The acceleration of global aging has exacerbated mental health issues among older adults, while traditional psychological services face challenges such as resource shortages, prolonged treatment cycles, and high costs. In recent years, artificial intelligence (AI) technologies, particularly natural language processing and machine learning, have emerged as innovative tools to support elderly mental health care. This review synthesizes the applications of AI in screening, early identification, and personalized intervention for mental health conditions in the elderly, and examines associated challenges including ethical considerations and privacy concerns, thereby providing a theoretical foundation for developing comprehensive mental health service systems for the aging population.

Parkinson’s disease (PD) is a neurodegenerative disorder characterized by the degeneration of the dopaminergic pathway in the substantia-striatal region, which brings great suffering to patients, and traditional treatment methods have limitations. In recent years, artificial intelligence has shown great potential in the treatment of PD. In this review, we systematically elaborate on the multi-faceted application of artificial intelligence in the treatment of PD through a comprehensive analysis of the existing literature, including drug treatment optimization, surgical treatment parameter adjustment, rehabilitation and symptom management, and non-motor symptom monitoring. In the future, multi-dimensional data fusion and model optimization are needed to further enhance the accuracy and accessibility of artificial intelligence in the treatment of Parkinson’s disease, providing new ideas for clinical treatment.

As the global aging process accelerates, the high prevalence of sleep disorders among the elderly has become a major public health challenge. The traditional diagnosis and treatment model relies on manual consultation and laboratory polysomnography monitoring, which is limited by low efficiency, poor accessibility and high cost. Artificial intelligence,through the fusion of multi-modal data and adaptive algorithms, offers an innovative path for the precision and intelligent transformation of sleep medicine. This review systematically explain the clinical transformation potential and challenges of artificial intelligence in the recognition and diagnosis of sleep disorders in the elderly, intelligent sleep monitoring and safety monitoring, personalized intervention application and other aspects, so as to provide theoretical basis for optimizing sleep health management in the elderly.

The social issues arising from global population aging are becoming increasingly severe, and cognitive dysfunction in the elderly has emerged as one of the most pressing challenges for healthcare and social security systems. Artificial intelligence (AI) technology, leveraging multimodal data fusion, can integrate various information sources such as images, speech, and physiological signals to conduct dynamic monitoring of cognitive function status in the elderly, identify early risks of cognitive dysfunction, and provide effective clinical diagnostic and therapeutic support for patients with cognitive dysfunction, thereby alleviating the pressure caused by shortages in medical resources. This paper reviews the latest research progress, which analyzes the key technologies and clinical value of multimodal AI in the assessment of cognitive dysfunction in the elderly, and explores its future development directions, thereby providing new insights and approaches for the health management of cognitive function in the elderly.

Objective To explore the association between household solid fuel use and motoric cognitive risk syndrome (MCR) among the elderly population in China. Methods Based on a cross-sectional design, a total of 1 040 couples aged 60 years and above enrolled in the China Health and Retirement Longitudinal Study (CHARLS) were analyzed. Household solid fuels included coal, crop residue, and wood burning for heating and/or cooking. After excluding cognitive impairment and mobility disabilities, the individuals presenting with both slow gait and subjective cognitive decline were considered to have MCR. Logistic regression model was applied to assess the association between household solid fuel use and MCR prevalence in both spouses and individual MCR. Results Among 2 080 participants (1 040 couples), a total of 264 (12.69%) participants had MCR. The proportions of both spouses without MCR, husband-only MCR, wife-only MCR and both spouses with MCR were 78.37%, 8.46%, 9.42% and 3.75%, respectively. Compared with clean fuel, the use of solid fuel for cooking could increase the risk of MCR in rural households (OR=1.41, 95%CI: 1.01-1.96). MCR was also associated with the use of solid fuel for both heating and cooking in rural households (OR=1.92, 95%CI: 1.12－3.27), whereas no significant association was found in urban households (P>0.05). Within the household, wives who used solid fuel for cooking had a higher risk of MCR (OR=1.56, 95%CI: 1.03－2.35) than those who used clean fuel. MCR was also significantly associated with solid fuel use for both heating and cooking (OR=1.93, 95%CI: 1.08－3.45) among wives, while no above significant association was observed among husbands (P>0.05). Conclusions In Chinese households, solid fuel use is associated with the risk of MCI among wives.

