Implementation and impact of the World Health Organization integrated care for older people (ICOPE) program in China: a randomised controlled trial.

BACKGROUND: Fragmentation of services increases health and social care burden as people live longer with higher prevalence of diseases, frailty and dependency. Local evidence for implementing person-centred integrated care is urgently needed to advance practice and policies to achieve healthy ageing. OBJECTIVE: To test the feasibility and impact of World Health Organization's (WHO) Integrated Care for Older People (ICOPE) approach in China. DESIGN: A randomised controlled trial examining the feasibility of implementing ICOPE approach, evaluating its impact on health outcomes and health resource utilisation. SETTING: Primary care setting in urban and suburban communities of Chaoyang District, Beijing, China. SUBJECTS: Community-dwelling older adults screened as at-risk of functional declines and randomised into intervention (537) and control (1611) groups between September 2020 and February 2021. METHODS: A 6-month intervention program following WHO's ICOPE care pathways implemented by integrated care managers compared to standard available care. RESULTS: After 1 to 1 propensity score matching, participants in intervention and control groups (totally 938) had comparable baseline characteristics, demonstrated feasibility of implementing ICOPE with satisfaction by participants (97-99%) and providers (92-93%). All outcomes showed improvements after a 6-month intervention, while statistically significant least-squares mean differences (control-intervention) in vitality (Mini-Nutritional Assessment Short Form to measure vitality, -0.21, 95% CI, -0.40-0.02), mobility (Short Physical Performance Battery to measure mobility, -0.29, 95% CI, -0.44-0.14) and psychological health (Geriatric Depression Scale five items to measure psychological health, 0.09, 95% CI, 0.03-0.14) were observed (P < 0.05). CONCLUSIONS: It is feasible to localise and implement WHO's ICOPE approach in regions with fragmented resources such as China. Preliminary evidence supports its acceptance among key stakeholders and impact on health outcomes.

Data-Driven Optimal Tracking Control for Discrete-Time Nonlinear Systems With Unknown Dynamics Using Deterministic ADP.

This article aims to solve the optimal tracking problem (OTP) for a class of discrete-time (DT) nonlinear systems with completely unknown dynamics. A novel data-driven deterministic approximate dynamic programming (ADP) algorithm is proposed to solve this kind of problem with only input-output (I/O) data. The proposed algorithm has two advantages compared to existing data-driven deterministic ADP algorithms for the OTP. First, our algorithm can guarantee optimality while achieving better performance in the aspects of time-saving and robustness to data. Second, the near-optimal control policy learned by our algorithm can be implemented without considering expected control and enable the system states to track the user-specified reference signals. Therefore, the tracking performance is guaranteed while simplifying the algorithm implementation. Furthermore, the convergence and stability of the proposed algorithm are strictly proved through theoretical analysis, in which the errors caused by neural networks (NNs) are considered. At the end of this article, the developed algorithm is compared with two representative deterministic ADP algorithms through a numerical example and applied to solve the tracking problem for a two-link robotic manipulator. The simulation results demonstrate the effectiveness and advantages of the developed algorithm.

Factors associated with frailty transitions among the old-old in a community.

AIM: The study aimed to explore the factors associated with frailty transitions among the old-old (aged ≥75 years) in a community. METHODS: The participants were all from a prospective cohort study in a community in Beijing, China. Frailty states were assessed using FRAIL at baseline and at 1-year follow-up. The association between factors, including comprehensive geriatric assessment and laboratory indicators, and frailty transitions were explored by binary logistic regression. The predicted value of the factors associated with frailty transitions was analyzed using the receiver operating characteristic curve (ROC) and the area under the ROC (AUC) for each factor was calculated. RESULTS: In total, 183 older adults (mean age: 83.9 ± 4.4 years; women, 59%) completed the frailty state assessment at baseline and 1-year follow-up. After adjusting for age and sex, physical function, including walking speed, timed up-and-go test and short physical performance battery, serum albumin and serum high-sensitivity C-reactive protein (hsCRP) were associated with worsening of the frailty state. Cognitive function was associated with improving the frailty state. ROC analysis showed that low walking speed (AUC: 0.81), long timed up-and-go test time (AUC: 0.77), low short physical performance battery score (AUC: 0.75), low serum albumin (AUC: 0.68) and high serum hsCRP (AUC: 0.80) could predict the decline in frailty state. Good cognitive function (AUC: 0.69) predicted an improvement in the frailty state. CONCLUSIONS: The frailty state of the old-old with poor physical function, low serum albumin and high serum hsCRP was likely to decline, but it could improve with good cognitive function. Geriatr Gerontol Int 2023; 23: 405-410.

