Abstract:Objective To investigate the effect of restarting antiplatelet therapy on clinical outcomes in elderly male patients with intracranial hemorrhage (ICH). Methods Clinical data of 113 elderly male ICH patients admitted in the Second Medical Center of Chinese PLA General Hospital from January 2006 to December 2021 were collected and retrospectively analyzed. According to whether antiplatelet therapy was restarted, they were divided into restart antiplatelet group (Re-AP, n=67) and non-restart antiplatelet group (Non-AP, n=46). Their baseline data and clinical outcomes (ischemic vascular events, recurrent ICH, all-cause death, and vascular death) were recorded. SPSS statistics 26.0 was used for data analysis. Depending on the data types, student′s t test, Mann-Whitney U test, Chi-square test, or Fisher′s exact test was employed for comparison between groups. Univariate and multivariate Cox proportional hazards regression models were applied to analyze the risk factors for clinical outcome events. Results The Re-AP group had larger proportions of atrial fibrillation and statin use, and lower ratio of lobar hemorrhage and lower serum creatinine level than the Non-AP group. The median time to restart antiplatelet therapy was 178 (46,780) d. Multivariate Cox regression analysis showed that restarting antiplatelet therapy was independently associated with a reduced risk of ischemic vascular events (HR=0.377,95%CI 0.160-0.888; P=0.026), but not associated with an increased risk of recurrent ICH (HR=1.563,95%CI 0.767-3.184; P=0.219), all-cause mortality (HR=0.734,95%CI 0.404-1.336; P=0.312) or vascular death (HR=0.454,95%CI 0.159-1.293; P=0.139). Age and elevated creatinine level were independent risk factors for all-cause mortality (HR=1.100,95%CI 1.048-1.155; P=0.000; HR=1.009, 95%CI1.005-1.014; P=0.000), and elevated serum creatinine level was an independent risk factor for vascular death (HR=1.009, 95%CI 1.001-1.017; P=0.028). Conclusion In elderly male patients with ICH, restarting antiplatelet therapy after a median time of 178 d reduces the risk of ischemic vascular events and does not increase the risk of recurrence of ICH.

Abstract:Objective To analyze the incidence of inappropriate use for renal drugs renally inappropriate medications (RIM) and related influencing factors in elderly inpatients with chronic kidney disease (CKD) in order to provide evidence for rational clinical drug use. Methods The clinical data of 748 elderly patients with CKD hospitalized in a large-scale general hospital from January 2020 to December 2020 were collected and retrospectively analyzed. The occurrence of RIM was evaluated by using pharmaceutical tools such as domestic and foreign drug instructions, expert consensus, medication manuals and Micromedex database. SPSS statistics 22.0 was used for data analysis. Multivariate logistic regression was used to analyze the risk factors of RIM. Results The incidence of RIM was 50.27% (376/748) in the elderly CKD patients, and a total of 739 RIM occurred. The top 5 drug categories of RIM were antimicrobial [46.01% (340/739)], endocrine system drugs [11.77% (87/739)], urinary system drugs [11.50% (85/739)], cardiovascular system drugs [9.88% (73 / 739)] and analgesics [7.31% (54/739)]. The top 3 commonly used drugs were spironolactone [9.47% (70/739)], levofloxacin [9.34% (69/739)], and cefoperazone sodium and sulbactam sodium [7.04% (52/739)]. The main inappropriate drug use was that the dose of relevant drugs was not adjusted when the renal function was declined. Multivariate logistic regression analysis showed that age (75-84 years:OR=1.582,95%CI 1.101-2.272; ≥85 years:OR=3.026,95%CI 1.532-5.978, P<0.001), number of drug varieties (11-25:OR=2.379,95%CI 1.500-3.773, P<0.001; ＞25:OR=13.086,95%CI 6.991-24.496, P<0.001), CKD stage (3b stage:OR=2.183,95%CI 1.348-3.536, P=0.002; 4 stage:OR=4.287, 95%CI 2.485-7.395, P<0.001; 5 stage:OR=4.779,95%CI 2.984-7.654, P<0.001) and Charlson comorbidity index (CCI) ≥5 (OR=2.455,95%CI 1.523-3.957; P<0.001) were independent risk factors for RIM in the CKD patients. Conclusion The incidence of RIM is relatively high in the elderly CKD inpatients. To reduce the occurrence of RIM,the CKD patients ≥75 years old, with number of drug varieties≥11, CKD stage≥3b and CCI≥5 should be paid attention to.