Objective To explore the correlation between dynamic change pattern of prealbumin (PA) and 28-day prognosis in elderly patients with severe community-acquired pneumonia (SCAP). Methods A total of 80 elderly patients with SCAP admitted to Xuanwu Hospital Capital Medical University from January 2024 to January 2025 were enrolled. The patients were divided into survival group and death group based on 28-day outcomes. The level of PA on the first day, fourth day and seventh day of admission were compared between the two groups. According to the type of PA change, the patients were divided into the group with initial rise and then decline, the group with continuous decrease and the group with other types, and the survival curves of the three groups were compared. Results On the first and fourth day of hospitalization, there was no statistically significant differenct in PA levels betwwen the survial group and death group (P＞0.05); On the seventh day, the level of PA in the survival group (140.0±59.1 mg/L) was significantly higher than that in the death group (107.9±51.6 mg/L) (P<0.05). There was a significant difference in the distribution of PA change patterns between the two groups (P<0.05). Median survival time was highest in the group with other types, followed by the group with initial rise and then decline and the group with continuous decrease (P<0.001). Conclusions Dynamic PA change patterns is associated with 28-day mortality in the elderly patients with SCAP.

Objective To investigate the clinical efficacy of intramedullary reduction technique combined with proximal femoral nail anti-rotation (PFNA) internal fixation in the elderly patients with irreducible varus intertrochanteric fractures. Methods The clinical data of 22 elderly patients with irreducible varus intertrochanteric fractures from September 2022 to September 2024 in Geriatric Hospital of Nanjing Medical University were retrospectively analyzed. The PFNA main nail was utilized for intramedullary compression reduction during surgery. Postoperative fracture reduction quality was evaluated by anteroposterior and lateral radiographs of the proximal femur within 48 hours after the operation, while hip function was assessed by Harris Hip Score (HHS) at final follow-up. Results The mean operative time was 60.5±11.5 min, and the average blood loss was 131.8±57.5 mL. The average time for fractures healing was 4.6±0.9 months. All patients were followed up for an average of 10.8 months. HHS at final follow-up showed excellent in 16 cases, good in 4 cases, and poor in 2 cases, with an excellent/good rate of 90.9% (20/22). Fracture reduction quality was graded as good in 14 cases, acceptable in 5 cases, and poor in 3 cases. Positive coronal buttress was observed in 15 cases and neutral buttress in 7 cases. Conclusions Intramedullary reduction technique demonstrates satisfactory outcomes in the elderly patients with irreducible varus intertrochanteric fractures, which can effectively correct the inversion deformity on the coronal plane and achieve satisfactory reduction effect.

Objective To investigate the correlation between retinal arteriosclerosis (RA) and systemic factors in the elderly population. Methods A retrospective analysis was conducted on 2 107 elderly participants (≥60 years) who underwent health examinations at Jiangsu Province Official Hospital from October 2022 to September 2024. Among them, 891 individuals with RA were assigned to the RA group, and 1 216 subjects without RA served as the control group. Systemic factors were collected, including gender, age, blood pressure, body mass index (BMI), waist to hip ratio(WHR), fasting plasma glucose(FPG), triglycerides(TG), total cholesterol(TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), creatinine(Cr), Urea, uric acid(UA), hypertension, diabetes, smoking status, alcohol consumption. Univariate screening followed by multivariate logistic regression analysis was conducted using SPSS 26.0 to identify systemic factors associated with RA. Results The RA group showed significantly higher values than the control group in age, systolic and diastolic blood pressure, FPG, TG, Cr, WHR, as well as the prevalence of previous history of hypertension, diabetes and overweight, obesity (all P<0.05). The levels of TC and HDL-C levels were lower in the RA group than those in the control group (P<0.05). Multivariate logistic regression revealed age (OR=1.05), WHR (OR=6.21), and hypertension history (OR=2.28) as independent risk factors for RA (all P<0.05). Conclusions Age, WHR, and hypertension history are major risk factors for RA in the elderly population. Early identification and active management of these factors may reduce the risk of retinal vascular diseases.

