Table of Content

20 August 2026, Volume 40 Issue 8 Previous Issue    Next Issue

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Principles of psychotropic medication use in elderly YUAN Yucheng, CHEN Gang 2026, 40 (8):  759-763.  doi: 10.3969/j.issn.1003-9198.2026.08.002 Abstract ( 77 )   PDF (1070KB) ( 195 )   Save With the accelerating global population aging, the burden of mental disorders among the elderly continues to rise, leading to an increasing use of psychotropic medications in this demographic. Elderly patients exhibit heightened sensitivity to adverse effects of psychotropic medications due to alterations in physiological functions, comorbidities, and the prevalence of polypharmacy, necessitating stricter safety protocols and individualized management approaches in clinical practice. This article reviews the clinical applications, major risks, and medication precautions of antipsychotics, antidepressants, and sedative-hypnotics in elderly patients, aiming to provide a reference for the individualized use of psychiatric medications in this population and thereby comprehensively improve the quality of life of elderly patients with mental disorders. References | Related Articles | Metrics

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Advances in the clinical diagnosis and treatment of anxiety and depression in elderly patients with somatic diseases DENG Jibao, TAN Li, WANG Yanrong 2026, 40 (8):  764-769.  doi: 10.3969/j.issn.1003-9198.2026.08.003 Abstract ( 62 )   PDF (1080KB) ( 141 )   Save Elderly patients with somatic diseases exhibit a higher probability of concurrent anxiety and depression; Conversely, depressive and anxious symptoms can exacerbate the progression of somatic diseases. The management of anxiety and depression in elderly patients is particularly crucial, understanding their pathogenesis and selecting appropriate assessment tools are key to effective treatment. This article reviews relevant studies on the pathological mechanisms and diagnostic/therapeutic advancements of anxiety and depression co-occurring in elderly patients with somatic diseases, aiming to provide clinical reference for the management of these comorbid conditions. References | Related Articles | Metrics

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Diagnosis and treatment progress of delirium in elderly patients with somatic diseases WANG Lanlan, JI Yunxin 2026, 40 (8):  770-774.  doi: 10.3969/j.issn.1003-9198.2026.08.004 Abstract ( 68 )   PDF (1132KB) ( 139 )   Save With the ongoing advancement of population aging, the incidence of delirium has significantly increased among elderly patients with somatic diseases. This condition is characterized by high rates of missed diagnosis, poor prognosis, elevated mortality, and a tendency to accelerate cognitive decline. Currently, numerous limitations persist in the study of delirium, including challenges in early identification, nonstandardized assessment methods, and inconsistent intervention strategies. In recent years, continuous advancements in clinical classification, risk prediction, neuroimaging assessment methods, and comprehensive prevention and treatment approaches have provided new directions for the precise diagnosis and management of delirium associated with somatic diseases in elderly patients. This article systematically reviews the research progress regarding its clinical characteristics and classification, risk factors, assessment techniques, intervention strategies, and management protocols, summarizes current diagnostic and therapeutic challenges as well as future development directions, and to provide a theoretical foundation for optimizing the standardized diagnosis and treatment framework for geriatric delirium.     References | Related Articles | Metrics

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Advances in the clinical diagnosis and treatment of geriatric somatic distress disorder WU Heng, YUAN Yonggui 2026, 40 (8):  775-780.  doi: 10.3969/j.issn.1003-9198.2026.08.005 Abstract ( 72 )   PDF (1134KB) ( 90 )   Save According to statistics released by the World Health Organization (WHO), the global population aged 60 years and over is projected to reach 2.1 billion by 2050, accounting for 22% of the total global population. With the progressive intensification of population aging, bodily distress disorder (BDD), as one of the prevalent psychosomatic health conditions in the elderly population, has garnered growing attention in the fields of clinical practice and public health. Characterized by core symptoms of excessive attention to and preoccupation with physical discomfort, BDD is often accompanied by abnormalities in emotional regulation, cognitive function, and social functioning. It not only significantly impairs the quality of life of elderly patients but also imposes a substantial burden on medical resources. Notably, the clinical manifestations of geriatric BDD are more insidious and complex, and it is highly prone to comorbidity with various physical diseases, which renders its identification and intervention relatively challenging. In this review, we systematically collate relevant research findings at home and abroad, summarize the current research status and diagnosis and treatment advances in geriatric BDD, aiming to provide a theoretical reference for its clinical identification, standardized management, and subsequent research. References | Related Articles | Metrics

