Elderly Group Research Articles

Clinical characteristics and influencing factors of anti-PD-1/PD-L1-related severe cardiac adverse event: based on FAERS and TCGA databases.

Combining the FDA Adverse Event Reporting System (FAERS) and the Cancer Genome Atlas (TCGA) databases, we aim to explore the factors that influence anti-programmed cell death protein-1 inhibitors/programmed death-ligand-1 (PD-1/PD-L1) related severe cardiac adverse events (cAEs). We obtained anti-PD-1/PD-L1 adverse event reports from January 2014 to December 2022 from the FAERS database. Disproportionality analysis was performed to find anti-PD-1/PD-L1-related cAEs using the proportional reporting ratio (PRR). We were exploring influencing factors based on multivariate logistic regression analysis. Finally, we utilized a strategy that combines FAERS and TCGA databases to explore the potential immune and genetic influencing factors associated with anti-PD-1/PD-L1-related severe cAEs. Reports of severe cAEs accounted for 7.10% of the overall anti-PD-1/PD-L1 adverse event reports in the FAERS database. Immune-mediated myocarditis (PRR = 77.01[59.77-99.23]) shows the strongest toxic signal. The elderly group (65-74: OR = 1.34[1.23-1.47], ≥ 75: OR = 1.64[1.49-1.81]), male (OR = 1.14[1.05-1.24]), anti-PD-L1 agents (OR = 1.17[1.03-1.33]), patients with other adverse events (OR = 2.38[2.17-2.60]), and the concomitant use of proton pump inhibitor (OR = 1.29[1.17-1.43]), nonsteroidal anti-inflammatory drugs (OR = 1.17[1.04-1.31]), or antibiotics (OR = 1.24[1.08-1.43]) may increase the risk of severe cAEs. In addition, PD-L1 mRNA (Rs = 0.71, FDR = 2.30 × 10- 3) and low-density lipoprotein receptor-related protein 3 (LRP3) (Rs = 0.82, FDR = 2.17 × 10- 2) may be immune and genetic influencing factors for severe cAEs. Severe cAEs may be related to antigen receptor-mediated signalling pathways. In this study, we found that age, gender, anti-PD-1/PD-L1 agents, concomitant other adverse events, concomitant medication, PD-L1 mRNA, and LRP3 may be influencing factors for anti-PD-1/PD-L1-related severe cAEs. However, our findings still require a large-scale prospective cohort validation.

Enhancing pharmacist intervention targeting based on patient clustering with unsupervised machine learning

ABSTRACT Objectives Adherence to the American Diabetes Association (ADA) Standards of Medical Care is low. This study aimed to assist pharmacists in identifying patients for diabetes control interventions using unsupervised machine learning. Methods This study analyzed the 2021 Medical Expenditure Panel Survey and used a k-mode cluster analysis. Patient features analyzed were adherence to a select set of preventive measures from the ADA Standards of Medical Care (HbA1c test, foot examination, blood cholesterol test, dilated eye examination, and influenza vaccination) and some patient characteristics (age, gender, health insurance, insulin use, and diabetes-related complications). Results The study included 1,219 patients with self-reported diabetes, and the adherence rate to the ADA standards was 33.72%. Five distinct clusters emerged: (A) moderate-complexity, privately insured male; (B) moderate-complexity, publicly insured female; (C) low-complexity, privately insured female; (D) high-complexity, publicly insured female; (E) moderate-complexity, publicly insured male. Groups B, C, and E exhibited nonadherence. Conclusions Pharmacists can target publicly insured elderly (Groups B and E) and privately insured middle-aged females (Group C) for interventions. For instance, pharmacists may help patients in Groups B and E locate existing resources in their insurance program and remind those in Group C of the importance of adequate diabetes care.

The Importance of Orthostatic Increase in Pulse Wave Velocity in the Diagnosis of Early Vascular Aging.