Abstract:Objective To investigate the clinical characteristics and influencing factors of non-alcoholic fatty liver disease (NAFLD) in the elderly. Methods A total of 782 retired elderly people aged ≥60 years in Haidian District of Beijing were included during May and September 2021. According to whether they had NAFLD or not, they were divided into NAFLD (n=200) and non-NAFLD groups (n=582). The baseline data were compared between the 2 groups of patients. SPSS statistics 25.0 was used for data analysis. Multivariate logistic regression analysis was employed to analyze the influencing factors of NAFLD. A multi-index combined prediction model was established, and its clinical predictive value for NAFLD was evaluated by receiver operating characteristic (ROC) curve. Results The prevalence of NAFLD was 25.58% (200/782). Compared with the non-NAFLD group, the NAFLD group had significantly higher body mass index (BMI), larger proportion of diabetes, and higher levels of alanine aminotransferase, aspartate aminotransferase, triglyceride (TG), fasting blood glucose (FBG) and uric acid, and obviously younger age, lower prevalence of chronic obstructive pulmonary disease and lower high-density lipoprotein-cholesterol level (all P<0.05). Multivariate logistic regression analysis showed that NAFLD was positively correlated with female (OR=1.882,95%CI 1.142-3.100; P=0.013), BMI (OR=1.303,95%CI 1.219-1.393; P=0.000), FBG (OR=1.215,95%CI 1.076-1.372; P=0.002), TG (OR=1.738,95%CI 1.401-2.154; P=0.000), and negatively with age (OR=0.979,95%CI 0.964-0.995); P=0.009). ROC curve analysis showed that the combination of age, female, BMI, FBG and TG had a good predictive value for elderly NAFLD, with an area under the curve of 0.782 (95%CI 0.751-0.811). Conclusion The prevalence of NAFLD in the elderly is decreased with age. NAFLD in the elderly is affected by many factors. Female, obesity, diabetes and dyslipidemia, especially TG elevation, are the risk factors of NAFLD in the elderly.

Abstract:Objective To investigate the status and influencing factors of social support for hospitalized disabled elderly with chronic obstructive pulmonary disease (COPD). Methods A total of 200 COPD elderly patients who were determined to be disabled by activities of daily living (ADLs) and hospitalized in respiratory departments from 6 Class-A tertiary hospitals in Chengdu City during June and October 2021 were recruited in this study. Self-made questionnaires, Chinese version of medical outcomes study social support survey (MOS-SSS), Chinese meaning in life questionnaire (C-MLQ), Templer-death anxiety scale (T-DAS) were used for investigation. SPSS statistics 22.0 was used for statistical analysis. Intergroup comparison was performed using student′s t test or ANOVA depending on data types. Multivariate stepwise linear regression analysis was applied to analyze the factors affecting social support in hospitalized disabled elderly with COPD. Results The average score of social support was (60.26±12.78) points for the cohort, which was at a low level. Multivariate regression analysis indicated that sense of meaning in life, self-assessment of family relationships, death anxiety, depression and marital status showed certain predictive effects on the social support of COPD hospitalized disabled elderly (P ＜0.05). Conclusion The current status of social support for the hospitalized disabled elderly with COPD is easily overlooked. It is necessary to pay more attention to their psychological problems, improve clinical nursing interventions, and promote the transformation of “appropriate aging” in the aging society.