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Risk factor analysis and prediction model construction for multiple organ dysfunction syndrome in elderly patients with upper gastrointestinal bleeding YANG Liu, LIANG Zhifang, WANG Yan, WEI Jing, CHENG Xiaomei, LI Ni, JING Yujie, LI Hao 2026, 40 (8):  781-786.  doi: 10.3969/j.issn.1003-9198.2026.08.006 Abstract ( 77 )   PDF (1639KB) ( 145 )   Save Objective To investigate the risk factors for multiple organ dysfunction syndrome (MODS) in elderly patients with upper gastrointestinal bleeding (UGIB) and to develop a nomogram prediction model for early clinical identification of the high-risk patients. Methods A retrospective cohort study was conducted involving 365 elderly UGIB patients admitted to 986th Hospital of Xijing Hospital, Air Force Medical University from March 2022 to March 2025. All the patients were divided into a MODS group (n=55) and a non-MODS group (n=310). LASSO regression was used to select variables, and multivariate logistic regression analysis was applied to identify risk factors for MODS in elderly UGIB patients. Based on these results, a nomogram prediction model was constructed. Results Six variables [blood loss, hemorrhagic shock, hemoglobin level, systemic inflammatory response syndrome (SIRS), cardiovascular disease, and Sequential Organ Failure Assessment (SOFA) score] were selected through LASSO regression and incorporated into a multivariate logistic regression analysis, which showed that hemorrhagic shock, SIRS, and cardiovascular disease were independent risk factors for MODS in elderly UGIB patients (P<0.05), while high hemoglobin level was a protective factor (P<0.05). The nomogram prediction model constructed based on these factors showed good fit (Hosmer-Lemeshow test:χ2=4.544,P=0.631), high discriminative ability (C-index=0.972), excellent predictive performance (AUC=0.972), and strong clinical applicability. Conclusions Hemorrhagic shock, SIRS, cardiovascular disease and low hemoglobin level were independent risk factors for MODS in elderly UGIB patients. The nomogram model, developed from these factors, demonstrated good performance in predicting MODS risk among elderly UGIB patients, potentially enabling timely intervention for high-risk individuals. References | Related Articles | Metrics

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Meta-analysis of incidence and influencing factors of falls in elderly patients with atrial fibrillation WANG Xuefei, KANG Shengqin, WANG Wei, WANG Jie, CAI Cuichun 2026, 40 (8):  787-792.  doi: 10.3969/j.issn.1003-9198.2026.08.007 Abstract ( 64 )   PDF (2770KB) ( 90 )   Save Objective To systematically evaluate the incidence and expplore the influencing factors of falls in elderly patients with atrial fibrillation (AF), providing evidence-based guidance for fall prevention. Methods Literature on the incidence and/or influencing factors of falls in elderly AF patients was systematically searched in Chinese and English databases (CNKI, Wanfang, VIP, Sinomed, PubMed, Web of Science, Cochrane Library, CINAHL). The search period spanned from database inception to January 2025. Two researchers independently screened and extracted data. Meta-analysis was performed using Stata 16.0. Results Nine studies involving 228 821 elderly AF patients were included. Meta-analysis revealed a pooled fall incidence of 19%(95%CI: 15%-23%)in the elderly AF patients. Subgroup analysis showed higher fall incidence in cross-sectional studies (51%) compared to cohort studies (10%), in studies with follow-up durations ≥3 years (22%) versus <3 years (6%). For influencing factors, meta-analysis identified amiodarone use as an independent risk factor for falls(OR =2.84, 95%CI: 1.42-5.65, P<0.01). Benzodiazepines, cardiovascular diseases, musculoskeletal diseases, and advanced age also showed trends toward increased fall risk, though these associations were not statistically significant (P>0.05). Conclusions Elderly AF patients exhibit a high incidence of falls, with amiodarone identified as an independent risk factor. Medication review and comprehensive comorbidity management should be integrated into fall prevention strategies in AF management. References | Related Articles | Metrics

