Pelvic floor dysfunction in elderly women is a prevalent condition that significantly affects patients’quality of life. Clinical manifestations primarily include urinary incontinence, pelvic organ prolapse, and anal dysfunction. With the accelerating global aging trend, research on its diagnosis and treatment has become a critical focus in medical science. Although multiple diagnostic techniques are now widely adopted, diagnostic accuracy remains suboptimal. This review systematicly examines the pathogenesis of pelvic floor dysfunction in elderly women, with particular emphasis on advanced diagnostic technologies developed in recent years.

As women aged and their pelvic floor support structures weaken, pelvic organ prolapse (POP) has become a major health concern for elderly women. This article systematically explores three key areas of research progress in elderly women with POP: diagnosis, conservative treatment, and surgical intervention. It particularly focuses on innovative surgical techniques and their outcomes, along with the application of novel mesh materials in surgical procedures.Finally, looking ahead to the future of POP treatment, it is necessary to combine individual needs and realize the integrated development of multiple disciplines to improve the treatment effect and prognosis.

Constipation is a highly prevalent gastrointestinal functional disorder among the aging population. Its incidence increases with age, significantly impairing quality of life and predisposing patients to multiple complications. This review focuses on the etiological features, pathophysiological mechanisms, and recent advances in the diagnosis and management of constipation in the elderly. The causes are multifactorial, including inadequate dietary fiber intake, reduced physical activity, adverse drug effects, comorbid chronic conditions, and age-related decline in bowel function. Diagnosis should be based on the Rome Ⅳ criteria, aiming to exclude organic pathologies through comprehensive medical history collection, physiological function assessment, and evaluation of accompanying symptoms. Individualized and integrated management is essential, encompassing lifestyle modifications, pharmacological treatments, and surgical interventions when appropriate. Promising emerging options include probiotics, fecal microbiota transplantation, and traditional Chinese medicine. Future studies should further explore the distinct mechanisms underlying constipation in the elderly and optimize clinical strategies for intervention.

Objective To compare the association patterns of overall sleep quality and its related factors with depressive symptoms between older adults with mild cognitive impairment (MCI) and those with dementia in nursing homes. Methods This cross-sectional study enrolled 522 institutionalized older adults with cognitive impairment. Cognitive function, sleep quality, and depressive symptoms were assessed using the Mini-Mental State Examination (MMSE), the Pittsburgh Sleep Quality Index (PSQI), and the 15-item Geriatric Depression Scale (GDS-15), respectively. Multivariable logistic regression analysis was employed to investigate the correlation between specific sleep-related factors and depressive symptoms. Results Of the 522 participants, 60.0% (n=313) were classified as having MCI and 40.0% as having dementia. The overall prevalence of sleep disturbances was 40.2%. The prevalence of sleep disturbances and the use of hypnotic agents were significantly higher in the MCI group compared to the dementia group (P<0.05). After adjusting for general characteristics, multivariate logistic regression analysis revealed that in the MCI group, experiencing nightmares and pain were significantly associated with depressive symptoms(P<0.05); In the dementia group, nocturnal awakening or early morning awakening, difficulty breathing, loud snoring or coughing, feeling cold, and feeling hot were significantly associated with depressive symptoms(P<0.05). Conclusions There are signifant differences in sleep quality and in association pattrerns sleep disorder manifestations and depressive symptoms among older adults with MCI compared to those with dementia in nursing homes.These findings suggest that tailored sleep intervention strategies, based on the stage of cognitive impairment, are necessary for the effective prevention and management of depressive symptoms.

Objective To explore the predictive value of non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) for coronary artery calcification (CAC) in elderly patients with type 2 diabetes mellitus (T2DM). Methods A total of 249 elderly patients with T2DM admitted to Huai’an First People’s Hospital from January to December 2023 were selected. Based on chest CT results, all patients were divided into a non-CAC group and a CAC group using the Shemesh visual calcification score method. NHHR was calculated according to the patients’ laboratory test results. Univariate and multivariate logistic regression analysis were employed to determine whether NHHR was an independent risk factor for CAC in patients with T2DM. Restricted Cubic Spline (RCS) analysis was used to analyze potential nonlinear relationships between NHHR and CAC. The predictive value of NHHR for the presence of CAC was assessed using receiver operating characteristic (ROC) curve analysis. Results Multivariate logistic regression combined with RCS analysis identified both NHHR (OR=1.53, 95%CI: 1.05－2.21) and age (OR=1.07, 95%CI: 1.01－1.13) as independent risk factors for CAC in elderly patients with T2DM (P<0.05), with a linear relationship between NHHR and CAC risk observed. Furthermore, the ROC curve analysis showed that the area under the curve (AUC) for predicting CAC using NHHR was 0.650 (95% CI: 0.563-0.736, P<0.05). At the optimal cut-off value of 2.28, the sensitivity and specificity were 57.0% and 72.0%, respectively. Conclusions An elevated NHHR is associated with an increased risk of CAC in elderly patients with T2DM. NHHR demonstrates a certain predictive value for CAC.

