Late-life depression (LLD), characterized by complex pathogenesis and heterogeneous clinical manifestations, has become a significant public health challenge in aging societies. This review systematicly synthesizes the latest advancements in genomic, epigenomic, transcriptomic, proteomic, metabolomic, and multi-omics integrated studies on LLD, provides novel biomarkers and therapeutic strategies for early diagnosis, prognosis assessment, and personalized treatment. Future research should focus on achieving breakthroughs in large-scale cross-ethnic validation, biomarkers translation, and age-related interventions.

Frailty is a geriatric syndrome that reflects declining physiological reserve and strongly impairs quality of life of the elderly. Recently study implicated systemic processes such as oxidative stress and chronic inflammation in the acceleration of physical decline, yet the precise pathogenesis of frailty remains elusive. Accurate screening tools and a clear understanding of its molecular basis are therefore essential for early identification and intervention, which is the key challenges in frailty field. The rapid evolution of multi-omics technologies (including genomics, transcriptomics, proteomics, metabolomics, and microbiomics) has ushered frailty investigations into a new era. This paper reviews the current application of multi-omics approaches in frailty research, highlighting their immense potential for discovering novel biomarkers and exploring pathogenic mechanisms.

With the advancement of social modernization and global population aging, sleep disorders among the elderly have become increasingly prominent. The elderly commonly experience difficulties in falling asleep, insufficient sleep duration, and frequent sleep interruptions. Poor sleep quality can lead to a range of health issues, including falls, fatigue, exhaustion, and subjective cognitive decline. Sleep disorders are complex polygenic conditions influenced by gene-environment interactions. By investigating the pathogenesis of various types of sleep disorders in the elderly population in China through multi-omics approaches (encompassing genomics, transcriptomics, proteomics, and metabolomics) as well as key molecular regulatory networks, novel regulatory targets for sleep disorders can be identified. These findings may provide both foundational and clinical scientific evidence to support the development of diagnosis and treatment strategies for sleep disorders in the elderly in China.

Sarcopenia is an age-related degenerative disease characterized by progressive loss of skeletal muscle mass and function. In recent years, although significant progress has been made in the research on the pathogenesis of sarcopenia, its fundamental etiology and molecular mechanisms have not been fully clarified, and it involves a complex regulatory network. With the development of high-throughput technology, omics technology, with its powerful systematic analysis capabilities, has become an important tool for exploring potential biomarkers and related molecular mechanisms of sarcopenia. This paper reviews the current application status and latest progress of various omics methods (including genomics, transcriptomics, proteomics, and metabolomics) in sarcopenia research. This review aims to provide theoretical basis and new ideas for future research, promote the discovery of therapeutic targets and biomarkers, which has significant scientific value for the development of novel intervention strategies.

Hearing impairment, one of the most prevalent age-related syndromes, ranks as the third leading health condition affecting quality of life in the eldery. Its complex pathogenesis results from the combined effects of genetic, environmental, and metabolic factors. While single-omics approaches are limitated in comprehensively analyzing this intricate mechanism, the recent emergence of multi-omics technologies has opened new avenues for revealing the pathogenic mechanisms of hearing disorders. This review synthesizes recent advancements in genomics, epigenomics, transcriptomics, proteomics, metabolomics, and multi-omics integration within the field of hearing impairment research. Although multi-omics studies have deepened our understanding of hearing disorder mechanisms, future research must focus on mechanistic exploration and clinical translation to advance precision prevention and treatment strategies.

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive impairment and neuronal damage, with its pathogenesis involving the interaction of multiple factors including genetic, epigenetic, proteostatic imbalance, and metabolic disorders. In recent years, integrated studies using multi-omics technologies such as genomics, epigenomics, transcriptomics, proteomics, and metabolomics provide new insights into AD’s molecular mechanisms. The integration of multi-omics data not only aids in discovering early biomarkers for AD but also offers novel strategies for targeted therapies (such as HDAC6 inhibitors and natural compound interventions). Future research should combine single-cell technology with artificial intelligence to advance precision diagnosis and treatment of AD.

