2.Geriatric Nutritional Risk Index as a Possible Predictor of Decline in Kidney Function in Older People
Sukmin YOON ; Nak Gyeong KO ; Yu-Ji LEE
Annals of Geriatric Medicine and Research 2024;28(2):164-170
Background:
The Geriatric Nutritional Risk Index (GNRI) is associated with morbidity and mortality in older individuals. Our study explored the relationship between GNRI, decline in kidney function, and all-cause mortality in older individuals.
Methods:
This retrospective cohort study analyzed data from participants aged ≥60 years who underwent a general health checkup between 2002 and 2018. The primary exposure was the GNRI, divided into quartiles. The primary and secondary outcomes were a decline in kidney function assessed using the 5-year estimated glomerular filtration rate (eGFR) and all-cause mortality, respectively.
Results:
The analysis included a total of 1,599 participants (median age, 63 years; interquartile range [IQR], 61–67; 54% males). The mean±standard deviation of GNRI was 114±7. Compared with the highest GNRI quartile, the lower GNRI quartiles were associated with steeper 5-year slopes in eGFR, with a fully adjusted beta coefficient and 95% confidence intervals (CIs) of −0.50 (−0.86, −0.14), −0.29 (−0.63, 0.05), and −0.19 (−0.53, 0.14) for the first, second, and third GNRI quartiles, respectively. The median follow-up duration was 7.4 years (IQR, 4.6–12.4). During this period, we identified 108 deaths (7.8 per 1,000 person-years). The first GNRI quartile was associated with all-cause mortality compared to the highest GNRI quartile (hazard ratio of 2.20; 95% CI 1.23, 3.95).
Conclusion
Nutritional status, as evaluated using the GNRI, was associated with 5-year changes in kidney function and all-cause mortality in older individuals.
3.Evaluation of Factors Influencing Handgrip Strength Asymmetry in Older Peruvian Adults
Alba ZEVALLOS ; Renzo PAJUELO-VÁSQUEZ ; Kiara CAMACHO-CABALLERO ; Rodrigo CORCUERA-CIUDAD ; Paola GOICOCHEA-ROMERO ; Wendy GUTIÉRREZ-BACA ; Diego CHAMBERGO-MICHILOT ; José F. PARODI ; Fernando M. RUNZER-COLMENARES
Annals of Geriatric Medicine and Research 2024;28(2):184-191
Background:
Sarcopenia is a musculoskeletal disease involving the reduction of muscle mass, strength, and performance. Handgrip strength (HGS) measurements included in frailty assessments are great biomarkers of aging and are related to functional deficits. We assessed the association between potential influencing factors and HGS asymmetry in older Peruvian adults.
Methods:
We used a database of the Peruvian Naval Medical Center "Cirujano Santiago Távara" located in Callao, Peru. All the patients included were ≥60 years old and had an HGS measurement in the dominant and non-dominant hand.
Results:
From a total of 1,468 patients, 74.66% had HGS asymmetry. After adjustment, calf circumference weakness (adjusted prevalence ratio [aPR]=1.08; 95% confidence interval [CI], 1.01–1.15), falls risk (aPR = 1.08; 95% CI, 1.02–1.16), and an altered Lawton index (aPR=0.92; 95% CI, 0.84–0.99) were associated with HGS asymmetry.
Conclusion
Our findings suggest that HGS asymmetry should be measured along with other geriatric assessments used to evaluate health outcomes in the elderly to enhance health promotion and prevention aimed at preserving muscle strength to curb functional limitations in the elderly.
4.Global Research on Centenarians: A Historical and Comprehensive Bibliometric Analysis from 1887 to 2023
Ivan David LOZADA-MARTINEZ ; Maria Carolina DIAZGRANADOS-GARCIA ; Sandra CASTELBLANCO-TORO ; Juan-Manuel ANAYA
Annals of Geriatric Medicine and Research 2024;28(2):144-155
Background:
Centenarians are considered the most successful human biological aging model. However, the characteristics and patterns of research among centenarians have not been described or analyzed. Thus, this study aimed to disclose the historical landscape of global research on centenarians.
Methods:
This bibliometric study investigated historical evidence on centenarian research published in the Scopus database. The bibliometrix package in R was used to perform visual and quantitative analyses of research metrics, trends, and patterns.
Results:
Of the 2,061 documents included between 1887 and 2023, 84.2% (n=1,736) were published as articles with primary data. We identified international collaboration and annual growth rates of 21.4% and 3.15%, respectively. The United States published the highest number of papers on centenarians (n=786), whereas the publications from Italy had the highest impact (h-index of 90). Based on the frequency of keywords, mortality, genetics, dementia, Alzheimer’s disease, and immunosenescence are a few of the most studied topics among centenarians, with emerging research related to mitochondrial DNA and comparison of results between nonagenarians and centenarians. Italy, the United States, and China lead the global research collaboration network, collaborating most frequently with Japan and European countries.