Objective To explore the application effect of cardiac exercise rehabilitation based on shared decision-making in elderly patients in the pre-frailty stage. Methods A total of 100 elderly patients in the pre-frailty stage admitted to Department of Geriatrics,Union Hospital,Tongji Medical College of Huazhong University of Science and Technology from July 2023 to June 2024 were selected and randomly divided into the control group and the intervention group using random number table method, with 50 cases in each group. The control group was given conventional treatment and nursing care for geriatric diseases, and the patients were instructed to perform aerobic exercise and resistance exercise.The intervention group received cardiac exercise rehabilitation based on shared decision-making additionally. The exercise compliance, physical activity function (Short Physical Performance Battery, SPPB), frailty score (Fried Phenotype), cardiopulmonary function , exercise capacity , and quality of life were compared between the two groups. Results After 12 weeks of intervention, the intervention group showed significantly better improvement in terms of exercise compliance, SPPB score, frailty score, LVEF, VO₂AT, VO₂max, exercise tolerance, 6MWD, and higher scores in both physical and mental health compared with the control group (P<0.05). Conclusions Cardiac exercise rehabilitation based on shared decision-making can improve exercise compliance in elderly patients in the pre-frailty stage, thereby enhancing physical activity function, alleviating the pre-frailty state, improving cardiopulmonary reserve and exercise tolerance, and enhancing quality of life.

Objective To construct a parametric assessment tool based on the International Classification of Functioning, Disability, and Health (ICF) for community rehabilitation in elderly patients with chronic stroke. Methods Using convenience sampling and maximum variation sampling principles, 207 elderly patients with chronic stroke were recruited from the Jiangsu-Zhejiang-Shanghai region. An ICF questionnaire with 136 categories was developed based on the intersection of the ICF category set for community-dwelling older adults and the extended comprehensive ICF core set for stroke. All items were included in subsequent modeling:an Item Response Theory (IRT) model was constructed to estimate difficulty parameters, while a Bayesian Graphical Modeling technique was applied to build a Graphical Modeling (GM) for estimating intervention benefit parameters. Results The established Rasch model demonstrated good reliability (Cronbach’s α=0.966) and validity.The visualization tool identified categories that matched the patients’ ability levels and offered suitable intervention benefits. Thirty-seven of these categories showed significant benefits. Conclusions Building on the existing comprehensive ICF core sets for strokes, the parametric assessment tool incorporates category difficulties and treatment benefit indices. This tool facilitates quantitative decision-making tailored to the capabilities of community-dwelling elderly patients with stroke.

Objective To examine the association between sleep quality and frailty among the oldest old (≥80 years) residing in integrated medical and long-term care institution, and to inform frailty prevention and management. Methods In a cross-sectional study conducted in Jiangsu Province Zhongshan Sanatorium from January to April 2024, 130 residents aged ≥80 years were surveyed using convenience sampling. Sleep quality was assessed subjectively using the Pittsburgh Sleep Quality Index (PSQI) and objectively via a wrist-worn smart band, which captured various sleep parameters.Frailty was screened using the FRAIL Scale. Multivariable logistic regression was applied to evaluate associations between sleep-related variables and frailty. Results The prevalence rates of sleep disturbance and frailty were 56.9%(74/130) and 40.8%(53/130), respectively.Among 74 participants with sleep disturbances, 39 individuals presented with frailty. Univariate analysis demonstrated that frailty group exhibited shorter nocturnal sleep duration, increased light sleep duration, and a higher frequency of daytime napping compared to non-frail group (P<0.05).Multivariable logistic regression analysis revealed that higher PSQI score (PSQI≥5) (OR=1.392, 95%CI: 1.151-1.680), longer total sleep time (OR=2.431, 95%CI: 1.202-4.911), longer light sleep duration (OR=1.123, 95%CI: 1.013-1.252), and greater number of daytime naps (OR=1.680, 95%CI:1.050-2.671) were independent risk factors for frailty. Conversely, longer nighttime sleep duration (OR=0.359, 95%CI: 0.178-0.731) was a protective factor. Conclusions Frailty among oldest old in integrated medical and long-term care institution is closely associated with poor sleep quality, impaired sleep structure and fragmented circadian rhythms, exhibiting characteristics of poor quality and fragmentation. Targeted intervention strategies need to be developed to improve sleep quality in order to mitigate the risk of frailty.

