To clarify the association of dietary diversity and dietary intake frequency with frailty among older adults, and to provide an evidence-based foundation for developing nutritional intervention strategies for frailty prevention and treatment.

Basic information, dietary status, and frailty prevalence (assessed using the frailty index) were collected from 9785 older adults in the 2018 Chinese Longitudinal Healthy Longevity Survey-Home Follow-up (CLHLS-HF). All the participants were divided into the frail group and the non-frail group. T test or χ² test was used to compare the differences in dietary intake between the two groups. Logistic regression was used to analyze the relationship between the intake frequency of 9 routinely monitored food types and frailty in older adults.

The average age of the participants was (85.04±11.52) years, the frailty index was (0.17±0.13), the detection rate of frailty was 24.24% (2 372 cases), and the dietary diversity score was (4.65±1.98) points. Multivariate logistic regression indicated that insufficient dietary diversity (OR=1.239, 95%CI: 1.130-1.359, P < 0.01) was a risk factor for frailty. Conversely, increased intake of fresh vegetables, meat, soy productsand tea could reduce the risk of frailty (OR=0.564, 0.814, 0.847, 0.853; 95%CI: 0.480-0.663, 0.710-0.933, 0.754-0.953, 0.729-0.998, P < 0.05 or P < 0.01).

Insufficient dietary diversity is a risk factor for frailty. Maintaining good dietary diversity, such as increasing the intake of fresh vegetables, meat, soy products, and tea, represents a potential nutritional intervention direction for reducing the risk of frailty in older adults.

To investigate the impact of different amputation timings on the prognosis of elderly patients with diabetic foot after failed limb salvage therapy, and to provide evidence for optimizing clinical decision-making regarding amputation.

A retrospective analysis was conducted on the clinical data of 37 elderly patients with diabetic foot who underwent amputation after failed limb salvage therapy in the Department of Hand and Foot Surgery of our hospital from January 2022 to December 2024. According to the timing of amputation, patients were divided into an early amputation group (surgery within 72 hours after failed limb salvage, n=16) and a delayed amputation group (surgery more than 72 hours after failed limb salvage, n=21). T test or χ² test was used to compare the differences in incidence of postoperative complications, wound healing time, hospital stay, 6-month survival rate, and quality of life (SF-36) scores between the two groups. Multivariate Logistic regression analysis was used to identify risk factors affecting prognosis.

The total postoperative complication rates in the early amputation group and the delayed amputation group were 31.25% and 66.67% respectively, with a statistically significant difference (χ²=5.231, P < 0.05). The wound healing time and hospital stay in the early amputation group were (28.6±5.2) days and (35.2±8.7) days respectively, while those in the delayed amputation group were (42.5±7.8) days and (52.6±10.3) days, respectively. The differences were statistically significant between the two groups (t=6.325, 5.871; P < 0.01). At 6 months after surgery, the survival rate and quality of life score in the early amputation group were 93.75% and (68.5±10.2) points, respectively, while those in the delayed amputation group were 71.43% and (52.3±8.6) points, respectively. The differences were statistically significant between the two groups (χ²=3.968, t=5.124; P < 0.05 or P < 0.01). Multivariate Logistic regression analysis showed that delayed amputation timing, preoperative severe infection, and poor nutritional status were independent risk factors for poor prognosis (OR=3.852, 4.218, 3.526; 95%CI: 1.215~12.163, 1.356~13.132, 1.087~11.445; P < 0.05).

For elderly patients with diabetic foot after failed limb salvage therapy, early amputation (within 72 hours) under relatively stable conditions can reduce the incidence of postoperative complications, shorten wound healing time and hospital stay, and improve survival rates and quality of life, making it worthy of clinical promotion.

To investigate the clinical efficacy of a pulmonary rehabilitation self-management device in improving lung function in patients with stable chronic obstructive pulmonary disease (COPD).

A total of 90 stable COPD patients who met the inclusion and exclusion criteria and received basic pharmacological treatment were enrolled from the First Hospital of Shanxi Medical University between June 2024 and February 2025. They were randomly divided into three groups using a random number table: the self-management group (remote supervision and daily rehabilitation training using the pulmonary rehabilitation self-management device), the home rehabilitation group (daily home-based rehabilitation training with record-keeping and monthly telephone follow-ups), and the health education group (receiving pulmonary rehabilitation education at discharge). Each group consisted of 30 patients. After 12 weeks, lung function, exercise endurance, muscle strength, and dyspnea improvement were compared among the three groups. T test, non-parametric test, or analysis of variance was used to compared the measurement data, χ² test was used to compared the count data.