Conclusion
Global research on centenarians has grown over the last 20 years, primarily led by Italy, the United States, and China. Latin American and African countries have conducted little or no research on centenarians. The most widely studied topics include mortality, cognition, immunosenescence, and genetics.
5.Factors Associated with the Deterioration of Intrinsic Capacity among Older Adults in Mexico and Colombia
Claudia Liliana Valencia RICO ; Nora Hilda González QUIRARTE ; Lidia Guadalupe Compeán ORTIZ ; Hortensia Castañeda HIDALGO ; Sandra Milena Campiño VALDERRAMA ; Lilia Fletes RAYAS
Annals of Geriatric Medicine and Research 2024;28(2):156-163
Background:
Intrinsic capacity (IC) is defined as "all the physical and mental attributes possessed by the older person." This concept has gained momentum in recent years because it provides insights into the changes in the functional capacity of individuals during their life. This study examined common factors associated with IC decline among older adults in Mexico and Colombia.
Methods:
This cross-sectional, correlational study included 348 community-dwelling older adults. Sociodemographic, clinical, and family conditions were assessed as possible associated factors, and IC was analyzed across five domains: cognitive, locomotor, psychological, vitality (malnutrition through deficiency and excess), and sensory (visual and auditory). Parametric and non-parametric statistical analyses were performed.
Results:
The common factors associated with impairment according to domain were family dysfunctionality (cognitive domain); myocardial infarction, family dysfunctionality, age >80 years, home occupation, and not having a partner (locomotor domain); dysfunctional family and risk of falls (psychological domain); age >80 years and not having a partner (malnutrition by deficiency domain); age 60–79 years, walking <7,500 steps/day, and peripheral vascular disease (malnutrition by excess domain); risk of falling and being female (visual sensory domain); risk of falling (auditory sensory domain); and dysfunctional family and risk of falling (total intrinsic capacity).
Conclusion
Both populations had common sociodemographic, clinical, and familial factors that directly affected total IC stocks and their domains.
6.Social Network Typologies and Digital Literacy Differences among Korean Older Adults: A Latent Class Analysis
Hamin LEE ; Mi Kyeong KIM ; Hae Yean PARK ; Kang-Hyun PARK
Annals of Geriatric Medicine and Research 2024;28(2):134-143
Background:
This study categorized older Korean adults’ social networks and analyzed their characteristics and digital literacy differences based on type.
Methods:
We analyzed data from 9,377 Korean older adult participants of the 2020 National Survey of Older Koreans, and performed latent class analysis (LCA) chi-square and Welch’s F analyses to understand the characteristics of each social network type. The Games–Howell post-hoc test was applied to determine the significance of differences between groups.
Results:
The three social network types derived using LCA were “child-centered,” “child-friend,” and “friend-centered.” The digital literacy levels differed significantly according to social network type.
Conclusion
The results of this study can be used to propose intervention programs and services associated with older adults’ social networks by examining their social network types and the corresponding differences in digital literacy.
7.Podocyte Disease Following Treatment with Intravenous Ibandronate in an Older Patient
Ye Rin CHUNG ; Hyun Soon LEE ; Dong Young LEE ; Sang Hee LEE ; Jin Seon JEONG ; Beom KIM
Annals of Geriatric Medicine and Research 2024;28(2):228-230
Bisphosphonates are commonly used to treat osteoporosis. While renal toxicity is common with pamidronate and zoledronate, few ibandronate-related cases are reported. We describe a rare case of ibandronate-associated nephrotoxicity. An 88-year-old woman was admitted for edema. She had been receiving intravenous ibandronate treatment for postmenopausal osteoporosis and had no other diagnosed diseases. She was presented with proteinuria, hypoalbuminemia (1.9 g/dL), and an elevated serum creatinine level (1.8 mg/dL). Renal biopsy revealed podocyte disease, favoring a diagnosis of focal segmental glomerulosclerosis. She was treated with diuretics, tacrolimus, and fimasartan. Steroids were avoided due to severe osteoporosis. Three months later, the edema had subsided and the laboratory findings had improved (serum albumin 3.5 g/dL, serum creatinine 0.97 mg/dL). This case emphasizes the importance of careful monitoring of proteinuria and renal function during ibandronate treatment. In older adult patients, kidney biopsy and immunosuppressive treatment may be considered based on physical activity and underlying diseases.
