Enhancing the spatial resolution of time-of-flight based non-line-of-sight imaging via instrument response function deconvolution.

Non-line-of-sight (NLOS) imaging retrieves the hidden scenes by utilizing the signals indirectly reflected by the relay wall. Benefiting from the picosecond-level timing accuracy, time-correlated single photon counting (TCSPC) based NLOS imaging can achieve theoretical spatial resolutions up to millimeter level. However, in practical applications, the total temporal resolution (also known as total time jitter, TTJ) of most current TCSPC systems exceeds hundreds of picoseconds due to the combined effects of multiple electronic devices, which restricts the underlying spatial resolution of NLOS imaging. In this paper, an instrument response function deconvolution (IRF-DC) method is proposed to overcome the constraints of a TCSPC system's TTJ on the spatial resolution of NLOS imaging. Specifically, we model the transient measurements as Poisson convolution process with the normalized IRF as convolution kernel, and solve the inverse problem with iterative deconvolution algorithm, which significantly improves the spatial resolution of NLOS imaging after reconstruction. Numerical simulations show that the IRF-DC facilitates light-cone transform and frequency-wavenumber migration solver to achieve successful reconstruction even when the system's TTJ reaches 1200 ps, which is equivalent to what was previously possible when TTJ was about 200 ps. In addition, the IRF-DC produces satisfactory reconstruction outcomes when the signal-to-noise ratio (SNR) is low. Furthermore, the effectiveness of the proposed method has also been experimentally verified. The proposed IRF-DC method is highly applicable and efficient, which may promote the development of high-resolution NLOS imaging.

High accuracy ranging for space debris with spaceborne single photon Lidar.

The increasing risk posed by space debris highlights the need for accurate localization techniques. Spaceborne single photon Lidar (SSPL) offers a promising solution, overcoming the limitations of traditional ground-based systems by providing expansive coverage and superior maneuverability without being hindered by weather, time, or geographic constraints. This study introduces a novel approach leveraging non-parametric Bayesian inference and the Dirichlet process mixture model (DPMM) to accurately determine the distance of space debris in low Earth orbit (LEO), where debris exhibits nonlinear, high dynamic motion characteristics. By integrating extended Kalman filtering (EKF) for range gating, our method captures the temporal distribution of reflected photons, employing Markov chain Monte Carlo (MCMC) for iterative solutions. Experimental outcomes demonstrate our method's superior accuracy over conventional statistical techniques, establishing a clear correlation between radial absolute velocity and ranging error, thus significantly enhancing monostatic space debris localization.

Changes in the combination of the triglyceride-glucose index and obesity indicators estimate the risk of cardiovascular disease.

BACKGROUND: Cardiovascular disease (CVD) is closely associated with the triglyceride glucose (TyG) index and its related indicators, particularly its combination with obesity indices. However, there is limited research on the relationship between changes in TyG-related indices and CVD, as most studies have focused on baseline TyG-related indices. METHODS: The data for this prospective cohort study were obtained from the China Health and Retirement Longitudinal Study. The exposures were changes in TyG-related indices and cumulative TyG-related indices from 2012 to 2015. The K-means algorithm was used to classify changes in each TyG-related index into four classes (Class 1 to Class 4). Multivariate logistic regressions were used to evaluate the associations between the changes in TyG-related indices and the incidence of CVD. RESULTS: In total, 3243 participants were included in this study, of whom 1761 (54.4%) were female, with a mean age of 57.62 years at baseline. Over a 5-year follow-up, 637 (19.6%) participants developed CVD. Fully adjusted logistic regression analyses revealed significant positive associations between changes in TyG-related indices, cumulative TyG-related indices and the incidence of CVD. Among these changes in TyG-related indices, changes in TyG-waist circumference (WC) showed the strongest association with incident CVD. Compared to the participants in Class 1 of changes in TyG-WC, the odds ratio (OR) for participants in Class 2 was 1.41 (95% confidence interval (CI) 1.08-1.84), the OR for participants in Class 3 was 1.54 (95% CI 1.15-2.07), and the OR for participants in Class 4 was 1.94 (95% CI 1.34-2.80). Moreover, cumulative TyG-WC exhibited the strongest association with incident CVD among cumulative TyG-related indices. Compared to the participants in Quartile 1 of cumulative TyG-WC, the OR for participants in Quartile 2 was 1.33 (95% CI 1.00-1.76), the OR for participants in Quartile 3 was 1.46 (95% CI 1.09-1.96), and the OR for participants in Quartile 4 was 1.79 (95% CI 1.30-2.47). CONCLUSIONS: Changes in TyG-related indices are independently associated with the risk of CVD. Changes in TyG-WC are expected to become more effective indicators for identifying individuals at a heightened risk of CVD.