Objective To evaluate the quality of Frailty Screening Questionnaire (FSQ) in older adults in terms of acceptability, reliability and validity. Methods A total of 249 older adults aged ≥60 years were selected for frailty screening and assessment using FSQ and Fried Frailty Phenotype. Acceptability was evaluated through scale acceptance rate, criterion attainment rate, and completion time. Internal consistency reliability was assessed using Cronbach’s α, Spearman-Brown coefficient and Guttman split-half reliability. Exploratory factor analysis was used to evaluate construct validity. Criterion validity was evaluated by comparing the correlations of the FSQ with the Fried Frailty Phenotype. Results Acceptability analysis demonstrated a 100% acceptance rate and 100% pass rate for the scale, with completion time within 1 minute. Internal consistency reliability tests showed the FSQ’s Cronbach’s α coefficient, Spearman-Brown coefficient, and Guttman split-half coefficients were 0.608,0.516, and 0.472 respectively. Exploratory factor analysis identified two common factors contributing 62.08% of total variance, with item factor loadings ranging from 0.487 to 0.924. Validity assessment revealed a significant correlation coefficient of 0.683 (P<0.001) between the FSQ and Fried’s Frailty Phenotype. Conclusions FSQ has good acceptability, reliability and validity, which can be used as a reliable tool for the screening of frailty in the elderly.

Objective To investigate the interaction and mediating effects of thoracic paravertebral block (TPVB) and opioid consumption(oral morphine equivalent,OME) on postoperative pulmonary complications (PPCs) in the elderly patients undergoing thoracoscopic partial pulmonary resection (TPPR). Methods The data of 816 elderly patients aged ≥65 years old who underwent TPPR at the First Affiliated Hospital of Nanjing Medical University were analyzed retrospectively. The patients were divided into PPCs group and non-PPCs group according to whether they presented with PPCs. Multivariate logistic regression was used to evaluate the independent effect of TPVB and OME on PPCs, and the interaction effect and mediation effect between TPVB and OME were analyzed. Results The incidence rate of PPCs was 40.4%. Multivariate logistic regression analysis showed that OME was a risk factor for PPCs, while TPVB was a protective factor (P<0.001). The multiplicative interaction between these two factors showed that the patients who did not receive TPVB and were administered high-dose opioids had a 4.6-fold increased risk of developing PPCs (OR=4.556, 95% CI: 2.248-9.234). Even with the use of TPVB combined with high doses of opioids, the risk of PPCs was 2.1 times higher (OR=2.098, 95% CI: 1.126-3.910). Moreover, opioid consumption was found to mediate the relationship between TPVB and PPCs (Z=-2.124, P=0.034). Conclusions TPVB and opioid consumption exert significant interactive and mediating effects on the development of PPCs in the elderly patients undergoing TPPR. In clinical practice, optimizing perioperative analgesia, actively applying TPVB, and appropriately regulating opioid administration are crucial to reduce the risk of PPCs in the elderly patients with TPPR.

Objective To analyze the effect of intraoperative blood transfusion on deep venous thrombosis (DVT) of lower limbs in the elderly patients after neurosurgery. Methods The clinical data of 352 elderly patients who underwent neurosurgery in Changhai Hospital from January 2023 to November 2024 were retrospectively analyzed. According to whether intraoperative blood transfusion was performed, the patients were divided into blood transfusion group (82 cases) and non-blood transfusion group (270 cases). The clinical data and the incidence of postoperative DVT were compared between the two groups. In addition, the patients were divided into DVT group (104 cases) and non-DVT group (248 cases) according to whether DVT occurred in the lower limbs after operation. Univariate and multivariate logistic regression analysis was used to analyze the independent risk factors for DVT in the lower limbs. Results There were significant differences in American Society of Aneshesiologists (ASA ) classification and postoperative fibrinogen level between blood transfusion group and non-blood transfusion group (P<0.05). The incidence of DVT in 352 patients was 29.55% (104/352), and the incidence of DVT in blood transfusion group was higher than that in non-blood transfusion group (45.12% vs 24.81%, P<0.001). Multivariate logistic analysis showed that after adjusting age, hypertension, dehydrating agent use, prolonged bed rest, comorbid malignancy, postoperative D-dimer level, the risk of DVT in blood transfusion patients was higher than that in non-blood transfusion patients (OR=2.502, 95%CI: 1.357-4.613, P<0.05). Conclusions Intraoperative blood transfusion is an independent risk factor for postoperative DVT of lower limb in the elderly patients undergoing neurosurgery.

