Abstract Background Dual task (DT) assessments evaluating walking combined with a cognitive task are valuable tools for testing functional capacity and monitoring age-related decline. Despite this, motor-cognitive DT assessments are underutilised in clinical practice. This has been attributed in part to methodological challenges, including heterogeneity in DT measurement protocols and poor reliability of outcome measures. To address these barriers, this scoping review systematically identified motor-cognitive DT walking assessments used with healthy older adults and examined current practice in reporting and standardisation. The purpose was to inform the refinement of DT assessments to enhance their precision and reproducibility, facilitating their future integration into routine clinical practice. Method A systematic search of five electronic databases identified studies that investigated motor-cognitive DT walking assessments in community-dwelling, cognitively healthy older adults. The reporting and standardisation of measurement procedures was extracted using the COSMIN framework. The findings were analysed descriptively. Results The review included 38 studies investigating a walking motor task combined with a variety of cognitive tasks. The most common walking tasks were unidirectional gait, the timed up and go (TUG), or walking and turning tasks. The most prevalent cognitive tasks included serial subtraction, animal naming, and reciting alternate alphabet letters. There was substantial variability in the administration of DT assessments and no studies fully reported the procedures for set up, test performance, and data collection. Of particular concern was the poor reporting of general task instructions, task prioritisation, and practice trials. Conclusion The review identified a lack of standardisation in DT walking measurement procedures, which likely contributes to measurement variability and limits clinical replication. Given that measurement variability inherent in single task assessments is compounded when motor and cognitive tasks are combined, it is critical to address these sources of inconsistency to ensure DT measures detect and accurately reflect true performance changes. Recommendations are made to improve standardisation of DT measurements with the aim of facilitating their broader adoption and implementation in clinical practice.
The development and progression of breast cancer are closely linked to estrogen levels. For patients with estrogen receptor-positive breast cancer, endocrine therapy targeting estrogen pathways remains a cornerstone of postoperative treatment. Aromatase, a critical enzyme in estrogen biosynthesis, exhibits heightened expression in breast tumors and their surrounding tissues. Consequently, aromatase inhibitors (AI) have become widely adopted as a primary endocrine therapy for breast cancer. While AI effectively lower tumor recurrence rates, they are associated with adverse effects such as bone loss, osteoporosis, and increased risk of osteoporotic fractures. These effects are particularly pronounced in elderly breast cancer patients, who are predisposed to accelerated bone mass loss and a higher prevalence of osteoporosis. This review explores the mechanisms of action of AI, the pathways through which they contribute to bone density reduction and osteoporosis, and the risk stratification for osteoporotic fractures. Additionally, it highlights evidence-based strategies for preventing and managing AI-induced osteoporosis in elderly breast cancer patients. By addressing these challenges, the review aims to enhance understanding of the bone health issues faced by this patient population, improve their quality of life, and reduce the incidence of complications.
Objectives: This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City, China, and provide suggestions to enhance these competencies. Methods: This study was conducted in 204 hospitals in Southwest China from December 24, 2022 to January 7, 2023. The “Geriatric Nursing Competence of Clinical Nurse Investigation Tool” was used to explore factors that influence geriatric nurses’ competencies via stratified sampling. The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing. Results: A total of 10,692 nurses answered the questionnaires. Of these questionnaires, 9,442 were valid. The total geriatric nursing competence score of the clinical nursing staff was 2.29 ± 0.81, the secondary hospital score was 2.23 ± 0.78, and the tertiary hospital’s overall mean score was 2.33 ± 0.83. The factors that influenced secondary hospitals included the department of medicine, age of nurses and total length of career (P < 0.05). The factors that influenced tertiary hospitals included the department of medicine, age of nurses, nurses’ professional title, and geriatric practical advanced nurses’ certification (P < 0.05). Conclusions: Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors. The findings highlight the need for further clinical training in geriatric nursing. The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.