Objective To explore the correlation between frailty and apathy in community-dwelling elderly adults. Methods A cross-sectional study was conducted from September to December 2024. A total of 415 elderly individuals aged 60 years and over were included by convenience sampling. Frailty and apathy were assessed by Fried frailty phenotype scale and the apathy items derived from the Geriatric Depression Scale (GDS-3A),respectively. Multivariate logistic regression was used to analyze the correlation between frailty and apathy, and the receiver operating characteristic ( ROC ) curve was drawn to evaluate the predictive value of frailty for apathy. Results The prevalence of apathy was 40% (166/415). Frailty was identified as an independent influencing factor for apathy (OR=1.971, 95%CI: 1.518-2.561, P<0.001). The ROC curve analysis showed that frailty score had a predictive efficacy for apathy (AUC=0.673, 95%CI: 0.621-0.725, P<0.001). Conclusions Frailty is an independent factor for apathy in community-dwelling elderly adults. Interventions targeting frailty may represent a novel strategy for mitigating apathy in this population.

Objective To investigate the effects of mild hyperventilation on short-term postoperative diaphragmatic function in elderly patients undergoing laparoscopic radical resection for colorectal cancer, and to analyze the effects on postoperative cognitive function. Methods Eighty-eight elderly patients scheduled for elective laparoscopic colorectal surgery under general anesthesia were enrolled. They were randomly divided into the controlled hyperventilation group (Group H) and the conventional ventilation group (Group C) according to random number table, with 44 cases in each group. After induction of anesthesia and endotracheal intubation, both groups received mechanical ventilation in volume-controlled ventilation (VCV) mode. The respiratory rate (RR) was adjusted to maintain an end-tidal carbon dioxide partial pressure (PetCO₂) of 35-45 mmHg in Group C and 30-34 mmHg in Group H. Arterial blood gas analysis was performed at the following time points: before anesthesia (T0), immediately after CO₂ pneumoperitoneum establishment (T1), 1 h after pneumoperitoneum (T2), 2 h after pneumoperitoneum (T3), and immediately after extubation (T4). The score of the Mini-Mental State Examination (MMSE) was recorded 12 h before operation and 6, 24, and 48 h after operation. M-mode ultrasonography was used to measure diaphragmatic excursion (DE) and the diaphragmatic rapid shallow breathing index (D-RSBI) at T0 and T4. Results Compared to Group H, Group C showed a more significant decrease in postoperative diaphragmatic excursion and a more significant increase in the level of D-RSBI (P<0.05). At T2, T3 and T4, Group H had significantly higher pH values (P<0.05) and lower PaCO₂ levels (P<0.05) compared to Group C. The incidence rate of postoperative diaphragmatic dysfunction showed significant difference between the two groups (P< 0.05). There were no statistically significant differences in the other indexes between the two groups. Conclusions Maintaining mild hyperventilation with a target PetCO₂ of 30-34 mmHg can improve short-term postoperative diaphragmatic function in elderly patients undergoing laparoscopic radical resection for colorectal cancer, without exerting adverse effects on postoperative cognitive function.

Objective To explore the predictive effects of dietary inflammatory index (DII) on the onset of sarcopenia in the elderly patients with chronic obstructive pulmonary disease (COPD). Methods A total of 212 patients with COPD were enrolled from the Department of Geriatrics of Tongling People’s Hospital from January to December 2023. The dietary pattern and DII score were evaluated by semi-quantitative food frequency questionnaire (SFFQ). After a follow-up of 12 months, the muscle mass, grip strength, and gait speed were examined. The association of DII score with the onset of sarcopenia was further investigated. Results The average age of the enrolled patients was 75.18±5.91 years. The DII score was 0.98±2.22. The incidence rate of sarcopenia was 26.89%. When compared to those without sarcopenia, patients with sarcopenia were older, and had lower levels of body mass index and higher proportion of malnutrition, as well as higher levels of DII score at baseline (P<0.05). Further multiple logistic regression analysis demonstrated that the association of high DII score with increased risk of sarcopenia remained significant even after adjustment for confounding factors (adjusted HR=1.34, 95%CI: 1.12-1.60, P=0.001). Conclusions High DII score is associated with increased risk of sarcopenia in elderly patients with COPD. Dietary interventions with low DII score may have beneficial effect on the prevention of sarcopenia in the elderly patients with COPD.

