Many countries face an unprecedented challenge in aging demographics. This has led to an exponential growth in research on aging, which, coupled to a massive financial influx of funding in the private and public sectors, has resulted in seminal insights into the underpinnings of this biological process. However, critical validation in humans has been hampered by the limited translatability of results obtained in model organisms, additionally confined by the need for extremely time-consuming clinical studies in the ostensible absence of robust biomarkers that would allow monitoring in shorter time frames. In the future, molecular parameters might hold great promise in this regard. In contrast, biomarkers centered on function, resilience, and frailty are available at the present time, with proven predictive value for morbidity and mortality. In this review, the current knowledge of molecular and physiological aspects of human aging, potential antiaging strategies, and the basis, evidence, and potential application of physiological biomarkers in human aging are discussed.

Although previous studies have reported associations between sarcopenic obesity (SO) and metabolic syndrome (MetS), the findings remain inconsistent. This study aimed to investigate the associations between sarcopenia, obesity, and MetS, and to determine whether sarcopenic obesity synergistically increases the risk of MetS.

The data were extracted from the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015. Participants were categorized into five groups: non-sarcopenia non-obesity, non-sarcopenia obesity, non-obesity sarcopenia, possible SO, and SO. MetS was defined using the diagnostic criteria recommended by the National Cholesterol Education Program Adult Treatment Panel III. Logistic regression models were employed for both cross-sectional and longitudinal analysis.

In 2011, a total of 9322 participants were included in the cross-sectional analysis, with 3674 individuals followed up in 2015. In the cross-sectional study, non-sarcopenia obesity (OR = 9.20, CI: 8.06 to 10.50), possible SO (OR = 2.04, CI: 1.94 to 2.15), and SO (OR = 1.61, CI: 1.47 to 1.77) were associated with a higher prevalence of MetS. In contrast, non-obesity sarcopenia (OR = 0.85, CI: 0.74 to 0.98) was associated with a lower prevalence. In the longitudinal analysis, non-sarcopenia obesity (OR = 2.87, CI: 2.34 to 3.52) and possible SO (OR = 1.41, CI: 1.30 to 1.53) were associated with an increased incidence of MetS, while non-obesity sarcopenia (OR = 0.75, CI: 0.62 to 0.91) was associated with a reduced incidence. Notably, SO (OR = 1.00, CI: 0.80 to 1.25) was not associated with the incidence of MetS.

Possible SO, defined by low muscle mass, was not associated with subsequent new-onset MetS. This study highlights that the obesity component, rather than the muscle mass component, is the primary driver of MetS risk in middle-aged and older adults in China.

The association between the Metabolic Score for Visceral Fat (METS-VF) and sarcopenia remains unclear. This study aims to explore the relationship between METS-VF and sarcopenia in the middle-aged and older adults in China.

Data were collected from 2011 and 2015 of the China Health and Retirement Longitudinal Survey (CHARLS) and 2948 participants were enrolled in this study. METS-VF was calculated using data from CHARLS. Sarcopenia was defined according to the criteria set by the Asian Working Group for Sarcopenia (AWGS) 2019. Potential confounders were identified through the Directed Acyclic Graph (DAG). The association between METS-VF and sarcopenia was then analyzed using multivariate logistic regression and restricted cubic spline (RCS) analysis.

Compared with low METS-VF, high METS-VF (OR = 1.65, 95 % CI = 1.08-2.52) showed a significant association with the occurrence of sarcopenia. Subgroup and interaction analyses revealed that residence (P for interaction = 0.012) influenced the relationship between METS-VF and sarcopenia. Additionally, RCS analysis demonstrated a non-linear relationship between METS-VF and sarcopenia.

There is a positive non-linear correlation between METS-VF and sarcopenia with residence showing an impact on this association. Early identification of patients with possible sarcopenia by METS-VF is of great value for disease prediction, prevention, early diagnosis and timely treatment to reduce the potential disease burden.

To date, the mechanisms underlying the relationship between lung function and cognitive decline remain poorly understood. This study aims to investigate the mediating effect of depression in the longitudinal association between lung function and subsequent cognitive impairment (CI).

In the China Health and Retirement Longitudinal Study (CHARLS), a total of 7275 participants were included in the final analysis. Lung function was evaluated using peak expiratory flow (PEF) measured by a peak flow meter. A composite cognitive score was used to assess cognitive function. Linear and logistic regression models, along with bootstrap analyses, were used to investigate the mediating effect of depressive symptoms on the relationship between lung function and cognitive decline.

After adjusting for potential covariates, scores on both overall cognition and its four dimensions demonstrated an increasing trend from quartile 1 (Q1) to quartile 4 (Q4) of PEF and PEF% predicted (p < 0.001). Higher PEF values (Q4 vs Q1: OR = 0.93, 95 % CI 0.90 to 0.97, p = 0.001) as well as elevated PEF% predicted (Q4 vs Q1: OR = 0.94, 95 % CI 0.90 to 0.97, p = 0.001) were associated with a reduced risk of developing CI onset. The mediation effect of depression accounted for approximately 8.2 % of the total effect concerning lung function's impact on cognitive decline.

Higher PEF was associated with a slower rate of longitudinal cognitive decline in middle-aged and older adults. Although depressive symptoms acted as a mediator associated with the development of CI, the majority of variance remained unexplained.

Studies have shown that sarcopenia prevalence in the Chinese population aged over 60 years was 14%. The quality of life of older adults with sarcopenia has drawn increasing attention. Sarcopenia-related quality of life has not been well studied. We explored the quality of life of patients with sarcopenia and the related influencing factors in Xinjiang.

This study was conducted from July-September 2023 in the northern and southern regions of Xinjiang, China. Possible sarcopenia and sarcopenia were diagnosed according to the AWGS 2019. The Sarqol® questionnaire was used to evaluate quality of life. A linear regression model with a stepwise method was used to identify quality-of-life-associated factors for possible sarcopenia and sarcopenia.

A total of 987 older adults were enrolled,18.5% had possible sarcopenia, and 15.1% had sarcopenia. Quality of life scores: possible sarcopenia 26.46-92.55 (56.31 ± 14.69), sarcopenia 30.74-90.93 (56.91 ± 13.45).The indicators for which the difference analysis were meaningful, in the group with possible sarcopenia are gender, inhabiting information, ACCI score, hearing loss, social support level and self-rated risk of falling. In the sarcopenia group are gender, ACCI score, hearing loss, vision loss, self-rated health status, number of remaining teeth, self-rated risk for falling, and dysphagia status. The risk factors for quality of life in patients with possible sarcopenia were gender and hearing loss, whereas self-rated of general health, self-rated of poor health, self-rated of very poor health and falls were risk factors in the sarcopenia group.

This study focused on quality of life and factors in older adults with possible sarcopenia or sarcopenia. The research results showed that in order to prevent the decline in the quality of life of older adults with sarcopenia, it is very important to regularly examine the oral health status of the older adults, prevent the occurrence of chronic diseases.Multimodal interventions address common sensory impairments.Carry out aging-friendly renovation of the home environment and conduct balance training to prevent the occurrence of falls among the older adults.

Recent research has reported a potential bidirectional association between sarcopenia and depression, yet systematic evidence supporting this relationship is still lacking. This study evaluated the bidirectional association of sarcopenia with depression to provide reliable evidence for the development of specific prevention and control strategies.

Relevant articles were extracted from PubMed, Embase, Cochrane, and Web of Science from inception to July 4, 2024. Quality was assessed using the Newcastle-Ottawa Scale (NOS) for cohort and case-control studies, and the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for cross-sectional studies. Changes in the association between sarcopenia and depression were compared across different study designs, sources of study subjects, and sarcopenia diagnostic criteria by subgroup analyses. Meta-analysis was conducted using R 4.4.1.