8.Association of Phase Angle Dynamics with Sarcopenia and Activities of Daily Living in Osteoporotic Fracture Patients
Yusuke ITO ; Yoshihiro YOSHIMURA ; Fumihiko NAGANO ; Ayaka MATSUMOTO ; Hidetaka WAKABAYASHI
Annals of Geriatric Medicine and Research 2024;28(2):192-200
Background:
This study aimed to determine whether changes in phase angle during rehabilitation are associated with clinical outcomes such as activities of daily living (ADL), skeletal muscle mass index (SMI), and strength in patients with osteoporotic fractures.
Methods:
This retrospective observational study included patients with osteoporotic fractures admitted to convalescent rehabilitation wards. Changes in phase angle were defined as the difference between the phase angle values at discharge and on admission. The primary outcome was the Functional Independence Measure motor (FIM-motor) score at discharge. The secondary outcomes were SMI and handgrip strength at discharge. We used multivariate analysis to adjust for confounding factors and examine the association between changes in the phase angle and outcomes.
Results:
We analyzed a total of 115 patients (97 women, mean age of 81.0±10.0 years), with a median change in phase angle of 0° during hospitalization. We observed increased phase angles in 49 patients (43%), with a median increase of 0.2°. Multiple regression analysis showed that changes in phase angle were independently associated with FIM-motor score at discharge (β=0.238, p=0.027). Changes in phase angle were not significantly associated with SMI (β=0.059, p=0.599) or handgrip strength (β=-0.032, p=0.773) at discharge.
Conclusion
An increased phase angle during rehabilitation was positively associated with ADL improvement in patients with osteoporotic fractures. These findings may help clinicians make informed decisions regarding patient care and treatment strategies for better outcomes.
9.Association of Olfactory and Gustatory Function with Memory among Community-Dwelling Independent Older Adults
Hyuma MAKIZAKO ; Yuki NAKAI ; Shoma AKAIDA ; Yoshiaki TANIGUCHI ; Takaki MIWA ; Shigeto MORIMOTO
Annals of Geriatric Medicine and Research 2024;28(2):178-183
Background:
This study examined the association between memory function and reduced olfactory and gustatory function among independent community-dwelling older adults.
Methods:
This cross-sectional study included 127 older adults (65.4% women). We assessed their memory, odor, and taste identification skills. Open essence (OE) test and taste strips (TS) were used to identify hyposmia (OE test ≤6) and hypogeusia (TS test ≤8), respectively.
Results:
Participants with severe hyposmia had significantly poorer memory functions compared to participants without severe hyposmia. After adjusting for covariates, multivariate logistic regression models revealed a significant association between immediate recognition performance and a decreased likelihood of severe hyposmia (odds ratio=0.65; 95% confidence interval 0.47–0.90). We observed no significant association between taste function and memory.
Conclusion
Memory function may be associated with olfactory impairment in older adults.
10.Predicting Mortality Risks Using Body Mass Index and Weight Loss at Admission in Patients with Heart Failure
Yuria ISHIDA ; Keisuke MAEDA ; Kenta MUROTANI ; Akio SHIMIZU ; Junko UESHIMA ; Ayano NAGANO ; Tatsuro INOUE ; Naoharu MORI
Annals of Geriatric Medicine and Research 2024;28(2):171-177
Background:
The association of the combination of body mass index (BMI) and weight change at admission with prognoses in patients with heart failure (HF) is unclear. Therefore, we investigated whether BMI and weight changes at admission affect mortality in patients with HF.
Methods:
This retrospective cohort study lasted 99 months, starting in April 2014, and included 4,862 patients with HF from a Japanese real-world database. Cubic and thin-plate smoothing spline analyses were performed to investigate the association of BMI and weight changes with mortality. The percentage weight change was calculated every 6 months. The study outcome was the presence or absence of death.
Results:
The patients’ mean age was 81.5±9.6 years, and 1,239 (25.5%) patients died. Cubic spline analysis revealed a negative correlation of BMI with mortality hazard ratio (HR) (BMI of 18.5 kg/m2 and 25 kg/m2; HR=1.3 [1.2–1.4] and 0.8 [0.7–0.9], respectively). Cubic spline analysis of weight change showed that weight loss tended to increase the mortality HR (each 6% decrease in weight change rate was associated with a 1.1 times higher mortality risk (95% CI [1.0–1.2]) Thin-plate smoothing spline analysis showed that the odds ratio (OR) negatively correlated with BMI (1-year mortality: BMI of 18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.5, 1.0, and 0.7, respectively; 2-year mortality: BMI=18.5 kg/m2, 22 kg/m2, and 25 kg/m2; OR at 0% weight change=1.4, 0.9, and 0.7, respectively).
Conclusion
A low BMI in patients with HF was associated with a higher risk of mortality. Weight loss in patients, regardless of BMI, was associated with a higher OR for mortality.