The National Health and Nutrition Examination Survey (NHANES) in the United States is a research program designed to assess the health and nutritional status of adults and children in the country. Due to its adoption of a complex sampling design, it is imperative to correctly apply the weights provided by NHANES to ensure the accuracy and external validity of research results. This article first introduces the relevant concepts of the NHANES database and its weights, followed by a practical demonstration of weight selection, calculation, and implementation in the R programming language. It further discusses the significance of using weights in NHANES data and systematically showcases how to perform weighted analysis based on R, providing a valuable reference for relevant researchers.
ObjectiveTo compare the disease burden of cancers and the effectiveness of prevention and control strategies among elderly populations (aged ≥65 years) between China and the United States (US). MethodsUsing data from the GLOBOCAN 2022 database, we extracted age-standardized incidence rates (ASIR), age-standardized mortality rates (ASMR), and mortality-to-incidence ratio (M/I) for major cancer types in both countries. Joinpoint regression analysis was used to examine the temporal trends in incidence rates of the US (from 2000 to 2017) and China (from 2002 to 2017). ResultsAmong Chinese elderly populations, the overall ASIR was 1109.4 per 100000, lower than that in the US of 1754.4 per 100000. However, the ASMR in China was 779.0 per 100000, higher than that in the US of 664.4 per 100000. The M/I were 0.70 for China and 0.38 for the US. Cancer incidence rates among the elderly in both China and the United States were showing an overall downward trend. By cancer type, China faced a relatively heavy burden from lung cancer, colorectal cancer, stomach cancer, and liver cancer. In contrast, the US demonstrated high incidence but low mortality for prostate and breast cancers, reflecting advantages in its screening and treatment systems. ConclusionThe differences in the disease burden of cancers among the elderly populations between China and the US reflect a combination of factors, including the two countries’ stages of economic development, the progression of cancer spectrum shifts, and differences in the prevalence of major risk factors. It is recommended that China prioritize lung cancer, colorectal cancer, stomach cancer, and liver cancer, strengthen targeted screening and primary-care management, and establish a full-cycle system encompassing "prevention, screening, diagnosis, treatment, and rehabilitation" to narrow the gap in prevention and control effectiveness between China and the US.
Sarcopenia, a skeletal muscle degenerative condition, is inextricably linked to the physiological processes of aging. Sarcopenia is characterized by a reduction in muscle mass, a decline in muscle strength, and/or deterioration of physical function. Comprehensive interventions are essential for the management of sarcopenia. This patient version of guideline has been developed by adapting the " Comprehensive intervention for sarcopenia among older adults: an evidence-based clinical practice guideline." This patient version of guideline is designed to enhance health education and promote the widespread adoption of comprehensive intervention strategies for sarcopenia.
Sarcopenia, a skeletal muscle degenerative condition, is inextricably linked to the physiological processes of aging. Sarcopenia is characterized by a reduction in muscle mass, a decline in muscle strength, and/or deterioration of physical function. Comprehensive interventions are essential for the management of sarcopenia. The team from the National Clinical Research Center for Geriatrics has authored the "Comprehensive intervention for sarcopenia among older adults: an evidence-based clinical practice guideline" which discuss the specific contents of exercise, nutrition, and drug interventions for sarcopenia. This article provides a comprehensive interpretation of the guideline to facilitate their dissemination, promotion, and application.
With the acceleration of population aging, the health problems and care service needs of the elderly are increasing, while the capacity for family-based care is declining. To address these challenges, China has proposed the "integrated medical and nursing care" service model, which integrates medical and health services with elderly care. Geriatric medicine is one of the key technical components of this integrated service model. This study aims to construct a technical standard system for geriatric medicine within the integrated medical and elderly care services. It mainly includes the basic principles, overall framework, structure, and explanations of the geriatric medicine technical standard system, providing a technical and directional framework for the geriatric medicine technical standard system in the context of integrated medical and elderly care services.
Rapidly advancing demographic aging in China has led to an increasing prevalence of terminal patients suffering from malignant tumors and chronic diseases, thereby escalating the demand for palliative care services. Palliative care is a multidisciplinary comprehensive management model for patients in the terminal stage and at the end of life. It aims to effectively alleviate the patients' painful symptoms, improve their quality of life, and ensure their comfortable and dignified departure. Symptom control is at the core of palliative care, and rational drug use is the foundation of symptom control. The complexity of physical and psychological factors in terminal patients and the ethical background pose significant challenges to rational drug use. In addition, elderly hospice patients usually suffer from multiple diseases, and their physiological functions decline, resulting in specific pharmacokinetics and reactivity, which undoubtedly increases the complexity of medical decision-making, making doctors often face multiple medication challenges during the treatment process, which in turn poses potential drug treatment risks. Based on current evidence, a multidisciplinary team led by geriatricians registered and drafted the "Protocol for medication guideline for symptom management in elderly hospice care (2025)". This paper provides a detailed introduction to the planning process for the development of the guidelines.
