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Effectiveness of Nurse‐Led Interventions in Older Adults With Mild Cognitive Impairment or Dementia: A Systematic Review and Meta‐Analysis

ABSTRACT

Background

The rising prevalence of cognitive impairment has made it a critical public health priority. Nurses are central to chronic disease management, yet the efficacy of the interventions in older adults with cognitive disorders remains uncertain.

Objective

To evaluate the efficacy of nurse-led interventions in older adults with cognitive disorders.

Methods

A comprehensive search was conducted across seven electronic databases from their inception to August 2025. This meta-analysis focused on nurse-led interventions. The primary outcome was cognitive function, and secondary outcomes included depressive symptoms and quality of life. Due to the heterogeneity of the studies, we employed a random effects model for the meta-analysis.

Results

The results indicated that nurse-led interventions significantly improved cognition (SMD = 0.64; 95% CI, 0.39–0.88; p < 0.05), substantially alleviated depressive symptoms (SMD = −0.32; 95% CI, −0.53–0.11; p < 0.05) and enhanced quality of life (QoL) (SMD = 0.40; 95% CI, 0.17–0.64; p < 0.05).

Conclusions

The results of this study indicate that nurse-led interventions are highly beneficial for elderly individuals with mild cognitive impairment (MCI) or dementia. In future research, it is necessary to comprehensively consider the roles that nurses undertake. They should play an active role in the recovery from chronic diseases. These findings provide an important basis for policymakers and clinicians.

Trial Registration

PROSPERO Registration number: CRD42024619016

Relationship Between Sleep and Cognitive Frailty in Older Adults: A Systematic Review and Meta‐Analysis

ABSTRACT

Aim

To explore the relationship between sleep and cognitive frailty in older adults.

Design

A systematic review and meta-analysis.

Data Sources

The Web of Science, Cochrane Library, CINAHL, Embase, PsycINFO and PubMed databases were searched from inception to October 28, 2024.

Methods

Two investigators independently conducted literature screening, data extraction and quality assessment. The Joanna Briggs Institute Critical Appraisal Tool and Newcastle–Ottawa Scale were used to evaluate methodological quality. This review followed PRISMA guidelines.

Results

This review included 13 articles involving 14,223 individuals, and 10 studies included in the meta-analysis. Across 13 studies, the overall prevalence of cognitive frailty was 25%. Sleep problems were categorised into four categories; the results reported that poor sleep quality, long sleep time and insomnia were correlated with the presence of cognitive frailty. However, the relationship between short sleep time and cognitive frailty was not significant.

Conclusions

This review quantitatively suggested that sleep parameters such as long sleep time, insomnia and poor sleep quality were correlated with the presence of cognitive frailty. Future research should adopt longitudinal designs and use validated instruments to measure both quantitative and qualitative aspects of sleep, thereby facilitating a thorough examination of the strength of the relationship between sleep and cognitive frailty, as well as the direction of causality.

Impact

The review highlights the need to integrate comprehensive sleep assessments and targeted interventions into nursing care plans for older adults to enhance their sleep health. The findings will provide support for the development of effective interventions to prevent and manage cognitive frailty in the older population.

Patient or Public Contribution

No patient or public contribution.

Identification of the Central Symptoms of Multidimensional Frailty Among Older Adults Using the Tilburg Frailty Indicator: A Network Analysis

ABSTRACT

Background

Symptom networks offer a new approach to explore the relationships among various symptoms and provide information for optimising precise symptom management strategies. However, no previous studies have identified the central symptoms of multidimensional frailty.

Design

A cross-sectional study was conducted from December 2023 to March 2024 in China.

Settings and Participants

A total of 933 community-dwelling older adults (aged 60 years or older) in China were recruited via convenience sampling.

Methods

Sociodemographic variables, clinical variables and scores on the Tilburg Frailty Indicator were assessed in all participants. The qgraph package and IsingFit package of R software were applied to construct the symptom network. Three node centrality indices (strength, betweenness and closeness) and the expected influence were calculated to identify the central symptoms of the multidimensional frailty network. All statistical analyses were performed in R.

Results

A total of 933 individuals were surveyed in this study, including 472 (50.6%) females. The median age of all participants was 71.0 years. A total of 408 subjects were assessed as multidimensional frailty. The prevalence of multidimensional frailty was 43.7%. The centrality indices revealed that ‘difficulty in walking’, ‘difficulty in maintaining balance’, and ‘feeling down’ were the symptoms with the largest strength and expected influence values.

Conclusion

This study primarily utilised network analysis to construct a symptom network of multidimensional frailty among community-dwelling older adults. The findings revealed that difficulty in walking, difficulty in maintaining balance, and feeling down were the most central symptoms.

Implications

This study identified the central symptoms of multidimensional frailty in older adults, which may serve as primary intervention targets. Nursing staff could incorporate targeted physical and psychological interventions into person-centred care plans.

Reporting Methods

This study was reported in accordance with the STROBE guidelines.

Patient or Public Contribution

No patient or public contribution was involved in this study.

Effectiveness of E‐Health Interventions on Improving Physical Activity in Pregnant Women: A Systematic Review and Meta‐Analysis

ABSTRACT

Aims

This study aimed to (1) evaluate the effectiveness of e-health interventions in improving physical activity and associated health outcomes during pregnancy, (2) compare the e-health functions employed across interventions and (3) systematically identify the behaviour change techniques (BCTs) used and examine their interrelationships.

Design

A systematic review and meta-analysis following the PRISMA 2020 guidelines.

