Matala
- Department of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany, One University Place, Rensselaer, NY, 12144
| | - Y H Mo
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - J L Liu
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - J G Jin
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - S H Zhang
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Y Q Ou
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China
| | - Y Yang
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China.
| | - H J Dong
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 510080, China; Nyingchi People's Hospital, Nyingchi, 860000, Tibet, China.
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Yu L, Guo Z, Long Q, Zhao X, Liu Y, Cao X, Zhang Y, Yan W, Qian QQ, Chen J, Teng Z, Zeng Y. Modifiable Lifestyle, Sedentary Behaviors and the Risk of Frailty: A Univariate and Multivariate Mendelian Randomization Study. Adv Biol (Weinh) 2024; 8:e2400052. [PMID: 38532244 DOI: 10.1002/adbi.202400052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/11/2024] [Indexed: 03/28/2024]
Abstract
This research conducted a two-sample univariate and multivariate Mendelian Randomization (MR) analysis to explore the causal link between different types of leisure sedentary behavior (LSB) and frailty. Independent instrumental variables significantly associated with sedentary behaviors (p < 5 × 10-8) are obtained from a genome-wide association study (GWAS) of 422,218 individuals, and Frailty Index (FI) are derived from the latest GWAS dataset of 175,226 individuals. MR analysis is conducted using inverse variance weighting, MR-Egger, weighted median, simple mode, and weighted mode, supplemented by MRAPSS. Univariate MR revealed that sedentary behaviors such as watching television increased the risk of frailty (OR, 1.271; 95% CI: 1.202-1.345; p = 6.952 × 10-17), as sedentary driving behaviors are done (OR, 1.436; 95% CI: 1.026-2.011; p = 0.035). Further validation through APSS, taking into account cryptic relatedness, stratification, and sample overlap, maintained the association between television viewing and increased frailty risk (OR, 1.394; 95% CI: 1.266-1.534; p = 1.143 × 10-11), while the association with driving dissipated. In multivariate inverse variance weighted (IVW) analysis, after adjusting for C-reactive protein (CRP) levels, television Sedentary behavior (SB) inversely affected frailty (OR, 0.782; 95% CI: 0.724-0.845; p = 4.820 × 10-10). This study indicates that televisio SB significantly increases the risk of frailty, suggesting potential biological heterogeneity behind specific sedentary activities. This process may interact with inflammation, influencing the development of frailty.
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Affiliation(s)
- Ling Yu
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Zeyi Guo
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Qing Long
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Xinling Zhao
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Yilin Liu
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Xiang Cao
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Yunqiao Zhang
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Weimin Yan
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Qing Qing Qian
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Jian Chen
- Department of Gastroenterology, Nanchong Central Hospital, Nanchong, Sichuan Province, 637000, China
| | - Zhaowei Teng
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
| | - Yong Zeng
- Department of Psychiatry, the Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, 650101, China
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15
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Pan Y, Ma L. Inflammatory Markers Associated with Physical Frailty and Cognitive Impairment. Aging Dis 2024; 16:859-875. [PMID: 38739942 PMCID: PMC11964426 DOI: 10.14336/ad.2024.0258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/17/2024] [Indexed: 05/16/2024] Open
Abstract
In older adults, physical frailty and cognitive impairment contribute to adverse outcomes. However, the research on mechanisms underlying physical frailty and cognitive impairment is limited. Low-grade chronic inflammation is a characteristic of aging. Particularly, an imbalance in pro- and anti-inflammatory mechanisms may be involved in frailty and neurodegenerative disorders. Therefore, exploring the inflammatory markers of physical frailty and cognitive impairment is crucial to fully understanding these mechanisms and establishing a substantial link between these two disorders. Notably, few studies have focused on exploring inflammatory markers in both physical frailty and cognitive impairment, posing a major challenge in elucidating the link between them. Therefore, substantial efforts are required for the better prevention of physical frailty and cognitive impairment. In this review, we explored the role of inflammatory markers as a potential link between frailty and cognitive impairment.
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Affiliation(s)
| | - Lina Ma
- Correspondence should be addressed to: Dr. Lina Ma, Xuanwu Hospital Capital Medical University, National Research Center for Geriatric Medicine, Beijing 100053, China.
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16
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Yang C, Su G. Letter to the Editor: prevalence and associated factors of frailty in patients with chronic kidney disease: a cross-sectional analysis of PEAKING study. Int Urol Nephrol 2024; 56:1201-1202. [PMID: 37676385 DOI: 10.1007/s11255-023-03780-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023]
Affiliation(s)
- Changyuan Yang
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510000, China
| | - Guobin Su
- Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, The Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, 510000, China.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, 11228, Stockholm, Sweden.