Alessandra da Silva Oliveira, Claudia Teixeira-Arroyo
Objetivo: Verifi car o efeito de um programa de exercícios físicos funcionais, associados ao componente lúdico, nos sintomas depressivos, na capacidade de realização das atividades da vida diária (AVD) e nos sintomas de dor de idosos institucionalizados. Métodos: Participaram dez idosos institucionalizados (idade = 72,6 ± 5,2). Para coleta de dados foi utilizada a Escala Geriátrica de Depressão (GDS-15), o Índice de Katz, para avaliar as AVD e a escala numérica de dor. O programa de exercícios teve duração de 3 meses (60 min, 2 vezes/semana). Resultados: O teste de Wilcoxon apontou diferença signifi cativa entre os dois momentos para: depressivos (z = -2,388; p = 0,017), AVD nos itens “vestir-se” (z = -2,000; p = 0,046) e “trabalho doméstico” (Z = -2,236; p = 0,025) e intensidade da dor (Z = -2,121; p = 0,034). Conclusão: O programa de exercício funcional foi efi ciente em minimizar os sintomas depressivos e de dor e melhorar a capacidade dos idosos para as AVD.
Agnieszka Kujawska, Sławomir Kujawski, Melanie Dani
et al.
Abstract Orthostatic hypotension (OH) is common in older people. We examined the influence of self-reported occupational-related physical activity (PA) and leisure-time physical exercise (PE) on orthostatic response in a sample of older people over a 2 year period. Supine and orthostatic systolic blood pressure (sBP), diastolic blood pressure (dBP), and mean blood pressure (mBP) were assessed in response to Active Stand (AS) test in 205 older subjects (> 60 years old) at baseline and 2-year follow-up. OH was found in 24 subjects (11.71%) at baseline and 20 subjects (9.76%) after 2 years, with a significant degree of variability in the occurrence of OH after 2 years. Twenty-two subjects who had OH at baseline were free of it after 2 years, two subjects had persistent OH at baseline and after 2 years. After 2 years, adults with occupational PA showed no significant decrease of blood pressure in response to AS test, while lack of undertaking an occupation-related PA was significantly related with a greater decrease in sBP and mBP in response to AS testing in the 1st min. Occupation-related PA and leisure-time-related PE were related to an increase in the response of BP on AS in change between baseline and after 2 years. High between-subjects variance in OH over 2 years was noted. Occupations that involved continuous physical activity and leisure-time physical exercise in middle age were both protective for BP decline on orthostatic stress test within 2 years.
Pigmented actinic keratosis (PAK) is an uncommon variant of actinic keratosis that can mimic different pigmented lesions, which may be benign or malignant. The diagnosis of PAK is often challenging because of overlapping features with lentigo maligna melanoma (LMM). Clinically, lesions of both conditions almost look similar; the diagnoses must be established histologically and with the help of immunostaining whenever needed. The distinction between a large PAK and LMM is important because their prognosis and management differ. We present a 75-year-old female with annular brown-to-black-colored maculo-plaque on forehead having clinical suspicious of melanocytic malignancy; which was diagnosed with a PAK on biopsy with help of histopathology and confirmed with Melan A/MART-1 immunostaining.
L. V. Simhachalam Kutikuppala, Venkataramana Kandi, Ashish K. Sarangi
et al.
Global public health is significantly challenged due to the continuing COrona VIrus Disease 2019 (COVID-19) outbreak brought forth by the severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) [...]
Irene Lobon, Manuel Solís-Moruno, Manuel Solís-Moruno
et al.
The role of somatic mutations in complex diseases, including neurodevelopmental and neurodegenerative disorders, is becoming increasingly clear. However, to date, no study has shown their relation to Parkinson disease’s phenotype. To explore the relevance of embryonic somatic mutations in sporadic Parkinson disease, we performed whole-exome sequencing in blood and four brain regions of ten patients. We identified 59 candidate somatic single nucleotide variants (sSNVs) through sensitive calling and a careful filtering strategy (COSMOS). We validated 27 of them with amplicon-based ultra-deep sequencing, with a 70% validation rate for the highest-confidence variants. The identified sSNVs are in genes with synaptic functions that are co-expressed with genes previously associated with Parkinson disease. Most of the sSNVs were only called in blood but were also found in the brain tissues with ultra-deep amplicon sequencing, demonstrating the strength of multi-tissue sampling designs.