Abstract:Objective To investigate the predictive value of serum heparin binding protein (HBP) and procalcitonin (PCT) for 28-day mortality risk in patients with sepsis associated acute kidney injury (SA-AKI). Methods A retrospective analysis was performed of the clinical data of 75 SA-AKI patients admitted to the intensive care unit (ICU) of Emergency Department in Shanxi Bethune Hospital from July 2020 to February 2022. They were divided into the survival group (n=51) and death group (n=24) based on 28-day outcome, and the two groups were compared in HBP, PCT and other clinical data. SPSS statistics 26.0 was used for data analysis. Depending on the data type, t-test, Mann-Whitney U test, or χ² test was used for comparison between groups. Univariate analysis and multivariate logistic regression were used to analyze the factors influencing the risk of death at 28 days, and forest plots were drawn to compare the independent prognostic factors. Receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of 28-day death risk factors. Results The two groups differed significantly in HBP [115.66 (96.88,255.20) vs 95.61(46.82,114.79) ng/ml], PCT [29.13(26.03,111.53) vs 14.41(6.62,23.91) ng/ml], lactic acid [3.90(1.75,6.93) vs 2.02(1.47,4.08) mmol/L], APACHE Ⅱ [25.50 (21.25,31.00) vs 20.00(16.00,26.25) points], SOFA [(11.46±3.68) vs (8.69±3.50) points], hospital stay [9.00(5.50,19.75) vs 21.50(15.00,30.00) d], use of mechanical ventilation support [24(100.0%) vs 35(68.6%)], and use of vasoconstrictor [22(91.7%) vs32(62.7%)] (P＜0.05). Logistic regression analysis showed that HBP (OR= 1.155, 95% CI 1.007-1.325), PCT (OR=2.698,95% CI 1.003-7.254) and hospital stay (OR= 0.379,95%CI 0.144-0.995) were independent influencing factors for death at 28 days in the SA-AKI patients. ROC curve analysis showed an area under the curve (AUC) of 0.755 for HBP with an optimal cut-off value of 65.815 ng/ml, a sensitivity of 58.3% and a specificity of 78.4%; an AUC of 0.871 for PCT with an optimal cut-off value of 20.670 ng/ml, a sensitivity of 100.0% and a specificity of 64.7%; and an AUC of 0.903 both with an optimal cut-off value of 0.222 ng/ml, a sensitivity of 100.0% and a specificity of 70.6%. Conclusion Elevated serum levels of HBP and PCT were independent risk factors for 28-day death in SA-AKI patients. Serum levels of HBP and PCT have good predictive value for 28-day death in SA-AKI patients, and they predict better in combination than individually.

Abstract:Objective To compare the plaque composition and burden between patients with acute coronary syndrome (ACS) and those with stable coronary artery disease (SCAD) using quantitative plaque assessment with coronary computed tomography angiography (CCTA). Methods A total of 116 patients in the Department of Cardiology, First Medical Center, Chinese PLA General Hospital from January 2021 to March 2021 were retrospectively included, who were divided into the ACS group (n=81) and the SCAD group (n=35) according to the clinical diagnosis. All the patients underwent CCTA and coronary angiography within 14 days after the diagnosis. A CCTA software for plaque quantification analysis was used to measure such imaging features as plaque component volume and burden, minimal lumen diameter (MLD), remodeling index (RI), and eccentric index (EI). SPSS 20.0 was used for statistical analysis. Depending on the data type, data comparison between two groups was performed using t-test, Wilcoxon test or χ²test.Results The ACS patients had higher total plaque burden (TPB), non-calcified component burden (NCPB), and lipid component burden (LPB), the differences being statistically significant[(60.5±11.2)% vs (51.7±14.4)%,(58.9±12.0)%vs (50.1±15.2)%,17.9%(11.6%,27.6%) vs 14.2%(7.5%, 20.8%),all P<0.05]. There was no significant difference between the two groups in plaque component volume, calcification component burden (CPB), RI and EI. In the ACS patients, the culprit lesions had higher TPB, NCPB and LPB than the non-culprit lesions[(62.3±10.4)% vs (54.8±10.6)%,(60.7±11.0)% vs (52.4±11.0)%,(19.7±10.3)% vs (15.1±9.2)%,all P<0.05)]. In addition, the culprit lesions had smaller CPB than non-culprit lesions[0.5%(0.0,2.6)% vs 1.5%(0.3,3.6)%,P<0.05]. Conclusion Quantitative CCTA analysis of the coronary plaque composition revealed that patients with ACS and culprit lesions show higher TPB, NCPB and LPB.