Thirty-three original studies involving 119,421 subjects were incorporated into this review. Pooled analysis revealed a significant reciprocal relationship between sarcopenia and depression in community populations. The risk of depression increased when sarcopenia was the exposure factor [OR = 2.40(95 % CI: 1.87, 3.08)]. Conversely, the risk of sarcopenia significantly increased when depression was the exposure factor [OR = 1.90(95 % CI: 1.44, 2.50)]. Additionally, there was a markedly increased risk of sarcopenia when depressive symptoms were the exposure factor [OR = 1.38(95 % CI: 1.25, 1.53)]. Similar conclusions were obtained in patients with other diseases.

The significant bidirectional association between sarcopenia and depression enhances the prevention, screening, diagnosis, and treatment of depression, thereby improving quality of life and outcomes.

Handgrip strength is a key indicator of overall health in older adults, and its decline is linked to various adverse health outcomes. Despite numerous studies on factors influencing handgrip strength, few attempts have integrated multiple factors into a practical clinical tool. This study aims to develop and validate a nomogram based on a logistic regression model to predict the risk of low handgrip strength in older adults. Using data from the China Health and Retirement Longitudinal Study (CHARLS), 1138 participants were included. Firth-adjusted logistic regression identified predictors of low handgrip strength, with variable selection based on the Bayesian Information Criterion (BIC). Model performance was assessed using calibration curves, ROC curves, and decision curve analysis (DCA). Internal validation was performed with 10-fold cross-validation and bootstrapping, determining the optimal risk threshold. Key predictors identified included age, chronic disease history, marital status, lifestyle, education, BMI, activities of daily living, and glycated hemoglobin. The simplified model exhibited good discriminatory ability (AUC = 0.78) and calibration performance. The optimal threshold (0.40) yielded sensitivity of 72.5% and specificity of 69.8%. Decision curve analysis confirmed significant net benefit within the clinically relevant threshold range. The nomogram provides a practical tool for identifying at-risk individuals and guiding intervention, integrating modifiable and non-modifiable factors for personalized risk assessment and early intervention.

To identify the evidence of gender disparities in frailty and explore the factors contributing to male-female differences.

A longitudinal study.

A total of 24,429 older adults (60+) were enrolled. Frailty was assessed by frailty index and frailty risk based on Rockwood's cumulative deficit frailty index. OLS and logistic regression models were conducted, with Oaxaca-Blinder and Fairlie decomposition methods to further analyse the factors contributing to gender disparities in frailty.

The paper used four waves of the China Health and Retirement Longitudinal Study from 2011 to 2018, a nationwide survey organised by the National Development Institute of Peking University.

Women had higher frailty status than men, with more pronounced increases. Among the factors, education has the most significant association with frailty gender disparities. The contribution of individual characteristics, particularly education, to gender disparities in frailty appeared to diminish over time, while the contribution of family and regional factors remained relatively stable, and the contribution of institutions was deemed inadequate.

The frailty in Chinese older adults is generally on the rise with continuously expanded gender disparities. It is crucial to consider the contributing factors to frailty in older adults for effective prevention and intervention strategies. Additional gender-specific geriatric care policies are needed in order to address gender inequality in health.

The findings of this study highlight the prevalence of increasing gender disparities in frailty and identify that the level of education, per capita annual household income as well as marital status are the most significant factors contributing to the gender gap. Those findings provide policy implications for healthcare nursing service from a gender-specific perspective in order to achieve health equity.

This study has adhered to the STROBE guideline.

No Patient or Public Contribution. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY: This study provided implications on gender-specific geriatric care nursing services. The study highlighted the importance of focusing on frailty and its gender disparities in geriatric clinical nursing.

This study investigates the relationship between the Cardiometabolic Index (CMI) and cardiovascular disease (CVD) risk in diabetic populations using data from the National Health and Nutrition Examination Survey (NHANES) and the China Health and Retirement Longitudinal Study (CHARLS). Understanding the predictive role of CMI in assessing CVD risk is essential for enhancing preventive strategies in diabetic patients.

A cross-sectional analysis was conducted on diabetic participants from NHANES (2005-2018) and CHARLS (2011). CMI was calculated based on the waist-to-height ratio and the triglyceride-to-HDL-C ratio. Multivariable logistic regression models and restricted cubic spline analyses were utilised to evaluate the associations between CMI and CVD risk, adjusting for demographic and clinical covariates.

In the NHANES cohort (n = 2044), a higher CMI was significantly associated with an increased risk of CVD after adjusting for confounding factors (OR = 2.01, p = 0.0074). Similarly, in the CHARLS cohort (n = 3964), a higher CMI was linked to an elevated CVD risk (OR = 1.45, p = 0.009). Subgroup analyses demonstrated consistent results across various age, gender and health status subgroups. The restricted cubic spline analysis revealed significant non-linear trends between CMI and CVD risk in both cohorts (p < 0.05).

CMI is a robust and independent predictor of CVD risk among diabetic individuals across different populations. These findings highlight the potential clinical value of incorporating CMI into routine assessments to identify high-risk diabetic patients. Future longitudinal studies are needed to further validate these findings and explore the underlying mechanisms.

Mild cognitive impairment (MCI) is a critical stage in the development of Alzheimer's disease, and early intervention in patients during this stage may reverse or delay their disease progression. As one of the regions with severe aging in China, it is necessary to understand the prevalence of MCI in Huzhou and adopt effective intervention measures. The study was aimed to investigate the prevalence rate and influencing factors of MCI in the elderly population in Huzhou city.

A cross-sectional study was conducted involving 800 elderly residents of Huzhou city. The Montreal Cognitive Assessment (MoCA) and the activity of daily living (ADL) were used to assess the occurrence of MCI in the elderly. The influencing factors of MCI were investigated by univariate analysis and multi-factor analysis.

A total of 800 questionnaires were sent out in this survey, and 778 were effectively collected, with an effective recovery rate of 97.25%. Among 778 elderly people in Huzhou city, 668 had normal cognitive function, 82 had MCI, and 28 had dementia, the prevalence rate of MCI was 10.54% (82/778). According to the presence or absence of MCI, the patients were divided into an MCI group (n = 82) and a non-MCI group (n = 668). Female (p = 0.026), high age (p = 0.009), low Community Screening Instrument for Dementia (CSI-D) score (p = 0.007), high Dementia Screening Questionnaire (AD8) score (p < 0.001), high Patient Health Questionnaire Depression Scale (PHQ-9) score (p = 0.037) were all risk factors for MCI in the urban elderly population of Huzhou City.

The prevalence of MCI in the elderly population in Huzhou City is high, and its occurrence is closely related to many factors. It is necessary to increase attention to the high-risk population of MCI and implement targeted intervention measures to improve their cognitive function and improve the quality of life of the elderly population.

Normalized creatinine-to-cystatin C ratio (NCCR) was reported to approximate relative skeletal muscle mass and diabetes risk. However, the association between NCCR and cardiometabolic multimorbidity (CMM) remains elusive. This study aimed to explore their relationship in a large-scale prospective cohort.

This study included 5,849 middle-age and older participants from the China Health and Retirement Longitudinal Study (CHARLS) enrolled between 2011 and 2012. The baseline NCCR was determined as creatinine (mg/dL)/cystatin C (mg/L)×10/body mass (kg). CMM was defined as the simultaneous occurrence of two or more of the following conditions: heart disease, stroke, and type 2 diabetes mellitus. Logistic regression analysis and Cox regression analysis were employed to estimate the relationship between NCCR and CMM. The joint effect of body mass index and NCCR on the risk of CMM were further analyzed.