Motoric Cognitive Risk Syndrome and the Risk of Incident Dementia: A Systematic Review and Meta-Analysis of Cohort Studies.

BACKGROUND: Epidemiologic studies have indicated an association of motoric cognitive risk syndrome (MCR), a pre-dementia stage characterized by the presence of cognitive complaints and a slow gait, with increased risk of incident dementia. OBJECTIVES: We aimed to clarify this association using meta-analysis. METHODS: We systematically searched the PubMed, Embase, and Web of Science databases up to December 2022 for relevant studies that investigated the association between MCR and incident all-cause dementia and Alzheimer's disease (AD). The random-effects model was used to determine a pooled-effect estimate of the association. RESULTS: We identified seven articles that corresponded with nine cohort studies investigating the association between MCR and the risk of dementia. Pooled analysis showed that MCR was associated with a significantly increased risk of incident all-cause dementia (HR = 2.28; 95% CI: 1.90-2.73) and AD (HR = 2.05; 95% CI: 1.61-2.61). Sensitivity analysis showed that there was no evidence that individual studies influenced the pooled-effect estimate, verifying the robustness of the results. CONCLUSIONS: Our results confirm that MCR is an independent risk factor of incident all-cause dementia and AD. Future studies are needed to better understand the mechanisms underlying this association.

Underwater single photon 3D imaging with millimeter depth accuracy and reduced blind range.

Mono-static system benefits from its more flexible field of view and simplified structure, however, the backreflection photons from mono-static system lead to count loss for target detection. Counting loss engender range-blind, impeding the accurate acquisition of target depth. In this paper, count loss is reduced by introducing a polarization-based underwater mono-static single-photon imaging method, and hence reduced blind range. The proposed method exploits the polarization characteristic of light to effectively reduce the count loss of the target, thus improving the target detection efficiency. Experiments demonstrate that the target profile can be visually identified under our method, while the unpolarization system can not. Moreover, the ranging precision of system reaches millimeter-level. Finally, the target profile is reconstructed using non-local pixel correlations algorithm.

Dependence of the ellipse fitting noise on the differential phase between interferometers in atom gravity gradiometers.

Ellipse fitting is widely used in the extraction of the differential phase between atom interferometers amid substantial common phase noise. This study meticulously examines the dependency of extraction noise on the differential phase between atom interferometers during ellipse fitting. It reveals that the minimum extraction noise can manifest at distinct differential phases, contingent upon the dominance of different noise types. Moreover, the outcomes are influenced by whether the interferometers undergo simultaneous detection or not. Our theoretical simulations find empirical validation in a compact horizontal atom gravity gradiometer. The adjustment of the differential phase significantly enhances measurement sensitivity, culminating in a differential gravity resolution of 1.6 × 10-10 g @ 4800 s.

Ranging analysis of a moving target based on the dynamic instrument response function.

A ranging high-speed moving target with a high accuracy is challenging for a single-photon ranging system (SPRS). In this Letter, the dynamic instrument response function (IRF) is proposed to establish a dynamic discrete model (DDM) by introducing a velocity and a system timing resolution, which leads to better accuracy of cross-correlation results. And with the data of a dynamic Monte Carlo (DMC), the ranging accuracy can be improved with DDM.

A comparison of three approaches to measuring frailty to determine adverse health outcomes in critically ill patients.