Methods

Randomised controlled trials were included. Meta-analyses and subgroup analyses were performed using RevMan 5.3. Social network analysis was conducted to determine the most central BCTs within the intervention landscape.

Data Sources

Ten databases were searched, including PubMed, Embase, Web of Science, Cochrane Library, ProQuest, Scopus, SinoMed, China National Knowledge Infrastructure, WanFang and the China Science and Technology Journal Database, from inception to April 22, 2024.

Results

Thirty-five studies were included. Pooled analyses indicated that e-health interventions significantly improved both total (SMD: 0.19; 95% CI: 0.10 to 0.27; I 2 = 55%) and moderate-to-vigorous physical activity (SMD: 0.16, 95% CI: 0.06 to 0.26; I 2 = 53%) in pregnant women. Subgroup analyses revealed that interventions based on theoretical frameworks and those not specifically targeting overweight or obese women demonstrated greater effectiveness. Additionally, e-health interventions were associated with significant reductions in both total and weekly gestational weight gain. Six of the twelve e-health functions were utilised, with ‘client education and behaviour change communication’ being the most prevalent. Thirty unique BCTs were identified; among them, ‘instruction on how to perform the behaviour’, ‘self-monitoring’, ‘problem solving’, and ‘goal setting’ showed the highest degree of interconnectedness.

Conclusion

E-health interventions are effective in enhancing physical activity and reducing gestational weight gain during pregnancy. Incorporating theoretical frameworks and well-integrated BCTs is recommended to optimise intervention outcomes.

Relevant to the Clinical Practice

Integrating e-health interventions into existing perinatal care models holds promise for enhancing physical activity among pregnant women and improving maternal health outcomes.

Reporting Method

This study adhered to the PRISMA checklist.

Patient or Public Contribution

No patient or public involvement.

Trial Registration

The study protocol was preregistered in the International Prospective Register of Systematic Reviews (CRD42024518740)

Single‐Center Epidemiological Analysis of Malignant Transformation With Skin Ulcers in Outpatients

ABSTRACT

Investigate the epidemiological characteristics of outpatients initially diagnosed with skin ulcers who were ultimately confirmed to have cutaneous malignant tumours, and provide a diagnostic and therapeutic basis for the occurrence of secondary diseases in chronic wounds. We conducted a retrospective study analysing clinical data from patients initially diagnosed with skin ulcers at our hospital between July 2021 and February 2025, and analysed the epidemiological characteristics of malignant transformation in these ulcer cases. Among 128 patients initially diagnosed with skin ulcers, 16 cases (12.5%) were confirmed with cutaneous malignancies. The malignant group had a significantly higher mean age (69.44 ± 11.30 years) compared to the non-malignant group (58.39 ± 17.88 years; t = 5.752, p = 0.01). The distribution of lesion sites differed significantly between the malignant and non-malignant groups (χ2 = 30.498, p < 0.01). In the malignant group, the head and neck (41.2%) and trunk & extremities (41.2%) were the predominant sites. The most common malignancy was squamous cell carcinoma (SCC). The trunk & extremities was the most frequent site (62.5%). The second was basal cell carcinoma, which mainly occurs in the head and neck (80.0%). The mean duration of ulceration was 4.5 years. The primary treatment modality was surgical excision (11 cases, 68.8%). Approximately one-seventh of skin ulcer cases were confirmed as cutaneous malignancies. This finding underscores the significance of skin ulcers as potential malignant lesions, highlighting the need for clinicians to maintain a high index of suspicion and promptly perform histopathological examinations to improve early detection rates of skin cancers.

Multi-omics analysis reveals diagnostic and therapeutic biomarkers for aging phenotypes in ulcerative colitis

by Lei Guo, Jun Ge, Li Cheng, Xinyi Zhang, Zhengzheng Wu, Meili Liu, Hanmei Jiang, Wei Gong, Yi Liu

Background

The incidence of ulcerative colitis (UC) remains high, with an increasing prevalence among elderly patients. Cellular senescence has been widely recognized as a contributor to UC susceptibility; however, the underlying molecular mechanisms remain incompletely understood. This study aimed to identify senescence-associated biomarkers in UC to provide new insight for diagnosis and treatment.

Methods

By integrating transcriptomic data from UC patients with established aging-related databases, we identified aging-associated differentially expressed genes (DEGs). Using weighted gene co-expression network analysis (WGCNA) and Cytoscape, we pinpointed the core genes involved. A diagnostic model for UC was then developed based on these core genes, and their expression patterns were characterized at single-cell resolution. The roles of these genes were ultimately validated through in vitro and animal experiments.

Results

We identified 24 aging-related DEGs in UC, which were primarily implicated in inflammatory responses and cytokine-receptor interactions. Further analyses pinpointed three core genes (CXCL1, MMP9, and STAT1) that were predominantly expressed in macrophages. A diagnostic model constructed using these genes exhibited robust predictive performance. Experimental validation confirmed that the expression levels of all three core genes were significantly upregulated in both a UC mouse model and in macrophages compared to controls. Additionally, pathway analyses revealed elevated levels of CXCL12 and VEGFA in the enriched pathways.

Discussion

Our findings underscore the pivotal roles of CXCL1, MMP9, and STAT1 in UC-associated cellular senescence. The analysis positions these molecules as promising macrophage-mediated diagnostic biomarkers and therapeutic targets. Collectively, this work provides novel insights into UC pathogenesis and lays a foundation for developing precision medicine strategies that target senescence pathways.

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