Abstract The PI3K/AKT/mTOR and RAF/MEK/ERK pathways are commonly activated by mutations and chromosomal translocation in vital targets. The PI3K/AKT/mTOR signaling pathway is dysregulated in nearly all kinds of neoplasms, with the component in this pathway alternations. RAF/MEK/ERK signaling cascades are used to conduct signaling from the cell surface to the nucleus to mediate gene expression, cell cycle processes and apoptosis. RAS, B-Raf, PI3K, and PTEN are frequent upstream alternative sites. These mutations resulted in activated cell growth and downregulated cell apoptosis. The two pathways interact with each other to participate in tumorigenesis. PTEN alterations suppress RAF/MEK/ERK pathway activity via AKT phosphorylation and RAS inhibition. Several inhibitors targeting major components of these two pathways have been supported by the FDA. Dozens of agents in these two pathways have attracted great attention and have been assessed in clinical trials. The combination of small molecular inhibitors with traditional regimens has also been explored. Furthermore, dual inhibitors provide new insight into antitumor activity. This review will further comprehensively describe the genetic alterations in normal patients and tumor patients and discuss the role of targeted inhibitors in malignant neoplasm therapy. We hope this review will promote a comprehensive understanding of the role of the PI3K/AKT/mTOR and RAF/MEK/ERK signaling pathways in facilitating tumors and will help direct drug selection for tumor therapy.
It is challenging to trace the complicated individual-based variations of HIV-specific immunocompetence shift during the successful antiretroviral therapy (ART) era. Using eight rhesus monkeys simulating a longitudinal stage-dependent cohort (baseline-SIV acute infection-SIV suppression by ART-ART withdrawal), baseline immunocompetence monitoring for 28 days (SIV-negative stage, SN) was compared with host immunocompetence undergoing 90-day ART treatment (SIV-suppressed stage, SS) to reveal the SIV-specific immunity shift aroused by undetectable individual viral replication. During acute SIV infection for 98 days (SIV-emerged stage, SE), immune activation was compared with re-immune activation post ART for 49-day follow-up (SIV-rebounded stage, SR) to reveal the SIV-specific immune activation variation aroused by detectable individual viral replication. Individual immunocompetence was measured by co-expression of CD4, CD8, CD38, HLA-DR, CCR7, CD45RA, and PD-1 on T cells and a cytokine panel. Compared with SN, mild immune activation/exhaustion was characterized by increased CD38+ HLA-DR– CD4+/CD8+ T-cell subsets and PD-1+ memory CD4+/CD8+ T-cell subsets with three elevated cytokines (MIP-1β, IL-8, and IL-10) significantly emerged in SS. Compared with SE, SR produced more exhaustion characterized by increased PD-1+ CD4+ TCM cells and decreased PD-1+ CD4+ TEM cells with four elevated pro-inflammatory cytokines (IFN-γ, IL-1β, IL-6, and TNF-α). By such individualized stage-dependent comparison, the sustainable immune activation was found from activation/exhaustion shifted into exhaustion during the longitudinal viral persistence. Further, validated SIV accelerates host immunosenescence continuously independent of viral replication.
Victor Garcia-Martin MD, Ana Verdejo-González MD, David Ruiz-Picazo MD
et al.
Introduction: Physiological aging frequently leads to degenerative changes and spinal deformity. In patients with hypolordotic fusions or ankylosing illnesses such as diffuse idiopathic skeletal hyperostosis or ankylosing spondylitis, compensation mechanisms can be altered causing severe pain and disability. In addition, if a total hip replacement and/or knee replacement is performed, both pelvic and lower limbs compensation mechanisms could be damaged and prosthetic dislocation or impingement syndrome could be present. Pedicle subtraction osteotomy has proven to be the optimal correction technique for spinal deformation in patients suffering from a rigid spine. Case Presentation: A 70-year-old male patient with diffuse idiopathic skeletal hyperostosis criteria and a rigid lumbar kyphosis, who previously underwent a total hip and knee replacement, had severe disability. We then performed corrective surgery by doing a pedicle subtraction osteotomy. The procedure and outcomes are presented here. Conclusion: In symptomatic patients with sagittal imbalance and a rigid spine, pedicle subtraction osteotomy can indeed correct spinal deformity and re-establish sagittal balance.
