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2021 ◽  
Vol 8 ◽  
Xingqi Cao ◽  
Guanglai Yang ◽  
Xurui Jin ◽  
Liu He ◽  
Xueqin Li ◽  

Objective: Biological age (BA) has been accepted as a more accurate proxy of aging than chronological age (CA). This study aimed to use machine learning (ML) algorithms to estimate BA in the Chinese population.Materials and methods: We used data from 9,771 middle-aged and older Chinese adults (≥45 years) in the 2011/2012 wave of the China Health and Retirement Longitudinal Study and followed until 2018. We used several ML algorithms (e.g., Gradient Boosting Regressor, Random Forest, CatBoost Regressor, and Support Vector Machine) to develop new measures of biological aging (ML-BAs) based on physiological biomarkers. R-squared value and mean absolute error (MAE) were used to determine the optimal performance of these ML-BAs. We used logistic regression models to examine the associations of the best ML-BA and a conventional aging measure—Klemera and Doubal method-BA (KDM-BA) we previously developed—with physical disability and mortality, respectively.Results: The Gradient Boosting Regression model performed the best, resulting in an ML-BA with an R-squared value of 0.270 and an MAE of 6.519. This ML-BA was significantly associated with disability in basic activities of daily living, instrumental activities of daily living, lower extremity mobility, and upper extremity mobility, and mortality, with odds ratios ranging from 1 to 7% (per 1-year increment in ML-BA, all P < 0.001), independent of CA. These associations were generally comparable to that of KDM-BA.Conclusion: This study provides a valid ML-based measure of biological aging for middle-aged and older Chinese adults. These findings support the application of ML in geroscience research and may help facilitate preventive and geroprotector intervention studies.

2021 ◽  
pp. 073346482110538
Shannon T. Mejía ◽  
Tai-Te Su ◽  
Qingyi Lan ◽  
Ajiang Zou ◽  
Aileen Griffin ◽  

Falls are not only a leading cause of death and disability, but also a strain on the capacity for caregivers to provide care. This study examined how the context of caregiving relates to the importance of caregiver-defined mobile fall prevention feature sets. A sample of 266 family caregivers, recruited from a Chinese social media platform, reported care for an older adult and interest in mobile fall prevention technology features. Factor analysis identified three caregiver-defined feature sets: automatic fall response, digitized fall prevention tools, and social features. Multiple regression showed caregivers’ concern about falling was the most robust predictor of a feature set’s importance. Poisson regression revealed that caregiver concern and assistance with instrumental activities of daily living were associated with rating more features as important. Our findings suggest that caregivers are interested in mobile fall prevention technologies that support older adults’ independence while also alleviating concerns about falling.

2021 ◽  
Vol 12 ◽  
Xuelin Feng ◽  
Zubiao Song ◽  
Mengli Wu ◽  
Yanmei Liu ◽  
Sushan Luo ◽  

Introduction: Approximately 10–20% of patients WITH myasthenia gravis (MG) are refractory to conventional immunotherapies. The purpose of this study was to conduct a systematic review and meta-analysis to explore the optimal therapies for refractory MG.Method: Correlative studies were performed through a search in PubMed, Cochrane Library, and Embase databases. The primary outcome was defined by changes in the quantitative myasthenia gravis score (QMG). Secondary outcomes were defined by the Myasthenia Gravis Activities of Daily Living Scale (MG-ADL), Myasthenia Gravis Foundation of America (MGFA) post intervention status, adverse events, and disease exacerbation after treatment.Result: A total of 16 studies were included with 403 patients with refractory MG on therapies with rituximab, eculizumab, tacrolimus, and cladribine. Therapeutic efficacy of rituximab and eculizumab was identified with an estimated reduction in QMG score (4.158 vs. 6.928) and MG-ADL (4.400 vs. 4.344), respectively. No significant changes were revealed in efficacy or exacerbation density between the two independent therapeutic cohorts. The estimated adverse event density of eculizumab was more significant than that in the rituximab group (1.195 vs. 0.134 per patient-year), while the estimated serious event density was similar.Conclusion: The efficacy and safety of rituximab and eculizumab have been approved in patients with refractory MG. Rituximab had a superior safety profile than eculizumab with a lower incidence of adverse events.Systematic Review Registration:, identifier CRD42021236818.

