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Geriatrics Research
CN: 37-1522/R
ISSN: 2096-9058
Governed by: Health Commission of Shandong Province
Sponsored by: Shandong Provincial Hospital Affiliated to Shandong First Medical University
Editor-in-Chief: SUN Zhijian
Deputy Editor-in-Chief: WANG Jianchun
Founded in 2020, bimonthly.
Indexed by: CNKI, Wanfang, Weipu, Chaoxing, CBM.
Construction and evaluation of a prognostic risk prediction model for community-acquired pneumonia in older adults based on Comprehensive Geriatric Assessment
SHEN Xiaoqian;FU Yimin;WANG Xiaojun;Objective To investigate the predictive value of models constructed based on the Comprehensive Geriatric Assessment(CGA) for short-term prognosis in older adults with community-acquired pneumonia(CAP). Methods A prospective cohort study was conducted, enrolling 100 older adults with CAP. CGA indicators were collected, and followup was performed on the length of hospital stay, unplanned outpatient/emergency visits, and unplanned readmissions within 3 months after discharge. Using univariable analyses(Spearman rank correlation, Mann-Whitney U test, and univariable binary logistic regression) for screening and multivariable analyses(multiple linear regression and multivariable binary logistic regression) for modeling, prediction models were constructed and evaluated via internal validation for discrimination, calibration, and robustness. Results The prediction model for length of hospital stay incorporated comorbidities, frailty, and Activities of Daily Living(ADL), explaining 50. 7% of the variance. The risk prediction model for unplanned emergency/outpatient visits within 3 months after discharge included frailty and depression score(AUC=0. 78,95% CI:0. 68-0. 88). The risk prediction model for unplanned readmission within 3 months after discharge included depression score, ADL, and number of medications(AUC=0. 839,95% CI:0. 662-1. 000). All models showed stable performance in internal validation. Conclusion The CGA-based prediction models can effectively identify the risk of shortterm adverse outcomes in older adults with CAP, providing a reference for clinical risk assessment and intervention.
Meta-analysis of influencing factors of activation levels in patients with chronic disease
ZHANG Tao;LI Jinxiu;DENG Libang;TIAN Yanzhen;ZHANG Shiji;FENG Nina;Medical College of Jishou University;Objective To explore the influencing factors of activation levels in patients with chronic disease. Methods Literature on the influencing factors of activation levels in patients with chronic diseases were retrieved from databases including CNKI, VIP, Wanfang, CBM, PubMed, and The Cochrane Library, with the search period spanning from the inception of each database to October 15, 2024. After literature screening, data extraction, and quality assessment, RevMan 5. 3 software was used for meta-analysis. Results A total of 21 studies were included. The meta-analysis revealed that patients aged over 65 years(OR=0. 98, 95% CI: 0. 96-0. 99, P<0. 000 01), disease severity(OR=0. 45, 95% CI: 0. 22-0. 93, P=0. 008), comorbidities(OR=0. 31, 95% CI: 0. 19-0. 50, P<0. 000 01), anxiety and depression(OR=0. 57, 95% CI: 0. 36-0. 90, P=0. 02) were the negative factors for the activation level of patients with chronic diseases. While educational level(OR=10. 98, 95% CI: 6. 34-19. 00, P<0. 000 01), residing in the city(OR=8. 94, 95% CI: 2. 53-31. 54, P=0. 000 7), social support(OR=1. 30, 95% CI: 1. 19-1. 43, P<0. 000 01), health literacy(OR=1. 26, 95% CI: 1. 14-1. 39, P<0. 000 01), monthly household income per capita ≥1 000 yuan(OR=25. 26, 95% CI: 14. 17-45. 03, P<0. 000 01), and long disease duration(OR=4. 60, 95% CI: 2. 35-8. 99, P<0. 000 01) were the promoting factors for the activation level of patients with chronic diseases. Conclusions Patient activation level in chronic disease patients is influenced by multiple factors. Age over 65 years old, educational level of high school or below, severe illness, living in rural areas, having complications, low health literacy, anxiety and depression, and a per capita monthly family income <1 000 yuan are their negative factors, while social support and a long course of disease are their promoting factors. Healthcare professionals should dynamically assess patients' activation levels and implement targeted, individualized interventions to enhance activation, thereby improving self-management abilities and quality of life.