Dawei Wang,1,* Hongyan Cao,2,* Xu Wang,3 Jinchun Wang,4 Manli Wang,5 Jian Zhang,6 Lin Wang6 1Department of Emergency, The First Hospital of Jilin University, Changchun, 130021, People’s Republic of China; 2Department of Cardiology, The First Hospital of Jilin University, Changchun, 130021, People’s Republic of China; 3Department of Colorectal and Anal Surgery, The First Hospital of Jilin University, Changchun, 130021, People’s Republic of China; 4Department of Emergency, Jilin Provincial FAW General Hospital, Changchun, 130011, People’s Republic of China; 5Department of Geriatrics, Changchun Central Hospital, Changchun, 130000, People’s Republic of China; 6Department of Cardiovascular Center, The First Hospital of Jilin University, Changchun, 130021, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jian Zhang; Lin WangDepartment of Cardiovascular Center, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, 130021, Jilin Province, People’s Republic of ChinaTel +86-0431-88783417Email wanglinjdyy@jlu.edu.cn; Kenny1026@jlu.edu.cnBackground: Exercise training has been regarded as an effective mean of prevention and treatment of cardiovascular diseases (CVD), and exercise can improve the antioxidant capacity of the myocardial. While SIRT1 has been proved to protects the heart from myocardial ischemia/reperfusion (MI/R) injury and apoptosis, less is known about the association between exercise-induced cardioprotection and SIRT1.Methods and Results: MI/R injury model was constructed after swimming training in mice. Significantly reduced myocardial infarct size, decreased apoptosis ratio and upregulated SIRT1 protein expression in heart were found in swam mice by 2,3,5-triphenyltetrazolium chloride (TTC) staining of heart sections, TUNEL staining of frozen sections and Western blotting. The results of TUNEL staining and Western blotting suggested activation of SIRT1 using resveratrol (RSV) or inhibition of SIRT1 using EX527 in vitro blocked or accelerated cardiomyocytes apoptosis which induced by hypoxia/reoxygenation (H/R) respectively and regulated the expression of antioxidants in vitro. PGC-1α has been identified as one of the downstream genes of SIRT1 modulating oxidative stress and apoptosis. Importantly, the data of TTC staining, TUNEL staining, Western blotting, echocardiography and histopathological staining revealed that mice with inducible cardiac SIRT1-knockout blocked the protective effects of exercise preconditioning on myocardial infarct size, myocardial apoptosis, adverse ventricular remodeling, cardiac fibrosis and cardiac dysfunction after MI/R injury, simultaneously exercise-induced expression of myocardial antioxidant stress factors was hindered which was detected by immunohistochemical analysis.Conclusion: SIRT1 protects against oxidative stress after MI/R injury by activating downstream PGC-1α and promoting the production of antioxidant enzymes. SIRT1 is required for exercise to protect against myocardial apoptosis and maladaptive ventricular remodelling induced by myocardial ischemia/reperfusion injury.Keywords: exercise, myocardial ischemia/reperfusion injury, oxidative stress, SIRT1
Mari Nordbø Gynnild,1,2 Steven HJ Hageman,3 Jannick AN Dorresteijn,3 Olav Spigset,4,5 Stian Lydersen,6 Torgeir Wethal,1,2 Ingvild Saltvedt,1,7 Frank LJ Visseren,3 Hanne Ellekjær1,2 1Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, NTNU – Norwegian University of Science and Technology, Trondheim, Norway; 2Department of Stroke, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; 3Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands; 4Department of Clinical Pharmacology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; 5Department of Clinical and Molecular Medicine, NTNU – Norwegian University of Science and Technology, Trondheim, Norway; 6Department of Mental Health, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, Trondheim, Norway; 7Department of Geriatrics, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, NorwayCorrespondence: Mari Nordbø GynnildDepartment of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU – Norwegian University of Science and Technology, Trondheim, NorwayEmail mari.nordbo.gynnild@ntnu.noPurpose: Suboptimal secondary prevention in patients with stroke causes a remaining cardiovascular risk desirable to reduce. We have validated a prognostic model for secondary preventive settings and estimated future cardiovascular risk and theoretical benefit of reaching guideline recommended risk factor targets.Patients and Methods: The SMART-REACH (Secondary Manifestations of Arterial Disease-Reduction of Atherothrombosis for Continued Health) model for 10-year and lifetime risk of cardiovascular events was applied