BACKGROUND: studies comparing different frailty measures in intensive care unit settings are lacking. We aimed to compare the frailty index based on physiological and laboratory tests (FI-Lab), modified frailty index (MFI) and hospital frailty risk score (HFRS) to predict short-term outcomes for critically ill patients. METHODS: we conducted a secondary analysis of data from the Medical Information Mart for Intensive Care IV database. Outcomes of interest included in-hospital mortality and discharge with need for nursing care. RESULTS: the primary analysis was conducted with 21,421 eligible critically ill patients. After adjusting for confounding variables, frailty as diagnosed by all three frailty measures was found to be significantly associated with increased in-hospital mortality. In addition, frail patients were more likely to receive further nursing care after being discharged. All three frailty scores could improve the discrimination ability of the initial model generated by baseline characteristics for adverse outcomes. The FI-Lab had the best predictive ability for in-hospital mortality, whereas the HFRS had the best predictive performance for discharge with need for nursing care amongst the three frailty measures. A combination of the FI-Lab with either the HFRS or MFI improved the identification of critically ill patients at increased risk of in-hospital mortality. CONCLUSIONS: frailty, as assessed by the HFRS, MFI and FI-Lab, was associated with short-term survival and discharge with need for nursing care amongst critically ill patients. The FI-Lab was a better predictor of in-hospital mortality than the HFRS and MFI. Future studies focusing on FI-Lab are warranted.

Whole-genome metagenomic analysis of the oral microbiota in patients with obstructive sleep apnea.

PURPOSE: The oral microbiota is closely associated with systemic health, but few studies have investigated the oral microbiota in patients with obstructive sleep apnea (OSA). This study aimed to identify the variation of oral microbiota among patients with severe OSA, and the change of oral microbiota after treatment with continuous positive airway pressure (CPAP). METHODS: Participants were enrolled in the study from November 2020 to August 2021. Sleep parameters using full nocturnal polysomnography (PSG) were collected on healthy controls, patients with severe OSA, and patients with severe OSA after CPAP treatment for 3 months. Oral samples were also collected by rubbing disposable medical sterile swabs on the buccal mucosa. Routine blood tests and biochemical indicators were measured using the fully automated biochemical analyzer. Oral microbial composition of oral samples were determined using whole-genome metagenomic analysis in all participants. Correlations were analyzed between the oral microbiota and blood lipids. RESULTS: Study enrollment included 14 participants, 7 healthy controls and 7 patients with severe OSA. At the species level, the relative abundances of Prevotella, Alloprevotella, Bacteroides, Veillonella_tobetsuensis, Candidatus saccharimonas, and Leptotrichia in the groups with severe OSA were significantly lower than those in the healthy controls (P both < 0.05). The abundances of Capnocytophaga, Veillonella, Bacillus_anthracis, Eikenella, and Kingella were significantly higher whereas the abundances of Gordonia and Streptococcus were significantly lower in the group with severe OSA compared to the severe OSA-CPAP group (P < 0.05 for both). According to the Kyoto Encyclopedia of Genes and Genomes (KEGG), 4 pathways changed in the group with severe OSA compared with healthy controls (P both < 0.05). Pathways related to Novobiocin biosynthesis, 2-Oxocarboxylic acid metabolism, and Histidine metabolism were enriched in the patients with severe OSA. Nine pathways showed significant differences with regard to the relative abundances of phenylalanine metabolism; alanine, aspartate, and glutamate metabolism; one carbon pool by folate; monobactam biosynthesis; 2-oxocarboxylic acid metabolism; arginine biosynthesis and vitamin B6 metabolism; novobiocin biosynthesis; and arginine and proline metabolism, which were significantly higher in the group with severe OSA compared to the severe OSA-CPAP group (P both < 0.05). The Spearman correlation analysis between blood lipid parameters and oral microbiota components showed that negative correlations were observed between total cholesterol and Streptomyces (r = - 0.893, P = 0.007), and high-density lipoprotein cholesterol (HDL-C) and Gordonia (r = - 0.821, P = 0.023); positive correlations were observed between HDL-C and Candidatus saccharimonas (r = 0.929, P = 0.003), and low-density lipoprotein cholesterol (LDL-C) and Capnocytophaga (r = 0.893, P = 0.007). CONCLUSION: There was an apparent discrepancy of the oral microbiota and metabolic pathways between the group with severe OSA and controls, and CPAP significantly changed oral microbial abundance and metabolic pathways in patients with severe OSA. Correlation analysis showed that these oral bacteria were strongly correlated with the blood lipids level.

Association between allostatic load and adverse outcomes among older patients with heart failure with preserved ejection fraction.