During a median 4-year follow-up, 227 (3.9%) participants developed CMM. The risk of CMM was significantly decreased with per standard deviation increase of NCCR (odds ratio, 0.72; 95% confidence interval, 0.62 to 0.85) after adjustment for confounders (P<0.001). Further sex-specific analysis found significant negative associations between NCCR and CMM in female either without or with one CMM component at baseline, which was attenuated in males but remained statistically significant among those with one basal CMM component. Notably, non-obese individuals with high NCCR levels had the lowest CMM risk compared to obese counterparts with low NCCR levels in both genders.

High NCCR was independently associated with reduced risk of CMM in middle-aged and older adults in China, particularly females.

The long-term effects of early famine exposure on cognitive function remain understudied. This study examined the association between famine exposure and 10-year trajectories of cognitive function, and also assessed the mediating role of depressive symptoms.

We included 2434 participants from waves 1-5 of the China Health and Retirement Longitudinal Study (CHARLS), with complete baseline data and at least three cognitive assessments. Famine exposure data were obtained from the 2000 China Census, and its severity was determined using the pre-famine Cohort Size Shrinkage Index. Group-based trajectory modeling was used to identify distinct 10-year cognitive function trajectories, and logistic regression was used to estimate the association between famine exposure and trajectory membership. The mediating effect of depressive symptoms was assessed using the Karlson-Holm-Breen method.

Among the 2434 participants, two global cognitive function trajectories were identified: persistently low (n = 743, 30.5 %) and persistently high (n = 1691, 69.5 %). Similar patterns were found across cognitive dimensions, including orientation, memory, computation, and drawing. In the fully adjusted model, moderate famine exposure was associated with an increased risk of a persistently low global cognition trajectory [odds ratio (OR) = 1.37, 95 % confidence interval (CI): 1.04-1.82], and severe famine exposure showed a similar trend (OR = 1.57, 95 % CI: 0.97-2.56). Moreover, both moderate (OR = 1.67, 95 % CI: 1.28-2.15) and severe (OR = 1.61, 95 % CI: 1.01-2.54) famine exposures were linked to a heightened risk of a persistently low trajectory for computation, while severe famine exposure was additionally associated with a persistently low trajectory for orientation (OR = 1.90, 95 % CI: 1.15-3.14). Moderate famine exposure, however, was not associated with a persistently low trajectory for orientation (OR = 0.98, 95 % CI: 0.71-1.36). Additionally, while depressive symptoms did not mediate the associations between moderate famine and any cognitive trajectories, they partially mediated the associations between severe famine and global, computation, and orientation trajectories by 20.07 %, 11.76 %, and 10.38 %, respectively.

Our study identified two distinct cognitive function trajectories, with both moderate and severe famine exposure being linked to persistently low trajectories. Furthermore, depressive symptoms partially mediated the association between severe famine exposure and cognitive function in middle-aged and older adults.

Recent studies have highlighted an association between lipid disorders and sarcopenia. The role of the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) has not been explored among Chinese adults. This study aimed to investigate the association between the NHHR and incident sarcopenia in the Chinese population.

The study included a total of 4,046 participants aged 50 years and older without a history of sarcopenia, from the China Health and Retirement Longitudinal Study (CHARLS). A multivariate logistic regression model and a restricted cubic spline model were used to investigate the association between NHHR and sarcopenia. Subgroup and sensitivity analyses were conducted to assess the robustness of the findings.

A total of 309 (7.6%) participants were newly diagnosed with sarcopenia in the 2015 wave. Participants in the highest NHHR quartile (≥3.99) had a significantly lower adjusted odds ratio for sarcopenia (OR = 0.40; 95% CI, 0.280.58; p < 0.001) compared with those in the lowest quartile (<2.24). Restricted cubic spline analysis revealed a nonlinear relationship between NHHR and sarcopenia risk (p for nonlinearity <0.05). In piecewise regression models, the adjusted OR for sarcopenia was 0.65 (95% CI, 0.550.78, p < 0.001) among participants with NHHR <4.4, whereas no significant correlation was observed among those with NHHR ≥ 4.4. No significant interactions were found between NHHR and age, sex, hypertension, or diabetes in stratified analysis (p for interaction >0.05).

There is an inverse relationship between NHHR and sarcopenia risk in the Chinese population. A higher NHHR is associated with a lower risk of sarcopenia below the inflection point, beyond which NHHR is no longer significantly associated with sarcopenia risk.

This study aimed to assess the current situation and influencing factors of life satisfaction among Chinese older adults with hypertension and to identify its key factors.

In this study, 4,197 hypertensive patients were selected from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) database for inclusion in the analysis. A multivariate logistic regression model was used to analyze the influencing factors of life satisfaction in hypertensive patients, and the random forest was further used to rank the importance of the significant influencing factors.

Overall, 29.52% of hypertensive patients reported dissatisfaction with their lives. The life satisfaction of these patients was influenced by a combination of factors. According to the results of the random forest, the variables that significantly influenced life satisfaction, in descending order of importance, are self-rated health, economic status, depressive symptoms, sleep duration, fruits, living arrangements, hearing impairment, heart disease, and gender.

Our research indicates that currently, people with hypertension experience a high level of dissatisfaction with their lives, making it necessary to take preventive and intervention measures from multiple aspects.

Objectives: The longitudinal relationship between sarcopenia, depression, and cognitive impairment has been insufficiently studied in China. This study aimed to characterize the association between sarcopenia and cognitive impairment and the mediating role of depression using nationally representative data. Methods: 7091 middle-aged and older adults were analyzed from the China Health and Retirement Longitudinal Study (CHARLS) across three waves (2011, 2013, and 2015). Cognitive trajectories were modeled using a group-based trajectory model (GBTM), while multivariable ordinal logistic regression was employed to evaluate the associations with cognitive trajectories. The mediating role of depressive symptoms was assessed through bootstrap mediation analysis and cross-lagged panel modeling (CLPM). Results: Trajectory analysis identified four distinct cognitive function patterns: "High and Stable" trajectory (n = 2563, 36.73%), "Middle and Stable" group (n = 2860, 38.76%), "Middle and Decline" group (n = 1280, 18.62%), and "Low and Decline" group (n = 388, 5.90%). Sarcopenia and depressive symptoms were associated with the "Low and Decline" trajectory of cognitive function [Overall: OR (95%CI) of 0.315 (0.259, 0.382) and 0.417 (0.380, 0.459)]. Mediation analysis indicated that depressive symptoms accounted for 11.78% of the relationship between sarcopenia and cognitive trajectories. The cross-lagged panel modeling demonstrated a significant mediation pathway of "T1 cognitive function → T2 depression → T3 sarcopenia", with T2 depression mediating 5.31% of the total effect. Conclusions: Our study identified four distinct cognitive trajectories, with sarcopenia and depressive symptoms significantly associated with worse cognitive trajectories over time. Depressive symptoms mediated the relationship between sarcopenia and cognitive function. This highlights the importance of integrating mental health and physical health interventions to address the interconnected risks associated with aging.

Disability profoundly affects older adults' quality of life and imposes considerable burdens on health care systems in China's aging society. Timely predictive models are essential for early intervention.

We aimed to build effective predictive models of disability for early intervention and management in older adults in China, integrating physical, cognitive, physiological, and psychological factors.

