郑州市社区老年人衰弱及认知衰弱现状研究

目的 分析郑州市社区老年人衰弱及认知衰弱现状并探讨其影响因素。方法 2020年8—12月采用方便抽样方法分别在郑州市下辖区、县和代管县级市的其中1个社区服务中心设立调查项目志愿者招募点招募≥60岁居民进行调查。采用Fried衰弱表型（FP）、临床痴呆评定量表（CDR）、中文版蒙特利尔认知评估量表（MoCA）等进行衰弱及认知衰弱评估,对≥60岁居民衰弱及认知衰弱现状进行描述性分析,并采用单、多因素分析方法对衰弱及认知衰弱影响因素进行分析。结果 最终纳入2 596名社区老年人进行调查分析,男性1 391人,女性1 205人。年龄60~86岁,以60~69岁所占比例最大,占38.0%。衰弱247例（9.5%）、衰弱前期614例（23.7%）;认知衰弱169例,发生率为6.5%。多因素Logistic回归分析结果显示,年龄越大（OR=2.563）、BMI≥28.0 kg/m²（OR=2.447）、有基础疾病（OR=2.765）是社区老年人衰弱的危险因素,与配偶和（或）子女居住（OR=0.442、0.575）、体育锻炼>3次/周（OR=0.629）是社区老年人衰弱的保护因素;有基础疾病（OR=2.743）是社区老年人认知衰弱的危险因素,受教育年限越长（OR=0.388）、与配偶和（或）子女居住（OR=0.452、0.612）、体育锻炼>3次/周（OR=0.429）是社区老年人认知衰弱的保护因素。结论 郑州市社区老年人衰弱及认知衰弱较为常见,其发生受多种因素影响,需要关注高危人群并针对性采取有效的干预措施,减少或延缓社区老年人衰弱及认知衰弱的发生,提升社区老年人生活质量。     

睡眠质量对社区老年人认知衰弱影响的归因分析

目的 探究睡眠质量和睡眠时长对社区老年人认知衰弱的作用大小。方法 采用现况调查方法,利用匹兹堡睡眠质量指数量表(Pittsburgh Sleep Quality Index, PSQI)评估老年人的睡眠质量,中文版AscertainDementia-8(AD-8)量表评估认知状态,Frail衰弱量表评估躯体衰弱。采用logistic回归分析和多因素调整的人群归因危险度分析睡眠对认知衰弱的作用大小。结果 本研究共调查955名社区老人受试者,男性425名(44.5%),女性530名(55.5%)。认知衰弱的检出率为8.7%,睡眠障碍的检出率为24.5%。在调整性别、年龄、BMI、婚姻、体育锻炼、午睡、慢性病、身体疼痛、抑郁、焦虑等混杂因素后,睡眠障碍(OR=1.891,95%CI:1.087～3.291)和睡眠时间<6 h(OR=1.859, 95%CI:1.044～3.312)的老年人更易发生认知衰弱,认知衰弱的发生风险随着PSQI得分增加而逐渐上升。睡眠质量和睡眠时长对于认知衰弱人群归因危险度分别为25.53%和23.95%。结论 社区老年人睡眠质量与认知衰弱程度相关,睡眠质量差...     

中国老年人衰弱状况与社会参与及其交互作用对抑郁影响研究

目的 了解我国老年人衰弱状况与社会参与及其交互作用对抑郁影响。方法 收集2018年中国健康与养老追踪调查数据（CHARLS）中4 521名≥60岁老年人相关数据,采用logistic回归分析老年人抑郁的影响因素,并将衰弱状况和社会参与作为2个交互项,调整混杂因素,评价衰弱状况和社会参与交互作用对老年人抑郁的影响。结果 有抑郁症状者1 414人（31.27%）。抑郁与非抑郁老年人在性别（χ2 = 49.237,P＜0.001）、年龄（χ2 = 119.612,P＜0.001）、婚姻状况（χ2 = 14.016,P＜0.001）、文化程度（χ2 = 50.851,P＜0.001）、居住地（χ2 = 32.584,P＜0.001）方面有统计学差异。控制混杂因素后,多因素logistic回归分析结果显示,社会隔离(OR = 2.457,95%CI:1.384～3.532)和衰弱前期(OR = 1.201,95%CI:1.121～1.289)、衰弱(OR = 1.860,95%CI:1.290～1.976)是老年人抑郁发生的影响因素。交互作用结果显示,衰弱与社会隔离对老年人抑郁发生存在相乘(P交互＜0.001)和相加交互作用(OR = 7.715,95%CI:5.426～12.062),RERI(95%CI)、API(95%CI)、Index S(95%CI)分别为1.137(0.252～1.807)、0.316(0.158～0.476)、3.972(1.639～4.665)。结论 衰弱和社会隔离是老年人抑郁的危险因素且二者存在交互作用。     