BACKGROUND: The allostatic load (AL) refers to the cumulative weakening of multiple physiological systems caused by repeated adaptation of the body to stressors There are still no studies have focused on the association between AL and the prognosis of patients with heart failure with preserved ejection fraction (HFpEF). The present study aimed to investigate the association between AL and adverse outcomes, including mortality and HF admission, among elderly male patients with HFpEF. METHODS: We conducted a prospective cohort study of 1111 elderly male patients with HFpEF, diagnosed between 2015 and 2019 and followed up through 2021. We constructed an AL measure using a combination of 12 biomarkers. The diagnosis of HFpEF was made according to the 2021 European Society of Cardiology guidelines. A Cox proportional hazards model was used to determine the associations between AL and adverse outcomes. RESULTS: In multivariate analysis, AL was significantly associated with increased risk of all-cause mortality (medium AL: adjusted hazard ratio [HR] = 2.53; 95% confidence interval [CI] 1.37-4.68; high AL: HR = 4.21; 95% CI 2.27-7.83; per-score increase: HR = 1.31; 95% CI 1.18-1.46), cardiovascular mortality (medium AL: HR = 2.67; 95% CI 1.07-6.68; high AL: HR = 3.13; 95% CI 1.23-7.97; per-score increase: HR = 1.20; 95% CI 1.03-1.40), non-cardiovascular mortality (medium AL: HR = 2.45; 95% CI 1.06-5.63; high AL: HR = 5.81; 95% CI 2.55-10.28; per-score increase: HR = 1.46; 95% CI 1.26-1.69), and HF admission (medium AL: HR = 2.68; 95% CI 1.43-5.01; high AL: HR = 3.24; 95% CI 1.69-6.23; per-score increase: HR = 1.24; 95% CI 1.11-1.39). Consistent results were found in multiple subgroup analyses. CONCLUSIONS: A higher AL was associated with poor prognosis in elderly men with HFpEF. AL relies on information that is easily obtained in physical examinations and laboratory parameters and can be assessed in various care and clinical settings to help risk stratification of HFpEF patients.

Development and validation of a nomogram-assisted tool to predict potentially reversible cognitive frailty in Chinese community-living older adults.

BACKGROUND: Cognitive frailty (CF) is a complex and heterogeneous clinical syndrome that indicates the onset of neurodegenerative processes and poor prognosis. In order to prevent the occurrence and development of CF in real world, we intended to develop and validate a simple and timely diagnostic instrument based on comprehensive geriatric assessment that will identify patients with potentially reversible CF (PRCF). METHODS: 750 community-dwelling individuals aged over 60 years were randomly allocated to either a training or validation set at a 4:1 ratio. We used the operator regression model offering the least absolute data dimension shrinkage and feature selection among candidate predictors. PRCF was defined as the presence of physical pre-frailty, frailty, and mild cognitive impairment (MCI) occurring simultaneously. Multivariate logistic regression was conducted to build a diagnostic tool to present data as a nomogram. The performance of the tool was assessed with respect to its calibration, discrimination, and clinical usefulness. RESULTS: PRCF was observed in 326 patients (43%). Predictors in the tool were educational background, coronary heart disease, handgrip strength, gait speed, instrumental activity of daily living (IADL) disability, subjective cognitive decline (SCD) and five-times-sit-to-stand test. The diagnostic nomogram-assisted tool exhibited good calibration and discrimination with a C-index of 0.805 and a higher C-index of 0.845 in internal validation. The calibration plots demonstrated strong agreement in both the training and validation sets, while decision curve analysis confirmed the nomogram's efficacy in clinical practice. CONCLUSIONS: This tool can effectively identify older adults at high risk for PRCF, enabling physicians to make informed clinical decisions and implement proper patient-centered individual interventions.

A review of the formation conditions and assessment methods of black and odorous water.

Black and odorous water is an extreme pollution phenomenon. This article reviews the formation process, formation conditions, and evaluation methods of black and odorous water. The results indicate that N, P, and TOC are the key nutrients inducing black and odorous water while S, Fe, and Mn are key elements forming blackening and odorizing pollutants. In addition, Cyanobacteria, Proteobacteria, Firmicutes, Verrucomicrobia, Planctomycetes, and Actinobacteria participate in the biogeochemistry cycles of key elements and play important roles in the blackening and odorizing process of water. The black and odorous thresholds that need further verification are as follows: 1.0 g/L of organic matrix, 2.0-8.0 mg/L of NH3-N, 0.6-1.2 mg/L of TP, 0.05 mg/L of Fe2+, 0.3 mg/L of Mn2+, 1.2-2.0 mg/L of DO, and -50 to 50 mV of the ORP. In order to propose a universal assessment method, it is suggested that NH3-N, DO, COD, BOD, and TP serve as the assessment indicators, and the levels of pollutions are I (not black odor), II (mild black odor), III (moderate black odor), IV (severe black odor), and inferior IV (extremely black odor).