Objective To explore the impact of sarcopenic obesity(SO) and chronic inflammation on the prognosis of the elderly patients with metastatic driver gene-negative non-small cell lung cancer(NSCLC). Methods A total of 99 elderly patients with metastatic driver gene-negative NSCLC treated at Department of Oncology of the First Affiliated Hospital with Nanjing Medical University and Geriatric Hospital of Nanjing Medical University from January 2020 to December 2022 were enrolled retrospectively. The patients were divided into SO group and non-SO group according to the result of CT body composition analysis. The first-line treatment regimen consisted of platinum-based doublet chemotherapy plus immunotherapy. Chronic inflammation was assessed using the fibrinogen-to-albumin ratio(FAR). Median progression-free survival (mPFS), median overall survival (mOS), FAR, and adverse reactions were compared between the groups. Results In SO group and non-SO group, mPFS was 7.0 months (95%CI:6.7-7.3) and 10.2 months (95%CI:8.9-11.5), and mOS was 12.0 months (95%CI:10.1-13.9) and 18.2 months (95%CI:14.2-22.2) respectively. Both mPFS and mOS in SO group were significantly lower than those in non-SO group(P＜0.05) .FAR was 0.090(0.079-0.098) and 0.060(0.050-0.068) in SO group and non-SO group, respectively (P＜0.001). High FAR was present in 18.4% (9 cases) of SO group and 4.0% (2 cases) in non-SO group. The proportion of chemotherapy intensity reduced to <50% of standard due to adverse reactions in SO group was significantly higher than that in non-SO group(49.0% vs 20.0%, P＜0.05). Conclusions SO may induce chronic low-grade inflammation, which is associated with poor treatment tolerance and prognosis in the elderly patients with metastatic driver gene-negative NSCLC.

Objective To explore the relationship between serum homocysteine (Hcy) levels and insomnia in the elderly patients with acute ischemic stroke (AIS). Methods A total of 98 elderly patients with AIS in 981st Hospital of China People’s Liberation Army Joint Logistics Support Force from May 2022 to May 2024 were selected and divided into the insomnia group (n=40) and the non-insomnia group (n=58) based on whether insomnia occurred. The clinical data of the two groups were compared, and multiple logistic regression analysis was used to investigate the influencing factors for insomnia in the elderly AIS patients. Restricted cubic spline models were employed to analyze the association between Hcy level and the risk of insomnia in the elderly AIS patients. Results Age, scores of Hamilton Anxiety Scale(HAMA) and Hamilton Depression Scale(HAMD) and serum Hcy level in the insomnia group were higher than those in the non-insomnia group (P<0.05). Multivariate logistic regression analysis showed that age, HAMA score, HAMD score and serum Hcy level were influencing factors for insomnia in the elderly AIS patients (P<0.05). Restricted cubic spline model analysis indicated a nonlinear dose-response relationship between serum Hcy level and the risk of insomnia in the elderly AIS patients (P<0.05). Conclusions There is a nonlinear dose-response relationship between serum Hcy level and the risk of insomnia in the elderly patients with AIS. Monitoring patients’ Hcy levels can help to identify and prevent insomnia early and improve patients’ prognosis.

Objective To explore the correlations of the levels of serum neurofilament light chain (NfL), homocysteine (Hcy), and meteorin-like protein (Metrnl) with diabetic peripheral neuropathy (DPN) in the elderly with type 2 diabetes mellitus(T2DM), so as to provide new reference indicators for the early diagnosis of DPN in the elderly. Methods From July 2022 to June 2024, 81 elderly patients with T2DM admitted to NO.215 Hospital of Shaanxi Nuclear Industry were divided into DPN group (n=31) and non-DPN group (n=50) according to whether DPN occurred. The general clinical information of all the patients were collected, and enzyme linked immunosorbent assay was used to detect the serum levels of NfL, Hcy, and Metrnl. Multivariate logistic regression was used to analyze the influencing factors for DPN in the elderly T2DM patients. The diagnostic value of each indicator for DPN was analyzed by the receiver operating characteristic(ROC) curve. Results The course of disease in DPN group was significantly longer than that in non-DPN group(P<0.05). The levels of NfL, Hcy and fasting plasma glucose(FPG) in DPN group were higher and the levels of Metrnl and fasting C-peptide were lower than those in non-DPN group (P<0.05). Multivariate logistic regression suggested that long disease duration, high levels of FPG, NfL and Hcy were risk factors for DPN in elderly T2DM patients, while high levels of fasting C-peptide and Metrnl were protective factors for DPN (P<0.05). The area under curve (AUC) of combined diagnosis was 0.968, with a sensitivity and specificity of 93.55% and 90.00%, respectively, which was better than those of individual diagnosis (P<0.05). Conclusions The serum levels of NfL and Hcy are significantly increased, and the Metrnl level is significantly decreased in elderly DPN patients. The three indicators could be used as early diagnostic indicators for DPN, and the combined detection is of great significance to improve the diagnostic efficacy.