Parallel Image-Based Visual Servoing/Force Control of a Collaborative Delta Robot.

In this paper, a parallel Image-based visual servoing/force controller is developed in order to solve the interaction problem between the collaborative robot and the environment so that the robot can track the position trajectory and the desired force at the same time. This control methodology is based on the image-based visual servoing (IBVS) dynamic computed torque control and couples the force control feedback in parallel. Simulations are performed on a collaborative Delta robot and two types of image features are tested to determine which one is better for this parallel IBVS/force controller. The results show the efficiency of this controller.

Model-Free Optimal Tracking Control of Nonlinear Input-Affine Discrete-Time Systems via an Iterative Deterministic Q-Learning Algorithm.

In this article, a novel model-free dynamic inversion-based Q-learning (DIQL) algorithm is proposed to solve the optimal tracking control (OTC) problem of unknown nonlinear input-affine discrete-time (DT) systems. Compared with the existing DIQL algorithm and the discount factor-based Q-learning (DFQL) algorithm, the proposed algorithm can eliminate the tracking error while ensuring that it is model-free and off-policy. First, a new deterministic Q-learning iterative scheme is presented, and based on this scheme, a model-based off-policy DIQL algorithm is designed. The advantage of this new scheme is that it can avoid the training of unusual data and improve data utilization, thereby saving computing resources. Simultaneously, the convergence and stability of the designed algorithm are analyzed, and the proof that adding probing noise into the behavior policy does not affect the convergence is presented. Then, by introducing neural networks (NNs), the model-free version of the designed algorithm is further proposed so that the OTC problem can be solved without any knowledge about the system dynamics. Finally, three simulation examples are given to demonstrate the effectiveness of the proposed algorithm.

Design of a Gough-Stewart Platform Based on Visual Servoing Controller.

Designing a robot with the best accuracy is always an attractive research direction in the robotics community. In order to create a Gough-Stewart platform with guaranteed accuracy performance for a dedicated controller, this paper describes a novel advanced optimal design methodology: control-based design methodology. This advanced optimal design method considers the controller positioning accuracy in the design process for getting the optimal geometric parameters of the robot. In this paper, three types of visual servoing controllers are applied to control the motions of the Gough-Stewart platform: leg-direction-based visual servoing, line-based visual servoing, and image moment visual servoing. Depending on these controllers, the positioning error models considering the camera observation error together with the controller singularities are analyzed. In the next step, the optimization problems are formulated in order to get the optimal geometric parameters of the robot and the placement of the camera for the Gough-Stewart platform for each type of controller. Then, we perform co-simulations on the three optimized Gough-Stewart platforms in order to test the positioning accuracy and the robustness with respect to the manufacturing errors. It turns out that the optimal control-based design methodology helps get both the optimum design parameters of the robot and the performance of the controller {robot + dedicated controller}.

Nutritional Status According to the Short-Form Mini Nutritional Assessment (MNA-SF) and Clinical Characteristics as Predictors of Length of Stay, Mortality, and Readmissions Among Older Inpatients in China: A National Study.

BACKGROUND: Studies are scarce in China that explore the association of nutritional status, measured using the Short-Form Mini Nutritional Assessment (MNA-SF) and biochemical data, on adverse clinical outcomes among older inpatients. In this study, we aimed to determine the prevalence of malnutrition in tertiary hospitals of China and the associations between malnutrition and adverse clinical outcomes. METHODS: This prospective study involved 5,516 older inpatients (mean age 72.47 ± 5.77 years) hospitalized in tertiary hospitals between October 2018 and February 2019. The tertiary hospitals refer to the hospital with more than 500 beds and can provide complex medical care services. The MNA-SF was used to assess nutritional status. Multiple logistic regression and negative binomial regression were used to analyze the relationship between nutritional parameters and risk of hospital length of stay (LoS), mortality, and rehospitalization. RESULTS: We found that 46.19% of hospitalized patients had malnutrition or malnutrition risk, according to the MNA-SF. Death occurred in 3.45% of patients. MNA-SF scores 0-7 (odds ratio [OR] 5.738, 95% confidence interval [CI] 3.473 to 9.48) were associated with a six-fold higher likelihood of death, and scores 8-11 (OR 3.283, 95% CI 2.126-5.069) with a three-fold higher likelihood of death, compared with MNA-SF scores 12-14 in the logistic regression model, after adjusting for potential confounders. A low MNA-SF score of 0-7 (regression coefficient 0.2807, 95% CI 0.0294-0.5320; P < 0.05) and a score of 8-11 (0.2574, 95% CI 0.0863-0.4285; P < 0.01) was associated with a significantly higher (28.07 and 25.74%, respectively) likelihood of increased LoS, compared with MNA-SF score 12-14. MNA-SF scores 0-7 (OR 1.393, 95% CI 1.052-1.843) and 8-11 (OR 1.356, 95% CI 1.124-1.636) were associated with a nearly 1.5-fold higher likelihood of 90-day readmission compared with MNA-SF scores 12-14 in the logistic regression model. Moreover, hemoglobin level, female sex, education level, former smoking, BMI 24-27.9 kg/m2, age 75 years and above, and current alcohol consumption were the main factors influencing clinical outcomes in this population. CONCLUSIONS: Malnutrition increases the risk of hospital LoS, mortality, and 90-day readmission. The use of nutritional assessment tools in all hospitalized patients in China is needed. The MNA-SF combined with hemoglobin level may be used to identify older inpatients with a high risk of adverse clinical outcomes. These findings may have important implications for the planning of hospital services.