Feedback control of atom trajectories in a horizontal atom gravity gradiometer.

The coincidence between the atom trajectory and the Raman pulse sequence is very important for an intersection type atom interferometer. Here we present a feedback control technique for the atom trajectories in our horizontal gravity gradiometer, which improves the stabilities of the trajectories by about 2 orders of magnitude. Through the further study of the dependence of the interferometer contrasts on the atom trajectories, we lock the trajectories at optimal positions. And by this technique, the sensitivity of the gravity gradiometer is improved from 982 E/Hz1/2 to 763 E/Hz1/2, while the long-term stability is enhanced more significantly and reaches 8.9 E after an integration time of 6000 s. This work may provide hints to other experiments based on intersection type atom interferometers.

Fast non-line-of-sight imaging based on product-convolution expansions.

Non-line-of-sight (NLoS) imaging reveals a hidden scene using indirect diffuse reflections. A common choice for analyzing the time-of-flight (ToF) data from a non-confocal system is an ellipsoid model whose operator is high-dimensional, leading to a computationally arduous task. In this Letter, the product-convolution expansions method is utilized to formulate the operator and its adjoint based on the observation of a shift-variant point spread function (PSF) in the ToF data. The operator and its adjoint are locally approximated as a convolution, which allows the forward and backward procedure to be computed efficiently through fast Fourier transform (FFT). Moreover, the low-rank approximation of the operator is obtained by matrix decompositions, further improving the computational efficiency. The proposed method is validated using publicly accessible datasets.

Association between depression and motoric cognitive risk syndrome among community-dwelling older adults in China: A 4-year prospective cohort study.

BACKGROUND AND PURPOSE: Depression can lead to a wide range of adverse health outcomes, including dementia. However, evidence supporting the relationship between depression and motoric cognitive risk syndrome (MCR), a pre-dementia syndrome, remains lacking. This study aimed to examine the association between depression and MCR among community-dwelling Chinese older adults. METHODS: Data were taken from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS). Depression was defined by a Center for Epidemiological Studies Depression Scale (CES-D) score ≥10. MCR was defined as subjective cognitive complaints and objective slow gait speed. Multivariate logistic regression analyses were conducted to examine the cross-sectional and longitudinal associations between depression and MCR at baseline and a 4-year follow-up period for the sample population and gender groups. RESULTS: The prevalence of MCR was higher in participants with depression than in those without depression at baseline (12.2% vs. 8.9%; p = 0.001). Participants with depression at baseline had a higher 4-year incidence of MCR than those without depression (14.8% vs. 8.7%; p < 0.001). Both cross-sectional analysis (odds ratio [OR] 1.41, 95% confidence interval [CI] 1.13-1.75) and prospective analysis (OR 1.95, 95% CI 1.56-2.44) demonstrated that depression was significantly associated with MCR. These associations were consistent across different gender groups and stronger among female individuals. CONCLUSIONS: Depression is an independent risk factor for MCR among community-dwelling Chinese older adults. Special attention should be paid to the care of older people with depression to reduce the occurrence of MCR and even dementia.

Prevalence and factors associated with atrial fibrillation in older patients with obstructive sleep apnea.