Objective To evaluate the effect of preoperative nebulized esketamine on the incidence and severity of sufentanil-induced cough(SIC)during general anesthesia induction in the elderly. Methods A total of 102 elderly patients scheduled for elective tracheal intubation and general anesthesia surgery at Geriatric Hospital of Nanjing Medical University from April 2023 to April 2024 were enrolled and randomly divided into control group and esketamine group. The esketamine group received esketamine nebulization before surgery, while the control group received 0.9% saline nebulization. The incidence and severity of SCI, dizziness, nausea, vomiting, chest tightness, and respiratory depression within 1 minute after sufentanil injection for anesthesia induction were recorded. Heart rate(HR) and mean arterial pressure(MAP) were observed and compared before pre-treatment (T₀), 2 minutes after pre-treatment (T₁), at intubation (T₂), and 2 minutes after intubation (T₃).The time of extubation and the incidence of adverse events in the postanesthesia care unit(PACU) such as agitation, respiratory depression, delayed recovery from anesthesia, postoperative nausea and vomiting(PONV), sore throat and hoarseness 30 minutes after extubation were recorded. Results In the esketamine group, the incidence rates of SCI and mild to moderate cough within 1 minute after sufentanil injection were significantly lower than those in the control group (P<0.05). There were no significant differences in HR and MAP between the two groups at T₀-T₃ (P>0.05). Compared with the control group, the incidence rates of sore throat and hoarseness 30 minutes after extubation in the esketamine group were significantly decreased (P<0.05).There were no significant differences in the incidence rates of dizziness, nausea, vomiting, chest tightness, respiratory depression within 1 minute after sufentanil injection, adverse events in the PACU, and extubation time between the two groups (P>0.05). Conclusions Preoperative esketamine nebulization can significantly reduce the incidence and severity of SIC during anesthesia induction, reduce the incidence rates of postoperative sore throat and hoarseness, without increasing the adverse reactions related to opioids and adverse events during PACU, and has no significant effect on intraoperative hemodynamic stability and postoperative anesthesia awakening.

Objective To investigate the correlation of triglyceride glucose index (TyG index) and its derivative indices with atrial fibrillation (AF) in the elderly patients with coronary heart disease (CHD). Methods A retrospective analysis included 261 patients with CHD admitted to Cardiovascular Department of Xuzhou Central Hospital from October 2022 to October 2023 was conducted. All patients were divided into CHD without AF group (n=128) and CHD with AF group (n=133) according to the presence of AF during hospitalization. The clinical data and laboratory results were collected, and TyG index and TyG-BMI index were subsequently calculated. Multivariate logistic regression analysis was used to analyze the risk factors for AF in CHD patients. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive value of TyG index and TyG-BMI index for AF in CHD patients. Spearman correlation coefficient was used to evaluate the correlation between TyG index, TyG-BMI index and the severity of AF. Results The levels of TyG index and TyG-BMI index in CHD with AF group were significantly higher than those in CHD without AF group (P<0.05). Multivariate logistic regression analysis showed that TyG index was an independent risk factor for AF in CHD patients (P<0.05). The areas under the ROC curve of TyG index and TyG-BMI index in predicting AF in CHD patients were 0.736 (95%CI: 0.675－0.797, P<0.05), and 0.621 (95% CI: 0.552－0.689, P<0.05), respectively. Spearman rank correlation analysis showed positive correlations between both indices and the severity of AF(r=0.337 for TyG index, r=0.202 for TyG-BMI index, both P<0.01). Conclusions TyG index is an independent risk factor for AF in CHD patients, and demonstrates predictive value for the occurrence of AF. It is positively correlated with the severity of AF. Monitoring TyG index can help identify high-risk patients with AF.

Objective To investigate the effect of Yueju pill combined with sacubitril/valsartan in the treatment of the elderly patients with permanent atrial fibrillation and heart failure. Methods A total of 100 elderly patients with permanent atrial fibrillation and heart failure admitted to Yixing Hospital of Traditional Chinese Medicine from July 2023 to June 2024 were enrolled and randomly divided into two groups by random number table. The control group was given sacubitril/valsartan combined with ventricular rate control therapy. The study group was given Yueju pill on the basis of control group. The cardiac function and efficacy were compared between the two groups. Results The total effective rate of the study group was 92%, which was higher than that of the control group (74%) (P<0.05). After treatment, the serum levels of intercellular adhesion molecule-1 (ICAM-1), N-terminal pro-brain natriuretic peptide (NT-proBNP) and adrenocorticotropic hormone (ACTH)were significantly lower, and the level of left ventricular ejection fraction (LVEF) was higher in the two groups than those before treatment, especially in the study group, and the differences were statistically significant (P< 0.05). Conclusions Yueju pill combined with sacubitril/valsartan is effective in the treatment of the elderly patients with permanent atrial fibrillation and heart failure,which can effectively improve the cardiac function and improve the quality of life.

