With the deepening of the aging population, China's healthcare resources and social security systems are facing increasingly significant challenges.Concurrently, the field of geriatric medicine is experiencing vigorous development, with the Chinese Medical Association playing a pivotal role in the discipline construction of geriatrics.This article will systematically outline the current development landscape, core achievements, existing challenges, and future directions of geriatric medicine in China.

Objective:To explore the impact of different nutritional statuses on the prognosis of elderly patients with idiopathic pulmonary fibrosis(IPF), and to provide a basis for early intervention of the nutritional status of elderly IPF patients.Methods:A retrospective analysis was conducted on 237 elderly patients clinically diagnosed with IPF who were admitted to the First Hospital of Shanxi Medical University from January 2018 to May 2024.The GLIM criteria were applied to diagnose malnutrition and classify its severity.The patients were divided into two groups: those without nutritional risk(Group A)and those with nutritional risk(Group B). Group B was further subdivided into three subgroups: patients with only nutritional risk(Subgroup B1), those with moderate malnutrition(Subgroup B2), and those with severe malnutrition(Subgroup B3). The study observed the clinical characteristics of elderly IPF patients and the impact of nutritional factors on hospital admission frequency, activities of daily living(ADL), and all-cause mortality.Results:A total of 237 patients was included, with 129 patients(54.43%)in Group A and 108 patients(45.57%)in Group B. Among them, there were 34 patients(14.35%)in Subgroup B1, 57 patients(24.05%)in Subgroup B2, and 17 patients(7.17%)in Subgroup B3.The number of hospitalizations was significantly higher in both Group B and Subgroup B3 compared to Group A(both P < 0.05). However, no significant differences were found in the number of hospitalizations between Subgroup B1 or Subgroup B2 and Group A. There was no significant difference in the reduction of ADL between Group B(including all its subgroups)and Group A. The risk of mortality significantly increased with the increase in the severity of malnutrition(all P<0.05). After adjusting for factors such as gender, age, polypharmacy, home oxygen therapy, self-care ability, days of hospital stay, number of hospitalizations, pulmonary function, and inflammatory factors, nutritional risk and the degree of malnutrition remained independent risk factors for all-cause mortality in elderly IPF patients. Conclusions:A significant proportion of elderly IPF patients were found to have nutritional risk or malnutrition.The number of hospitalizations was significantly correlated with the nutritional status of these patients.After adjusting for multiple relevant factors, nutritional risk and the severity of malnutrition remained independent risk factors for mortality in elderly IPF patients.Therefore, greater emphasis should be placed on nutritional assessment and early nutritional intervention in the management of elderly IPF patients, so as to prevent and reduce the occurrence of nutrition-related adverse events.

Objective:To investigate the association between short-term blood pressure variability(BPV)and all-cause mortality in elderly patients with early sepsis-associated acute kidney injury(SA-AKI).Methods:A retrospective study was conducted on elderly patients with early SA-AKI from the Medical Information Mart for Intensive Care Ⅳ(MIMIC-Ⅳ)database between 2008 and 2022.All patients were divided into four groups(Q1-Q4)according to the quartiles of the 24-hour systolic blood pressure coefficient of variation(SBPCV): Q1(SBPCV<8.69%), Q2(8.69%≤SBPCV<10.84%), Q3(10.84%≤SBPCV<13.64%), Q4(SBPCV≥13.64%). Cox regression analysis was used to assess the association between SBPCV and one-year all-cause mortality.Restricted cubic spline regression was used for non-linear testing, and threshold effect analysis was further performed for non-linear relationships.Results:A total of 5 955 elderly patients were included in the study, and 2 746(46.11%)patients died within one year following the diagnosis of early SA-AKI.Patients in groups Q1 to Q4 had one-year all-cause mortality rates of 46.34%(690/1 489), 45.56%(678/1 488), 42.47%(632/1 488), and 50.07%(746/1 490), respectively.After adjusting for relevant confounding variables, Cox regression analysis showed that the Q1 group and Q4 group had a 26%( HR=1.26, 95% CI: 1.13-1.41, P<0.001)and 12%( HR=1.12, 95% CI: 1.01-1.24, P=0.047)higher risk of one-year mortality compared to the Q3 group, respectively.SBPCV and one-year all-cause mortality showed a U-shaped non-linear manner( P for nonlinear<0.001). Threshold effect analysis indicated that when SBPCV<13.07%, each standard deviation increase in SBPCV was associated with a 15% reduction in mortality risk( HR=0.85, 95% CI: 0.78-0.92, P<0.001); conversely, when SBPCV>13.07%, each standard deviation increase in SBPCV was associated with an 11% increase in mortality risk( HR=1.11, 95% CI: 1.03-1.21, P=0.011). Conclusions:Short-term BPV may be associated with long-term all-cause mortality in elderly patients with early SA-AKI in a U-shaped manner.However, these findings require further confirmation through high-quality prospective studies.