Background/Objectives: Vascular aging can be assessed by arterial stiffness measured through pulse wave velocity (PWV). Increased PWV predicts arterial hypertension, cardiovascular events and all-cause mortality. Detection of early signs of vascular aging remains an unmet problem. To search for the most sensitive markers for the early increase in vascular stiffness in a healthy population. Methods: One-hundred and twenty healthy subjects were divided in three equal age groups: <30 years, 30-45 years and >45 years. Head-up tilt test (HUTT) protocol was applied, providing a standardized hydrostatic column height. PWV at the brachial-ankle artery site (baPWV) was measured using a multichannel sphygmomanometer ABI System 100 PWV in three positions: in the baseline horizontal (supine) position-baPWVb; during the head tilt-up with an individual angle of inclination-baPWVt; and when returning to supine. Results: The most sensitive marker of early stiffness increase in a healthy population is the relative orthostatic increase in baPWV, ΔbaPWV/baPWVb, where ΔbaPWV = baPWVt - baPWVb. The significance of differences in this parameter between the young and elderly groups reached p = 0.000075 and p = 0.000006, respectively. Conclusions: The proposed index ΔbaPWV/baPWVb can be considered as a promising sensitive early biomarker of vascular aging and as a potential effective indicator in cardiovascular prevention. A longitudinal cohort study is needed to confirm this assumption.

Global, regional, and national burden and trends of air pollution-related neoplasms from 1990 to 2019: An observational trend study from the Global Burden of Disease Study 2019

BackgroundAir pollution-related neoplasms are a major global public health issue and are one of the leading causes of death worldwide. Air pollution is one of the important risk factors of air pollution-related neoplasms and is associated with a variety of air pollution-related neoplasms.The primary objective of this study was to estimate the epidemiological patterns of death rates and disability-adjusted life years (DALYs) associated with air pollution-related neoplasms on a global scale, covering the period from 1990 to 2019. Furthermore, we aimed to predict the trends in these epidemiological patterns up to 2050. By achieving these goals, our study seeks to provide a comprehensive understanding of the potential causes underlying the observed disparities in neoplasm-related health outcomes, ultimately contributing to the development of effective strategies for addressing this major public health issue. MethodsBased on data from the 2019 Global Burden of Disease (GBD) study, the indicators of the air pollution-related neoplasms disease burden was the numbers and age-standardized rates (ASR) of deaths and disability-adjusted life years (DALYs) from 1990 to 2019. First, we compared the burden of air pollution-related neoplasms and temporal trends by gender, age, socio-demographic index (SDI), region, and country. Furthermore, driving factors and improvement potential were evaluated using decomposition and frontier analysis. Finally, forecasting analyses of the changing trend in the burden of air pollution-related neoplasm up to 2050 was conducted based on time series forecasting models. ResultsIn 2019, air pollution-related neoplasms accounted for 387.45 million (95 % UI 288.04–490.06 million) deaths and 8951.97 million (95 % UI 6680.89–11342.60 million) DALYs globally. Deaths and DALYs demonstrated an upward trend from 1990 to 2019, while their ASR showed a downward trend. The disease burden and the decline degree of males were both significantly higher than that of females, and the high burden was mainly in the elderly groups. The middle SDI region possessed the highest burden with the most significant upward trend, while the high SDI region had the lowest burden with the most significant downward trend. Decomposition analyses represented that the increase in the overall deaths and DALYs of air pollution-related neoplasms was mainly driven by population growth. The predictive analyses expected that the deaths and DALYs of air pollution-related neoplasms will continue to rise, while their corresponding ASR will decrease by 2050. ConclusionThe global burden of air pollution-related neoplasms remained high, and deaths and DALYs will be on upward trends up to 2050, with differences among genders, ages, SDI levels, GBD regions, and countries. It is essential to understand the air pollution-related neoplasm burden and contributing epidemiological factors for implementing effective and factor-tailored interventions to reduce the global burden.

Network infrastructure and individual mental health: evidence from China

ABSTRACT Network infrastructure has changed people’s daily life through digital transformation, thus influencing social welfare and individual health. Based on the quasi-natural experiment ‘Broadband China Strategy’, this study investigates the impact of network infrastructure construction on individual mental health by utilizing a multi-period difference-in-differences model with data from China Family Panel Studies (2010–2018). The empirical results confirm that the network infrastructure construction significantly enhances the individual mental health of residents. The impact channel tests reveal that network infrastructure construction promotes individual mental health through income improving and consumption upgrading. Furthermore, heterogeneity analysis suggests that the ‘Broadband China’ strategy has a more substantial impact on individual mental health in lower educated, middle-aged and elderly groups.

Relationship of SOD-1 Activity in Metabolic Syndrome and/or Frailty in Elderly Individuals.