to 465 patients in the Norwegian Cognitive Impairment After Stroke (Nor-COAST) study, a multicenter observational study with two-year follow-up by linkage to national registries for cardiovascular disease and mortality. The residual risk when reaching recommended targets for blood pressure, low-density lipoprotein cholesterol, smoking cessation and antithrombotics was estimated.Results: In total, 11.2% had a new event. Calibration plots showed adequate agreement between estimated and observed 2-year prognosis (C-statistics 0.63, 95% confidence interval 0.55– 0.71). Median estimated 10-year risk of recurrent cardiovascular events was 42% (Interquartile range (IQR) 32– 54%) and could be reduced to 32% by optimal guideline-based therapy. The corresponding numbers for lifetime risk were 70% (IQR 63– 76%) and 61%. We estimated an overall median gain of 1.4 (IQR 0.2– 3.4) event-free life years if guideline targets were met.Conclusion: Secondary prevention was suboptimal and residual risk remains elevated even after optimization according to current guidelines. Considerable interindividual variation in risk exists, with a corresponding variation in benefit from intensification of treatment. The SMART-REACH model can be used to identify patients with the largest benefit from more intensive treatment and follow-up.Keywords: secondary prevention, ischemic stroke, risk factors, risk assessment, risks and benefits, cardiovascular diseases
Xiaoyue Song,1,2 Weihong Zhang,2 Cynthia Hallensleben,1 Anke Versluis,1 Rianne van der Kleij,1 Zongliang Jiang,2 Niels H Chavannes,1 Robbert JJ Gobbens3– 5 1Department of Public Health and Primary Care, Leiden University Medical Center, Leiden 2333 ZD, The Netherlands; 2School of Nursing, Zhengzhou University, Zhengzhou, People’s Republic of China; 3Faculty of Health, Sports and Social Work, Inholland University of Applied Sciences, Amsterdam, The Netherlands; 4Zonnehuisgroep Amstelland, Amstelveen, The Netherlands; 5Department of Primary and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, BelgiumCorrespondence: Xiaoyue SongDepartment of Public Health and Primary Care, Leiden University Medical Center, Hippocratespad 21, Leiden 2333 ZD, The NetherlandsTel +31682817080Email x.song@lumc.nlPurpose: To investigate the prevalence of multidimensional frailty in older people with hypertension and to examine a possible relationship of general obesity and abdominal obesity to frailty in older people with hypertension.Patients and Methods: A sample of 995 community-dwelling older people with hypertension, aged 65 years and older and living in Zhengzhou (China), completed the Tilburg Frailty Indicator (TFI), a validated self-report questionnaire for assessing multidimensional frailty. In addition, socio-demographic and lifestyle characteristics were assessed by self-report, and obesity was determined by measuring waist circumference and calculating the body mass index.Results: The prevalence of multidimensional frailty in this older population with hypertension was 46.5%. Using multiple linear regression analysis, body mass index was significantly associated with physical frailty (p = 0.001), and waist circumference was significantly positively associated with multidimensional frailty and all three frailty domains. Older age was positively associated with multidimensional frailty, physical frailty, and psychological frailty, while gender (woman) was positively associated with multidimensional, psychological, and social frailty. Furthermore, comorbid diseases and being without a partner were positively associated with multidimensional, physical, psychological, and social frailty. Of the lifestyle characteristics, drinking alcohol was positively associated with frailty domains.Conclusion: Multidimensional frailty was highly prevalent among Chinese community-dwelling older people with hypertension. Abdominal obesity could be a concern in physical frailty, psychological frailty, and social frailty, while general obesity was concerning in relation to physical frailty.Keywords: older people, multidimensional frailty, obesity, hypertension