Data from the China Health and Retirement Longitudinal Study (CHARLS), spanning from 2015 to 2020 and involving 2450 older individuals initially in good health, were analyzed. The dataset was randomly divided into a training set with 70% data and a testing set with 30% data. LASSO regression with 10-fold cross-validation identified key predictors, which were then used to develop an Extreme Gradient Boosting (XGBoost) model. Model performance was evaluated using receiever operating characteristic curves, calibration curves, and clinical decision and impact curves. Variable contributions were interpreted using SHapley Additive exPlanations (SHAP) values.

LASSO regression was used to evaluate 36 potential predictors, resulting in a model incorporating 9 key variables: age, hand grip strength, standing balance, the 5-repetition chair stand test (CS-5), pain, depression, cognition, respiratory function, and comorbidities. The XGBoost model demonstrated an area under the curve of 0.846 (95% CI 0.825-0.866) for the training set and 0.698 (95% CI 0.654-0.743) for the testing set. Calibration curves demonstrated reliable predictive accuracy, with mean absolute errors of 0.001 and 0.011 for the training and testing sets, respectively. Clinical decision and impact curves demonstrated significant utility across risk thresholds. SHAP analysis identified pain, respiratory function, and age as top predictors, highlighting their substantial roles in disability risk. Hand grip and the CS-5 also significantly influenced the model. A web-based application was developed for personalized risk assessment and decision-making.

A reliable predictive model for 5-year disability risk in Chinese older adults was developed and validated. This model enables the identification of high-risk individuals, supports early interventions, and optimizes resource allocation. Future efforts will focus on updating the model with new CHARLS data and validating it with external datasets.

Social isolation and loneliness are associated with increased risk of cardiovascular disease (CVD). Most research examining the effects of social isolation and loneliness on CVD is based in Western countries. This study examined the effects of loneliness and social isolation on cardiovascular disease in China.

Data were derived from the China Health and Retirement Longitudinal Study (CHARLS). Social isolation, loneliness and CVD were measured at baseline. The analytical sample size was 6,860 for the analysis of self-reported CVD. Cox proportional-hazard regression adjusted for confounding factors were used to assess the association between baseline isolation, loneliness, and CVD.

Incident CVD was followed-up from 2011 to 2018. During the 7 years of follow-up, we found that loneliness was associated with an increased risk of CVD events (adjusted HR, 1.24; 95% CI, 1.06-1.44). In the moderately isolated group, loneliness was significantly associated with an elevated risk of incident CVD after adjusting for all confounders (adjusted HR, 1.40; 95% CI, 1.13-1.73). Loneliness was significantly associated with an increased risk of incident CVD among female participants (adjusted HR, 1.29; 95% CI, 1.07-1.56).

Loneliness significantly increased the risk of incident CVD, while social isolation did not exhibit a similar correlation. Our findings suggest that targeted and practical social interventions could improve the accuracy and efficiency of identifying individuals at high risk.

This study aimed to identify and analyze the factors associated with the prevalence of diabetes among Chinese adults, using data from the China Health and Retirement Longitudinal Study (CHARLS). Data from the CHARLS cohort, with a mean age of 63.3 years, were analyzed using SPSS software. Descriptive statistics were performed for the overall population, as well as urban and rural subgroups. Logistic regression models were employed to assess the association between diabetes and variables such as age, gender, smoking, alcohol consumption, hypertension, and mental health disorders. Paired-sample t-tests were conducted to evaluate changes in diabetes prevalence across 2015, 2018, and 2020. The average of diabetes increased from 1.08 in 2015 to 1.15 in 2020, with a statistically significant difference (P < 0.001). Paired-sample t-tests showed significant differences between 2020 and 2018, as well as between 2018 and 2015 (P < 0.001). Logistic regression analysis identified hypertension (aOR = 0.447, 95% CI: 0.410-0.488, P < 0.001) and chronic disease (aOR = 0.024, 95% CI: 0.013-0.042, P < 0.001) as key risk factors for diabetes. Mild physical exercise was a protective factor (aOR = 0.813, 95% CI: 0.708-0.935, P < 0.01), while smoking (aOR = 1.220, 95% CI: 1.088-1.369, P < 0.001) and alcohol consumption (aOR = 1.125, 95% CI: 1.020-1.242, P < 0.05) increased the risk. Smoking and alcohol had a greater impact in urban areas, while hypertension and mental health disorders were more influential in rural areas. This study demonstrates that age, gender, smoking, alcohol consumption, hypertension, and mental disorders significantly influence the risk of diabetes among Chinese adults aged 45 and above. Distinct risk factors were identified between urban and rural populations, highlighting the necessity for tailored intervention strategies. The longitudinal analysis from 2015 to 2020 revealed a substantial increase in diabetes prevalence, underscoring the critical need for sustained and targeted public health efforts.

Background/Objectives: Alterations of oxysterols and gut microbiota have been recognized as indicators affecting mild cognitive impairment (MCI) and sarcopenia, respectively, whereas their association with co-dysfunction has not been investigated. Methods: In this study, a total of 1035 individuals were divided into Control (n = 264), MCI (n = 435), and MCI with possible sarcopenia (MPS, n = 336) groups. Cognition and muscle indexes, serum oxysterols, and gut microbiota were measured. Spearman's rank coefficients were calculated to determine their correlations. Results: Performances of global and multidimensional cognitive tests was successively worse in the Control, MCI, and MPS groups. Longer duration of five-time chair stand test, lower 6-meter walk speed, and handgrip strength were observed in the MPS group, along with increased 27-hydroxycholesterol (27-OHC) and 5α,6α-epoxycholesterol and decreased 5α-Cholest-8(14)-ene-3β,15α-diol (15-HC). Higher concentrations of amyloid precursor protein (APP), neurofilament, and C-terminal agrin fragment (CAF) were discovered in the MCI and MPS groups. The α-diversity of gut microbiota in the MCI and MPS group was remarkably decreased, followed by a shifted abundance of microbial taxa, such as Alistipes and Rikenellaceae. Multiple significant correlations were found between cognition and muscle indexes and with oxysterols. Conclusions: Our study indicates that oxysterols and gut microbiota are prominently involved in the co-dysfunction of cognition and muscle.

Few studies have focused on comparing the effect of cognitive frailty (CF) with either cognitive impairment or frailty alone on fall risk. Further, studies investigating the effect of reversible cognitive frailty (RCF) or potentially reversible cognitive frailty (PRCF) on fall risk are scarce. This study aimed to investigate the influence of RCF and PRCF on falls in community-dwelling older adults of China and determine whether CF conferred a higher risk than cognitive impairment or frailty alone.

This study used data from five waves of the China Health and Retirement Longitudinal Study (CHARLS) conducted from 2011 to 2020. A total of 3,200 participants were divided into six groups: Healthy, cognitive impairment [subjective cognitive decline (SCD) and mild cognitive impairment (MCI)], Frailty, and CF (RCF and PRCF), according to their baseline cognitive and frailty status. A generalized estimating equation was applied to measure the association of cognitive status, frailty, and CF with risk of falls. Multivariate logistic regression models were employed to analyze potential multiplicative and additive interactions of baseline cognitive impairment and frailty on fall risk.