Although aging is a natural phenomenon, in recent years it has accelerated. One key factor implicated in the aging process is oxidative stress. Oxidative stress also plays a role in frailty (frail) and metabolic syndrome (MetS). A total of 66 elderly persons (65 years old and older) with no acute or severe chronic disorders were assessed for waist circumference (WC), arterial blood pressure, glycemia, glycated hemoglobin (HbA1c), plasma lipids, and activity of erythrocyte superoxide dismutase (SOD-1). Patients were classified as NonMetS-Nonfrail (n = 19), NonMetS-frail (n = 20), MetS-Nonfrail (n = 17), or MetS-frail (n = 10). There were no significant differences in superoxide dismutase activity among investigated elderly groups. However, the data suggest that MetS individuals, both frail and nonfrail, have higher risk factors for cardiovascular disease compared to NonMetS individuals. The correlations analyses of SOD-1 and other metabolic indices suggest that SOD-1 levels may be influenced by age, total cholesterol, HDL cholesterol, and fasting glucose levels in certain groups of seniors. Aging is associated with decreased antioxidant enzyme SOD-1 activity with glucose alteration in frailty syndrome as well as with lipids disturbances in metabolic syndrome. These factors provide a nuanced view of how frailty and metabolic syndrome interact with various health parameters, informing both clinical practice and future research directions.

A real-world data analysis of distribution and inconsistency between total serum IgE and allergen-specific IgE results in clinical practice.

The inconsistency between serum total IgE (tIgE) and allergen-specific IgE (sIgE) results is often encountered in clinical practice, but the distribution and influencing factors of the inconsistent results have not been fully understood. The aim of this study was to analyze the distribution and inconsistency between tIgE and sIgE test results. A retrospective study, from the electronic medical records of 2139 patients who underwent both tIgE and sIgE tests, from January to December 2023 was reviewed. The tIgE and sIgE results and their distribution, as well as their inconsistency, were analyzed based on sex, age, and disease subgroups. 36.2% of the patients had a positive sIgE, and 43.7% had an elevated tIgE level. sIgE and tIgE results were discordant in nearly 30% of patients, with no difference between genders, while individuals aged over 60 exhibited a significantly higher inconsistency rate than the other age groups, and the inconsistency rate between tIgE and sIgE results was significantly different among different tIgE levels, sIgE grades, positive allergen count and positive allergen types. In addition, patients with chronic urticaria (CU) had a higher inconsistency rate than those with other allergic diseases, but the difference was not statistically significant. The overall inconsistency rate between tIgE and sIgE results was about 30%. The elderly group older than 60 years old is more likely to have inconsistent results, and tIgE level, sIgE level, the number and type of positive allergens also affected the consistency of tIgE and sIgE results.

Features of the expression of genes of antimicrobial peptides and the microbiome at the level of the mucous membrane of the upper respiratory tract during aging

Today, the proportion of elderly and senile people is steadily growing throughout the world. The most important factors in the first line of immune defense of the mucous membranes of the upper respiratory tract are β-defensins, which are a group of secretory proteins with antimicrobial activity. The aim of this study was to study the expression of genes for antimicrobial peptides β-defensins and the composition of the microbiome of the mucous membranes of the upper respiratory tract in elderly people and long-livers with various aging phenotypes.The main study group included 67 centenarians and 49 elderly people, who were further divided into two subgroups depending on the course of aging (pathological and successful aging). Nucleic acids were isolated from nasopharyngeal scrapings and the expression levels of the DEFB1 and DEFB4 genes were determined using real-time polymerase chain reaction. The composition of the microbiota in nasopharyngeal swabs was determined by MALDI-TOF mass spectrometry.In analyzing the expression of the DEFB1 gene in elderly people and centenarians with successful and pathological aging phenotypes, no difference was revealed between the groups. Expression of the DEFB4 gene was increased in centenarians with pathological aging compared to centenarians with successful aging and in the elderly group. Excessive production of antimicrobial peptides is dual in nature; on the one hand, they provide the first line of defense against microorganisms, and on the other, they are cytotoxic to their own cells. An increase in the expression of the DEFB4 gene during aging may be due to an increase in the number of pathogen-associated molecular patterns, which can be one’s own microbiota and/or components of microbial metabolism. Analysis of the microbiota composition showed an increase in biodiversity in individuals with a successful aging phenotype compared to a pathological phenotype. Particular attention is paid to Staphylococcus spp., the species composition of which depends on the aging phenotype. In the pathological aging group, the frequency of St. aureus colonization is significantly higher than in the successful aging group.Thus, overexpression of the DEFB4 gene and changes in the composition of the microbiota of the mucous membranes of the upper respiratory tract may be one of the mechanisms explaining the increased susceptibility to infections in various aging phenotypes.