Objective To investigate the clinical effect of lamina replantation with mini-titanium plate and screw internal fixation in the elderly patients with intraspinal tumors. Methods The clinical data of the elderly patients who underwent intraspinal tumor resection and lamina replantation in Department of Spine Surgery of Nanjing Pukou People’s Hospital from January 2020 to February 2024 were retrospectively analyzed. The patients were divided into mini-titanium plate and screw internal fixation group(group A) and a pedicle screw internal fixation group(group B). The age, gender, operation time, blood loss, postoperative drainage volume, American Spinal Injury Association(ASIA) grade, postoperative cerebrospinal fluid leakage, spinal sagittal diameter, Visual Analogue Scale(VAS) score, Oswestry disability index(ODI) score were recorded and compared between the two groups. Results A total of 78 patients were enrolled in this study, with 42 cases in group A and 36 patients in group B. Compared with group B, the operation time and intraoperative blood loss in group A were significantly reduced(P<0.05). The VAS score and ODI score of the two groups 1 week and 1 year after surgery were significantly lower than those before surgery (P<0.05), and the VAS score and ODI score 1 year after surgery were significantly lower than those 1 week after surgery (P<0.05). Furthermore, the VAS score in group A 1 year after surgery was significantly reduced than that in group B (P<0.05). After operation, the symptoms and signs of the patients were significantly improved. The vertebral plates were fully bony healed. Conclusions For the elderly patients with spinal canal tumors, micro titanium plate and screw internal fixation has the advantages of shortening the operation time, reducing the bleeding, and reducing the long-term pain degree.

Objective To investigate the current status of intrinsic capacity(IC) and its correlation with body composition in the elderly patients undergoing maintenance hemodialysis(MHD). Methods The elderly outpatients receiving regular dialysis at the Blood Purification Center of Zhongda Hospital, Southeast University from July to September 2024 were enrolled in this study. IC was assessed on the day of dialysis, and body composition analysis was performed after dialysis on the same day. Multivariate logistic regression analysis was used to identify the influencing factors of IC decline. R software was employed to construct a nomogram of risk prediction model for IC decline in the elderly MHD patients. Internal validation was conducted using the enhanced Bootstrap method and a validation set, and the predictive performance of the model was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC) and calibration curve. Results A total of 133 elderly MHD patients were enrolled with 22 cases presenting with good IC, and 111 cases presenting with poor IC. The elderly MHD patients with poor IC had a higher edema index (extracellular water/total body water), fat tissue index (FTI), and lower skeletal muscle index (SMI) and phase angle (PA), compared with those in the elderly MHD patients with good IC (P<0.05). Multivariate logistic regression analysis showed that increased age, decreased SMI, and decreased albumin were independent risk factors for IC decline in the elderly MHD patients. The AUC of the training set was 0.94 (95%CI: 0.90-0.97), with a sensitivity of 83% and a specificity of 90%. Conclusions The elderly MHD patients, as a special group living with long-term diseases, are at high risk of IC decline. Age, SMI, and albumin are independent risk factors affecting IC in the elderly MHD patients. Formulating targeted comprehensive intervention strategies is of great clinical significance for improving the quality of life and prognosis of the elderly MHD patients.

Objective To investigate the predictive value of red blood cell distribution width(RDW)for the long-term prognosis of the elderly patients with acute ST-segment elevation myocardial infarction(STEMI). Methods The elderly patients with STEMI admitted to Nanjing First Hospital from July 2011 to April 2019 were continuously enrolled. Emergent percutaneous coronary intervention(PCI)was performed in all the patients. The general clinical data,laboratory results, coronary angiography and drug therapy data were collected. The primary endpoint was all-cause mortality. The secondary endpoint was myocardial infarction, cardiovascular death, ischemic stroke, stent thrombosis and target vessel revascularization. The primary safety endpoint was major bleeding(BRAC 3,5). Cox regression analysis was conducted to discover the influencing factors for the prognosis of the patients. Results A total of 625 patients with STEMI receiving PCI in the emergency department were enrolled with a median follow-up of 72(51-96) months. All-cause mortality occured in 97 patients. Receiver operating characteristic (ROC) curve analysis showed that at a cutoff value of 13.45 for RDW showed the highest predictive value for all-cause mortality in STEMI patients, with an area under the curve of 0.630, a sensitivity of 43.3%, and a specificity of 77.8%. Patients with high RDW tended to have a higher proportion of Killip Ⅲ-Ⅳ, higher levels of age, creatinine, urea nitrogen and hospital stays. Whereas,they had a lower proportion of diabetes and ticagrelor usage. Kaplan-Meier analysis demonstrated a significantly higher all-cause mortality in the high RDW group (log-rank P<0.001). Multivariate Cox regression analysis identified that age, creatine, RDW, left ventricular ejection fraction,single-vessel disease, beta-blockers and intra-aortic ballon pump(IABP) were independent predictive factors for all-cause mortality in the elderly patients with STMEI. Conclusions RDW is an affordable biomarker for predicting long term mortality in the elderly patients with STMEI.