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17
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Chehrehgosha M, Sharifi A, Meftah AM, Maleki H, Sajjadi-Jazi SM, Baharifar H, Khoshnevisan K, Sharifi F. Demographic and biological factors in interrelationships between physical, cognitive, psychological, and social frailty in community-dwelling older adults: Data from the Birjand Longitudinal Aging Study (BLAS). Maturitas 2024; 181:107905. [PMID: 38237276 DOI: 10.1016/j.maturitas.2023.107905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 12/23/2023] [Accepted: 12/30/2023] [Indexed: 02/05/2024]
Abstract
Complex interrelationships may exist among different types of frailty. This study aimed to evaluate the demographic and biological factors that influence the different types of frailty in community-dwelling older adults in Iran through a cross-sectional analysis of data obtained from the Birjand Longitudinal Aging Study. This study is an ongoing cohort study of people aged 60 years and over and employed a multistage stratified cluster random sampling. Anthropometric measures were obtained by nurses. The "Fried frailty phenotype" was defined as physical frailty. Cognitive frailty was assessed using the Mini-Mental State Examination. Social frailty was evaluated by some questions, and psychological frailty was assessed using a patient health questionnaire. Blood samples were taken after overnight fasting. All statistical analyses were performed using Stata12 (Texas, USA) and Python. Some type of frailty had been experienced by 62.27 % of the older adults. Cognitive frailty was the dominant type of frailty (55.69 %). Based on multivariate regression analysis, age, sex, education, and marital status were the influencing factors in all types of frailty. Network analysis revealed that physical, cognitive, psychological, and social frailty had synergistic effects on each other, and age and sex had dominant interactions with frailty types. Cognitive frailty was dominant compared with other types of frailty, indicating the need to detect cognitive frailty at the earliest stage and to implement an appropriate program to manage cognitive frailty in older adults.
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Affiliation(s)
- Maryam Chehrehgosha
- Department of Surgical Technology, Paramedical School, Golestan University of Medical Sciences, Gorgan 4934174515, Iran; Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran 1411713137, Iran
| | - Ali Sharifi
- Master of Artificial Intelligence, Faculty of Electronic and Computer Engineering, Tarbiat Modarres University, Tehran, Iran
| | | | - Hassan Maleki
- Nano Drug Delivery Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sayed Mahmoud Sajjadi-Jazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran 1411713137, Iran
| | - Hadi Baharifar
- Department of Biomedical Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Kamyar Khoshnevisan
- Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering and Applied Cell Sciences, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran 1411713137, Iran.
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18
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Guo XG, Zhang YJ, Lu YX, Lu JM, Zhang J, Li HX, Chen CJ, Yang JJ. Causal association between genetically predicted circulating immune cell counts and frailty: a two-sample Mendelian randomization study. Front Immunol 2024; 15:1336498. [PMID: 38322263 PMCID: PMC10844461 DOI: 10.3389/fimmu.2024.1336498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/08/2024] [Indexed: 02/08/2024] Open
Abstract
Background Despite the recognized link between immune responses and frailty, the association between immune cell counts and frailty based on previous observational studies remains disputed, with uncertain causal nexus. This study aimed to elucidate causal association between genetically predicted circulating immune cell counts and frailty. Methods We conducted the two-sample Mendelian randomization (MR) study with independent genetic variants associated with six immune cell subtype counts from genome-wide association studies in 563,946 European individuals. Frailty summary data, assessed via frailty index (FI), was obtained from study comprising 175,226 subjects. Univariate MR, reverse MR and multivariate MR were conducted to comprehensive investigate the association between immune cell counts and FI, with two-step MR analysis for mediation analysis. Results Univariate MR evidence indicated that among six leukocyte subtype counts, only elevated eosinophil count was significantly correlated with higher FI (β = 0.059, 95% confidence interval [CI], 0.042-0.078, P=5.63E-11), with no reverse causal relationship identified in reverse MR. In multivariate MR, the causal effect of eosinophil count retained statistical significance (β = 0.063, 95% CI, 0.021-0.104, P = 0.003). Ultimately, the two-step MR analysis demonstrated two mediators in this causal pathway: asthma (β= 0.019, 95% CI, 0.013-0.025, P = 35.84E-10, mediated proportion, 31.732%) and rheumatoid arthritis (β= 0.004, 95% CI, 0.001-0.006, P=1.75E-03, mediated proportion, 6.411%). Conclusions Within immune cell subtypes, MR evidence indicated only genetically predicted circulating eosinophil count had irreversible and independent causal effect on frailty, with asthma and rheumatoid arthritis possibly serving as partial mediators. The finding stressed the need for further exploring physiological functions of eosinophils in order to develop effective strategies against frailty.