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Predictive value of serum copeptin, sST2, and NGAL for heart failure in elderly patients with acute myocardial infarction after PCI FANG Yuanyuan, CHEN Xinxin, CAI Chunyu, KONG Lili 2026, 40 (8):  793-797.  doi: 10.3969/j.issn.1003-9198.2026.08.008 Abstract ( 53 )   PDF (1264KB) ( 80 )   Save Objective To investigate the influencing factors of heart failure (HF) in elderly patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI), and the prediative value of serum copeptin, soluble grouth stimulation gene 2 (sST2), and neutrophil gelatinase-associated lipocalin (NGAL). Methods A total of 400 elderly AMI patients treated with PCI at the 970th Hospital of the Joint Logistics Support Force of the People’s Liberation Army from January 2022 to November 2025 were enrolled. These patients were grouped based on the occurrence of postoperative early in-hospital heart failure (HF): those who developed HF were assigned to the HF group, while the remaining patients were included in the non-HF group. The general demographic data, laboratory test results, and imaging findings were collected and compared between the two groups. Univariate and multivariate logistic regression analysis were used to investigate the influencing factors of HF. The predictive value of serum copeptin, sST2, and NGAL expression levels for the occurrence of HF post-PCI in elderly patients with AMI was evaluated through receiver operating characteristic (ROC) curve analysis. Results A total of 62 patients (15.50%) developed HF. The HF group exhibited higher age, higher proportion of patients with a Clinical Fatigue Scale (CFS) score ≥5, longer time from onset to hospital admission, higher coronary stenosis severity (Gensini score), and higher levels of preoperative N-terminal brain natriuretic peptide precursor (NT-proBNP), left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVST), copeptin, sST2, and NGAL compared to the non-HF group, while having a lower level of left ventricular ejection fraction (LVEF) (P<0.01). Logistic regression analysis revealed that age, time from onset to hospital admission, Gensini score, NT-proBNP, copeptin, sST2, and NGAL were independent risk factors for post-PCI HF in elderly AMI patients, whereas LVEF was a protective factor (P<0.05). ROC curve analysis demonstrated that serum levels of copeptin, sST2, and NGAL could effectively predict the risk of post-PCI HF in elderly AMI patients, with combined prediction showing higher AUC and sensitivity (P<0.05). Conclusions The development of HF in elderly patients with AMI after PCI is influenced by multiple pathophysiological mechanisms. Serum copeptin, sST2, and NGAL serve as significant independent risk factors with high predictive value, and their combined use offers enhanced prognostic potential. References | Related Articles | Metrics

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Relationship of gut microbiota and serum solute carrier family 7 member 11 and soluble tumor necrosis factor receptor 2 expression levels with ventricular remodeling, prognosis in elderly patients with chronic heart failure FAN Yaning, XU Chenbo 2026, 40 (8):  798-804.  doi: 10.3969/j.issn.1003-9198.2026.08.009 Abstract ( 57 )   PDF (1284KB) ( 77 )   Save Objective To investigate the relationship of gut microbiota (GM), serum solute carrier family 7 member 11 (SLC7A11) and soluble tumor necrosis factor receptor 2 (sTNFR-2) expression levels with ventricular remodeling (VR) and prognosis in elderly patients with chronic heart failure (CHF). Methods From January 2022 to October 2024, 172 elderly patients with CHF who were treated in the First Affiliated Hospital of Xi’an Jiaotong University were enrolled in the CHF group. According to the New York Heart Association (NYHA) cardiac function classification, patients were divided into Group Ⅱ (61 cases), Group Ⅲ (56 cases), and Group Ⅳ (55 cases). Based on prognosis outcomes after 1 year, the patients were classified into a poor-prognosis group (54 cases) and a good-prognosis group (118 cases). The control group (HC group) consisted of 172 healthy individuals who underwent physical examinations and matched the study subjects in terms of age and gender ratio. Color Doppler echocardiography was employed to measure the left ventricular end-diastolic diameter (LVDD), left atrial diameter (LAD), left ventricular mass index (LVMI), and left ventricular ejection fraction (LVEF); Genomic diversity was assessed via 16S rRNA gene sequencing with calculation of α-diversity index; differences in GM community structure were evaluated using principal coordinate analysis based on Bray-Curtis distance and permutational multivariate analysis; Serum SLC7A11 and sTNFR-2 levels were measured by ELISA method; Multifactorial logistic regression analysis was conducted to identify independent prognostic factors for CHF patients; Receiver operating characteristic (ROC) curves were utilized to evaluate the predictive value of GM levels and serum SLC7A11/sTNFR-2 levels for CHF prognosis, with internal validation performed using bootstrap resampling. Results Compared with the HC group, the serum SLC7A11 level was significantly reduced and the sTNFR-2 level was significantly elevated in the CHF group (P<0.05). Statistically significant differences were observed between the HC group and the CHF group in the composition of the GM microbiota (R2=0.201, P<0.05). As the NYHA cardiac function classification progressed, the Chao1 index, Shannon index, serum SLC7A11 level, and LVEF in CHF patients showed a gradual decline, whereas LVDD, LAD, LVMI, and serum sTNFR-2 levels exhibited a progressive increase (P<0.05). Compared with the good-prognosis group, the poor-prognosis group demonstrated a longer disease duration, higher serum sTNFR-2 levels, a greater proportion of NYHA class Ⅳ cases, increased LVDD, LAD, LVMI, and relative abundance of Proteobacteria, as well as decreased LVEF, serum SLC7A11 levels, and relative abundance of Firmicutes (P<0.05). After adjusting for disease duration and traditional cardiac function parameters, elevated Firmicutes and SLC7A11 remained independent protective factors, while elevated Proteobacteria and sTNFR-2 remained independent risk factors (P<0.05). The area under the curve (AUC) values for predicting CHF prognosis by Firmicutes and Proteobacteria, serum SLC7A11, and sTNFR-2 alone were 0.803,0.804,0.816, and 0.838, respectively; the combined model achieved an AUC of 0.948, significantly superior to any single predictor (P<0.05). The combined model demonstrated good calibration accuracy and strong consistency with actual clinical outcomes. Conclusions The NYHA cardiac function in elderly patients with CHF are closely related to VR. Moreover, the combination of the Phylum Firmicutes, the Proteobacteria, and the levels of serum SLC7A11 and sTNFR-2 can effectively enhance the assessment value for the prognosis of patients with CHF. References | Related Articles | Metrics