Development and validation of risk prediction model for identifying 30-day frailty in older inpatients with undernutrition: A multicenter cohort study.

Objective: To develop and externally validate a frailty prediction model integrating physical factors, psychological variables and routine laboratory test parameters to predict the 30-day frailty risk in older adults with undernutrition. Methods: Based on an ongoing survey of geriatrics syndrome in elder adults across China (SGSE), this prognostic study identified the putative prognostic indicators for predicting the 30-day frailty risk of older adults with undernutrition. Using multivariable logistic regression analysis with backward elimination, the predictive model was subjected to internal (bootstrap) and external validation, and its calibration was evaluated by the calibration slope and its C statistic discriminative ability. The model derivation and model validation cohorts were collected between October 2018 and February 2019 from a prospective, large-scale cohort study of hospitalized older adults in tertiary hospitals in China. The modeling derivation cohort data (n = 2,194) were based on the SGSE data comprising southwest Sichuan Province, northern Beijing municipality, northwest Qinghai Province, northeast Heilongjiang Province, and eastern Zhejiang Province, with SGSE data from Hubei Province used to externally validate the model (validation cohort, n = 648). Results: The incidence of frailty in the older undernutrition derivation cohort was 13.54% and 13.43% in the validation cohort. The final model developed to estimate the individual predicted risk of 30-day frailty was presented as a regression formula: predicted risk of 30-day frailty = [1/(1+e-riskscore )], where riskscore = -0.106 + 0.034 × age + 0.796 × sex -0.361 × vision dysfunction + 0.373 × hearing dysfunction + 0.408 × urination dysfunction - 0.012 × ADL + 0.064 × depression - 0.139 × nutritional status - 0.007 × hemoglobin - 0.034 × serum albumin - 0.012 × (male: ADL). Area under the curve (AUC) of 0.71 in the derivation cohort, and discrimination of the model were similar in both cohorts, with a C statistic of nearly 0.7, with excellent calibration of observed and predicted risks. Conclusion: A new prediction model that quantifies the absolute risk of frailty of older patients suffering from undernutrition was developed and externally validated. Based on physical, psychological, and biological variables, the model provides an important assessment tool to provide different healthcare needs at different times for undernutrition frailty patients. Clinical trial registration: Chinese Clinical Trial Registry [ChiCTR1800017682].

An early predictive model of frailty for older inpatients according to nutritional risk: protocol for a cohort study in China.

BACKGROUND: Previous reports suggest that the attributes of frailty are multidimensional and include nutrition, cognition, mentality, and other aspects. We aim to develop an early warning model of frailty based on nutritional risk screening and apply the frailty early warning model in the clinic to screen high-risk patients and provide corresponding intervention target information. METHODS: The proposed study includes two stages. In the first stage, we aim to develop a prediction model of frailty among older inpatients with nutritional risk. Study data were collected from a population-based aging cohort study in China. A prospective cohort study design will be used in the second stage of the study. We will recruit 266 older inpatients (age 65 years or older) with nutritional risk, and we will apply the frailty model in the clinic to explore the predictive ability of the model in participants, assess patients' health outcomes with implementation of the frailty model, and compare the model with existing frailty assessment tools. Patients' health outcomes will be measured at admission and at 30-day follow-up. DISCUSSION: This project is the first to develop an early prediction model of frailty for older inpatients according to nutritional risk in a nationally representative sample of Chinese older inpatients of tertiary hospitals. The results will hopefully help to promote the development of more detailed frailty assessment tools according to nutritional risk, which may ultimately lead to reduced health care costs and improvement in independence and quality of life among geriatric patients. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800017682 , registered August 9, 2018; and ChiCTR2100044148 , registered March 11, 2021.