Objective To identify the risk factors for carbapenem-resistant pseudomonas aeruginosa (CRPA) infection in the elderly patients and to develop a nomogram prediction model for early recognition and intervention. Methods A retrospective study was conducted on 558 elderly patients (≥75 years) with pseudomonas aeruginosa (PA) infection admitted to Geriatric Hospital of Nanjing Medical University from January 2022 to December 2023. The patients were randomly divided into a training cohort (n=391) and a validation cohort (n=167). Multivariate logistic regression analysis was performed to identify the independent risk factors for CRPA infection. A nomogram prediction model was constructed using R software. The model’s performance was evaluated using receiver operating characteristic (ROC) curve analysis, calibration plots, and the Hosmer-Lemeshow test. Results Multivariate logistic regression analysis in the training cohort revealed four independent risk factors for CRPA infection in the elderly patients, including septic shock (OR=7.054, 95%CI:1.708－29.133), tracheostomy (OR=2.931, 95%CI:1.247－6.889), hospitalization history within 3 months (OR=22.575, 95%CI:11.524－44.222), and carbapenem use (OR=3.203, 95%CI:1.420－7.226). The model demonstrated a good fit of observed data, with an area under the ROC curve (AUC) of 0.816 (95%CI: 0.778－0.850) and 0.798 (95%CI: 0.736－0.860) for the experimental and validation cohort, respectively. The calibration curves and Hosmer-Lemeshow test results further confirmed the model had a good predictive performance. Conclusions Our prediction model exhibits a good predictive value in identifying elderly patients at risk of CRPA infection and can be used to guide preventive and treatment measures.

Objective To assess the clinical efficacy of endoscopic submucosal dissection (ESD) for double primary cancers of the esophagus and stomach in the elderly patients. Methods The clinicopathological data of 115 elderly patients with both superficial esophageal cancer (SEC) and early gastric cancer (EGC) were retrospectively analyzed to evaluate the short- and long-term efficacy of simultaneous resection by ESD. The patients were divided into curative resection group and non-curative resection group according to whether both esophageal and gastric lesions achieved curative resection by ESD, and the prognosis of the two groups was compared. Results The en bloc resection rate, complete resection rate and curative resection rate of the double lesions in 115 elderly patients was 100% (115/115), 93.9% (108/115) and 72.2% (83/115), respectively. Complications were observed in 11 patients (9.6%), including 7 cases of bleeding and 4 cases of esophageal stenosis. During a median follow-up time of 53 months, distant metastases occurred in 3 (2.6%) patients, and simultaneous and metachronous cancers developed in 5 (4.3%) and 15 (13.0%) patients, respectively, and there were no patients with local recurrence. The overall survival rate was 87.8% (101/115), and the disease-specific survival rate was 97.4%(112/115). The incidence of metachronous cancers (7.2% vs 28.1%) and distant metastasis (0 vs 9.4%) was lower, and the overall survival rate (92.8% vs 75.0%) and disease-specific survival rate (100% vs 93.7%) were both significantly higher in the curative resection group than those in the non-curative resection group (P＜0.05). Conclusions ESD may be a safe and effective treatment method for elderly patients with double primary cancers of the esophagus and stomach. The patients with curative resection of esophagogastric lesions have a better prognosis, but long-term postoperative endoscopic surveillance is needed.