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Development of a sarcopenia screening model for hospitalized elderly patients based on calf circumference, body mass index, and geriatric nutritional risk index YU Xinxue, JIN Di, QUAN Jingwen, JIANG Juan, LIU Juanzi, WEI Yuanhao, XIE Hong, HUANG Jinmei, XU Xi 2026, 40 (8):  805-810.  doi: 10.3969/j.issn.1003-9198.2026.08.010 Abstract ( 65 )   PDF (1414KB) ( 104 )   Save Objective To explore the association of calf circumference (CC), body mass index (BMI), and geriatric nutritional risk index (GNRI) with sarcopenia in hospitalized elderly patients, and to develop and validate a risk screening model for sarcopenia. Methods This cross-sectional study enrolled hospitalized patients aged ≥60 years at Chinese PLA General Hospital of Southern Theatre Command from January to June 2025. Demographic information, laboratory tests, and anthropometric measurements were collected. Patients were classified into sarcopenia group and non-sarcopenia group according to the Asian Working Group for Sarcopenia (AWGS) 2019 criteria. Multivariate logistic regression analysis was used to explore the independent influencing factors for sarcopenia in the hospitalized patients aged 60 years and over. And a predictive model was developed. Receiver operating characteristic (ROC) curve analysis and consistency testing were used to evaluate the predictive efficacy of the model. Results A total of 328 hospitalized elderly patients were enrolled in this study, and 191 cases (58.2%) were diagnosed with sarcopenia. Multivariate logistic regression analysis revealed that CC, BMI, and GNRI were independent protective factors for sarcopenia in hospitalized elderly patients. ROC curve analysis showed that the combined model incorporating CC, BMI, and GNRI demonstrated an area under the curve (AUC) of 0.855 (95%CI: 0.812-0.891), with a sensitivity of 85.9% and a specificity of 68.6%. Bootstrap internal validation showed good consistency. Conclusions CC, BMI, and GNRI are protective factors against sarcopenia in hospitalized elderly patients. The combined model based on these three indicators is simple, accessible, and exhibits satisfactory screening performance, making it an effective tool for the early identification of sarcopenia in this clinical population. References | Related Articles | Metrics

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Predictive value of residual cholesterol inflammation index for the prognosis in elderly patients with unstable angina pectoris LI Yangbo, ZHAO Zhengkun 2026, 40 (8):  811-815.  doi: 10.3969/j.issn.1003-9198.2026.08.011 Abstract ( 57 )   PDF (1109KB) ( 78 )   Save Objective To explore the predictive value of the residual cholesterol inflammatory index (RCII) for the prognosis in the elderly patients with unstable angina pectoris (UAP). Methods A total of 102 elderly UAP patients admitted to Xianyang Hospital of Yan’an University from January 2024 to December 2024 were selected. Baseline data of all patients were collected, and the value of RCII was calculated. All patients received standardized treatment and completed a 1-year follow-up, with the occurrence of major adverse cardiovascular events (MACE) as the endpoint. Based on follow-up results, the patients were divided into a good prognosis group (n=66) and an poor prognosis group (n=36). Multivariate logistic regression analysis was used to identify factors influencing the prognosis in the elderly UAP patients, and the receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of RCII for prognosis. Results Among the 102 elderly UAP patients, 36 cases (35.29%) experienced MACE. The age, global registry of acute coronary events (GRACE) score, proportion of prior percutanous coronary intervention (PCI) history, levels of residual cholesterol(RC), high-sensitivity C-reactive protein (hs-CRP), and RCII were significantly higher in the poor prognosis group than those in the good prognosis group (P<0.05). Multivariate logistic regression analysis revealed that RC (OR=2.006, 95%CI: 1.143-3.520), hs-CRP (OR=2.040, 95%CI: 1.240-3.356), GRACE score (OR=2.356, 95%CI: 1.372-4.047), and RCII (OR=2.798, 95%CI: 1.738-4.505) were independent risk factors for the prognosis of elderly UAP patients. ROC curve analysis demonstrated that the AUC values of RC, hs-CRP, and RCII for predicting prognosis in elderly patients with UAP were 0.792,0.804, and 0.917, respectively. Conclusions RCII is an effective novel composite indicator for predicting the prognosis of elderly UAP patients, with superior predictive performance compared to single RC or inflammatory markers, and has potential to guide clinical risk stratification and early intervention. References | Related Articles | Metrics