PURPOSE: This study sought to identify the prevalence and factors associated with atrial fibrillation (AF) in older patients with obstructive sleep apnea (OSA) in China.  METHODS: This was an explorative cross-sectional study. Between January 2015 and October 2017, we continuously recruited 1285 older patients with OSA who underwent overnight polysomnography from sleep centers of multiple hospitals. They were assessed using 12-lead ECG or 24-h dynamic ECG, and their baseline demographics, clinical characteristics, sleep parameters, and medical history were determined. Multivariate binary logistic regression analysis was used to investigate the factors related to AF in these older patients with OSA. RESULTS: The clinician classified 122 (9.5%) patients as having AF. The prevalence of AF significantly increased with age (P < 0.05) but did not significantly differ between the mild, moderate, and severe OSA groups. Additionally, the prevalence of paroxysmal AF was 7.2% among the overall study population, and it increased with OSA severity or advanced age (P < 0.05). Persistent AF was noted in 2.3% participants, and the prevalence also increased with age. The logistic regression analysis showed that age (OR = 1.054, 95%CI: 1.027-1.018, P < 0.001), history of drinking (OR = 1.752, 95%CI: 1.070-2.867, P < 0.05), chronic heart disease (OR = 1.778, 95%CI: 1.156-2.736, P < 0.01), diabetes mellitus (OR = 1.792, 95%CI: 1.183-2.713, P < 0.01), and reduced diastolic function (OR = 2.373, 95%CI = 1.298-4.337, P < 0.01) were relevant to AF among participants with OSA. CONCLUSION: The prevalence of AF is significantly common in older patients with OSA. Age, history of drinking, chronic heart disease, diabetes mellitus, and reduced diastolic function are independently related to AF in these patients.

Associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old.

BACKGROUND: This study aimed to investigate the associations of sarcopenia and its defining components with cognitive function in community-dwelling oldest old (over 80 years old) in China. METHODS: Sarcopenia was diagnosed by the 2019 Asian Working Group for Sarcopenia (AWGS) criteria. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCA). Logistic and linear regression models were used to explore the associations of sarcopenia and its defining components with risk of mild cognitive impairment (MCI), and performance on multiple cognitive domains among 428 adults aged 80 years and older. RESULTS: The overall prevalence of sarcopenia was 35.5%, with 40.34% for men and 32.14% for women. The prevalence of MCI was higher among sarcopenic oldest old than non-sarcopenic oldest old (28.95% vs. 17.39%, p = 0.005). Multivariate logistic regression analyses showed that sarcopenia [odds ratio (OR) = 1.86, 95% confidence interval (CI): 1.04-3.33], low handgrip strength (HS) [OR = 2.33, 95% CI: 1.40-3.87] and slow gait speed (GS) [OR = 2.31, 95% CI: 1.13-4.72] were significantly and independently associated with risk of MCI. Multivariate linear regression analyses showed that low HS was associated with worse performance in global cognitive function, visuospatial and executive function, naming and delayed recall. CONCLUSIONS: Sarcopenia, low HS and low GS was significantly associated with MCI in community-dwelling oldest old. The associations between sarcopenia and its defining components with different cognitive subdomains could be further explored in the future.

Validation of perceived physical fatigability using the simplified-Chinese version of the Pittsburgh Fatigability Scale.

BACKGROUND: The Pittsburgh Fatigability Scale (PFS) was developed to capture fatigue and demand in a single tool, filling a gap that no validated questionnaire existed to measure perceived fatigability. Since fatigability is a more sensitive measure of a person's susceptibility to fatigue, we validated the simplified-Chinese version of the PFS among Chinese community-dwelling older adults. METHODS: This cross-sectional study was conducted in an urban community in Beijing between November 2018 and July 2019. The PFS was translated into simplified-Chinese by the translation, retro-translation method. Internal consistency of the Physical subscale of the PFS was evaluated by Cronbach's alpha. Convergent validity and discriminant validity were evaluated against physical performance measures (i.e., Short Physical Performance Battery & Timed Up and Go Test) and daily living performance (i.e., Barthel Index & Instrumental activity of daily living). RESULTS: Our study included 457 participants, including 182 men (39.8%) and 275 women (60.2%). The age range of the included participants was 61-96 years (mean = 84.8 years, SD = 5.8 years). The simplified-Chinese version of PFS Physical scores showed strong internal consistency (Cronbach's alpha = 0.81). Higher PFS Physical scores were associated with worse physical performance, and daily living performance (|correlation coefficient| range: 0.36-0.56, p < .001). Age- and sex-adjusted PFS Physical scores had moderate to good overall discrimination for correctly classifying people by their physical performance and daily living performance (AUCs range 0.70-0.87, p < .001). CONCLUSIONS: The PFS simplified-Chinese version is a valid instrument to assess perceived physical fatigability in Chinese-speaking older adults with good convergent validity. Thus, the PFS, with low cost and greater feasibility, is a desired tool to measure fatigability in large population studies.