Flap‐Based Lower Extremity Reconstruction in the Elderly—Is It Safe and Does Age Impact Ambulation?

ABSTRACTIntroductionLower extremity (LE) reconstruction in the elderly population presents a multifaceted challenge, primarily due to age‐related degenerative changes, comorbidities, and functional decline. Elderly individuals often encounter conditions such as osteoarthritis, osteoporosis, and cardiovascular and peripheral artery disease (PAD), which can severely compromise the structural integrity and function of the lower limbs. As such, we aim to assess postoperative complications and functional recovery following LE reconstruction in elderly patients.MethodsPatients ≥ 18 years who underwent post‐traumatic LE reconstruction with flap reconstruction at a Level 1 trauma center between 2007 and 2022 were included. Patient demographics, flap/wound characteristics, complications, and ambulation for the elderly (≥ 60 years old) and the control (&lt; 60 years old) cohorts were recorded. The primary outcome was final ambulation status, modeled with logistic regression. Secondary outcomes included postoperative complications.ResultsThe mean ages of the control (n = 374) and elderly (n = 49) groups were 37.4 ± 12.6 and 65.8 ± 5.1 years, respectively. Elderly patients more frequently required amputation after flap surgery (p = 0.002). There was no significant difference between the two cohorts in preoperative ambulation status (p = 0.053). Postoperatively, 22.4% of elderly patients were independently ambulatory at final follow‐up, compared to 49.5% of patients &lt; 60. Of the elderly, 14.3% could ambulate with an assistance device (cane, walker, etc.), compared to 26.5% in the control group. A wheelchair was required for 46.9% of elderly patients, significantly higher than the 22.7% of those &lt; 60 years of age (p &lt; 0.001). Multivariate regression confirmed an association between older age and nonambulatory final status (p = 0.033).ConclusionLE reconstruction can likely be performed safely in patients 60 years of age or older. However, older age is independently associated with significantly worse postoperative ambulation. Preoperative assessment, including gait and muscle strength, and early initiation of postoperative rehabilitation can potentially improve ambulation in elderly individuals undergoing LE reconstruction.

Research on Universal Design of Smart Home Interface Navigation Based on Visual Interaction

The study focuses on analyzing the design characteristics of display and control interface navigation in smart home terminals for users of different ages. By examining the design features of the current typical smart home terminal display and control interface navigation, interface navigation design is the research object. Experimental research is conducted with young adult group (n = 15) and middle-aged to elderly group (n = 15) participants to identify the optimal interface navigation design through specific behavioral indicators, eye movement indicators, and subjective indicators. The results show that different interface layouts impact task completion performance. Middle-aged and older individuals perform better with multi-level highlighting operations. Both age groups prefer interface layouts featuring less-level dual navigation, specifically the left-side type, and multi-level highlighting. These results can improve the versatility of smart home interface design, expand the user base, and provide information for developing smart products.

Relationship Between Oral Hypofunction and Nutritional Status in Patients Treated With Maxillofacial Prostheses.

Introduction Patients who have jaw or tongue defects owing to head and neck cancer or congenital disease suffer from oral dysfunction such as speech, swallowing, and mastication. Although maxillofacial prostheses are applied to improve oral functions, their oral functions remain compromised compared to those of patients without jaw or tongue defects. On the other hand, it has been reported that oral hypofunction could lead to malnutrition in the general elderly. However, to date, no reports have evaluated the relationship between oral function and nutritional status in patients with maxillofacial prostheses. In this study, we comprehensively evaluated oral function according to the examination items for oral hypofunction. We assessed which functions were related to nutritional status in patients with jaw defects caused by tumors or congenital diseases who are candidates for maxillofacial prosthetic treatment. Methods Patients who underwent prosthetic treatment at the Department of Maxillofacial Prosthodontics, Aichi-Gakuin University Dental Hospital, between May 2021 and January 2024 and who were doing well were included in the study. Oral function was assessed with seven tests according to the criteria of the Japanese Society of Geriatric Dentistry, and nutritional status was evaluated using the Mini Nutritional Assessment Short-Form (MNA-SF). Patients were classified according to age and type of deficiency. Additionally, the presence or absence of oral hypofunction and malnutrition or risk of malnutrition were assessed. The impact of oral hypofunction tests and defect status on the risk of malnutrition was evaluated using a logistic regression model. Results Oral hypofunction and malnutrition or risk of malnutrition were more frequent in the elderly group by age. Regarding the type of defect, the rate of oral hypofunction and malnutrition or risk of malnutrition was highest in the tongue defect group. Results of the logistic regression analysis indicated that nutritional status was associated with tongue deficiency, tongue-lip motor function, tongue pressure, and swallowing function. Conclusion The nutritional status of maxillofacial prosthetic wearers was associated with oral hypofunction. Particularly, malnutrition and risk of malnutrition were increased with tongue defects and deficiencies in tongue-lip motor function, tongue pressure, and swallowing.