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Association between visceral fat area and atherosclerotic cardiovascular disease in the elderly patients aged ≥70 years ZHUANG Jianfen, SHAN Yangyang, CHEN Haixiao, YAN Xiaoyun, XU Shuang, YE Jiaqi, JIANG Ying, ZHANG Ying, QIANG Wenhui, ZHANG Qing 2026, 40 (8):  816-820.  doi: 10.3969/j.issn.1003-9198.2026.08.012 Abstract ( 55 )   PDF (1078KB) ( 91 )   Save Objective To explore the correlation between visceral fat area(VFA) and the prevalence of atherosclerotic cardiovascular disease (ASCVD) in the elderly patients aged ≥70 years. Methods A total of 243 elderly patients aged ≥70 years were enrolled. Body composition was measured using bioelectrical impedance analysis, and participants were divided into the ASCVD group and the non-ASCVD group based on their presence or absence of ASCVD. Differences in baseline characteristics between the two groups were analyzed. The chi-square test was employed to compare the prevalence of ASCVD among VFA quartiles; multivariate logistic regression was conducted to identify independent risk factors for ASCVD; and receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of VFA for ASCVD. Results The prevalence of hypertension, diabetes, body fat mass index (FMI), body fat percentage (PBF), and visceral fat area (VFA) were all higher in the ASCVD group than those in the non-ASCVD group (P<0.05). Inter-quarterile comparisons of VFA revealed a significant upward trend in ASCVD prevalence with increasing VFA levels (P<0.001). Multivariate logistic regression analysis identified VFA (OR=1.018,95%CI: 1.011-1.025, P=0.033) and diabetes (OR=1.897,95%CI: 1.012-3.559, P=0.046) as independent risk factors for ASCVD in elderly patients aged ≥70 years. The area under ROC curve of VFA in predicting ASCVD was 0.710 (95%CI: 0.644-0.776, P<0.001). Conclusions In elderly patients aged ≥70 years, ASCVD prevalence increases with higher VFA scores, confirming VFA as an independent risk factor for ASCVD. References | Related Articles | Metrics

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Effects of α2-adrenergic receptor agonist on elderly patients undergoing cataract phacoemulsification surgery FANG Xiangxiang, YANG Qingsong, JU Xuejun, JIANG Qiaomei, BAO Hongguang, LI Jiang, DING Zhenqin 2026, 40 (8):  821-825.  doi: 10.3969/j.issn.1003-9198.2026.08.013 Abstract ( 51 )   PDF (1019KB) ( 74 )   Save Objective To investigate the effects of the α2-adrenergic receptor agonist dexmedetomidine on hemodynamics, blood glucose levels, early postoperative cognitive function, and adverse reactions at various time points in elderly patients undergoing phacoemulsification for cataract surgery. Methods A total of 96 patients were enrolled for elective phacoemulsification surgery at Nanjing Tongren Hospital. Using a computer-generated block randomization sequence, the subjects were allocated in a 1∶1 ratio to either the dexmedetomidine group (Group D) or the normal saline control group (Group C), with 48 cases in each group. Both groups underwent standard mydriasis and local anesthesia prior to surgery. Group D received continuous intravenous infusion of dexmedetomidine via a pump until the end of surgery (total dose: 0.5 μg/kg); Group C received an equivalent volume of 0.9% sodium chloride solution. Mini-Mental State Examination (MMSE) scores of both groups were recorded 1 d before surgery, as well as 1, 3, 7 d after operation. The changes in hemodynamic parameters and blood glucose levels at different intraoperative time points were compared between the two groups, as well as patient’s and surgeon’s satisfaction rates and incidence of adverse reactions. Results Compared with Group C, Group D exhibited higher MMSE score at each postoperative time point, more stable intraoperative hemodynamics, smaller fluctuations in blood glucose, and significantly increased satisfaction rates among surgeons and patients (P<0.05). There was no statistically significant difference in the incidence of postoperative adverse reactions between the two groups (P>0.05). Conclusions Dexmedetomidine can improve early postoperative cognitive function in elderly patients undergoing cataract phacoemulsification, enhance patient comfort, and stabilize perioperative hemodynamics and blood glucose variations. References | Related Articles | Metrics