Objective To evaluate the predictive value of the systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) in identifying hospital-acquired pneumonia (HAP) in elderly patients with acute heart failure (AHF). Methods A total of 122 elderly AHF patients admitted to Nanjing’s Hospital of Nanjing Medical University from March 2020 to March 2023 were enrolled as the training set and were divided into an infected group (n=54) and an uninfected group (n=68) based on whether they had HAP. Logistic regression was used to identify risk factors for HAP and a prediction model was developed. The model was validated in an independent cohort of 80 patients admitted from April 2023 to March 2024. The performance of the model was assessed by the area under the receiver operating characteristic curve (AUC). Calibration and consistency between the training and validation sets were evaluated by Hosmer-Lemeshow and DeLong tests, respectively. Results The infected group and the uninfected group showed significant differences in age, smoking history, comorbidities, cardiac function, and inflammatory/nutritional parameters (all P<0.05). Multivariate logistic regression analysis identified age ≥66 years old, diabetes, invasive procedures, SII≥346, and PNI <43 as independent risk factors for HAP. The model demonstrated strong discrimination power, with an AUC of 0.829 in the training set and 0.830 in the validation set. Delong test revealed no significant difference in AUC between the two sets (P=0.990). Good calibration was confirmed by Hosmer-Lemeshow test (P=0.056, 0.159). Conclusions The prediction model based on SII and PNI effectively stratifies HAP risk in elderly AHF patients, showing good clinical applicability for early identification of high-risk individuals and optimized management.

Sepsis is one of the critical conditions endangering elderly patients.Due to characteristics such as diminished physiological reserve, weakened immune response, and frequent multimorbidity in the elderly, the early recognition of sepsis in this population within the emergency department becomes more challenging. The mutual influence between these age-specific factors and sepsis itself imposes limitations on currently available clinical diagnostic tools. This article reviews the emerging detection methods and interdisciplinary approaches, to provide new method for early recognition of sepsis in elderly patients.

Late-life depression (LLD) is a common psychiatric disorder in the elderly, characterized by diagnostic challenges and frequent misdiagnosis. Functional near-infrared spectroscopy (fNIRS), a non-invasive and user-friendly neuroimaging technique, is increasingly used to study brain function in LLD. This review summarizes recent advances in fNIRS research on LLD, with a focus on resting-state and task-based studies. It highlights characteristic abnormalities such as prefrontal hypoactivation and neurovascular coupling (NVC) dysfunction, which are frequently observed in patients. Furthermore, the potential of fNIRS in aiding clinical diagnosis, identifying LLD subtypes, and predicting treatment outcomes is discussed. Finally, we propose that fNIRS is expected to address the shortcomings of traditional imaging technologies in terms of accessibitity and dynamic monitoring, providing crucial support for the identification, classification, and intervention of LLD.

Vascular aging is closely associated with the onset and progression of cardiovascular diseases such as hypertension and atherosclerosis.The underlying mechanisms are complex and involve multiple molecular pathways. Acetylation modification regulates multiple biological processes including lipid synthesis, DNA damage repair, glycolysis, and cell cycle progression by modulating protein stability, enzyme activity, and subcellular localization. This review summarizes the acetylation regulatory mechanisms in vascular aging, including histone acetylation regulation and non-histone acetylation regulation, and discusses potential therapeutic targets to provide new ideas for the prevention and treatment of vascular aging-related diseases.

Vascular cognitive impairment (VCI) is the second most common cognitive disorder after Alzheimer’s disease. With the acceleration of population aging, the incidence of VCI continues to rise, becoming a significant public health concern. This review summarizes recent advances in understanding VCI pathogenesis, focusing on multiple pathological processes including cerebrovascular lesions, neurovascular unit dysfunction, oxidative stress, and neuroinflammation. The diagnostic methods of VCI are also introduced, which mainly include clinical symptom assessment, neuropsychological testing, and imaging examinations. The standard of Vascular Impairment of Cognition Classification Consensus Study (VICCCS) provides a standardized diagnostic framework. This article also discusses the research progress of drug therapy and non-drug intervention, and puts forward the diagnosis and treatment ideas of VCI based on the latest evidence.