Acute Diarrhea in a Tertiary Emergency Department: From Readmission Determinants to Antibiotic Prescription.

Acute diarrhea represents a major public health issue, and the management of adult patients admitted to the emergency department (ED) for this problem is still challenging. In a retrospective analysis on more than 20,000 patients visiting a tertiary ED for acute diarrhea and then being discharged home, we found that age > 65 years, onset of symptoms > 24 h since ED admission, refusal of hospitalization, and a history of chronic renal and liver diseases were independently associated with ED readmission for abdominal symptoms within 7 days. In the younger group, the presence of comorbidities significantly impacted on ED readmission, while fever and alteration of serum creatinine were the main determinants in the older group. Antibiotics were prescribed in about 25% of patients, although diarrhea etiology (viral or bacterial) was usually not available. According to international guidelines, fluoroquinolones were the most prescribed class, showing an inverse correlation to ED readmission. However, β-lactams and probiotics were also commonly prescribed; the latter were independently correlated to ED readmission in the elderly group. A comprehensive, guideline-based approach, including a detailed clinical history and laboratory and comorbidity assessment, should be encouraged to support physicians in the management of different age subgroups of adults admitted to the ED for acute diarrhea.

Relationship between paraspinal muscle morphology and function in different directions in a healthy Chinese population at different ages: a cross-sectional study

BackgroundParaspinal muscle degeneration occurs with age; however, it is unknown whether strength and endurance change with muscle cross-sectional area (CSA) and fatty infiltration (FI) parameters in Chinese healthy individuals.MethodsA total of 94 asymptomatic Chinese volunteers were enrolled in this study. The participants were divided into three groups: young (20–39 years old, n = 27), middle-aged (40–59 years old, n = 49), and elderly (≥ 60 years old, n = 18). CSA and FI of the psoas (PS), quadratus lumborum (QL), multifidus (MF), and erector spinae (ES) were measured using magnetic resonance imaging. The Bionix Sim3 Pro was used to evaluate the maximum isometric torque and the Ito test to evaluate endurance.ResultsThe CSA of the PS and ES in the elderly group was smaller than those in the other groups, while the CSA of QL in the young group was larger than that in the other groups. There were differences in the MF and ES FI among the three groups. The maximum isometric torque and endurance test time decreased with increasing age; however, these differences were not statistically significant. Maximum isometric torque positively correlated with the average paraspinal muscle CSA and negatively correlated with the torque and FI of the MF and ES muscles. The endurance test was found to be positively correlated with the FCSA of the MF and to be negatively correlated with the FI of the MF and ES. PS and QL can predict the maximum isometric torque, and MF and PS can predict the endurance time.ConclusionMF and ES showed earlier degeneration than PS and QL. MF is the first paraspinal muscle to undergo functional area atrophy, and it plays an important role in the endurance test. The maximum moment of equal length in all directions of the lumbar spine is not completely symmetrical, but it is correlated with the imaging parameters of the paraspinal muscles. QL and PS were more activated in the lumbar activity.Trial registrationThe study was registered in Chinese Clinical Trial Registry and the registration number is ChiCTR2000039073 on 15/10/2020 (https://www.chictr.org.cn/showproj.html?proj=62785). Ethical Approval was obtained from the Peking University Third Hospital Medical Science Research Ethics Committee (IRB00006761-M2020305).

Increased levels of urine volatile organic compounds are associated with hypertension risk.