2021 ◽  
Vol 23 (4) ◽  
pp. 395-405
Jin-Yeong Kim ◽  
Gwi-Ryung Son Hong

Purpose: The purpose of this study was to identify the factors associated with the fear of falling after discharge in older adults who had surgery for fall fractures.Methods: The participants were 143 older adults aged 65 or older hospitalized at the General Hospital due to a fall fracture. Data were collected from July 2019 to June 2020 using questionnaires for activities of daily living, pain, depression, and fear of falling. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson’s correlation, and multiple regression.Results: The average age of the subjects was 75.34±6.89 years, and 74.1% were women. The influencing factors on the fear of falling after discharge were activities of daily living (β=.31, p=.001), age (β=.20, p=.004), the need for walking aids or assistance in walking before the fall (β=.20, p=.005), and pain (β=.15, p=.027). Total explained variance was 55% (F=13.17, p<.001).Conclusion: Based on the results of this study, it is necessary to actively intervene the fear of falling once older adults are hospitalized, considering the factors associated with the fear of falling after discharge in older adults who had surgery after experiencing a fall fracture and to develop an educational program to reduce the fear of falling.

2021 ◽  
Vol 23 (4) ◽  
pp. 342-351
Hayoung Park ◽  
Oksoo Kim

Purpose: The aim of this study was to investigate hearing handicaps, instrumental activities of daily living, and hearing-handicap-related quality of life among community-dwelling older adults and identify factors that influence hearing-handicap-related quality of life.Methods: A total of 129 older adults aged 65 and over participated in the study, and data collection was conducted from December 20th, 2020 to March 20th, 2021. Descriptive statistics, t-test, ANOVA, Pearson’s correlations, and multiple linear regression were used for data analysis.Results: Self-reported hearing handicaps positively associated with instrumental activities of daily living (r=.82, p<.001), and negatively associated with hearing-handicap-related quality of life (r=-.80, p<.001). Instrumental activities of daily living negatively associated with hearing-handicap-related quality of life (r=-.71, p<.001). Hearing handicaps influenced hearing-handicap-related quality of life (β=-.70, p<.001). A regression model explained 66% of the variance in hearing-handicap-related quality of life.Conclusion: Hearing handicaps affect hearing-handicap-related quality of life of older adults living in the community. Therefore, nursing interventions to prevent hearing handicaps are required to improve hearing-handicap-related quality of life of older adults.

Lin-Yen Chen ◽  
Tzu-Jung Fang ◽  
Yu-Chih Lin ◽  
Hsiu-Fen Hsieh

With 16.15% of its total population aged 65 or above, Taiwan is already an aging society. Frailty is a natural consequence of aging, which may decrease physical strength and deteriorate physiological functioning. We examined the mediating effects of cognitive function, social support, activities of daily living (ADL), and depression in the relationship between age and frailty in older people living in the community. This cross-sectional study used a structured questionnaire to collect data from a convenience sample of 200 pre-frail to mildly frail older adults in southern Taiwan. Structural equation modeling was used for data analysis, with data collected from July to November 2020. ADL mediated the relationship between age and frailty, while cognitive function also mediated the relationship between age and frailty, indicating that ADL and cognitive function were significant determinants of frailty. The path from age to frailty was significant, indicating that age was a significant determinant of frailty. The standardized total effect of age affected frailty through the mediating roles of ADL and cognitive function. Age, depression, ADL, and cognitive function explained 59% of the variance in frailty among older adults. ADL and cognitive function are significant mediators of frailty among older adults.

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4291
Qianqian Gao ◽  
Kaiyan Hu ◽  
Chunjuan Yan ◽  
Bing Zhao ◽  
Fan Mei ◽  