With the acceleration of population aging in China, the number of elderly patients with lung cancer continues to rise. These patients not only face threats from the tumor itself but also often suffer from multiple chronic diseases and geriatric syndromes, which increase the complexity of perioperative management and surgical risks. To provide standardized perioperative management strategies for elderly lung cancer patients, this guideline aims to reduce postoperative complications and improve patients' quality of life through comprehensive geriatric assessment, comorbidity management, and early identification and intervention of complications. The guideline working group has drafted the "Protocol for guidelines on the comprehensive perioperative management of elderly patients with lung cancer (2025)", detailing the development process of the guidelines.
ObjectiveThis study aims to develop and implement a patient-centered, comprehensive perioperative geriatric syndrome management model. This systematic approach seeks to optimize preoperative status, mitigate surgical stress, and promote rapid postoperative recovery, ultimately achieving dual objectives: extending healthy lifespan and ensuring surgical safety and efficacy. MethodsThrough systematic literature review and clinical practice summarization, a perioperative geriatric syndrome management model for elderly lung cancer patients was developed. Based on comprehensive geriatric assessment, a multidisciplinary team was established to address seven common geriatric syndromes: frailty, delirium, sarcopenia, cognitive impairment, malnutrition, dysphagia, and emotional disorders. Dynamic assessment, risk stratification, and individualized comprehensive intervention plans were formulated. Concurrently, core involvement of family members and caregivers was emphasized. ResultsImplementation of this comprehensive management model established a systematic intervention pathway covering preoperative, intraoperative, and postoperative geriatric syndromes, enabling dynamic monitoring and individualized management of perioperative status in elderly lung cancer patients. The model effectively integrated multidisciplinary resources, enhanced family and caregiver support capabilities, and provided institutional and human resource guarantees for seamless transition of interventions between inpatient and outpatient settings, thereby preliminarily establishing a continuous perioperative geriatric support system. ConclusionThis patient-centered, comprehensive perioperative geriatric syndrome management model systematically addresses multiple geriatric syndromes in elderly lung cancer patients. It optimizes preoperative preparation, reduces surgical risks, and promotes postoperative recovery, holding significant clinical value for improving patient outcomes and quality of life. By emphasizing multidisciplinary collaboration and family involvement, this model provides a practical reference for continuous and holistic perioperative management of elderly lung cancer patients.
Older patients at the end of life often present with multiple geriatric syndromes and comorbidities, resulting in complex symptom profiles and a high risk of medication-related harm. These challenges not only compromise quality of life at the end of life but also complicate clinical decision-making. Currently, there is a lack of systematic, age-specific guidelines for medication management of symptoms in older palliative care patients in China. This guideline is developed in accordance with the standards of the grading of recommendations, assessment, development, and evaluations (GRADE) system and the reporting items for practice guidelines in healthcare (RIGHT). It addresses 15 symptoms, including pain, dyspnea, and cough in elderly palliative care patients, resulting in 67 recommendations. Based on the best available evidence, an expert panel conducted structured discussions and formulated recommendations. This guideline aims to identify and recommend appropriate pharmacological treatments for common and refractory symptoms in older palliative care patients, and to provide guidance for healthcare professionals on safe, rational, and standardized medication use.
With the accelerating aging of the population, the proportion of elderly patients with lung cancer continues to rise, presenting multiple challenges to perioperative management. This paper systematically reviews the clinical characteristics of elderly lung cancer patients. Based on the comprehensive geriatric assessment, it proposes incorporating seven major geriatric syndromes—frailty, delirium, sarcopenia, cognitive impairment, malnutrition, dysphagia, and mood disorders—into the core evaluation system. By integrating multimorbidity management with complication prevention and control, an integrated "geriatric syndrome-multimorbidity-complication" perioperative management model is constructed. Furthermore, this paper outlines stratified intervention strategies for geriatric syndromes, a "five-step" workflow for comorbidity management, and a comprehensive intervention pathway for complications across the preoperative, intraoperative, and postoperative phases. Multidisciplinary team (MDT) collaboration serves as the core mechanism to achieve individualized comprehensive treatment. This paper aims to provide a novel perioperative comprehensive treatment model for elderly lung cancer patients, which is centered on geriatrics, supported by multidisciplinary collaboration, and guided by precision medicine.