Individuals are exposed to various volatile organic compounds (VOCs) in their surroundings. VOCs were associated with some cardiovascular and metabolic diseases, but the effects on blood pressure (BP) have not yet been clarified. This study aimed to ascertain the relationship between the urine levels of VOCs and the prevalence of hypertension (HTN) in the general population. This analysis utilized data from 4156 participants aged from 20 to 79 years in 2013-2018 National Health and Nutrition Examination Survey (NHANES). Exposure to VOCs was assessed through measurements of urinary VOC metabolites, with 16 VOCs selected for analysis. The relationships between VOCs and the risk of HTN in patients were examined through the weighted logistic regression and the weighted linear regression models. Generalized additive models were employed to analyze potential nonlinear associations between VOCs and the risk of HTN. Additionally, subgroup analyses and intergroup interaction tests were conducted. A total of 4156 participants with 16 VOCs were finally included for analysis. Multivariable logistic regression showed that ln-transformed urine levels of N-acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) [odds ratio (OR) 1.54; 95% confidence interval (CI) 1.18-2.02], N-acetyl-S-(3-hydroxypropyl)-L-cysteine (3HPMA; OR 1.33; 95% CI 1.03-1.74), N-acetyl-S-(4-hydroxy-2-butenyl)-L-cysteine (MHBMA3; OR 1.68; 95% CI 1.29-2.20), and N-acetyl-S-(1-phenyl-2-hydroxyethyl)-L-cysteine + N-acetyl-S-(2-phenyl-2-hydroxyethyl)-L-cysteine (PHEMA; OR 1.55; 95% CI 1.19-2.00) were significantly associated with an increased risk of HTN in US general population. A nonlinear relationship and a threshold effect were only observed between ln (N-acetyl-S-(2-hydroxypropyl)-L-cysteine or 2HPMA) and HTN. There was a significantly positive correlation between ln(2HPMA) and HTN when ln(2HPMA) at least 5.29. Sub-analysis revealed that there was a more pronounced association in the elderly group (age ≥60 years), the overweight group (BMI ≥25), and the alcohol consumption group. Our work presents novel epidemiological evidence supporting the establishment of the relationship between environmental pollutants and HTN, highlighting hitherto ignored positive correlations between nonoccupational VOC exposure and the entire population's risk of HTN.

Efficacy and safety of atrial fibrillation ablation in patients with aged 80 years or older.

Atrial fibrillation (AF) is the most common cardiac arrhythmia observed in the elderly. Its prevalence rises with age, particularly in individuals over 80 years old. While catheter ablation has emerged as a first line therapy for the patients with symptomatic AF, evidence on its application in elderly patients remains controversial. This study aimed to assess safety and efficacy outcomes of AF ablation in patients aged ≥ 80 years.Consecutive 1327 patients who underwent a first pulmonary vein isolation (PVI) for AF were retrospectively analyzed. Patients aged ≥ 80 years (elderly group, n = 107) were compared with patients aged < 80 years (younger group, n = 1220). At 1-year follow-up, there was no significant difference in AF free rate between the elderly and the younger group (72.0% vs. 73.9%, P = 0.786). Regarding major complications, the elderly patients had a greater incidence of periprocedural stroke (1.9% vs. 0.1%, P = 0.018). The rates of cardiac tamponade, phrenic palsy, and vascular complications were not significantly different between the 2 groups.PVI for AF is effective in patients aged ≥ 80 years with a similar success rate, but periprocedural stoke risk was higher compared to the younger population.

Investigating the Health Diet Needs of Diabetic Elderly in Daily Life: A Systematic Review

Diabetes has increasingly affected populations over the decades, particularly among elderly groups. Maintaining a healthy diet is crucial for managing diabetes, yet elderly people with diabetes often exhibit poor dietary habits. Therefore, this paper aims to investigate the dietary needs of elderly individuals with diabetes to provide comprehensive guidance for improving their dietary habits and overall diabetes management. A systematic review approach was adopted in this study, three reference databases, Scopus, Web of Science, and PubMed were consulted; 28 articles were screened in the final data code and analysis. Results found that four important needs among diabetic elderly include healthy diet knowledge, dietary suggestions, glucose monitoring, and physical activity. Those findings reveal the significance of diabetes management, underscoring the need for targeted educational interventions. Personalized nutrition plans and user-friendly glucose monitoring technologies are essential for improving dietary adherence and blood glucose control. Barriers to regular physical activity, including mobility issues and fear of injury, highlight the need for tailored, enjoyable exercise programs. Addressing these issues through holistic and individualized approaches can enhance diabetes management and health outcomes for this population. The study emphasizes the need for healthcare providers to develop and implement personalized nutrition plans, user-friendly glucose monitoring devices, and tailored exercise programs to support better diabetes management in the elderly population. Future research should focus on creating and testing these user-friendly products to further enhance care for this vulnerable group.