Introduction. The subjective visual vertical (SVV) measures the perception of a person’s spatial orientation relative to gravity. Weighted central integration of vestibular, visual, and proprioceptive inputs is essential for SVV perception. Without any visual references and minimal proprioceptive contribution, the static SVV reflects balance of the otolith organs. Normal aging is associated with bilateral and progressive decline in otolith organ function, but age-dependent effects on SVV are inconclusive. Studies on sensory reweighting for visual vertical and multisensory integration strategies reveal age-dependent differences, but most studies have included elderly participants in comparison to younger adults. The aim of this study was to compare young adults with older adults, an age group younger than the elderly. Methods. Thirty-three young and 28 older adults (50–65 years old) adjusted a tilted line accurately to their perceived vertical. The rod’s final position from true vertical was recorded as tilt error in degrees. For otolithic balance, visual vertical was recorded in the dark without any visual references. The rod and frame task (RFT) with tilted disorienting visual frames was used for creating visuovestibular conflict. We adopted Nyborg’s analysis method to derive the rod and frame effect (RFE) and trial-to-trial variability measures. Rod alignment times were also analyzed. Results. There was no age difference in signed tilts of SVV without visual reference. There was an age effect on RFE and on overall trial-to-trial variability of rod tilt, with older adults displaying larger frame effects and greater variability in rod tilts. Alignment times were longer in the tilted-frame conditions for both groups and in the older adults compared to their younger counterparts. The association between tilt accuracy and tilt precision was significant for older adults only during visuovestibular conflict, revealing an increase in RFE with an increase in tilt variability. Correlation of σSVV, which represents vestibular input precision, with RFE yielded exactly the same contribution of σSVV to the variance in RFE for both age groups. Conclusions. Older adults have balanced otolithic input in an upright position. Increased reliance on visual cues may begin at ages younger than what is considered elderly. Increased alignment times for older adults may create a broader time window for integration of relevant and irrelevant sensory information, thus enhancing their multisensory integration. In parallel with the elderly, older adults may differ from young adults in their integration of sensory cues for visual vertical perception.
Wei Wang,1,2 Yi Zhang,3 Runzi Wang,1,2 Yeshaswi Shrestha,1,2 Yawei Xu,3 Luying Peng,1,4,5 Jie Zhang,1,2 Jue Li,1,2 Lijuan Zhang1,2 1Key Laboratory of Arrhythmias of the Ministry of Education, Tongji University School of Medicine, Shanghai 200092, People’s Republic of China; 2Institute of Clinical Epidemiology and Evidence-Based Medicine, Tongji University School of Medicine, Shanghai 200092, People’s Republic of China; 3Department of Cardiology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, Shanghai 200072, People’s Republic of China; 4Department of Pathology and Pathophysiology, Tongji University School of Medicine, Shanghai 200092, People’s Republic of China; 5Research Center for Translational Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, People’s Republic of ChinaCorrespondence: Jue Li; Lijuan ZhangKey Laboratory of Arrhythmias of the Ministry of Education, Tongji University School of Medicine, Shanghai 200092, People’s Republic of ChinaTel/fax +86 21 65985195Email jueli@tongji.edu.cn; zhangxiaoyi@tongji.edu.cnPurpose: Left ventricular diastolic dysfunction with preserved ejection fraction (LVDD-PEF) is an early-stage manifestation but poorly understood in the process of heart failure. This study was designed to investigate risk factors and epigenetic markers for predicting LVDD-PEF.Patients and methods: A community-based study in 1568 residents over 65 years was conducted in Shanghai, People’s Republic of China, from June 2014 to August 2015. Echocardiography was performed to diagnose LVDD-PEF. DNA methylation by whole-genome bisulfite sequencing was used to determine those potential epigenetic markers contributing to LVDD-PEF.Results: A total of 177 participants (11.3%) were diagnosed with LVDD-PEF, and higher prevalence in females than in males (15.0% vs 6.5%, P<0.001). Multivariate logistic regression analysis indicated that female sex (OR 2.46, 95% CI 1.47–4.13), body mass index (BMI) (OR 1.09, 95% CI 1.04–1.14), pulse pressure (PP) (OR 1.03, 95% CI 1.01–1.05) and carotid intima-media thickness (CIMT) (OR 4.20, 95% CI 1.40–12.55) showed a significant association with LVDD-PEF. Overall, 638 CpG sites were differentially methylated in LVDD-PEF group compared to non-LVDD-PEF group (P<0.001); 242 sites were significantly hypermethylated (covering 238 genes) and 396 sites were significantly hypomethylated (covering 265 genes).Conclusion: Our findings found female, BMI, PP, and CIMT were independent predictors for LVDD-PEF in the community-dwelling elderly population. Regulation of DNA methylation might play a crucial role for LVDD-PEF.Keywords: left ventricular diastolic dysfunction, DNA methylation, risk factor