(1) Background: To review the associated factors of sarcopenia in community-dwelling older adults. (2) Methods: PubMed, Embase, Web of Science, and four Chinese electronic databases were searched for observational studies that reported the associated factors of sarcopenia from inception to August 2021. Two researchers independently selected the literature, evaluated their quality, and extracted relevant data. The pooled odds ratio (OR) and its 95% confidence interval (CI) were calculated for each associated factors of sarcopenia using random-effects/fixed-effects models. Publication bias was assessed using funnel plot and the Eggers test. We performed statistical analysis using Stata 15.0 software. (3) Results: A total of 68 studies comprising 98,502 cases were included. Sociodemographic associated factors of sarcopenia among community-dwelling older adults included age (OR = 1.12, 95% CI: 1.10–1.13), marital status (singled, divorced, or widowed) (OR = 1.57, 95% CI: 1.08–2.28), disability for activities of daily living (ADL) (OR = 1.49, 95% CI: 1.15–1.92), and underweight (OR = 3.78, 95% CI: 2.55–5.60). Behavioral associated factors included smoking (OR = 1.20, 95% CI: 1.10–1.21), physical inactivity (OR = 1.73, 95% CI: 1.48–2.01), malnutrition/malnutrition risk (OR = 2.99, 95% CI: 2.40–3.72), long (OR = 2.30, 95% CI: 1.37–3.86) and short (OR = 3.32, 95% CI: 1.86–5.93) sleeping time, and living alone (OR = 1.55, 95% CI: 1.00–2.40). Disease-related associated factors included diabetes (OR = 1.40, 95% CI: 1.18–1.66), cognitive impairment (OR = 1.62, 95% CI: 1.05–2.51), heart diseases (OR = 1.14, 95% CI: 1.00–1.30), respiratory diseases (OR = 1.22, 95% CI: 1.09–1.36), osteopenia/osteoporosis (OR = 2.73, 95% CI: 1.63–4.57), osteoarthritis (OR = 1.33, 95% CI: 1.23–1.44), depression (OR = 1.46, 95% CI: 1.17–1.83), falls (OR = 1.28, 95% CI: 1.14–1.44), anorexia (OR = 1.50, 95% CI: 1.14–1.96), and anemia (OR = 1.39, 95% CI: 1.06–1.82). However, it remained unknown whether gender (female: OR = 1.10, 95% CI: 0.80–1.51; male: OR = 1.50, 95% CI: 0.96–2.34), overweight/obesity (OR = 0.27, 95% CI: 0.17–0.44), drinking (OR = 0.92, 95% CI: 0.84–1.01), hypertension (OR = 0.98, 95% CI: 0.84–1.14), hyperlipidemia (OR = 1.14, 95% CI: 0.89–1.47), stroke (OR = 1.70, 95% CI: 0.69–4.17), cancer (OR = 0.88, 95% CI: 0.85–0.92), pain (OR = 1.08, 95% CI: 0.98–1.20), liver disease (OR = 0.88, 95% CI: 0.85–0.91), and kidney disease (OR = 2.52, 95% CI: 0.19–33.30) were associated with sarcopenia. (4) Conclusions: There are many sociodemographic, behavioral, and disease-related associated factors of sarcopenia in community-dwelling older adults. Our view provides evidence for the early identification of high-risk individuals and the development of relevant interventions to prevent sarcopenia in community-dwelling older adults.

2021 ◽  
Vol 11 (1) ◽  
José Antonio Santoyo-Ramón ◽  
Eduardo Casilari-Pérez ◽  
José Manuel Cano-García

AbstractWearable Fall Detection Systems (FDSs) have gained much research interest during last decade. In this regard, Machine Learning (ML) classifiers have shown great efficiency in discriminating falls and conventional movements or Activities of Daily Living (ADLs) based on the analysis of the signals captured by transportable inertial sensors. Due to the intrinsic difficulties of training and testing this type of detectors in realistic scenarios and with their target audience (older adults), FDSs are normally benchmarked against a predefined set of ADLs and emulated falls executed by volunteers in a controlled environment. In most studies, however, samples from the same experimental subjects are used to both train and evaluate the FDSs. In this work, we investigate the performance of ML-based FDS systems when the test subjects have physical characteristics (weight, height, body mass index, age, gender) different from those of the users considered for the test phase. The results seem to point out that certain divergences (weight, height) of the users of both subsets (training ad test) may hamper the effectiveness of the classifiers (a reduction of up 20% in sensitivity and of up to 5% in specificity is reported). However, it is shown that the typology of the activities included in these subgroups has much greater relevance for the discrimination capability of the classifiers (with specificity losses of up to 95% if the activity types for training and testing strongly diverge).

2021 ◽  
Vol 12 ◽  
An Li ◽  
Dewen Wang ◽  
Shengnan Lin ◽  
Meijie Chu ◽  
Shiling Huang ◽  

With increasing age, middle-aged and older persons face a series of physical and mental health problems. This study aimed to explore the latent relationships among age, functional disability, depression, and life satisfaction. The data were obtained from the Wave 2 (in 2013–2014) and Wave 3 (in 2015–2016) surveys of the China Health and Retirement Longitudinal Study. The analytic sample in the present study included 15,950 individuals aged 45 years and over. The participants answered the same questions concerning depression and life satisfaction in both study waves, and functional disability was measured based on the activities of daily living and instrumental activities of daily living. Age was directly associated with functional disability, life satisfaction, and depression. Functional disability was positively correlated with depression and negatively correlated with life satisfaction. Functional disability strongly mediated the relationships among age, depression, and life satisfaction. Depression and life satisfaction were found to have enduring effects and effects on each other. Additionally, the model revealed a gender difference. Depression in middle-aged people should receive closer attention. Avoiding or improving functional disability may be an effective way to improve life satisfaction and reduce the level of depression in middle-aged and older persons. If prevention work successfully decreases depression, the life dissatisfaction of middle-aged and older people could be improved. Additionally, for the prevention of functional disability and depression and improvement in life satisfaction, gender differences need to be considered.

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