Objective To evaluate the therapeutic effect, safety and recurrence rate of mild to moderate atopic dermatitis (AD) in the elderly treated with sequential topical application of 0.1% mometasone furoate cream and 2% crisaborole ointment. Methods The clinical data of 209 elderly outpatients with mild to moderate AD who were diagnosed and treated at the Department of Dermatology of Geriatric Hospital of Nanjing Medical University from July 2022 to August 2024 were retrospectively analyzed. According to different medication regimens, they were divided into three groups: sequential treatment group (n=73), mometasone furoate group (n=68), and crisaborole group (n=68). The scores of Scoring Atopic Dermatitis (SCORAD) before and after treatment, pruritus visual analogue scale (VAS), the clinical efficacy, pruritus relief indices, adverse reactions after treatment and recurrence rate 4 weeks after discontinuation were observed and compared among the three groups. Results After 4 weeks of treatment, the SCORAD score and efficacy index showed no significant differences between the three groups, however, showing significant differences between both groups and the crisaborole group(P＜0.001). The effective rate showed no significant differences between the sequential treatment group and the mometasone furoate group and the crisaborole group.The adverse reaction rate was lower in the sequential treatment group than that in the mometasone furoate group(8.2% vs 25.0%, P＜0.05). Four weeks after discontinuation, the recurrence rate showed significant difference among the three groups(P＜0.05), and the mometasone furoate group presented with the highest rate, followed by the sequential treatment group and the crisaborole group. Conclusions The sequential topical application of 0.1% mometasone furoate cream and 2% crisaborole ointment in treating mild to moderate AD in the elderly shows significant clinical efficacy, a low recurrence rate, and minimal adverse reactions, which is a promising option for clinical practice.

The aging population presents a growing challenge, while neurodegenerative diseases (NDs) still lack scientifically validated treatments. Recent studies have highlighted the gut microbiota’s role in neurological disorders, suggesting dietary modifications could optimize its composition to positively influence NDs. Evidence demonstrates that polyphenols’ anti-inflammatory and antioxidant properties may modulate central nervous system (CNS) activity through the microbiota-gut-brain axis, offering novel therapeutic approaches. This review reveals polyphenols’ protective mechanisms via this axis in NDs, identifying potential clinical strategies for managing these conditions.

With the progression of population aging, the incidence of hip fractures in elderly patients has been increasing annually. Beyond inherent frailty and osteoporosis, elderly patients with hip fractures often suffer from multiple comorbidities, making perioperative management particularly challenging. These conditions lead to high postoperative disability rates and mortality rates, significantly increasing burdens on families and society. Current clinical guidelines and expert consensus recommendations for elderly hip fracture patients emphasize the importance of multidisciplinary perioperative care. Strengthening assessment and management of perioperative risk factors can improve patient’s outcomes. This article explores the evaluation and management of perioperative risk factors affecting hip fracture prognosis in elderly patients. By implementing systematic interventions and optimizations for controllable risk factors, we aim to enhance clinical outcomes for elderly hip fracture cases.

Objective To explore the risk factors for early peristomal moisture-associated skin damage (PMASD) after robot-assisted radical cystectomy (RARC) and urostomy in the elderly patients with bladder cancer, and to optimize the nursing strategies. Methods A retrospective analysis was performed on 172 elderly patients with RARC admitted to Department of Urology, the First Affiliated Hospital of Nanjing Medical Universiy from January 2016 to August 2024. According to whether PMASD occurred after urostomy, the patients were divided into non-PMASD group (n=107) and PMASD group (n=65). The basic information, clinical data, and ostomy-related data of the two groups were compared. Multivariate logistic regression was used to analyze the independent influencing factors for the early PMASD after RARC and urostomy in the elderly patients with bladder cancer. Results The proportion of patients undergoing radiotherapy was significantly higher and the Barthel index and the proportions of patients with ostomy bag replacement interval ≥7 days and standardized ostomy care behavior were lower in PMASD group than those in non-PMASD group (P<0.05). Multivariate logistic regression showed that radiotherapy history (OR=5.982, 95%CI:2.161-16.560, P<0.001) was an independent risk factor for PMASD, while high Barthel index (OR=0.975, 95%CI:0.952-0.999, P=0.040), ostomy bag replacement interval ≥7 days (OR=0.356, 95%CI: 0.163-0.776, P=0.009), and standardized ostomy care behavior (OR=0.201, 95%CI: 0.096-0.422, P<0.001) were protective factors for PMASD. Conclusions Radiotherapy history, low self-care ability after surgery, high frequency of ostomy bag replacement, and nonstandard stoma care behavior are influencing factors for early PMASD in the elderly patients with bladder cancer after RARC.