Bibliometric analysis of domestic and international literature on late-life depression from 2015 to 2024
LAI Jinghan;ZHANG Xingyu;WANG Huali;Objective To analyze the domestic and international research progress in the field of late-life depression(LLD) over the past decade, with the aim of providing targeted references for future research in this field. Methods A comprehensive search was conducted in the CNKI databases and Web of Science Core Collection for literature related to LLD published from January 1, 2015, to August 25, 2024. Bibliometric analyses were performed using CiteSpace and VOSviewer software through methods such as author and country collaboration networks, keyword co-occurrence networks, clustering analysis, and burst term analysis. A cross-linguistic comparative analysis was then carried out on the included Chinese and English literature. Results A total of 495 Chinese literature and 4 446 English literature were included in this study. The annual output of Chinese literature remained relatively stable with small fluctuations and a significantly lower total volume. The annual publication volume of English literature showed a steady slow upward trend over the decade. Core author teams and collaboration networks have been formed in both Chinese and English research communities; nevertheless, English-language research demonstrated greater breadth, depth, and interdisciplinary diversity. Social support, pharmacotherapy, and anxiety were identified as common research hotspots in both literatures. Notably, Chinese literature focused more on special populations and social determinants, while English literature formed distinct research clusters covering epidemiological characteristics, cognitive impairment associations, risk factors, anxiety comorbidity, and intervention approaches. Conclusions The field of LLD has accumulated substantial research achievements over the past decade. However, further in-depth exploration is still required regarding the unique social and physiological characteristics of elderly patients and the development of more optimized and individualized therapeutic strategies. Chinese-language research remains in the initial stage of development, and thus requires enhanced academic attention, improved systematicness, and enrichment of clinical evidence for novel antidepressant drugs to advance the field. For English-language research, there is an urgent need to strengthen studies specifically targeting the LLD population.
Retrospective comparative study on acute-phase clinical characteristics between vascular vertigo/dizziness and vestibular neuritis
LI Lili;HE Lili;LIU Yan;Objective To investigate differences in clinical characteristics between patients with vascular vertigo/dizziness(VVD) and vestibular neuritis(VN) during the acute phase, to provide evidence-based support for rapid differential diagnosis. Methods A total of 127 patients admitted to the Department of Neurology at Beijing First Hospital of Integrated Traditional Chinese and Western Medicine between January 2022 and June 2025 for acute vertigo or dizziness were enrolled. Patients were classified into the VVD group(n=74) and the VN group(n=53) according to established international diagnostic criteria. Demographic data, clinical symptoms and signs, vascular risk factors, ABCD2 scores, and laboratory parameters were collected and compared between groups. Results The age of the VVD group [(68. 91±11. 03) years] was higher than that of the VN group [(56. 64±12. 71) years], and the proportion of males(67. 6%) was also higher than that of the VN group(45. 3%)(all P<0. 05). The prevalence rates of hypertension, diabetes, hyperlipidemia, hyperhomocysteinemia, prior cerebral infarction or transient ischemic attack, and alcohol consumption were higher in the VVD group than in the VN group(all P<0. 05). The VVD group had a greater number of vascular risk factors [4. 5(4, 5)] and a higher ABCD2 score [5(4, 6)] than the VN group [2(2, 4) and 3(2, 4), respectively](all P<0. 001). The VN group had higher rates of vertigo, unsteadiness, and autonomic symptoms(all P<0. 001), while visual disturbances were more common in the VVD group(P=0. 036). Signs suggestive of central nervous system involvement: including dysarthria or dysphagia, central facial palsy, sensory deficits, limb weakness, ataxia, and gaze-evoked nystagmus were more common in the VVD group, whereas patients with VN predominantly exhibited unidirectional horizontal nystagmus(all P<0. 05). Additionally, the VVD group had lower high-density lipoprotein cholesterol and low-density lipoprotein cholesterol levels but higher homocysteine levels than the VN group(all P<0. 05). Conclusions Age at onset, sex, burden of vascular risk factors, ABCD2 score, specific clinical manifestations, and select laboratory parameters are valuable for differentiating VVD from VN. These features may facilitate early identification of high-risk VVD patients and guide targeted diagnostic evaluation.
Application effect of exercise rehabilitation program for elderly patients with ICF functional ankle instability
WANG Huanhuan;FAN Haiyan;WANG Lu;ZHAO Rong;YUE Jianxing;Objective To develop and preliminarily apply a functional rehabilitation program for elderly patients with functional ankle instability, and to evaluate its effectiveness. Methods Based on the International Classification of Functioning, Disability and Health(ICF), a rehabilitation exercise program for elderly patients with functional ankle instability was developed using methods such as literature review and expert consultation. Using convenience sampling, 64 elderly patients with functional ankle instability who visited the Rehabilitation Medicine Department of the Second Affiliated Hospital of Bengbu Medical University between December 2023 and August 2024 were selected as study subjects. Patients who visited between December 2023 and March 2024 were assigned to the control group and underwent conventional rehabilitation training. Patients admitted from April to August 2024 formed the intervention group, receiving training based on the developed exercise rehabilitation program. Each group comprised 32 patients. Before and after the intervention comparisons were conducted for the Cumberland Ankle Instability Test(CAIT) scores, Y Balance Test(YBT) distance, and Foot and Ankle Functional Measure(FAAM) scores between the two groups. Results After intervention, CAIT scores increased in both groups, with the intervention group scoring higher than the control group(P<0. 05). The measured distances in the anterior-posterior medial and posterior-lateral directions on the YBT increased in both groups, with the intervention group showing greater increases than the control group(P<0. 05). The total FAAM scores, along with scores on the Daily Activities and Physical Activities scales, increased in both groups, with the intervention group showing greater increases than the control group(P<0. 05). Conclusions An exercise program for functional ankle instability developed based on the ICF framework can effectively improve foot and ankle function in elderly patients with functional ankle instability. It enhances muscle strength, flexibility, and coordination in older adults, improves their balance, and increases their ability to perform daily activities.