Epidemiological Features of Obesity and Type 2 Diabetes Mellitus in the Russian Federation

Relevance. Obesity is associated with the risk of developing insulin resistance and type 2 diabetes mellitus (type 2 DM). Over the past 40 years, no country in the world has seen a decrease in the incidence of either obesity or diabetes. The epidemic growth rates of type 2 DM in the world, including in the Russian Federation, emphasize the close relationship of these endocrinopathies and identify obesity as one of the determinants of diabetes development. Aim. To study the intensity, dynamics and features of the formation of primary morbidity of obesity and type 2 DM among various population groups, as well as to identify correlations between the studied parameters in the groups. Materials and methods. A retrospective analysis of the primary incidence of obesity and type 2 DM in Russia in 2010–2021 was carried out. The source of the analyzed information was the statistical collections of the Ministry of Health of the Russian Federation «Morbidity of the population». To identify the relationship between the studied parameters, a correlation analysis was performed with the calculation of the Pearson coefficient (r). The interpretation of the closeness of the correlation was performed on the Chaddock scale. Results. The number of cases of obesity amounted to 4 428 975, type 2 DM – 3 839 772 in Russia in 2010–2021. The incidence of obesity among the entire population was 253,61 per 100 ths, type 2 DM – 220,47 per 100 ths population. The Siberian FD (377,29 per 100 ths) should be singled out as an epidemiologically significant obesity district, and for type 2 DM – the Southern FD (249,34 per 100 ths). The incidence of type 2 DM among adults was 274,22 per 100 ths, while the leading positions were taken by the Ural FD (313,56 per 100 ths) and the Southern FD (308,94 per 100 ths). In terms of obesity among adults, it should be noted that the Siberian FD is 359,21 per 100 ths (the excess of the incidence rate in Russia is 1,68 times). Among the elderly, the incidence of obesity in Russia was 1,15 times higher than in adults (247,15 per 100 ths), while in the Siberian FD the incidence was 1,23 times higher than in adults (440,9 per 100 ths). In the elderly population group, the maximum incidence of type 2 DM was noted in the Ural FD – 591,11 per 100 ths. The incidence of obesity among the children from 0 to 14 years was 370,99 per 100 ths, while the most unfavorable epidemic situation was noted in the North-Western FD (476,86 per 100 ths – exceeding the level in Russia by 1,29 times). Among the children from 15 to 17, the incidence of obesity was 697,67 per 100 ths, the maximum level was in the North-Western FD (869,1 per 100 ths) and the Southern FD (866,43 per 100 ths). In parallel, the North-Western FD is also leading in terms of type 2 DM (3,16 per 100 ths) among the teenagers 15–17 years old. Positive correlations between obesity and type 2 DM were established among the entire population of Russia in 2020 (r = 0,364 – weak level) and in 2021 (r = 0,260 – very weak level). Conclusion. A close association of obesity with the development of type 2 DM has been confirmed. In Russia, in parallel with the growth of obesity, there is an increase in type 2 DM. Special attention should be paid to the child population, since there is a pronounced trend towards an increase in the incidence of obesity among the children 0–14 years old and 15–17 years old. The level of type 2 DM is also increasing among the teenagers. A statistically significant correlation was obtained between obesity and type 2 DM among the entire population.

How safe is lung transplantation in patients of 65 years or older? A single-center retrospective cohort

IntroductionWith increasing experience in high-volume centers, age alone should not be an absolute contra-indication to lung transplantation (LT) but be considered as part of the patient's initial characteristics. The objective of this study is to provide early and long-term outcomes of LT in recipients aged 65 or older, compared with their younger counterparts. MethodsThis is a retrospective study, including all patients undergoing LT in Bichat Hospital (Paris, France) from January 2014 to March 2019. Two groups were defined depending on the patients’ age when they were transplanted: patients older than 65 were defined as the “elderly group” and patients younger than 65 years old were defined as the « younger group ». Primary endpoint was 90-day mortality. Secondary endpoints included 1-year mortality, 1-year FEV1 (forced expiratory volume in one second), and 5-year overall survival. ResultsFrom September 2014 to March 2019, 22 patients were included in the “elderly group” and 213 were included in the « younger group ». The elderly group had more single LT (SLT) (82% vs. 29%, p < 0.001), with a shorter cold ischemic time (243 min vs. 310 min, p = 0.001) and a lower rate of early humoral rejection (9% vs. 30%, p = 0.045) compared to the younger group. Ninety-day mortality was not significantly different between elderly and younger group (9% vs. 14%, p = 0.95, respectively), nor were 1-year mortality (23% vs. 25%, p = 0.9, respectively) and 5-year overall survival. Six months after LT, FEV1 was significantly better in the elderly group compared to the younger group (77.0% vs. 65.5%, p = 0.037 respectively), but the difference did not reach statistical significance after one year (78.5 vs. 68.3%, p = 0.18 respectively). ConclusionElderly patients underwent more frequently single LT, and achieved similar short and long term postoperative outcomes compared to their younger counterparts. LT for patients 65 years or older should be routinely considered when carefully selected.