Impact of obstructive sleep apnea complicated with type 2 diabetes on long-term cardiovascular risks and all-cause mortality in elderly patients.

BACKGROUND: The prognostic significance of obstructive sleep apnea (OSA) in elderly patients with type 2 diabetes is unclear. The aim of this study was to determine the risk of cardiovascular disease (CVD) and mortality in elderly patients with OSA complicated with type 2 diabetes compared to patients with OSA without type 2 diabetes. METHODS: From January 2015 to October 2017, 1113 eligible elderly patients with OSA, no history of cardiovascular, ≥60 years of age, and complete follow-up records were enrolled in this consecutive multicentre prospective cohort study. All patients had completed polysomnography (PSG) examinations. An apnoea-hypopnoea index of ≥5 events per hour recorded by polysomnography was defined as the diagnostic criterion for OSA. We collected baseline demographics, clinical characteristics, sleep parameters and follow-up outcomes. The primary aim of this study was to identify the risk of incident major adverse cardiovascular events (MACE). Secondary outcomes were all-cause mortality, components of MACE and a composite of all events. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate whether type 2 diabetes was associated with incident events. RESULTS: A total of 266 (23.9%) patients had OSA complicated with type 2 diabetes. MACE occurred in 97 patients during the median 42-month follow-up. Kaplan-Meier survival curves indicated a significant relationship between type 2 diabetes and MACE (log-rank P = 0.003). Multivariable Cox regression analysis showed that type 2 diabetes increased the risk of MACE (HR = 1.64, 95% CI:1.08-2.47, P = 0.019), hospitalisation for unstable angina (HR = 2.11, 95% CI:1.23-3.64, P = 0.007) and a composite of all events in elderly patients with OSA (HR = 1.70, 95% CI:1.17-2.49, P = 0.007). However, there were no significant differences in the incidence of cardiovascular death, all-cause mortality, MI and hospitalisation for heart failure between patients with and without diabetes (P > 0.05). The subgroup analysis demonstrated that females (AHR = 2.46, 95% CI:1.17-5.19, P = 0.018), ≥ 70 years (AHR = 1.95, 95% CI:1.08-3.52, P = 0.027), overweight and obese (AHR = 2.04, 95% CI:1.29-3.33, P = 0.002) with mild OSA (AHR = 2.42, 95% CI: 1.03-5.71, P = 0.044) were at a higher risk for MACE by diabetes. CONCLUSION: OSA and type 2 diabetes are interrelated and synergistic with MACE, hospitalisation for unstable angina and a composite of all events development. Overweight and obese females, ≥ 70 years with mild OSA combined with type 2 diabetes presented a significantly high MACE risk.

The modified Healthy Aging Index is associated with mobility limitations and falls in a community-based sample of oldest old.

BACKGROUND AND AIMS: The Healthy Aging Index (HAI) is useful in capturing the health status of multiple organ systems in older adults. Previous studies have mainly focused on the association of HAI with mortality and disability. We constructed a modified HAI (mHAI) to examine its association with mobility limitations and falls in a community-based sampling of older Chinese adults. METHODS: We investigated 399 community-dwelling older adults aged 80 years or older, and constructed the mHAI with five non-invasive tests (systolic blood pressure, the Montreal Cognitive Assessment test, glucose concentrations, cystatin C levels, and self-reported respiratory problems). RESULTS: The mean mHAI score for the participants in our study was 3.6. After multivariate adjustment, per unit increase in mHAI score was associated with self-reported difficulty in stooping, kneeling, or crouching (odds ratio [OR] = 1.16, 95% confidence interval [CI] 1.00-1.34), and walking 400 m (OR = 1.21, 95% CI 1.03-1.42). Per unit increase in mHAI score was also associated with poor balance (OR = 1.29, 95% CI 1.07-1.55), lower extremity strength limitation (OR = 1.30, 95% CI 1.10-1.52), low handgrip strength (OR = 1.25, 95% CI 1.08-1.46), and slow gait speed (OR = 1.21, 95% CI 1.02-1.42). The association between mHAI and falls was also significant (per unit of mHAI OR = 1.21, 95% CI 1.04-1.40). CONCLUSION: The mHAI can be used as a simple assessment tool to determine mobility status in older adults and identify those at high risk for falls.