Associations Between Nutritional Status, Sociodemographic Characteristics, and Health-Related Variables and Health-Related Quality of Life Among Chinese Elderly Patients: A Multicenter Prospective Study.

Background: Studies that explore the nutritional status, sociodemographic factors, mental health variables, and physical health variables that affect the health-related quality of life (HRQoL) of elderly patients are scarce in China. Objective: This study aimed to examine the association between health-related quality of life (HRQoL) and nutritional status, sociodemographic characteristics, and health-related variables among Chinese elderly patients. Materials and Methods: Participants were recruited from six tertiary-level hospitals in six provinces or municipalities/cities throughout China from October 2018 to February 2019: a total of 9,996 participants aged 65 years and older were enrolled. The nutritional status and HRQoL were measured using the Mini Nutritional Assessment-Short Form (MNA-SF) and the EuroQoL Five-Dimension Visual Analog Scale, respectively. BMI was taken using standard measurement protocols. Sociodemographic characteristics included age, sex, education, marital status, ethnicity, smoking, alcohol drinking, and current residence. Mental and physical health variables such as frailty and depression were assessed using validated tested instruments. Multiple linear regression analysis was used to analyze whether the nutritional status, sociodemographic characteristics, and health-related variables were associated with HRQoL. Results: According to the MNA-SF scores at the 30- and 90-day follow-up, 9.7% and 9.1% of participants were malnourished, respectively. Higher MNA-SF scores were related to higher HRQoL scores in older patients (regression coefficient; 95% confidence interval) both at the 30-day (0.660; 0.499-0.821) and 90-day (0.622; 0.434-0.809) follow-up. However, there were no significant associations between the body mass index values and HRQoL. Sociodemographic characteristics (such as age, smoking, and current residence), physical health variables (frailty, urinary function, defecation function, sleeping condition, and falling accidents in the past 12 months), and mental health variables (depression) were the main factors influencing HRQoL in this group. Conclusion: There are several factors associated with HRQoL among the population derived from this investigation of a representative sample of the Chinese hospitalized elderly population in tertiary hospitals. These findings could have major importance for the planning of "active aging" policies and programs. Trial Registration: Chinese Clinical Trial Registry, ChiCTR1800017682, registered August 9, 2018.

Potential associated factors of functional disability in Chinese older inpatients: a multicenter cross-sectional study.

BACKGROUND: There is still controversy about the relationship between aging and changes in functional ability. This study aims to describe the level of basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL) in different age groups and explore the factors associated with functional disability in Chinese older inpatients. METHODS: This cross-sectional study surveyed 9996 older inpatients aged 65 years and older from six tertiary hospitals in China from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale. A mixed-effect generalized linear model was used to examine the association between functional disability and covariates. RESULTS: The average ADL score was 89.51 ± 19.29 and the mean IADL score 6.76 ± 2.01 for all participants. There was a trend of decreasing scores along with aging, and significant differences between age groups were also observed (P < 0.001). The most affected ADL and IADL was stair climbing and shopping, respectively. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in the past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. Patients from the emergency department or transferred from other hospitals and former alcohol drinkers are at risk of ADL disability. Former smoking is a risk factor for IADL disability, whereas current drinking, higher-level education, and residing in a building without elevators were likely to maintain a better IADL performance. CONCLUSIONS: Functional ability declines with aging, older inpatients are low dependency upon ADL and IADL. There are several associated factors among the participants derived from this investigation of a large-scale, multicenter, nationally representative Chinese older inpatient population. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800017682 , registered August 9, 2018.

What Is the Amount of China's Building Floor Space from 1996 to 2014?