Objective To explore the effects of comprehensive geriatric assessment and intervention combined with the atrial fibrillation(AF) ABC structured pathway on the quality of life of the elderly patients with AF, and to provide a reference for the comprehensive management of the elderly AF patients. Methods From August 2023 to December 2024, a total of 100 elderly patients diagnosed with non-valvular AF were enrolled from the Geriatric Hospital of Nanjing Medical University and two community health service centers within its medical consortium. A randomized controlled trial using a two-group informed consent Zelen’s design was conducted. The patients were divided into the conventional group (n=50)and the study group (n=50). The conventional group received standard AF ABC comprehensive management, while the study group received comprehensive geriatric assessment and AF ABC comprehensive management. The AF-specific Quality of Life (AFEQT) score, standardized anticoagulation rate, blood pressure and heart rate control rate, atrial fibrillation symptom severity grade, CHA2DS2-VASc-60 score, and HAS-BLED score were compared between the two groups before and after management. Results Before the intervention, no statistically significant differences were observed between the two groups in the total AFEQT score, symptom domain, daily activities domain, and treatment concerns domain (P>0.05). After the intervention, the study group showed significant reductions in the total AFEQT score, symptom domain, and treatment concerns domain compared to the baseline values (P<0.05). Moreover, the study group showed significantly lower scores of total AFEQT, symptom domain, and daily activities domain than those of the conventional group, with statistically significant differences (P<0.05). In addition, systolic blood pressure and the proportion of symptomatic patients in the study group were significantly decreased after the intervention (P<0.05). Conclusions The application of comprehensive geriatric assessment and intervention as an adjunct to the ABC structured management in elderly AF patients can alleviate AF symptoms and improve their quality of life.

Objective To explore the correlation between blood pressure variability and adverse cardiovascular events in the elderly hypertensive patients. Methods A total of 182 elderly hypertensive patients admitted to Xianyang Hospital, Yan’an University from August 2022 to March 2023 were selected, and were followed uptill June 1, 2024, and the patients were divided into adverse cardiovascular event group and non-event group based on whether they presented with adverse cardiovascular events. Blood pressure levels were monitored using a non-invasive portable ambulatory blood pressure monitor, and blood pressure variability was assessed using the average real variation (ARV). The correlation between blood pressure variability and adverse cardiovascular events was analyzed using Point-biserial correlation analysis, and a multivariate logistic regression analysis was conducted. Results At the end of the last follow-up, a total of 10 cases were lost to follow-up, and 172 cases were finally included in the study. A total of 39 cases presented with the endpoint events and were classified as the adverse cardiovascular event group, while the other 133 cases were enrolled in the non-event group. There were significant differences in 24 h mean systolic blood pressure (24hSBP), 24 h mean diastolic blood pressure (24hDBP), night mean systolic blood pressure (nSBP), night mean diastolic blood pressure (nDBP), 24 h systolic blood pressure variability (24hSBPV), 24 h mean diastolic blood pressure variability (24hDBPV), day mean systolic blood pressure variability (dSBPV), day mean diastolic pressure variability (dDBPV), mean nocturnal systolic pressure variability (nSBPV) and mean nocturnal diastolic pressure variability (nDBPV) between the two groups(P<0.05).Point-biserial correlation analysis showed that 24hSBP, dSBP, nSBP, nDBP, 24hSBPV, 24hDBPV, dSBPV, dDBPV, nSBPV, nDBPV were positively correlated with the adverse cardiovascular events in the elderly hypertensive patients (P<0.05). Logistic regression analysis showed that nSBP (OR=1.129,95%CI: 1.050－1.215), nDBP (OR=1.150,95%CI: 1.021－1.294), nSBPV (OR=1.895,95%CI: 1.327－2.706) and nDBPV (OR=4.746,95%CI: 2.232－10.090) were independent risk factors for adverse cardiovascular events in the elderly patients with hypertension. Conclusions Nocturnal blood pressure variability is correlated with adverse cardiovascular events in the elderly hypertensive patients. Monitoring nocturnal blood pressure variability can provide a basis for predicting adverse cardiovascular events in the elderly hypertensive patients.