Abstract:Objective To explore the effect of long-term blood pressure variability and anti-hypertensive treatment on arterial stiffness. Methods A total of 411 elderly patients with essential hypertension who were treated and managed in our hospital from January to June 2017 were enrolled in this study. Brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) were used as indicators to evaluate arterial stiffness. Linear regression analysis was employed to analyze the correlations of blood pressure index and long-term blood pressure variability (BPV) with baPWV and ABI. BPV was expressed as systolic blood pressure standard deviation (SBP_SD). SPSS statistics 26.0 was applied for data analysis. The efficacy of anti-hypertensive therapy and the effect of antihypertensive therapy on arterial stiffness were analyzed by student′s t test. Results In those elderly patients with hypertension, 3 years′ anti-hypertensive treatment resulted in significantly decreased average systolic blood pressure [SBP, (131.78±7.36) vs (142.92±17.14) mmHg(1 mmHg=0.133 kPa)], diastolic blood pressure [DBP, (80.22±6.31) vs (81.49±10.01) mmHg], pulse pressure [PP, (51.57±7.81) vs (61.43±14.06) mmHg] and mean artery pressure [MAP, (97.41±5.57) vs (101.97±10.98) mmHg], obviously reduced fasting plasma glucose [FPG, (5.30±1.67) vs (5.81±1.69) mmol/L], total cholesterol [ (3.85±0.95) vs (4.42±0.90) mmol/L] and triglyceride [(1.27±0.68) vs (1.79±1.13) mmol/L], but remarkably elevated high-density lipoprotein cholesterol [(1.35±0.31)vs (1.21±0.31) mmol/L] when compared the corresponding values before treatment (all P<0.05). No such statistical change was seen in low-density lipoprotein cholesterol level before and after treatment. After adjustment for confounding factors, SBP, PP, MAP and SBP_SD were positively correlated with baPWV (β=10.390,5.500,14.940,11.110, all P<0.05) and negatively with ABI (β=-0.002, -0.001, -0.002, -0.003, all P<0.05 ) in the patients. DBP was only positively correlated with baPWV (β=8.690, P<0.05), but had no correlation with ABI. After antihypertensive treatment, baPWV was decreased from (1 782.70±308.87) cm/s to (1 732.43±261.73) cm/s, and ABI was increased from (1.12±0.10) to (1.14±0.08), with statistically differences (both P<0.05). Among them, baPWV showed a downward trend in gender and age stratifications, and significant difference was seen compared with that before antihypertensive treatment (P<0.05). ABI in the female patients and those aged 60-70 years was significantly different from that before anti-hypertensive treatment (P<0.05). The SBP difference and DBP difference before and after treatment were positively correlated with the difference of baPWV (β=3.000,3.290, P<0.05), but not with the difference of ABI. Conclusion SBP_SD is an influencing factor of arterial stiffness. The antihypertensive treatment and comprehensive management of elderly hypertensive patients can significantly improve their baPWV value, but the effect on ABI needs further research to clarify.

Abstract:Objective To investigate the association of serum uric acid (SUA) with readmission within 6 months after treatment in patients with acute coronary syndrome (ACS), and to investigate the predictive value of SUA for readmission within 6 months. Methods A retrospective cohort trial was carried out on the ACS patients hospitalized in Department of Cardiology of Chinese PLA General Hospital Hainan Hospital from January 2016 to March 2019. Univariate and binary logistic regression analyses were used to explore the related risk factors of readmission within 6 months after treatment. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive performance of SUA for readmission. SAS9.4 and R4.0.3 were used for statistical analysis. Data comparison between two groups was perfomed using t test, Mann-Whitney U test, χ² test or Bonferroni test depending on data type. Results A total of 462 patients were included in this study, and 47 of them were finally assigned into the readmission group and 415 into the non-readmission group in 6 months after treatment. Univariate analysis showed statistical significance in treatment method between the 2 groups (P<0.05). The patients from the readmission group had obviously higher SUA level (394.77±106.29 vs 346.17±91.58 μmol/L), larger ratios of hypertension [34 (72.34%) vs 231 cases (55.66%)], arthrolithiasis [13 (27.66%) vs 18 cases (4.34%)], and higher incidence of adverse events during hospitalization [12 (14.46%) vs16 cases (3.86%)], but lower estimated glomerular filtration rate [1.04 (72.01,106.02) vs 92.98 (78.76,106.62) ml/(min·1.73 m²)] and proportion of statin use [36 (76.60%) vs 372 cases (89.64%)] when compared with those of the non-readmission group (all P<0.05). Multivariate analysis indicated that SUA level (OR =1.004,95%CI 1.001-1.006), treatment method (OR=5.027,95%CI 2.855-8.853) and adverse events during hospitalization (OR=0.144, 95%CI 0.050-0.410) were closely associated with readmission within 6 months after discharge (all P<0.05). The higher the SUA level was, the higher proportion of readmission in the ACS patients, and the area under the ROC curve of SUA for readmission was 0.649. Conclusion Elevated SUA level increases the risk of readmission within 6 months after discharge in ACS patients and has predictive value for the risk.