A total of 28 patients in the home rehabilitation group, 29 in the self-management group, and 30 in the health education group completed the training and follow-up. Baseline characteristics showed no statistically significant differences among the three groups (P > 0.05). There was no statistically significant difference in the forced expiratory volume in one second (FEV1), forced vital capacity (FVC), the percentage of predicted FEV1 (FEV1%pred), and FEV1/FVC before and after treatment among the three groups (P > 0.05). In the self-management group, FEV1, FVC, FEV1%pred, and FEV1/FVC were significantly improved after treatment compared with those before treatment (t=-10.030, -4.647; Z=-9.604, -4.622; P < 0.01). After treatment, there were statistically significant differences in the 6-minute walk distance (6MWD), grip strength, 5-repetition sit-to-stand test (5R-STST), and COPD assessment test (CAT) scores among the three groups (F=5.015, 8.860; H=10.477, 12.795; P < 0.01). Among them, the self-management group showed the most significant improvement in all indicators (P < 0.05). After treatment, the 6MWD, grip strength, CAT score, and 5R-STST scores in both the home-based rehabilitation group and the self-management group showed significant improvement compared to those before treatment (t=-3.247, -2.066, Z=3.198, -4.690; t=-4.703, -14.832, Z=-4.406, 2.436; P < 0.01). The training compliance score in the self-management group was significantly higher than that in the home-based rehabilitation group (t=-3.300, P < 0.01).

The use of a pulmonary rehabilitation self-management device for daily training management in COPD patients effectively enhances training compliance, thereby significantly improving lung function, limb muscle strength, exercise endurance, and dyspnea symptoms.

To develop a frailty risk prediction model for elderly inpatients based on Meta-analysis, providing a basis for early clinical screening of frail older patients.

A systematic literature search was conducted to identify studies analyzing factors influencing frailty. Meta-analysis was then performed to pool the odds ratios (OR) or relative risks (RR) for each factor as summary statistics. The combined OR value was used to calculate β to construct a logistic regression equation, and the β was used to assign scores to each influencing factor to build a frailty risk scoring table. The FRAIL scale served as the gold standard for frailty diagnosis, and the model was externally validated in a cohort of elderly inpatients. The total score of the model was used as the test indicator for the diagnostic test, and the area under the curve (AUC) was used as the comprehensive evaluation index of the model.

A total of 57 studies were included in the meta-analysis. The constructed frailty risk scoring model assigns scores as follows: age (≥60 years old, 2 points), comorbidities (clinical diagnosis≥5, 10 points), physical activity (daily activity volume < 6000 steps, 17 points), hypertension (6.5 points), diabetes (6.5 points), renal insufficiency (5.5 points), NRS 2002≥3 points (13 points), BNP≥100 pg/mL (1 point), CRP≥5 mg/L (2 points). The external validation trial showed that the area under the receiver operating characteristic curve of this predictive model was 0.973 (95%CI: 0.955~0.991, P < 0.0001); when the frailty risk scale score was≥25 points, it could be judged as frail, and the sensitivity of this critical value was 0.925, and the specificity was 0.925.

The frailty risk prediction model constructed through meta-analysis in this study has excellent stability and predictive performance. The indicators collected by the model are highly accessible in clinical settings and are suitable for clinical application and promotion.

The kidneys, as an important metabolic and excretory organ in the human body, undertake crucial physiological functions such as eliminating metabolic waste, regulating water and salt balance, and maintaining acid-base homeostasis. With the increase of age, the kidneys undergo progressive functional decline, accompanied by significant macroscopic and microscopic histological changes. This age-related renal function impairment has become an important issue urgently needing to be addressed in clinical practice. In-depth research on the pathological features of kidney aging is of great significance for understanding and improving age-related renal injury. From the molecular mechanism perspective, cellular aging plays a decisive role in the aging process of the kidneys and involves multiple cell signal transduction pathways. These pathways provide potential intervention targets for delaying or reversing kidney aging. Therefore, systematic research on the molecular mechanism of kidney aging and its clinical significance is of great value for the early diagnosis in clinical practice, the delay of kidney aging, and the development of new treatment strategies for kidney diseases. This article focuses on the pathological features, molecular mechanisms, and potential treatment directions of kidney aging, providing new ideas for related research and clinical practice.

Frailty and hypertension are common syndromes and chronic conditions among older adults, sharing a close and bidirectional relationship. A potential reverse causality may exist between frailty and antihypertensive therapy in the elderly, and whether frail older patients should undergo intensive hypertension management remains debated. It is particularly important to note that current clinical practice necessitates a comprehensive frailty assessment before formulating hypertension management strategies for this population. Antihypertensive regimens should be formulated based on the presence of functional dependence and the extent of impairment in autonomous mobility due to frailty. The comprehensive management of hypertension in these patients requires shared decision-making among patients, healthcare professionals, and caregivers. This involves individualized interventions for frailty or hypertension through measures such as lifestyle modifications and pharmacological treatments, with dynamic adjustments to the management plan based on the patient’s blood pressure control status and adverse reactions. This approach aims to enhance patient adherence and achieve desired management outcomes. This article analyzes and elaborates on the particularities of hypertension treatment in frail older adults, specific strategies, intervention methods, and follow-up management.