Of the 3,200 participants, 17.7% and 8.3% experienced falls and fall-induced injuries, respectively, in wave 2013. After adjusting for all covariates, the participants in the PRCF group [odds ratio (OR) = 1.442, 95% confidence interval (CI): 1.179-1.922] had a higher risk of falling than those in the RCF group (OR = 1.302, 95% CI: 1.053-1.593), while cognitive impairment alone or frailty alone were not associated with increased risk. The interaction analyses revealed a lack of multiplicative (OR = 0.952, 95% CI: 0.618-1.468) or additive [relative excess risk (RERI) =-0.043, 95% CI: -0.495-0.409; attributable proportion (AP) =-0.035, 95% CI: -0.400-0.329; synergy index (S) = 0.840, 95% CI: 0.172-4.095] interactions of cognitive impairment and frailty for falls.

We found that the risk of falls increased in RCF and PRCF compared to either cognitive impairment or frailty alone, with PRCF being associated with a higher risk than RCF.

Not applicable.

Sarcopenia and diabetes are prevalent diseases among middle-aged and elderly population. This study aimed to investigate the bidirectional association between sarcopenia and diabetes.

This study comprised two longitudinal analyses. In cohort 1, the association between baseline diabetes and the risk of new-onset sarcopenia was assessed. In cohort 2, the association between baseline sarcopenia and the risk of new-onset diabetes was examined. Multivariate logistic regression models were used to calculate odds ratios (OR) and 95 % confidence intervals (95 % CI). Cross-lagged panel analysis was used to further validate their bidirectional associations.

Significant bidirectional associations were observed between sarcopenia and diabetes in both cross-sectional and longitudinal analyses (P < 0.05). After four years of follow-up, low handgrip strength (OR: 2.31, 95 % CI: 1.74-3.08) and appendicular skeletal muscle mass index (ASM/Ht2) (OR: 1.25, 95 % CI: 1.20-1.30) were associated with an increased risk of diabetes. Conversely, elevated fasting plasma glucose (FPG) (OR: 1.52, 95 % CI: 1.17-1.96) and glycated hemoglobin A1c (HbA1c) (OR: 1.35, 95 % CI: 1.05-1.73) were associated with a higher risk of sarcopenia. Cross-lagged analysis further confirmed their bidirectional longitudinal association.

This study identified significant longitudinal bidirectional association between sarcopenia and diabetes, highlighting that each condition serves as a risk factor for the other. Clinically, early assessments of handgrip strength and ASM/Ht2 may aid in diabetes prevention, while monitoring FPG and HbA1c could help reduce the risk of sarcopenia.

Pain, cognitive impairment, and sarcopenia share common risk factors and neurophysiological processes, but studies investigating cognition and sarcopenia in older adults with pain are scarce. This study's main aim was to compare cognition and sarcopenia between older adults with and without chronic pain. A secondary aim was to investigate predictors of cognition and sarcopenia at baseline and 3 months while adjusting for confounders. Participants (67 older adults with pain and 67 asymptomatic older adults) were assessed for sociodemographic and clinical information, pain (number of painful body sites - body chart, pain phenotype - PainDETECT, severity and disability - BPI, pain catastrophizing - PCS, and kinesiophobia - Tampa Scale), cognition (MoCA), sarcopenia (risk of sarcopenia - SARC-F, hand grip strength, and calf circumference) and physical activity (RAPA) at baseline and 3 months after. Older adults with and without pain did not differ in cognition (Mean (95% CI): Pain = 21.47 (20.60; 22.34); Asymptomatic = 21.75 (20.89; 22.61)), but older adults with pain had greater signs of sarcopenia than asymptomatic older adults, including higher risk of sarcopenia (Mean (95%CI): Pain=2.89 (2.41; 3.37); Asymptomatic=0.50 (0.32; 0.68)) and lower hand grip strength (Pain=24.01 (21.74; 26.29); Asymptomatic=27.98 (25.80; 30.16)). No between-group differences were found for calf circumference (Pain=35.03 (34.26; 35.79); Asymptomatic=34.55 (33.86; 35.24)). Pain phenotype (baseline) and kinesiophobia (3 months) contributed to poorer cognition. Kinesiophobia and catastrophizing (baseline), and pain severity (3 months) contributed to sarcopenia. Despite no differences in cognition between older adults with and without pain, pain-related variables contributed to explaining sarcopenia and cognition. PERSPECTIVE: This study compared cognition and sarcopenia between older adults with and without pain and explored the association between pain, cognition, and sarcopenia. Groups were similar for cognition, but older adults with pain showed higher signs of sarcopenia. Kinesiophobia and pain severity partially explained cognition and sarcopenia among those with pain.

BackgroundHome-dwelling situations (HDS) and neighborhood social interactions (NSI) significantly impact older adults' post-retirement lives. However, their relationship with subjective cognitive decline plus (SCD-plus), a potential biomarker of preclinical Alzheimer's disease (AD), remains uncertain.ObjectiveTo explore the association between NSI, HDS and SCD-plus among older adults.MethodsThis cross-sectional study utilized data from the Hubei Memory and Aging Cohort Study (HMACS, 2018-2022), examining the relationship between HDS, NSI, and SCD-plus status and feature scores, using logistic and linear regression models.ResultsAmong 3514 adults (age: ≥ 65 y; female: 52.44%), 1329 had SCD-plus status (37.82%). After adjusting for covariates, living with spouse only was associated with lower odds of SCD-plus (odds ratio [OR] = 0.72, 95% confidence interval [CI] [0.55, 0.95]) compared to living alone. Frequent NSI was linked to lower odds of SCD-plus (OR = 0.65, 95% CI [0.54, 0.80]) and reduced feature scores (regression coefficient [β] = -0.16, 95% CI [-0.25, -0.07]). Compared to living alone - no NSI, all other combinations showed better SCD-plus status, especially living with spouse only with frequent NSI, which demonstrated a 55% reduction in likelihood (OR = 0.45, 95% CI [0.28, 0.73]).ConclusionsLiving with spouse only and frequent NSI significantly lowers the odds of SCD-plus, providing a basis for further exploration of the impact of social interactions on cognitive health.

The primary aim of this scholarly investigation was to elucidate the correlation between Number of Pain Sites and cognitive decline within the older adult population. Additionally, the study sought to examine the potential mediating influence of depressive symptoms in moderating the association between pain and cognitive deterioration.

We analyzed 8,835 participants aged 45 and above, with data collected from 2011 to 2018. Participants were categorized into two groups-stable and rapidly declining cognitive function-using the KML3D clustering method. Binary logistic regression analysis was conducted to examine the association between pain status, depressive symptoms, and cognitive trajectories, and mediation analysis was used to assess the mediating role of depression.

Multi-site pain was significantly associated with the risk of rapid cognitive decline (adjusted OR = 1.30, 95% CI: 1.14-1.48), and depressive symptoms were also a significant predictor of rapid cognitive decline (adjusted OR = 1.49, 95% CI: 1.32-1.68). Mediation analysis revealed that depression mediated the effect of pain on cognitive decline, accounting for 25.71% of the total effect.

Our study establishes a significant longitudinal link between Number of Pain Sites and cognitive decline, mediated in part by depressive symptoms. This finding underscores the need for interventions that address pain and depression to potentially decelerate cognitive decline in older adults.

The link between serum insulin level and low muscle mass among older adults is not yet fully understood. This study seeks to investigate this association using data from a nationally representative large-scale survey.

The study utilized data from two waves of the China Health and Nutrition Survey (CHNS) conducted in 2009 and 2015. Subjects meeting the inclusion criteria were classified according to the Asia Working Group for Sarcopenia 2019 criteria. The study employed ordinary least squares (OLS) regression models to analyze the cross-sectional association between appendicular skeletal muscle mass (ASM) and serum insulin level. Additionally, based on the median insulin level in the population without low muscle mass in 2009, these individuals were divided into high insulin and low insulin groups. Logistic regression models were utilized to examine the longitudinal association between low muscle mass and serum insulin level.