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Affiliation(s)
- Xiao-Guang Guo
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ya-Juan Zhang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ya-Xin Lu
- Big Data and Artificial Intelligence Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jia-Mei Lu
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jie Zhang
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui-Xin Li
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Chao-Jin Chen
- Big Data and Artificial Intelligence Center, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Department of Anesthesiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian-Jun Yang
- Department of Anesthesiology, Pain and Perioperative Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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19
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Wu L, Zhao XH, Zhou SX, Jiang JJ. Genetic predisposition to white blood cells in relation to the risk of frailty. Aging Clin Exp Res 2023; 35:3023-3031. [PMID: 37923935 DOI: 10.1007/s40520-023-02609-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/24/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Observational studies have suggested an association between white blood cells (WBCs) and frailty, but considering the susceptibility to reverse causality and confounding, the causal direction and magnitude of this association remain ambiguous. Our aim was to investigate the causal effect of WBCs on frailty by means of a Mendelian randomization (MR) analysis. METHODS Based on the genome-wide association study (GWAS) summary statistics data provided by the European Bioinformatics Institute (EBI), we carried out a two-sample MR study. We applied the genetically predicted independent WBCs from GWAS as a measure of exposure data. The Rockwood Frailty Index (FI) was used as outcome measure, which was derived from a meta-analysis from GWAS in UK Biobank European ancestry participants and Swedish TwinGene participants. Our study applied inverse variance weighted (IVW), weighted median, Mendelian randomization-Egger (MR-Egger) and outlier test (MR-PRESSO) methods to explore relationships between various WBCs and frailty. RESULTS In our study, a possible causal relationship between eosinophil levels and frailty was demonstrated by two-sample MR analysis. Eosinophils were associated with FI (beta:0.0609; 95% CI 0.0382, 0.0836; P = 1.38E-07). Our results suggest that as the level of eosinophils increases, so does the risk of frailty. No meaningful causal relationship between neutrophils, lymphocytes, monocytes or basophils and FI was found in the MR results (P > 0.05). CONCLUSIONS According to this MR study, higher eosinophil counts are related to an increased risk of frailty. To validate these findings and investigate the mechanisms underlying these connections, future studies are warranted.
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Affiliation(s)
- Li Wu
- Department of Geriatics, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
- Key Laboratory of Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases of Zhejiang Province, Hangzhou, 310003, China
| | - Xiao-Hong Zhao
- Department of Geriatics, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
- Key Laboratory of Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases of Zhejiang Province, Hangzhou, 310003, China
| | - Shi-Xian Zhou
- Department of Geriatics, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China
- Key Laboratory of Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases of Zhejiang Province, Hangzhou, 310003, China
| | - Jing-Jin Jiang
- Department of Geriatics, The First Affiliated Hospital, School of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, 310003, Zhejiang, China.
- Key Laboratory of Diagnosis and Treatment of Aging and Physic-Chemical Injury Diseases of Zhejiang Province, Hangzhou, 310003, China.
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Guan L, Liu Q, Yao Y, Wang L, Peng Y, Chen S, Zhou L, Zheng X. Do neutrophil to lymphocyte ratio and platelet to lymphocyte ratio associate with frailty in elderly inpatient with comorbidity? Exp Gerontol 2022; 169:111955. [PMID: 36122594 DOI: 10.1016/j.exger.2022.111955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Inflammation is one of the pathogenesis of frailty, Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) are newly proposed inflammatory indicators. This study aimed to explore the relationship between NLR, PLR and frailty in elderly inpatient with comorbidity. METHODS Inpatient elderly with comorbidity in our geriatric department from January 2015 to December 2018 were selected, and three groups, which included frailty, pre-frailty and robust, were divided by 5-item FRAIL scale. General data of the patients were collected, and comprehensive geriatric assessment was performed. NLR and PLR were calculated by neutrophil, lymphocyte and platelet in blood. SPSS24.0 software was used for analysis. RESULTS CONCLUSION: Although results from the present study revealed associations between frailty and neutrophil and NLR in elderly inpatient with comorbidity, the potential role of these inflammation indicators on frailty needs further prospective investigation and researches involving larger population to improve its reliability.
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Affiliation(s)
- Lijuan Guan
- Department of gerontology and geriatrics, Chengdu Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China; Chengdu-Montpellier Geriatric Research Center, Chengdu 611130, China.
| | - Qian Liu
- Department of gerontology and geriatrics, Chengdu Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China; Chengdu-Montpellier Geriatric Research Center, Chengdu 611130, China
| | - Yao Yao
- Department of gerontology and geriatrics, Chengdu Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China; Chengdu-Montpellier Geriatric Research Center, Chengdu 611130, China
| | - Lingxiao Wang
- Department of gerontology and geriatrics, Chengdu Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China; Chengdu-Montpellier Geriatric Research Center, Chengdu 611130, China
| | - Yang Peng
- Department of gerontology and geriatrics, Chengdu Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China; Chengdu-Montpellier Geriatric Research Center, Chengdu 611130, China
| | - Shanping Chen
- Department of gerontology and geriatrics, Chengdu Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China; Chengdu-Montpellier Geriatric Research Center, Chengdu 611130, China
| | - Lihua Zhou
- Department of gerontology and geriatrics, Chengdu Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China; Chengdu-Montpellier Geriatric Research Center, Chengdu 611130, China
| | - Xiaomei Zheng
- Department of gerontology and geriatrics, Chengdu Fifth People's Hospital affiliated to Chengdu University of Traditional Chinese Medicine, Chengdu, China; Chengdu-Montpellier Geriatric Research Center, Chengdu 611130, China
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