Clinical characteristics and therapeutic outcomes after endoscopic endonasal surgery for craniopharyngioma in the elderly

OBJECTIVE Craniopharyngiomas (CPs) in adults are rare benign epithelial tumors, and few contemporary studies have explored outcomes after surgical treatment in elderly patients, especially with regard to endoscopic endonasal surgery (EES). METHODS A retrospective cohort study was conducted on patients aged ≥ 18 years with CP who were treated with EES from 2013 to 2022. The cohort was divided into nonelderly (18–64 years) and elderly (≥ 65 years) groups based on age. Various parameters, including patient and tumor characteristics, surgical outcomes, complications, and follow-up, were compared between the two age groups. RESULTS A total of 193 patients met the inclusion criteria, with 161 (83.4%) patients in the nonelderly group and 32 (16.6%) patients in the elderly group. Preoperatively, older patients were more likely to have memory impairment (4.3% vs 18.8%, p = 0.010), fatigue or decreased energy (9.3% vs 34.4%, p = 0.001), hypopituitarism (68.7% vs 90.6%, p = 0.012), or hydrocephalus (18% vs 40.6%, p = 0.005), and they were more likely asymptomatic (1.2% vs 9.4%, p = 0.033) and less likely to experience headache (57.8% vs 31.3%, p = 0.006). Patients in the elderly group had a longer symptom duration (median [IQR] 5 [10] months vs 9.5 [13] months, p = 0.001) and higher comorbidity scores (p &lt; 0.001). Postoperatively, gross-total resection was achieved in 145 (90.1%) and 28 (87.5%) patients in the nonelderly and elderly groups, respectively. Older patients were more likely to develop pneumonia (5% vs 21.9%, p = 0.004). There were no significant differences in the extent of resection (p = 0.541), pathological subtypes (88.2% vs 75.0% adamantinomatous, p = 0.089), operation time (mean ± SD 307.8 ± 68.3 minutes vs 323.5 ± 86.0 minutes, p = 0.257), estimated blood loss (median [IQR] 300 [200] ml vs 300 [238] ml, p = 0.594), length of stay (median [IQR] 15 [8] days vs 15 [22] days, p = 0.964), perioperative mortality (2.5% vs 3.1%, p &gt; 0.99), or postoperative severe hypothalamic dysfunction (37.9% vs 50.0%, p = 0.237) between the groups. Multivariate Cox regression analysis demonstrated that tumor calcification (HR 3.406, 95% CI 1.859–27.233, p = 0.038) and preoperative hydrocephalus (HR 3.688, 95% CI 1.310–10.386, p = 0.013) were independently associated with decreased survival. The median follow-up period in the elderly group was shorter (71 months vs 44 months, p = 0.001), and no recurrence was observed (7.1% vs 0%, p = 0.132). CONCLUSIONS This study demonstrates that EES is a viable treatment option for older CP patients. With appropriate perioperative management, EES does not significantly increase mortality and, in selected populations, is well tolerated by patients.

Exploring the control of whole-body angular momentum in young and elderly based on the virtual pivot point concept.

While walking, ground reaction forces point from the centre of pressure to the neighbourhood of a focal point, namely the virtual pivot point (VPP), that adjusts angular momentum around the centre of mass (CoM). This study explores how age and speed affect the VPP quality and position during walking. Analysing an experimental dataset reveals high quality of the VPP in the sagittal plane for both young and elderly groups, regardless of speed. However, in the frontal plane, the VPP quality decreases with increasing speed, with elderly participants exhibiting significantly lower quality. Although not a direct measure of balance, VPP quality reflects changes in whole-body angular momentum owing to ageing and speed. Additionally, a template model is used to reproduce the VPP quality and position trends observed in the experiment. Simulation results highlight the sensitivity of VPP quality to leg force feedback and show that changing VPP height has minimal effect on gait speed. Furthermore, energy redistribution occurs through increased hip extension and leg damping, associated with a greater horizontal VPP distance from the CoM, observed in elderly walking. This study shows promise for analysing gait based on VPP, potentially aiding clinical interventions and supporting locomotion in the elderly.