The amount of building floor space (BFS) plays a key role in the energy and material demand prediction. Unfortunately, BFS estimation has faced the challenge of ineffective and inadequate approaches, and thus reliable data concerning China's BFS is unavailable. This study proposes a new estimation method for China's BFS and then estimates historical BFS by type in China from 1996 to 2014. The results show that total Chinese BFS grew from 28.1 billion m2 in 1996 to 61.3 billion m2 in 2014, increasing more than twice, with an annual growth rate of 4.4% from 1996 to 2014. During 1996-2014, urban residential BFS witnessed the highest annual increase rate (9.3%), while the growth rate for commercial and rural residential BFS was lower: 4.4% and 1.6%, respectively. By comparing with available statistics data, this study finds the model deviations are well below 5%, which indicates the reliability of the proposed method and robustness of the results. The proposed method not only can address the deficiencies of statistic yearbook and overcome the shortages of previous estimation approaches but also can derive more accurate and reliable data. This study lays a sound basis for the following study on building stock and building energy efficiency work.

A potential urinary biomarker to determine frailty status among older adults.

BACKGROUND: Association of oxidative stress biomarkers with aging and several age-related diseases is well documented. However, the possible role of these factors on frailty status in older adults has not been extensively studied. OBJECTIVE: To evaluate whether urinary 8-oxo-7,8-dihydroguanosine (8-oxo-Gsn), a biomarker of RNA oxidative damage, was independently associated with frailty. METHODS: In this cross-sectional analysis, frailty phenotype was assessed among 230 participants living in a senior community. Participants received a comprehensive geriatric assessment. Serum high-sensitivity C-reactive protein (hsCRP), white blood cell count (WBC), urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine, and 8-oxo-Gsn were measured. RESULTS: Participants' mean age was 83.9 ± 4.4 years. In total, 33 % were frail, 45 % were pre-frail, and 22 % were non-frail. Urinary 8-oxo-Gsn, serum hsCRP, and WBC were significantly higher in the frail group than in the non-frail and pre-frail groups (p-values < 0.05). Adjusting for age, sex, and Charlson comorbidity index, statistically significant positive associations with frailty were observed for urinary 8-oxo-Gsn (odds ratio [OR]: 1.70, 95 % confidence interval [CI]: 0.264-0.732) and hsCRP (OR: 1.337, 95 % CI: 0.089-0.412). Urinary 8-oxo-Gsn of 3.175 µmol/mol had the optimal predictive value for frailty, with an area under the receiver operating characteristic curve (AUC) of 0.72 (95 % CI: 0.649-0.788). The prediction probability combining urinary 8-oxo-Gsn and a simple question evaluating exhaustion had the optimal predictive value for frailty, with an AUC of 0.90 (p < 0.001, 95 % CI: 0.85-0.95). CONCLUSION: Urinary 8-oxo-Gsn level was independently associated with frailty. This urinary biomarker may be a promising indicator of frailty.

Prevalence and associated factors for frailty among elder patients in China: a multicentre cross-sectional study.

BACKGROUND: To date, most previous studies of frailty among hospitalized elderly Chinese patients have been conducted based on small samples, which cannot represent the elderly patient population. The aim of this study was to identify the prevalence of and risk factors for frailty among elderly patients in China. STUDY DESIGN AND SETTING: This cross-sectional study surveyed 9996 elderly patients from 6 tertiary-level hospitals in China. The prevalence of frailty among patients from selected wards was surveyed by trained investigators. A mixed-effects Poisson regression model was used to analyse the factors associated with frailty among elderly patients. RESULTS: The mean age of all subjects was 72.47 ± 5.77 years. The prevalence rate of frailty in this study was 18.02%. After adjustments were made for the confounding effect of the clustering of hospital wards, a mixed-effects Poisson regression model showed that the associated factors of frailty included the following: age (OR: 1.016, 95% CI: 1.012-1.020), BMI < 18.5 (OR: 1.248, 95% CI: 1.171-1.330), female gender (OR: 1.058, 95% CI: 1.004-1.115), ethnic minority (OR: 1.152, 95% CI: 1.073-1.236), admission to hospital by the emergency department (OR: 1.104, 95% CI: 1.030-1.184), transit from another hospital (OR: 1.159, 95% CI: 1.049-1.279), former alcohol use (OR: 1.094, 95% CI: 1.022-1.171), fall history in the past 12 months (OR: 1.257, 95% CI: 1.194-1.323), vision dysfunction (OR: 1.144, 95% CI: 1.080-1.211), cognition impairment (OR: 1.182, 95% CI: 1.130-1.237), sleeping dysfunction (OR: 1.215, 95% CI: 1.215-1.318), urinary dysfunction (OR: 1.175, 95% CI: 1.104-1.251), and defecation dysfunction (OR: 1.286, 95% CI: 1.217-1.358). The results also showed some of the following protective effects: BMI > 28 (OR: 0.897, 95% CI: 0.856-0.940); higher education level, including middle school (OR: 0.915, 95% CI: 0.857, 0.977) and diploma and above (OR: 0.891, 95% CI: 0.821, 0.966); and current alcohol use (OR: 0.869, 95% CI: 0.815, 0.927). CONCLUSION: We identified a relatively high prevalence of frailty among elderly patients, and there are several associated factors among the population derived from this investigation of a large-scale, multicentre, nationally representative Chinese elderly inpatient population. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR1800017682, registered 09 August 2018.