Abstract:Objective To investigate the value of soluble growth STimulation expressed gene 2 (sST2) combined with N-terminal pro-B-type natriuretic peptide (NT-proBNP) to evaluate the prognosis of elderly patients with heart failure with mid-range ejection fraction (HFmrEF) after sacubitril-valsartan (SV) intervention. Methods A total of 81 HFmrEF patients admitted to our hospital from April 2018 to April 2020 were recruited in and treated with SV intervention. The risk factors affecting the occurrence of composite endpoints in HFmrEF patients with SV treatment were analyzed, and the value of sST2 combined with NT-proBNP for the prognosis of HFmrEF patients after SV intervention was evaluated. SPSS statistics 26.0 was used for data analysis. According to the data types, student′s t test, Rank sum test, Chi-square test or Fisher exact test was performed for comparison between groups. Cox hazards model was used to analyze the relationship between composite endpoints and variables. Results After 6 months of follow-up, 19 patients experienced composite endpoints and were included in the composite endpoint group, and the remaining 62 patients were included in the non-composite endpoint group. The composite endpoint group had significantly higher heart rate, lower serum creatinine, higher sST2 and NT-proBNP levels, larger left atrial diameter, and larger proportions of smoking history, PCI or thrombolysis history, and acute myocardial infarction history when compared with the non-composite endpoint group (P<0.05). Univariate and multivariate Cox regression analyses showed that sST2 and NT-proBNP levels were independent risk factors for composite endpoints in HFmrEF patients after SV treatment (P<0.05). Receiver operating characteristic (ROC) curve analysis indicated that the diagnostic value of sST2 combined with NT-proBNP was higher than that of a single index in predicting composite endpoint events. Conclusion sST2 combined with NT-proBNP has a significant predictive value for the prognosis of elderly HFmrEF patients after SV intervention.

Abstract:Objective To explore the role and mechanism of Ras protein activator like 2 (Rasal2) in the proliferation and migration of pulmonary artery smooth muscle cells (PASMCs). Methods The expression of Rasal2 in pulmonary arteries of chronic hypoxia-induced pulmonary hypertension (CH-PH) mice and in hypoxia-challenged PASMCs was analyzed by Western blotting. After Rasal2 in PASMCs was silenced by transfection of siRNA, the phosphorylation levels of downstream effector molecules of mammalian target of rapamycin complex 1 (mTORC1), S6 and 4E-binding protein 1 (4EBP1) were determined by Western blotting, and the proliferation and migration of PASMCs were measured with Ki-67 immunofluorescence staining and Transwell assay, respectively. The proliferation and migration of PASMCs were further determined after restoration of mTORC1 activity by insulin. Results Compared with the Normoxic group, the mRNA [(2.57±0.15) vs (1.02±0.09); P<0.001) and protein [(2.18±0.36) vs (0.97±0.14); P<0.001) levels of Rasal2 were significantly increased in the pulmonary artery of the CH-PH group. In the PASMCs of the Hypoxic group, the mRNA [(2.41±0.20), (2.86±0.24) vs (1.03±0.12); both P<0.001] and protein [(2.50±0.32), (2.79±0.38) vs (1.13±0.12); both P<0.01] levels of Rasal2 were obviously higher after 12 h and 24 h of exposure when compared with the Normoxic group. Compared with the siCon group, the protein level of Rasal2 in PASMCs of the siRasal2 group was significantly deceased [(1.09±0.09) vs (0.33±0.04), P<0.001]. Compared with the Normoxic+siCon group, the percentage of Ki-67-positive cells [(62.75±7.54)% vs (13.90±2.35)%; P<0.001], percentage of migrated cells [(305.25±58.28)% vs (88.90±13.67)%; P<0.05], and expression of p-S6Ser235/236/S6 [(3.27±0.24) vs (1.06±0.14); P<0.001] and p-4EBP1Thr37/46/4EBP1 [(2.95±0.15) vs (1.07±0.06);P <0.001] were both increased in the Hypoxic+siCon group. Compared with the Hypoxic+siCon group, the percentage of Ki-67-positive cells [(19.25±5.34)% vs (62.75±7.54)%; P<0.001], percentage of migrated cells [(115.25±19.00)% vs (305.25±58.28)%; P<0.05], and expression of p-S6Ser235/236/S6 [(1.90±0.06)vs (3.27±0.24); P<0.001] and p-4EBP1Thr37/46/4EBP1 [(1.70±0.13) vs (2.95±0.15); P<0.001] in the Hypoxic+siRasal2 group were both reduced. Additionally, the percentage of Ki-67-positive cells [(61.25±3.10)% vs (27.00±3.46)%; P<0.001], percentage of migrated cells [(315.00±21.49)% vs (141.00±15.30)%; P<0.001], and expression of p-S6Ser235/236/S6 [(0.94±0.16) vs (0.36±0.11); P<0.01] and p-4EBP1Thr37/46/4EBP1 [(0.99±0.09) vs (0.61±0.03); P<0.01] were both elevated in the Hypoxic+siRasal2+Insulin group than the Hypoxic+siRasal2 group. Conclusion Rasal2 promotes the proliferation and migration of PASMCs via mTORC1 pathway.