贵州省布依族地区老年人认知衰弱现况及影响因素研究

目的了解贵州省布依族地区老年人认知衰弱的流行及影响因素,为预防老年人认知衰弱提供依据。方法于2019年7-8月采用多阶段整群随机抽样方法,抽取贵州省黔南州贵定县和贵阳市花溪区布依族聚居地区≥60岁的1652名老年人为研究对象,进行问卷调查、体格检查和实验室检测。使用简易精神状态检查量表和衰弱表型评估工具调查研究对象认知衰弱的患病情况。采用SPSS 17.0软件进行χ²检验和趋势χ²检验,采用多因素logistic回归分析认知衰弱的影响因素。结果1652名老年人中患认知衰弱为55人,患病率为3.3%。男性认知衰弱患病率(2.3%)低于女性(4.1%),差异有统计学意义(P<0.05);认知衰弱患病率随年龄增加而增加,差异有统计学意义(P<0.01)。多因素logistic回归分析结果显示,家庭年收入较高(OR=0.229,95%CI:0.086~0.614)和有兴趣爱好(OR=0.385,95%CI:0.194~0.764)与老年人认知衰弱患病低风险相关;高密度脂蛋白胆固醇水平异常(OR=2.564,95%CI:1.161~5.660)与老年人认知衰弱患病高风险相关。结论贵州省布依族老年人认知衰弱流行率不高,家庭经济状态差、无兴趣爱好和血脂异常的老年人为高危人群,老年人应积极参与社会活动和控制血脂异常以预防认知衰弱。     

山西省农村老年人认知衰弱现状及与老化期望的相关分析

目的 调查山西省汾阳市农村老年人认知衰弱现状，并分析认知衰弱与老化期望的关系。方法 采用方便抽样法于2021年11月—2022年2月选取山西省汾阳市农村247例老年人为调查对象，采用一般资料调查表、衰弱表型、简易精神状态检查量表及老化期望-12量表对其进行调查，并对数据进行分析。结果 山西省汾阳市农村247例老年人认知衰弱发生率为39.7%。老化期望总分[M(P₂₅,P₇₅)]为26(20,29)分，其中身体健康、精神健康和认知功能期望维度得分分别为8(6,8)、10(8,11)和8(6,10)分。不同年龄、文化程度、婚姻状况、吸烟史、查尔森共病指数、抑郁状况、日常生活能力老年人的认知衰弱情况差异均有统计学意义(均P<0.05)。认知衰弱与老化期望得分呈负相关(r=-0.555,P<0.01)。高龄、日常生活能力中重度依赖和抑郁均是农村老年人认知衰弱的危险因素(均P<0.05)，而高水平老化期望为保护因素(P<0.01)。结论 山西省汾阳市农村老年人认知衰弱发生率高，老化期望呈中等偏上水平。且认知衰弱与老化期望有关，应...     

贵州农村老年人可逆认知衰弱与日常生活功能受损、住院、跌倒的关联研究

目的 了解农村老年人可逆认知衰弱与日常生活功能受损、住院、跌倒的关联，为预防老年人发生功能残疾、住院等不良结局及促进健康老龄化提供参考。方法 采用现况调查设计，多阶段整群抽样方法，选取贵州省2个县（区）内12个村60岁及以上老年人为研究对象，进行问卷调查及体格检查。通过多因素logistic回归模型分析并计算比值比（OR）和95%置信区间（CI）分析可逆认知衰弱与ADL受损、住院、跌倒之间关联。结果 此次纳入老年人1 279人，可逆认知衰弱的检出率为37.8%,ADL受损率为4.3%，住院率为19.0%，半年内跌倒率为10.7%。多因素二分类logistic回归调整混杂因素后结果显示，与无可逆认知衰弱的老年人相比，有可逆认知衰弱的老年人ADL受损风险较高（OR=4.492,95%CI:2.405～8.389），与住院风险存在关联（OR=1.371,95%CI:1.020～1.841），但与跌倒风险没有关联（OR=0.897,95%CI:0.612～1.313）。进一步对慢性病分层分析发现，可逆认知衰弱与ADL受损的关联依然存在（P<0.05），可逆认知衰弱与住院风险的关联仅存在于...     

南京市维持性血液透析患者认知衰弱现状及其影响因素调查分析

目的 调查维持性血液透析患者认知衰弱现状,并分析其影响因素。方法 以2019年8月至2022年11月南京市3所医院维持性血液透析患者为研究对象,利用衰弱型量表、简易精神状态量表及临床痴呆评估量表对认知衰弱进行筛查,并对维持性血液透析患者认知衰弱进行描述性分析,采用单、多因素分析方法分析影响维持性血液透析患者认知衰弱的相关因素。结果 1 215例维持性血液透析患者中存在认知衰弱255例(20.99%),非认知衰弱960例(79.01%)。多因素logistic回归分析结果显示性别(OR=1.897)、年龄(OR=1.751)、人均月收入(OR=1.658)、透析龄(OR=2.210)、并发症(OR=1.965)、SDS评分(OR=1.782)均为影响维持性血液透析患者认知衰弱的独立危险因素,血清肌酐(Scr)为保护因素(OR=0.994)。结论 性别、年龄、人均月收入、透析龄、并发症、抑郁及Scr均为影响维持性血液透析患者中存在认知衰弱的独立因素。应多加关注以上患者并采取针对性的措施进行干预,从而降低维持性血液透析患者中认知衰弱的发生风险。     