In 2009, a cross-sectional association study enrolled a total of 2329 participants aged over 60 years, with 53.1% women and a median age of 68.00 years. The prevalence of low muscle mass in the study population was 30.83%, with females accounting for 60.03%. In the adjusted OLS regression model based on blood biomarker, serum insulin level was positively associated with ASM (β = 0.075, 95% confidence interval (95% CI): 0.034-0.117, P < 0.01). A total of 944 individuals from the 2009 population without low muscle mass were divided into high insulin and low insulin groups based on the median insulin level, and were followed up until 2015. It was found that there was a significant difference in the incidence of low muscle mass between the two groups. (12.44% vs. 7.45%, P = 0.01). The adjusted logistic regression models indicated that higher serum insulin levels were associated with a reduced incidence of low muscle mass (Hazard ratio = 0.958, 95% CI: 0.925-0.989, P = 0.01).

Adequate serum insulin level could potentially serve as a protective factor in preserving healthy muscle mass among Chinese adults aged 60 and above.

Not applicable.

Cre/BW has been widely validated as a reliable biomarker for assessing muscle mass in clinical and epidemiological studies. Accumulating evidence from longitudinal cohort studies has demonstrated a significant association between sarcopenia and progressive cognitive decline in aging populations. To further elucidate this relationship, we conducted a comprehensive analysis using data from a nationally representative survey.

This study utilized longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS), with baseline measurements collected in 2012 and follow-up assessments conducted in 2018. To comprehensively evaluate the association between Cre/BW and cognitive function, we employed a dual analytical approach. Cross-sectional analyses were performed using multivariable-adjusted linear regression models for continuous cognitive scores and logistic regression models for dichotomous cognitive outcomes. For longitudinal assessment, we implemented time-to-event analyses using Cox proportional hazards models, with rigorous adjustment for potential confounders including demographic characteristics, lifestyle factors, and comorbidities.

Initial unadjusted linear regression analysis revealed a significant inverse association between Cre/BW ratio and total cognitive function score (β = -0.111, 95% CI: -0.013 to -0.008, p < 0.001). This association remained statistically significant after comprehensive adjustment for potential confounders, albeit with attenuated effect size (β = -0.052, 95% CI: -0.007 to -0.003, p < 0.001). When analyzing cognitive function scores by quartiles, we observed a consistent pattern where lower Cre/BW ratios were associated with better cognitive performance, even after multivariable adjustment (OR = 0.973, 95% CI: 0.951 to 0.996, p = 0.019). Longitudinal analysis using Cox proportional hazards models demonstrated that higher Cre/BW ratios were significantly associated with increased risk of cognitive impairment (HR = 1.207, 95% CI: 1.073 to 1.359, p = 0.002). Notably, participants in the highest Cre/BW quartile showed a 1.118-fold increased risk of cognitive impairment compared to those in the lowest quartile (95% CI: 1.048 to 1.346, p = 0.007), suggesting a dose-response relationship between Cre/BW ratio and cognitive outcomes.

Our findings demonstrate a significant inverse association between Cre/BW and cognitive function in the general Chinese adult population. Longitudinal analysis revealed that elevated Cre/BW ratio serves as an independent risk factor for cognitive impairment, with this association persisting after extended follow-up and comprehensive adjustment for potential confounding factors.

Probable sarcopenia is a condition related to low muscle strength which increases the risk of sarcopenia. Both probable sarcopenia and sarcopenia increases the risk of dementia. The aim of this study is to investigate the factors associated with dementia among probable sarcopenia and sarcopenia older adults. It was hypothesized that comorbidities among probable sarcopenia and sarcopenia subjects may elevate the risk of dementia.

This study involved 194 older adults with probable sarcopenia and sarcopenia aged 60 years and above. Sarcopenia was assessed using the Asian Working Group of Sarcopenia (AWGS) 2019. Among the parameters investigated in this study were sociodemographic, medical history, anthropometry, body composition, physical fitness, subjective cognitive decline, depressive symptoms, cognitive function and functional status. Dementia risk was assessed using the Montreal Cognitive Assessment (MoCA) tool. Adjusted binary logistic regression was employed to identify the factors associated with dementia among probable sarcopenia and sarcopenia older adults.

Probable sarcopenia subjects with dementia were older (68.5(7.8) years old) as compared to those without dementia (66.0(6.0) years old). Among the probable sarcopenia, 66.1% of the subjects with dementia had hypertension, while 64.3% of the sarcopenia subjects had hypertension. Fat mass was significantly higher among dementia subjects with probable sarcopenia (33.0(6.5) %) as compared to non-dementia subjects (30.4(6.8) %). Multivariate analysis revealed that hypertension (OR: 4.049; 95% CI: 1.510; 10.855, p = 0.005) was the only factor associated with dementia risk among older adults with probable sarcopenia and sarcopenia.

Hypertension is the only factors associated with risk of dementia after adjusting for potential confounders among older adults with probable sarcopenia and sarcopenia. Good control of blood pressure is essential among sarcopenia patients for lowering risk of dementia. Well-designed clinical trials are essential to investigate optimizing blood pressure level to reduce risk of dementia among patients with sarcopenia and probable sarcopenia.

Dysphagia is a geriatric syndrome often unrecognized or underestimated, and there is a lack of studies in a heterogeneous population in intermediate care (IC) services. This study aims to describe the prevalence of dysphagia and its association with geriatric syndromes in older patients in IC.

Prospective cohort study of patients 70 years and older admitted to an IC unit. At admission, the severity of the clinical conditions, comorbidity, delirium, frailty, sarcopenia, nutritional status, and medications were assessed. Each patient was evaluated with the 3-OZ test, and dysphagia was confirmed by a speech therapy consultation. Two multivariable logistic regression models were used to evaluate the association of dysphagia at admission with geriatric syndromes (model 1), along with the severity of illness and admission diagnosis (model 2).

A total of 455 patients were included. The prevalence of dysphagia was 10% and there was a high prevalence of mild-moderate dysphagia in patients with cognitive impairment and moderate risk of malnutrition. In the univariate analysis, an association was found between dysphagia and sarcopenia, malnutrition, and use of antipsychotics. In Model 1, higher odds of dysphagia were associated with the severity of comorbidity (Odds Ratio 6.49, 95% Confidence Interval: 2.02-20.78), and cognitive impairment (OR 0.91, 95% CI: 0.88-10.62); in Model 2, the severity of clinical conditions-NEWS2 (OR 1.61, 95% CI: 1.23-2.13) was associated with dysphagia, besides the severity of comorbidity and cognitive impairment. In a subset of 300 patients, delirium was also associated with dysphagia.

The study provides novel information on dysphagia prevalence in patients admitted to an IC unit and its association with geriatric syndromes. Additional research is needed to further define the relationship between geriatric syndromes and dysphagia, and to adequately standardize speech therapist treatments.

The older adult are at high risk of sarcopenia, making early identification and scientific intervention crucial for healthy aging.

This study utilized data from the China Health and Retirement Longitudinal Study (CHARLS), including a cohort of 2,717 middle-aged and older adult participants. Ten machine learning algorithms, such as CatBoost, XGBoost, and NGBoost, were used to construct predictive models.

Among these algorithms, the XGBoost model performed the best, with an ROC-AUC of 0.7, and was selected as the final predictive model for sarcopenia risk. SHAP technology was used to visualize the prediction results, enhancing the interpretability of the model, and the system was built on a web platform.