Abstract:Atrial fibrillation is the most common arrhythmia disease and the main cause of cardiogenic stroke. Atrial fibrillation seriously affects the life quality of patients, and its complications are highly crippled and lethal, which has become a serious public health problem. Overweight and obesity are substantial cardiovascular disease risk factors, and this topic has become a major focus in recent years. In this review, the association between obesity and auric fibrillation was discussed.

Abstract:Neutrophils, involved in pathogen clearance and early inflammatory responses, are an important part of the immune system. However, in recent years, more and more studies have shown that neutrophils mediate inflammatory responses and promote fibrosis by forming neutrophil extracellular traps (NETs), and their role in the pathogenesis of autoimmune diseases and pulmonary interstitial fibrosis has been attracting attention. The review first introduces the structures, functions, and formation of NETs, then summarizes their role in systemic lupus erythematosus-associated interstitial lung disease (SLE-ILD) in reference to the pathogenesis of other autoimmune diseases, and finally proposes prospective therapeutic targets of NETs in autoimmune disease-related ILD.

Abstract:After hepatitis B virus (HBV) infection, the virus replicates in the human body and causes cell damage, which activates the release of inflammatory factors in immune cells and further aggravates liver damage. Inflammatory liver damage involves a variety of immune cells, and the inflammatory factors secreted by them play a vital role in cellular and humoral immune responses, antiviral activity, virus clearance, apoptosis and fibrosis formation. HBV infection leads to interaction between a wide array of immune cells and inflammatory factors, forming a complex immune response network and thus promoting the occurrence and development of hepatitis. Inflammatory factors are the main cause of inflammation and liver damage after HBV infection. This article reviews the research progress in the mechanism of inflammatory factors involved in HBV development and liver damage after HBV infection in a view to providing reference for the prevention and treatment of hepatitis B.

Abstract:Type 2 diabetes mellitus (T2DM) has become a global public health problem. It has attracted much attention due to its increasing incidence rate and complex complications, and serious threats to human health and quality of life. Intestinal flora may be an important factor affecting the occurrence and development of T2DM in addition to genetics and life and diet styles. Its compositions may trigger T2DM by affecting the metabolism of short chain fatty acids and bile acids, endotoxemia and other ways. To reveal the correlation between intestinal flora and the pathogenesis of T2DM, it is suggested that the construction of intestinal flora homeostasis may become a new potential target for the prevention and improvement of T2DM.

Abstract:Cognitive frailty (CF) is a state of impairment with reduced cognitive reserve, which is reversible. Some studies have reported that CF may be an important target to prevent adverse outcomes such as dependence on care for the elderly in the community. Understanding the relevant influencing factors, pathophysiological mechanisms and prevention measures of CF among the elderly in the community will help prevent and delay the occurrence of CF, reduce nursing dependence, improve the quality of life in the elderly and caregivers, delay admission to long-term care institutions or reduce the time of admission to acute hospital nursing units, and reduce the social burden at the same time.

Abstract:As the population ages rapidly, the number of the elderly individuals with frailty and dementia also increases, which has a profound impact on their clinical outcomes. Current research on frailty is mainly focused on physical and physiological factors, and the association of frailty with cognitive, psychology, and society remains unclear. A comprehensive multidimensional and integrated assessment of frailty for individualized and integrated interventions is important to improve the quality of life of the elderly adults.