Factors associated with health-related quality of life in community-dwelling elderly people in China.

AIM: Few studies have comprehensively evaluated the factors associated with health-related quality of life (HRQOL) in the elderly. The purpose of the study is to identify the factors associated with HRQOL using a comprehensive geriatric assessment of community-dwelling elderly people in Beijing, China. METHODS: A cross-sectional survey of 896 community-dwelling elderly people in Beijing was conducted through face-to-face interviews. Data regarding sociodemographic factors, chronic disease (assessed by the Cumulative Illness Rating Scale for Geriatrics, CIRS-G), common geriatric syndromes and HRQOL (assessed by the EuroQol 5-Dimension questionnaire, EQ-5D) were collected using a structured questionnaire. Binary logistic regression analysis was used to identify the factors related to HRQOL. RESULTS: The CIRS-G comorbidity index was negatively related to the EQ-5D index and EQ-Visual Analog Scale (VAS) (P < 0.05). Geriatric syndromes such as chronic pain and non-optimal nutrition were negatively related to HRQOL (P < 0.05), and the negative influence of geriatric syndromes on the EQ-5D index was stronger than that of the cumulative comorbidities. Functional status in daily living activities was positively related to HRQOL (P < 0.05). Receiving care from children was positively related to EQ-VAS (P < 0.05). CONCLUSIONS: Besides cumulative comorbidities and geriatric syndromes, in particular nutritional problems and chronic pain exert a substantial negative impact on the HRQOL of elderly people in China, whereas family support is an important protective factor. Geriatr Gerontol Int 2020; 20: 422-429.

Prevalence and prognostic implications of sarcopenia in older patients with coronary heart disease.

BACKGROUND: Sarcopenia is a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of adverse outcomes, including falls, fractures, physical disability, and mortality. However, there have been few systematic studies of the prevalence and prognostic values of sarcopenia in older patients with coronary heart disease (CHD). This study aimed to investigate the prevalence of sarcopenia in hospitalized older patients with CHD, and to prospectively evaluate the effect of sarcopenia on the short-term prognosis of these patients. METHODS: Patients aged ≥ 65 years, with the diagnosis of CHD from Peking Union Medical College Hospital between December 2017 and November 2018, were included. Sarcopenia was diagnosed according to consensus of the Asian Working Group for Sarcopenia in 2014. Follow-up items included unscheduled return visits, occurrence of major adverse cardiac and cerebral events (MACCE), and all-cause mortality. The MACCE-free survival curve of sarcopenic and non-sarcopenic older patients with CHD was estimated by the Kaplan-Meier method. Cox regression analysis was used to analyze the association between sarcopenia and an unscheduled return visits, MACCE, and all-cause mortality. RESULTS: A total of 345 older patients with CHD were enrolled in the study, with a median age of 74 years. Among the patients, 78 (22.6%) were diagnosed with sarcopenia. During the follow-up time, there were significantly more unscheduled return visits in sarcopenic patients than in non-sarcopenic patients (34.2% vs. 21.8%, χ2 = 4.418, P = 0.036), while there was no significant difference in the occurrence of MACCE (χ2 = 2.869, P = 0.09) or all-cause mortality (χ2 = 1.673, P = 0.196) between these patient groups. The Kaplan-Meier curve showed that the MACCE-free survival time of sarcopenic patients was significantly shorter than that in non-sarcopenic patients (χ2 = 4.102, P = 0.043). After adjusting for sex, age, and the Charlson comorbidity index, sarcopenia was not an independent risk factor of unscheduled return visits (HR = 1.002, 95% CI: 0.556-1.807). However, the complication of anxiety and depression was an independent risk factor (HR = 1.876, 95% CI: 1.012-3.477, P = 0.046) for unscheduled return visits in older patients with CHD. CONCLUSIONS: There is a high prevalence of sarcopenia among hospitalized older adults with CHD. A shorter MACCE-free survival time and more unscheduled return visits are found in sarcopenic older patients with CHD. Clinicians should pay more attention to the functional status of older patients with CHD, as well as identification and management of geriatric syndromes.