The system provides the probability of sarcopenia onset within 4 years based on input variables and identifies critical influencing factors. This facilitates understanding and use by medical professionals. The system supports early identification and scientific intervention for sarcopenia in the older adult, offering significant clinical value and application potential.

Sarcopenia significantly increases the risk of cognitive impairments in older adults. Early detection of mild cognitive impairment (MCI) in individuals with sarcopenia is essential for timely intervention.

To develop an accurate prediction model for screening MCI in individuals with sarcopenia.

We employed machine learning and deep learning techniques to analyze data from 570 patients with sarcopenia from the China Health and Retirement Longitudinal Study (CHARLS). Our model forecasts MCI incidence over the next four years, categorizing patients into low and high-risk groups based on their risk levels.

The model was constructed using CHARLS data from 2011 to 2015, incorporating eight validated variables. It outperformed logistic regression, achieving an Area Under the Curve (AUC) of 0.708 (95% CI: 0.544-0.844) for the test set and accurately classifying patients' risk in the training set. The deep learning model demonstrated a low false-positive rate of 10.23% for MCI in higher-risk groups. Independent validation using 2015-2018 CHARLS data confirmed the model's efficacy, with an AUC of 0.711 (0.95 CI, 0.588-0.823). An online tool to implement the model is available at http://47.115.214.16:8000/ .

This deep learning model effectively predicts MCI risk in individuals with sarcopenia, facilitating early interventions. Its accuracy aids in identifying high-risk individuals, potentially enhancing patient care.

With the acceleration of societal aging, the physical health and cognitive function issues of seniors have increasingly garnered widespread attention. This article explores the impact of physical activity on the physical health and cognitive performance of seniors, aiming to provide a theoretical basis for health management and related policy formulation for seniors, which holds significant academic value and social significance.

This study constructs an ordered logit regression model to analyze the effects of physical activity on the physical health and cognitive performance of seniors, serving as the baseline model, and conducts a parallelism test to verify the model's applicability. To ensure the robustness of the results, various methods were employed for testing, including model substitution, replacement of independent and dependent variables, and the use of propensity score matching analysis. Through these methods, the marginal effects of physical activity on the physical health and cognitive performance of seniors were revealed, and further analysis was conducted on the heterogeneity of physical health and cognitive performance among different groups and regions of seniors.

(1) Physical activity has a significant promoting effect on the physical health and cognitive performance of seniors. Seniors who engage in physical activity demonstrate markedly better physical health and cognitive abilities compared to those who do not participate in physical activity, indicating that physical activity has a positive effect on improving the physical health and cognitive performance of seniors. (2) Physical activity exhibits notable marginal effects on the physical health and cognitive performance of seniors. The probability of seniors who participate in physical activity experiencing improvements in physical health and cognitive performance significantly increases, while those who do not engage in physical activity show the opposite trend, with a decrease in the probability of improvement. (3) There is significant heterogeneity in the effects of physical activity on the physical health and cognitive performance of different senior groups. Specifically, seniors who are female, married, or living in urban areas exhibit more pronounced improvements in health and cognition after engaging in physical activity, indicating that the benefits of physical activity are particularly prominent in these groups.

Seniors who participate in physical activity demonstrate significantly better physical health and cognitive abilities compared to those who do not engage in physical activity, suggesting that physical activity not only helps to delay physical aging but also effectively slows cognitive decline. Future policies should focus on enhancing the promotion and implementation of physical activity among seniors, especially within groups with differentiated needs, to advance the process of healthy aging and further enhance the overall well-being of the senior population.

This study seeks to determine the association between serum uric acid (SUA) and accelerated aging among middle-aged and older adults in China, as well as assess the relationship between SUA trajectories and the risk of accelerated aging.

We utilized data from the China Health and Retirement Longitudinal Study (CHARLS), selecting middle-aged and older participants who completed follow-ups between 2011 and 2015. Biological age was estimated using the Klemera-Doubal method, and accelerated aging was determined by calculating the difference between an individual's biological age and their chronological age. Logistic regression models were employed to analyze the relationship between baseline SUA levels, their trajectories, and accelerated aging, adjusting for potential confounding factors.

A total of 3,520 middle-aged and older participants (average age 59.00 years) were included. The results indicated a significant linear positive correlation between SUA levels and the risk of accelerated aging. Compared to the group with the lowest uric acid levels, those with the highest levels had a markedly increased risk of accelerated aging (OR = 1.5, 95% CI: 1.23-1.83, P < 0.001). Further longitudinal analysis suggested that maintaining low level of SUA associated with a significant reduction in the risk of accelerated aging.

This study indicates that elevated SUA levels constitute a risk factor for accelerated aging in middle-aged and older adults. Maintaining SUA at a low-level help to slow down aging. These findings highlight the importance of monitoring SUA levels in this demographic, providing a scientific basis for developing interventions to delay aging.

Social participation (SP) has been associated with cognitive benefits among older adults; however, little is known about SP patterns and their relationships with cognitive function in cognitively impaired populations. This study aimed to identify SP patterns among cognitively impaired older individuals and evaluate their associations with subsequent cognitive function, specifically mental intactness and episodic memory.

Data were drawn from the China Health and Retirement Longitudinal Study (CHARLS), including 5,673 individuals aged 60 years and older with cognitive impairment from 2015 to 2018. Latent class analysis (LCA) was used to identify SP patterns, and hierarchical linear regression analyses were conducted to examine associations between these patterns and cognitive function.

Four distinct SP patterns were identified: "Offline Social Participation Group" (Class 1), "Intellectual Social Participation Only Group" (Class 2), "Club and Volunteer Activities Group" (Class 3), and "Minimal Social Participation Group" (Class 4). The Class 4 comprised the majority (73%) and exhibited the poorest cognitive outcomes. Compared to the Class 4, Class 2 showed significant improvements in mental intactness (p < 0.001) and episodic memory (p = 0.022), while Class 3 demonstrated significant improvements in mental intactness (p = 0.032) but not episodic memory. Class 1 showed significant improvements in episodic memory (p = 0.023).

This study highlights the cognitive benefits of social participation, particularly intellectual activities, for older adults with cognitive impairment. Targeted interventions promoting SP, especially intellectual activities, are essential to mitigate cognitive decline and improve cognitive resilience in vulnerable populations.

Sarcopenia, characterized by the gradual decline of muscle mass and strength, seriously affects the health and mobility of older adults. The purpose of this study is to investigate the risk factors for sarcopenia, particularly the relationship between chronic diseases and lifestyle factors in individuals aged 60 and over.

This study used data from the Longitudinal Study on Health and Retirement in China (CHARLS) collected in 2011 and 2015. All eligible participants were classified according to the standards established by the Asian Sarcopenia Working Group in 2019. The evaluation of sarcopenia was based on a comprehensive score across five dimensions: strength, assistance in walking, rise from a chair, climb stairs, and falls. A multivariate logistic regression model was employed to explore the risk factors for sarcopenia.

The risk of sarcopenia is significantly influenced by multiple factors. Key findings include the association between past drinking and an increased risk of sarcopenia (HR = 2.198, 95% CI: 1.072-4.560, p < 0.05), indicating that individuals with a history of drinking have more than twice the risk of sarcopenia compared to non-drinkers. Chronic diseases such as stroke were also associated with a significantly elevated risk (HR = 3.137, 95% CI: 1.128-8.721, p < 0.05). Conversely, participation in social activities significantly reduced the risk of sarcopenia (HR = 0.482, 95% CI: 0.265-0.876, p < 0.05). A three-piece spline regression model revealed a nonlinear relationship between physical activity and the risk of sarcopenia, characterized by an initial decline in risk followed by an increase as physical activity levels rose. Moderate-intensity physical activity reduced the risk of sarcopenia by approximately 35% (HR ≈ 0.65). However, high-intensity physical activity led to a rebound in risk, increasing the likelihood of sarcopenia relative to moderate activity. Similarly, adequate sleep duration was associated with a reduced risk of sarcopenia, whereas excessive sleep counteracted this benefit.