Sarcopenia and cognitive impairment are highly prevalent degenerative diseases in the elderly population, which severely affect patients’ quality of life and prognosis. However, current clinical intervention strategies for this comorbidity remain relatively limited. This article summarizes previous studies on the effects of probiotics on sarcopenia and cognitive impairment, and explores the feasibility of probiotic supplementation in achieving synergistic intervention for sarcopenia with cognitive impairment. The mechanism involves reshaping the structure of gut microbiota, thereby regulating the profile of gut microbiota metabolites, modulating the levels of key cellular signaling pathways and inflammatory cytokines, thus offering novel insights and strategic directions for the clinical diagnosis and management of these patients.

Objective To explore the application effect of dual-task training based on full-cycle rehabilitation assessment and treatment in the elderly patients with chronic obstructive pulmonary disease with cognitive impairment. Methods The elderly patients with chronic obstructive pulmonary disease combined with cognitive impairment in Taixing People’s Hospital from January 2024 to January 2025 were selected as the research subjects. The patients were divided into the control group (n=44) and the experimental group (n=45) by random number table method. The control group received routine care and rehabilitation training, while the experimental group received dual-task training. The changes of pulmonary function, dyspnea index, cognitive function, exercise endurance and daily life quality before and after intervention were compared between the two groups. Results After 12 weeks of intervention, there were significant differences between the two groups in lung function, cognitive function and quality of life (P<0.05); After 8 weeks and 12 weeks of intervention, the dyspnea index and exercise endurance showed more significant improvement in the experiment group than those in the control group (P<0.05). Conclusions Dual-task training can effectively improve the pulmonary function, dyspnea indicators and cognitive function of the elderly patients with chronic obstructive pulmonary disease combined with cognitive impairment, and can improve the exercise endurance and quality of life.

Objective To explore the symptom experience and management needs of opioid-induced nausea and vomiting (OINV) in the elderly patients with cancer pain. Methods A phenomenological research method was adopted. From January to March 2025, 18 elderly patients with cancer pain who experienced nausea and vomiting after using opioids in Jiangsu Cancer Hospital were interviewed using purposive sampling. Colaizzi method was used for thematic analysis. Results Four main themes were extracted, including limited symptom awareness and attribution bias, somatic-functional interaction and multiple frailty risks, constrained self-management strategies and reliance on family/healthcare support, the application status and dilemmas of management strategies. Conclusions It is urgent to construct a whole-process management system of OINV centered on elderly patients, including dynamic assessment, personalized education, multidimensional interventions and support network reconstruction.

Objective To construct a health-related behavior intervention program based on Fogg behavior model and to explore its application effect. Methods A research team was established to consult relevant literature, construct a health-related behavioral intervention program for elderly patients with cirrhosis based on Fogg behavior model, and 152 elderly patients with cirrhosis were selected to carry out a randomized controlled study to explore its application effect. Results After 2 rounds of letter inquiry, a health-related behavior intervention program based on Fogg behavior model was formed, including 10 intervention items in 3 intervention stages. The Cr value of the two rounds of expert correspondence letters was 0.895 and 0.930, respectively. The application results showed that after the intervention, the self-management behavior score in the study group was 82.19±8.97, compared with 74.16±9.86 in the control group (P<0.05), and the self-efficacy score in the study group was 32.87±3.28, compared with 28.43±5.11 in the control group (P<0.05). Conclusions The health-related behavior intervention program based on Fogg behavior model can significantly improve patients’ self-management behavior and self-efficacy.

Objective To investigate the effect of different hemostatic methods on bleeding from PICC puncture site in the elderly patients. Methods A total of 150 elderly patients who underwent PICC placement at the Affiliated Geriatric Hospital of Nanjing Medical University from April 2022 to April 2024 were enrolled. Based on hemostatic methods, the patients were divided into the thrombin group (n=75) and the regular group (n=75). In the thrombin group, lyophilized thrombin powder was applied at the puncture site post-insertion, followed by catheter fixation and local compression with the hemostatic device for 15 minutes. The regular group received catheter fixation and compression with the hemostatic device for 15 minutes without thrombin powder. The incidence rate of complications was compared between the two groups. Results Compared with the regular group, the bleeding volume 24 h after insertion, duration of persistent puncture site bleeding, and the number of dressing changes within 7 d in the thrombin group were significantly reduced (all P<0.05). No infections were observed at the puncture sites in either group. Conclusions Application of lyophilized thrombin powder at the PICC puncture site in the elderly patients can effectively reduce post-procedural bleeding volume and duration, decrease catheter maintenance frequency, alleviate patients’ financial burden, and enhance clinical nursing efficiency.