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Study on the correlation of social support and depression with oral frailty in elderly stroke patients based on ICFM model BI Jing, WANG Yinuo, YU Dongmei 2026, 40 (8):  826-830.  doi: 10.3969/j.issn.1003-9198.2026.08.014 Abstract ( 75 )   PDF (1017KB) ( 88 )   Save Objective To investigate the current status of oral frailty in the elderly patients with stroke, and to explore the influencing mechanism of social support and depression on oral frailty based on the integral conceptual model of frailty (ICFM), so as to provide a theoretical basis for improving the oral health of elderly stroke patients. Methods A total of 400 elderly stroke patients who visited Department of Neurology, Beijing Geratric Hospital were selected from October 2024 to July 2025. The Geriatric Depression Scale (GDS-15), Social Support Rating Scale (SSRS), and Oral Frailty Index-8 (OFI-8) were used to assess depression, social support, and oral frailty, respectively. The differences in oral frailty scores among the patients with varying clinical characteristics were analyzed. Pearson correlation analysis was performed to analyze the correlations of depression and social support with oral frailty. The Bootstrap method was used to test the mediating effect of depression between social support and oral frailty. Results The mean score of oral frailty of the elderly stroke patients was 4.095±2.34, and 206 cases (51.5%) presented with oral frailty. Univariate analysis showed that gender, age, education level, marital status, sleep status, long-term medication history, and smoking history significantly influenced the level of oral frailty (P<0.05). Pearson correlation analysis indicated that social support was negatively correlated with both oral frailty (r=-0.636, P<0.001) and depression (r=-0.458, P<0.001), while depression was positively correlated with oral frailty (r=0.553, P<0.001). Bootstrap analysis revealed that social support directly affected oral frailty, with the direct effect of -0.235 (95%CI:-0.284 to -0.186) accounting for 74.84% of the total effect. Depression partially mediated the relationship between social support and oral frailty, with a mediated effect of -0.079 (95%CI:-0.110 to -0.051) accounting for 25.16% of the total effect. Conclusions Elderly stroke patients have a high prevalence of oral frailty. Enhancing social support and improving depression may help reduce the risk of oral frailty. References | Related Articles | Metrics

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Effect of sarcopenia on episodic memory function in patients with late-life depression GAO Xinyu, KONG Xiaoming, GENG Hao, LYU Siwen 2026, 40 (8):  831-836.  doi: 10.3969/j.issn.1003-9198.2026.08.015 Abstract ( 65 )   PDF (1042KB) ( 122 )   Save Objective To investigate the association between sarcopenia and episodic memory function in patients with late-life depression (LLD). Methods A total of 101 elderly patients with depression were recruited from May 2024 to February 2025. According to the Asian Working Group for Sarcopenia criteria, the patients were divided into a group with sarcopenia (LLD-S group,n=40) and a group without sarcopenia (LLD-NS group, n=61). The Auditory Verbal Learning Test-Huashan version was used to assess memory function. Sarcopenia indicators including muscle strength and physical function were measured and bioelectrical impedance analysis was performed. Hamilton Depression (HAMD) scale, Hamilton Anxiety(HAMA) scale, and Mini-Mental State Examination (MMSE) were applied to evaluate the mental and psychological state. Spearman correlation analysis was employed to evaluate the association between episodic memory function and relevant clinical indicators; And hierarchical linear regression model was constructed to analyze the independent impact of sarcopenia on episodic memory function in LLD patients. Results The LLD-S group exhibited higher age, poorer physical function, more severe depression and anxiety, as well as more pronounced cognitive and memory impairments compared to the LLD-NS group (all P<0.05). In LLD patients, short-delay recall, long-delay recall, and recognition were all negatively correlated with the duration of the five-chair-standing test, as well as HAMD and HAMA scores (P<0.05), while significantly positively correlated with grip strength, calf circumference, and 6-meter walking speed. Hierarchical regression showed that sarcopenia had significant negative effects on long-delay recall (B=-1.36, P=0.001), short-delay recall (B=-1.03, P=0.014), and recognition (B=-1.92, P=0.043). Conclusions Sarcopenia is closely associated with impaired episodic memory function in patients with LLD, and it is an independent risk factor for episodic memory impairment in LLD patients.     References | Related Articles | Metrics