Metabolic syndrome (MetS) represents a clinical syndrome composed of a series of risk factors for cardiovascular and cerebrovascular diseases.Emerging evidence highlights the multifaceted therapeutic potential of sodium-glucose cotransporter 2 inhibitors (SGLT-2i) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) beyond their established glucose-lowering efficacy, with recent studies demonstrating their remarkable ability to improve multiple metabolic parameters, including blood pressure reduction, weight loss, and cardiorenal function enhancement, suggesting a pivotal role in improving MetS-related risk factors.The elderly population represents a high-risk cohort for metabolic disorders.Nevertheless, conventional medications are associated with problems such as an elevated risk of hypoglycaemia and insufficient protection of multiple vital organs, including the heart and kidneys.This review expounds on the impacts of SGLT-2i and GLP-1RAs on elderly patients with MetS and their potential mechanisms of action, providing reference value for optimizing the management of metabolism-related diseases in the elderly.

This article systematically outlines the developmental pathway for early-career physicians from four key dimensions: the development of clinical skills, cultivation of scientific research thinking, nurturing of humanistic care, and future prospects.It draws upon the author's professional experience within the geriatrics department from 2007 to now, contextualized against the backdrop of the three pivotal phases of geriatric medicine development in China.The paper particularly highlights the significant breakthroughs in the construction of the Geriatrics specialty guided by the Chinese Medical Association, offering a practical reference for building talent pipelines within the discipline.

Objective:To evaluate the cumulative relationship between individual cardiometabolic diseases(CMDs)and the incidence of cataract in the elderly.Methods:This study was a prospective cohort study based on the UK Biobank, including 165 222 participants without cataract at baseline, aged 60.0 to 74.0 years, with an average age of(64.9±2.9)years, including 76 712 males(46.4%)and 88 510 females(53.6%). The exposure in this study was CMDs(including coronary heart disease, stroke, diabetes, and hypertension), and the outcome was the incidence of cataract.The Cox proportional hazards model was used to evaluate the cumulative hazard ratio( HR)and 95% confidence interval( CI)of the number of CMDs and cataract occurrence in the elderly. Results:After a median follow-up of 13.65 years, 35, 933 cataract events were observed.After adjusting for various factors, the HRs of cataract incidence in elderly patients with 1, 2, and 3 or more CMDs compared with those without CMDs were 1.11( HR=1.11, 95% CI: 1.08~1.14, P<0.001), 1.38( HR=1.38, 95% CI: 1.33~1.43, P<0.001), and 1.80( HR=1.80, 95% CI: 1.68-1.93, P<0.001), respectively.There was a significant dose-cumulative effect between the number of CMDs and the risk of cataract( HR=1.17, 95% CI: 1.15~1.19, P<0.001). Conclusions:The coexistence of CMDs in the elderly is an important risk factor for cataract development, and the risk of cataract increases in a dose-cumulative manner with the increase in the number of CMDs, suggesting that emphasizing health management of CMDs in the elderly population may help reduce the incidence of cataract.