Objective To identify the independent risk factors for lower extremity distal deep vein thrombosis (DDVT) in the elderly inpatients and to establish a nomogram prediction model. Methods The clinical data of 621 elderly inpatients from Department of Geriatrics, Ruijin Hospital were collected, and LASSO and multivariate logistic regression analysis were used to identify the independent risk factors for DDVT. In this way, a nomogram prediction model was established. Receiver operating characteristic curve analysis was used to calculate the area under the curve, and calibration and decision curves were plotted to assess the predictive performance of the model. Results A total of 621 elderly inpatients were enrolled, and 172 (27.70%) cases presented with lower extremity DDVT. Eleven predictors were identified as independent risk factors for lower extremity DDVT in elderly inpatients by multivariate logistic regression analysis, including gender(male), surgery within three months, acute cerebral stroke, active malignant tumor, long-term use of corticosteroids, acute infection in four weeks, immobility in 72 hours, heart failure, D-dimer≥0.55 mg/L, fibrin degradation products(FDP)≥5.0 mg/L, CA125>24 U/L. C index was 0.930(95%CI: 0.909－0.951), which showed good discrimination. The calibration curve and decision analysis curve indicated good predictive performance and clinical benefit. Conclusions The established prediction model has a high accuracy in predicting the risk of lower extremity DDVT in the elderly inpatients, providing an effective tool for clinicians to identify high-risk patients and implement early intervention.

The region specific role of insulin resistance in the central nervous system is receiving increasing attention. This review systematically integrates recent research and finds that insulin sensitive brain regions such as the hippocampus, prefrontal cortex, and hypothalamus can trigger key pathological processes of Alzheimer’s disease, including glucose metabolism disorders, mitochondrial dysfunction, neuroinflammation cascade amplification, abnormal deposition of β-amyloid protein, and excessive phosphorylation of Tau protein, under insulin resistance. The core mechanism involves the disruption of brain region specific insulin signaling pathways by insulin resistance, leading to synaptic plasticity damage, weakened neurotrophic support, and accelerated neuronal degeneration. Notably, targeted intervention strategies have shown potential to modulate Alzheimer’s disease pathology in preclinical studies. Starting from the sensitivity of different brain regions to insulin resistance, this article explores its mechanism in Alzheimer’s disease, in order to provide a new perspective for the prevention and treatment of Alzheimer’s disease.

Diabetic kidney disease, a common complication of diabetes mellitus, is characterized by a complex pathogenesis involving the interplay of multiple factors, including hyperglycemia, oxidative stress, inflammatory responses, and metabolic disorders. In recent years, sinomenine, a traditional Chinese herbal component, has demonstrated significant potential in the treatment of various renal diseases due to its pharmacological properties of anti-inflammation, antioxidant effects, and immune regulation. This article reviews the pathogenesis of diabetic kidney disease and the specific mechanisms by which sinomenine treats diabetic kidney disease through its anti-inflammatory and antioxidant effects. Additionally, it preliminarily explores the prospects of integrating the multi-target intervention characteristics of sinomenine with the holistic treatment philosophy of traditional Chinese medicine, aiming to provide a dialectical approach for the comprehensive management of diabetic kidney disease.

Objective To evaluate the effect of stage-matched nursing intervention (SMNI) in the care of arteriovenous fistula (AVF) in the elderly patients receiving maintenance hemodialysis (MHD). Methods A total of 212 patients undergoing MHD in Shanghai Ninth People’s Hospital were enrolled and randomly divided into control group (n=106) and observation group (n=106). The control group was treated with routine AVF nursing, while the observation group was treated with SMNI. Each patient was observed for 6 months, and the behavioral compliance rate and the incidence of AVF complications were recorded and compared. Results After 6 months of intervention, the proportion of patients in the pre-intentional stage, intentional stage, and preparatory stage of AVF self-care behaviors was significantly lower and the proportion of them in the action phase and maintenance phase was significantly higher in the observation group than that in the control group (P<0.05). The self-care ability score of the observation group was significantly higher and the total incidence rate of AVF complications was significantly lower (13.21% vs 35.85%) in the observation group than that in the control group (P<0.05). Conclusions Application of SMNI in MHD patients can significantly improve the quality of AVF nursing, modify the behavior of the MHD patients and reduce the incidence of AVF complications.