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Clinical characteristics and prognostic analysis of late-onset connective tissue disease-associated pulmonary arterial hypertension XU Jie, ZHANG Yixin, ZHANG Miaojia, WANG Qiang, SUN Xiaoxuan 2026, 40 (8):  837-842.  doi: 10.3969/j.issn.1003-9198.2026.08.016 Abstract ( 63 )   PDF (1045KB) ( 81 )   Save Objective To explore the clinical characteristics and risk factors for poor prognosis in patients with late-onset connective tissue disease (CTD) associated pulmonary arterial hypertension (PAH). Methods A retrospective analysis was conducted on patients diagnosed with CTD-PAH at Department of Rheumatology, the First Affiliated Hospital of Nanjing Medical University from January 2019 to December 2023 using right heart catheterization(RHC). Patients were divided into two groups: early-onset group(onset age<60 years) and late-onset group(onset age ≥60 years). Demographic data, cardiovascular risk factors (hypertension, coronary artery disease and diabetes), echocardiographic and RHC parameters, treatment for CTD and PAH, clinical failure-free survival rates were observed and compared between the two groups. And the influecing factors for clinical failve events was analysized. Results Compared with the early-onset group, the late-onset group had a higher prevalence of coronary heart disease and hypertension; Late-onset patients exhibited worse cardiac function, with a higher proportion of cardiac function grading Ⅲ-Ⅳ and significantly shorter 6-minute walk distance (6MWD) (P＜0.05). Two-dimensional echocardiography showed that left atrial diameter (LAD), left ventricular end-diastolic diameter (LVDd), and the E/e′ ratio were significantly increased in the late-onset group than those in the early-onset group(P＜0.05). Compared with the early-onset group, the utilization rate of glucocorticoids and the rate of combination targeted therapy for PAH were significantly lower in the late-onset group(P＜0.05). Within one year of follow-up, the proportion of patients achieving a low-risk status in the late-onset group was significantly lower than that in the early-onset group (25.0% vs 62.1%,P＜0.05). Cox regression analysis indicated that the E/e′ ratio was a risk factor for clinical failure events in patients with late-onset CTD-PAH(HR=1.295,95%CI:1.039-1.615,P=0.022). Conclusions Late-onset CTD-PAH patients have a higher incidence of cardiovascular risk factors, with elevated left atrial pressure and impaired left ventricular diastolic function. They generally have a poorer prognosis, and E/e′ is a risk factor for adverse outcomes in these patients.     References | Related Articles | Metrics

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Association between fatigue and frailty among community-dwelling older people aged ≥60 years old in Nanjing YANG Luyan, YE Qing, WANG Zhiyong, HU Caihong, XU Huiqing, AO Guofeng, XU Fei 2026, 40 (8):  843-849.  doi: 10.3969/j.issn.1003-9198.2026.08.017 Abstract ( 54 )   PDF (1061KB) ( 157 )   Save Objective To investigate the prevalence of frailty among community-dwelling older adults in Nanjing and to examine the association between fatigue and frailty. Methods Based on data from the 2023 survey of community-dwelling older adults in Nanjing, a total of 5484 older adults aged ≥60 years were enrolled through multistage stratified sampling. Fatigue was assessed using the Pittsburgh Fatigability Scale (PFS), with a total score ≥15 indicating fatigue. Frailty was assessed using the Groningen Frailty Indicator (GFI), with a total score ≥3 indicating frailty. A mixed-effects logistic regression model with community as a random intercept was used to analyze the association between fatigue and frailty. Given the relatively high prevalence of frailty (24.9%), robust Poisson regression based on generalized estimating equations (GEE), with community as the clustering unit, was further used to examine the association between continuous PFS scores and frailty prevalence, and prevalence ratios (PRs) with 95%CI were reported. Effect estimates were also converted for every 5-point and 10-point increase in PFS score. Results The prevalence of frailty was 24.9% (95%CI:23.8%-26.1%). Mixed-effects logistic regression showed that fatigue was significantly positively associated with frailty in the unadjusted model (OR=2.04, 95%CI:1.78-2.35, P<0.001). After further adjustment for sociodemographic characteristics, lifestyle factors, chronic diseases, sleep quality, and anxiety/depression, the positive association remained significant (OR=1.61, 95%CI:1.38-1.86, P<0.001). Stratified analysis showed that this association was present across gender and age groups. Robust Poisson regression using GEE indicated a linear dose-response relationship between PFS scores and frailty prevalence: after adjustment, each 1-point increase in PFS score was associated with a PR of 1.02 (95%CI:1.01-1.03, P<0.001), each 5-point increase with a PR of 1.11 (95%CI:1.06-1.16, P<0.001), and each 10-point increase with a PR of 1.23 (95%CI:1.12-1.36, P<0.001). Conclusions Frailty is relatively prevalent among community-dwelling older adults in Nanjing. Fatigue is stably and positively associated with frailty, and higher fatigue score is linearly associated with a higher prevalence of frailty.     References | Related Articles | Metrics