The findings underscore the critical role of lifestyle modifications and balanced physical activity in mitigating the risk of sarcopenia among older adults. Implementing targeted interventions for high-risk groups is essential to reduce the incidence of sarcopenia.

Previous investigations have indicated that both sarcopenia and depressive symptoms are linked to a heightened risk of falls. However, the potential synergistic effect of these conditions on fall risk remains unclear. This study aims to assess the combined influence of sarcopenia and depressive symptoms on the occurrence of falls in the Chinese population.

The analysis included 8,405 participants from the China Health and Retirement Longitudinal Study (CHARLS), conducted from 2011 to 2015. Sarcopenia was confirmed using the 2019 Asian Working Group for Sarcopenia (AWGS) algorithm consisting of muscle strength, appendicular skeletal muscle mass (ASM), and physical performance. ASM was calculated using the formula: 0.193 × weight (kg) + 0.107 × height (cm) - 4.157 × sex - 0.037 × age (years) - 2.631. The Center for Epidemiological Research Depression Scale was utilized to assess depressive symptoms, with a cut-off score of 12 points. Depressive sarcopenia is defined as the coexistence of sarcopenia and depression. Multiple logistic regression analyses were conducted to explore the associations among sarcopenia, depressive symptoms, and fall occurrences.

During the four-year follow-up, 1,275 participants reported experiencing falls. A significant synergistic effect was identified between sarcopenia and depressive symptoms regarding fall risk. Compare to robust individuals, those with sarcopenia alone or depression alone had increased falls risks, but those with both conditions exhibited the highest fall risk, with adjusted odds ratios (OR) of 1.21 (95% CI 1.03, 1.42; P = 0.0174), 1.53 (95% CI 1.24, 1.88; P < 0.001), and 1.78 (95% CI 1.48, 2.15; P < 0.001), respectively.

The findings highlight a synergistic effect between sarcopenia and depressive symptoms on fall risk. This study highlights the importance of early detection and intervention for both conditions, especially in older and middle-aged individuals, to mitigate fall risk.

The potential association between depressive status and the risk of mild cognitive impairment (MCI) remains unclear, especially in the absence of prospective evidence. This study aims to elucidate the impact of either depression score or depression on the risk of MCI using longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS).

This prospective study included 5,766 participants from CHARLS followed from 2011 to 2015. We calculated the baseline depression score using the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10) and the cognitive status score after 3 years of follow-up through four dimensions: orientation, memory, calculation, and draw. We collected baseline sociological characteristics and health-related factors as covariates, using multivariate-adjusted logistics regression models (odds ratios (OR) and 95% confidence intervals (CI)) and restricted cubic splines (RCS) to estimate the effect of depressive status on MCI risk.

We observed 724 new cases of MCI at follow-up. Logistics regression analysis showed that participants with depression had a 58% higher risk of developing MCI than those without depression (OR = 1.58, 95%CI: 1.35-1.85), and the positive association persisted after adjusting for covariates such as sociological characteristics of the population and health-related factors (OR = 1.24, 95%CI: 1.04-1.48). We also observed a dose-response relationship between depression score and MCI risk, with participants with 11~20 and 21~30 scores having a progressively higher risk of MCI compared to participants with depression score of 0~10 (p for trend < 0.05), and a 3% increase in MCI risk for each 1-point increase in depression scores (OR = 1.03, 95%CI: 1.01-1.04). RCS analysis also showed a nonlinear association between depression score and MCI risk (p for non-linearity = 0.001), with MCI risk increasing with increasing depression score. In addition, stratified analyses based on sex, age, marital status, residence, BMI, nighttime sleep, smoking status, alcohol drinking status, baseline serological indicators, and comorbidities showed no interaction (p for interaction > 0.05) other than serum total cholesterol levels (p for interaction = 0.008).

Among middle-aged and elderly adults from CHARLS, depression is an independent risk factor for MCI, indicating that individuals with more severe depression symptoms are more likely to suffer from MCI. Early depression screening based on CESD-10 may help identify individuals at high risk of MCI, and early intervention may reduce the incidence of MCI and Alzheimer's disease, thereby reducing the social care burden of an ageing population.

As the population ages, concerns about cognitive decline have become increasingly relevant in medical consultations. This study aims to analyze the interaction between muscle strength, lung function, and cognitive function in Chinese middle-aged and older adults, providing a theoretical basis for better prevention of cognitive decline.

This study used data from the China Health and Retirement Longitudinal Study (CHARLS) wave 3, including 13 716 participants aged 45 years or older. Cognitive function was assessed through two dimensions, resulting in a total score ranging from 0 to 31 points, with higher scores indicating better cognitive function. Muscle strength was measured using normalized grip strength and chair-standing time, while lung function was evaluated using peak expiratory flow (PEF).

Total cognitive function scores exhibited significant correlations with grip strength, chair-standing time, and PEF. Muscle strength and lung function demonstrated significant associations with cognitive function, with lung function emerging as a notable mediating factor. This relationship persisted even after adjusting for potential confounding variables. Specifically, PEF played a substantial mediating role in linking grip strength to cognitive function scores (estimated indirect effect = 0.0132, boot-strapped standard error = 0.0015, boot-strapped standard 95% confidence interval = 0.0104, 0.0162). Additionally, PEF served as a significant mediator in the association between chair-standing time and cognitive function scores (estimated indirect effect = -0.0204, boot-strapped standard error = 0.0023, boot-strapped standard 95% confidence interval = -0.0251, -0.0159).

The study highlights the importance of addressing declines in muscle strength and lung function to identify risk factors associated with cognitive function. Understanding these relationships can provide insights into potential pathways linking these variables and may aid in better prevention of cognitive decline. Further long-term longitudinal cohort studies are needed to explore the causality between these factors.

Sarcopenia, with its complex diagnostic process, is a likely independent predictor of poor prognosis in patients with Alzheimer's disease (AD). However, research on the clinical characteristics and biomarkers of AD patients with sarcopenia (ADSA) is limited.

This study included 180 ADSA and 188 AD patients without sarcopenia (ADNSA), and evaluated demographics, cognitive function, motor capacity, emotional state, and daily living abilities.

ADSA patients were older, with worse motor and cognitive functions, more severe depression, poorer social functioning, and lower daily living abilities compared to ADNSA patients. Multivariate regression identified age, low Frailty Rating Scale (FRS) scores, low serum albumin level, and low creatinine/cystatin C ratio (CCR) as risk factors for sarcopenia. A nomogram model based on these indicators demonstrated high discriminative power and clinical utility.

Sarcopenia significantly affects AD patients' various functions. The nomogram model aids in the early detection of and personalized interventions for sarcopenia in AD.

Sarcopenia is a risk factor for Alzheimer's disease (AD), and the coexistence of sarcopenia affects various functions and quality of life in patients with AD. Serum albumin and Frailty Rating Scale (FRS) scores are significantly associated with both sarcopenia and cognitive assessment indicators in AD patients with sarcopenia (ADSA). The combined sarcopenia nomogram model with indexes of age at diagnosis, creatinine/cystatin C ratio (CCR), FRS score, and albumin levels can aid in effectively identifying and personalizing interventions for sarcopenia in the AD population.