Objective:To investigate the correlation between relative fat mass(RFM)and Estimated Glomerular Filtration Rate(eGFR)in an elderly hypertensive population.Methods:This cross-sectional study enrolled elderly hypertensive individuals aged 65 years and older from Huai'an city between June 2023 and December 2023.Clinical data for these subjects were collected, and RFM and eGFR were calculated according to established formulas.Subsequently, the subjects were divided into two groups based on their eGFR levels: the eGFR normal group and the eGFR decreased group.Differences between these two groups were compared.Multivariate logistic regression models were employed to analyze the association between RFM and eGFR, and a subgroup analysis was conducted.The predictive value of RFM for renal function decline was evaluated using receiver operating characteristic curves(ROC).Results:Among the 2, 603 subjects, 921(35.4%)were assigned to the eGFR decreased group, while 1, 682(64.6%)were assigned to the eGFR normal group.The proportion of males, married individuals, smokers, and alcohol drinkers, as well as diastolic blood pressureand cultural levels, were significantly lower in the eGFR decreased group compared to the eGFR normal group (all P<0.05). Conversely, the duration of hypertension, proportion of comorbidities, age, fasting blood glucose, triglycerides, low-density lipoprotein cholesterol(LDL-C), relative fat mass(RFM), visceral fat index(VAI), dysfunctional obesity index(DAI), body roundness index(BRI), and conicity index(C-index)were all significantly higher in the eGFR decreased group compared to the eGFR normal group(all P<0.05). After adjusting for confounding factors, multivariate logistic regression analysis revealed that when RFM was treated as a continuous variable, the risk of eGFR decline increased with rising RFM(odds ratio[ OR]=1.035, 95% confidence interval[95% CI]: 1.008-1.063, P=0.010). When grouped according to RFM quartile levels(in ascending order)into Q1(<26.22), Q2(26.22-<30.53), Q3(30.53-<39.26), and Q4(≥39.26), using the Q1 group as a reference, the risk of eGFR decline increased in the Q3( OR=1.691, 95% CI: 1.777-2.430, P=0.004)and Q4( OR=1.743, 95% CI: 1.118-2.717, P=0.014)groups.In the subgroup analysis, gender( P-interaction=0.034)and smoking( P-interaction=0.012)were identified as having significant interaction effects on RFM and the decline in eGFR.In the male subgroup( OR=1.067, 95% CI: 1.027-1.108, Ptrend=0.001)and the smoking subgroup( OR=1.109, 95% CI: 1.026-1.199, Ptrend=0.009), the risk of eGFR decline significantly increased with higher levels of RFM.The restricted cubic spline(RCS)analysis indicated that when RFM exceeded 30.609, the risk of eGFR decline increased with rising RFM levels, demonstrating a non-linear correlation between RFM and the risk of eGFR decline( Pnonlinearity=0.048 5). The ROC curve analysis revealed that the area under the curve(AUC)for RFM in predicting eGFR reduction was 0.635(95% CI: 0.613-0.657, P1<0.001), which was significantly higher than the AUC for VAI(AUC=0.573, 95% CI: 0.550-0.596, P2<0.001), DAI(AUC=0.562, 95% CI: 0.539-0.584, P2<0.001), BRI(AUC=0.564, 95% CI: 0.541-0.587, P2<0.001), and the C-index(AUC=0.536, 95% CI: 0.513-0.559, P2<0.001). Conclusions:Elevated RFM is an independent risk factor for eGFR decline in elderly hypertensive individuals.There exists a significant interaction between gender and smoking with respect to the risk of RFM and eGFR decline.Additionally, RFM demonstrates a notable predictive value for eGFR decline in elderly hypertensive individuals.

Bereavement support for caregivers is an important component of palliative care practice, but there is currently a lack of corresponding regulations and consensus in China.A recent review published in Front Psychol systematically outlined the core principles and practical guidelines framework for bereavement support for adult family caregivers in palliative care, covering the entire process from entering palliative care to the bereavement period after death.Based on this, this article aims to interpret the guidelines framework, providing clinical practice references for hospice and palliative care practitioners and geriatric healthcare workers in China, thereby promoting the development and improvement of bereavement support services.

Osteoarthritis(OA), a chronic degenerative osteoarticular disorder, stands as one of the most common causes of chronic musculoskeletal pain in adults, with a particularly high prevalence among elderly populations.The knee joint is the most frequently affected site of OA.In recent years, clinical studies have highlighted the good efficacy of genicular artery embolization(GAE)in addressing refractory pain associated with knee osteoarthritis(KOA). This article reviews the epidemiology of KOA-related pain in aging populations, the current therapeutic status, the pathophysiological rationale underpinning GAE in treating KOA-related pain, the treatment process, clinical application and prospects.

Multiple stages of digital fixed restorations may have impact on the occlusal accuracy of the final restorations.Among them, the determination of occlusal plane, the records of static and dynamic occlusion are key stages.Facing the situation of more residual roots, residual crowns, as well as unstable occlusion in elderly people, the accurate occlusal records are of greater significance.This review focuses on above influencing factors combined with evaluation methods for occlusal accuracy.It is believed that in general, whether to transfer personalized occlusion plane should be decided according to the clinical needs, meanwhile fixed restorations made by directly scanning static occlusion under heavy bite force, and obtaining dynamic occlusion using mandibular movement system have more accurate occlusal morphology.However, more randomized controlled clinical trials with large sample size supporting this field of research are still needed for the elderly population.