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Research progress on digital exclusion among older adults DENG Ting, YANG Wei, WANG Weihua, XIN Yuanyuan 2026, 40 (8):  850-854.  doi: 10.3969/j.issn.1003-9198.2026.08.018 Abstract ( 59 )   PDF (1037KB) ( 84 )   Save With the accelerating population aging in China and the rapid advancement of artificial intelligence in healthcare, digitalization has become a primary channel for accessing medical resources and social services. However, older adults face a severe risk of digital exclusion due to declining physiological functions, lack of digital literacy, and insufficient social support. They not only struggle to effectively integrate into the digital society but also encounter practical barriers in digital medical services, which undermines the accessibility and continuity of medical resources and largely exacerbates health inequality and social isolation. This paper focuses on summarizing the definition and manifestations of digital exclusion among the elderly, the research status and influencing factors of digital exclusion, and explores corresponding intervention strategies based on the practical difficulties the elderly face in accessing medical resources through digital means. It aims to provide references for improving the elderly’s experience of digital medical treatment and promoting the age-friendly development of medical services. References | Related Articles | Metrics

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Research progress on the association between osteosarcopenic obesity and cardiovascular diseases BU Xianghui, YANG Wei, YANG Shenshen, DENG Ting, ZHAO Yuan, WANG Weihua 2026, 40 (8):  855-859.  doi: 10.3969/j.issn.1003-9198.2026.08.019 Abstract ( 58 )   PDF (1001KB) ( 97 )   Save Osteosarcopenic obesity syndrome (OSO) has attracted much attention in recent years. This syndrome not only affects an individual’s bone and muscle health, but also closely related to the occurrence and development of cardiovascular diseases. This article reviews the diagnosis and epidemiological characteristics of OSO, the association mechanism between OSO and cardiovascular diseases, as well as relevant clinical evidence. It proposes that in the future, a unified diagnostic standard for OSO should be established, OSO-related indicators should be incorporated into cardiovascular disease risk assessment and management, and research on the shared pathological mechanisms and risk factors between OSO and cardiovascular diseases should be strengthened, ultimately aiming to construct a scientific and systematic diagnosis and treatment system. References | Related Articles | Metrics

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Fall risk stratification profiles and associated factors in elderly inpatients experienced falls: a retrospective analysis ZHOU Chunxia, TIAN Meng, LI Qian, CHEN Ying 2026, 40 (8):  860-864.  doi: 10.3969/j.issn.1003-9198.2026.08.020 Abstract ( 70 )   PDF (1002KB) ( 72 )   Save Objective To analyze the differences in clinical characteristics among hospitalized elderly patients experienced falls with different fall risk levels, investigate the influencing factors of fall risk levels, and provide evidence for developing precise fall prevention strategies. Methods This study included 190 elderly inpatients who experienced falls at the First Affiliated Hospital, Zhejiang University School of Medicine between July 2022 and July 2024. Demographic data, clinical characteristics, and laboratory test results were collected. Based on the results of admission fall risk assessment, the patients were divided into three groups:a high-risk group, a medium-risk group, and a low-risk group. Univariate analysis was used to compare the differences in characteristics among the groups, and ordinal logistic regression analysis was employed to identify factors associated with an increased risk of falling. Results Of the 190 patients, 28 (14.74%) were at low risk for falls, 111 (58.42%) were at moderate risk, and 51 (26.84%) were at high risk. Univariate analysis revealed statistically significant differences in age, length of hospital stay, comorbidity status, history of malignant tumors, Barthel Index, serum potassium, serum calcium, hemoglobin, and fasting blood glucose levels among the different fall risk groups (P<0.05). Ordinal logistic regression analysis indicated that age, Barthel Index, serum potassium, serum calcium, and history of malignant tumors were independent risk factors for fall risk levels in the elderly inpatients experienced falls. Conclusions Hospitalized elderly patients who have fallen are primarily those at moderate to high risk of falling, and their risk level is influenced by a combination of factors, including age, physical function, serum potassium, serum calcium, and malignancies history. References | Related Articles | Metrics