广州市社区≥60岁人群衰弱现状及影响因素调查

目的 调查广州市老年人群衰弱现状并分析其影响因素。方法 采用便利抽样法对2019年1月至2020年12月广州市6个社区的1 400名老年人进行调查,利用自制一般资料调查问卷与衰弱评估表（FRAIL）,调查老年人一般人口学资料、个人生活习惯、健康状态及衰弱发生情况等,采用多因素非条件Logistic回归分析老年人衰弱的影响因素。结果 1 400名老年人中衰弱患病人数为185例,检出率为13.21%,衰弱前期检出率为59.36%。多因素Logistic回归分析结果显示,年龄80~89岁（OR=2.043）、抑郁（OR=2.694）、营养不良（OR=4.346）为老年人衰弱的危险因素,BMI≥24.0（OR=0.269）、有伴侣（OR=0.358）、文化程度是专科及以上（OR=0.342）为老年人衰弱的保护性因素。结论 广州市老年人群衰弱检出率较高,高龄、抑郁、营养不良可增加老年人群衰弱发生风险,高文化程度、高BMI、有伴侣可减少衰弱发生风险。可通过加强健康宣教、衰弱筛查、指导老年人加强运动锻炼、给予营养干预、心理疏导等措施预防老年衰弱及控制病情进展。     

中国老年人社会隔离对认知衰弱患病风险的影响

目的 探讨社会隔离对中国老年人认知衰弱患病风险的影响。方法 本研究选取2018年中国老年健康影响因素跟踪调查(CLHLS)的60岁及以上老年人作为研究对象，采用社会网络指数、简易精神状态评价量表(MMSE)和FRAIL量表分别评价社会隔离、认知功能和衰弱。采用logistic回归模型分析社会隔离对认知衰弱患病风险的影响。结果 共有15 572名老年人纳入本研究。中国老年人社会隔离发生率为30.5%,轻度认知障碍、衰弱与认知衰弱的发生率分别为28.4%、13.4%、7.6%。在控制了年龄、性别、户籍类型、文化程度、家庭经济状况、自评健康状况、吸烟、饮酒、体育锻炼、水果摄入、蔬菜摄入、饮茶后，社会隔离与老年人认知衰弱患病风险增加有关(OR=2.079,95%CI:1.779～2.430,P<0.001)。结论 社会隔离是我国老年人认知衰弱的重要危险因素，社区及医疗卫生工作者应积极关注老年人的社会关系网络，降低社会隔离发生率，从而降低认知衰弱的患病风险。     

社区老年人久坐行为、社会参与度与抑郁的关系研究

目的 调查社区老年人久坐行为、社会参与度与老年抑郁之间关系。方法 在2020年6月至8月间选择安徽省合肥市4个社区的632名60岁及以上的人群为调查对象,使用一般资料调查表、久坐行为自评问卷、社会活动参与频率问卷及病人健康问卷抑郁量表对目标人群进行问卷调查,使用Pearson相关分析和logistic回归分析探讨社区老年人久坐行为、社会参与度与抑郁的关系。结果 社区老年人每天久坐行为时间为（6.88±1.98）h,社会参与度得分为（15.53±3.79）分,抑郁的检出率为11.6%;社区老年人抑郁与久坐行为呈现正相关,与社会参与度呈现负相关（P<0.05）;logistic回归分析显示,在校正社会人口学等变量后,久坐行为是抑郁的危险性因素［OR=2.029,95%CI（1.689~2.439）;P<0.001］;社会参与度是社区老年人抑郁的保护性因素［OR=0.795,95%CI（0.721~0.877）;P<0.001］。结论 社区老年人久坐行为水平普遍较高,久坐行为及社会参与度是老年人抑郁患病风险的重要影响因素,社区卫生保健人员可通过干预老年人群的久坐时长,鼓励老年人群多参与社会交往频率从而减少抑郁的患病风险。     

Frailty Severity and Cognitive Impairment Associated with Dietary Diversity in Older Adults in Taiwan

This study aims to investigate whether frailty severity in conjunction with cognitive function, termed as” cognitive frailty”, is associated with dietary diversity in older adults. This cross-sectional study used the data from the 2014–2016 Nutrition and Health Survey in Taiwan (N = 1115; age ≥ 65 years). Dietary intake was assessed using a 24 h dietary recall and food-frequency questionnaire, and dietary diversity score (DDS; range, 0–6) and food intake frequency were calculated. The presence of frailty phenotypes was determined using the FRAIL scale, which was proposed by the International Association of Nutrition and Aging, and cognitive function was assessed using the Mini–Mental State Examination (MMSE) score. The prevalence of cognitive frailty (FRAIL scale score ≥ 3 and MMSE score ≤ 26) was 4.2%. A higher consumption frequency of dairy products, whole grains, vegetables, fruit, fish and seafood, nuts, tea, and coffee, as well as lower pickled vegetable, was inversely associated with cognitive frailty. Those with prefrailty or frailty and lower DDS demonstrated a higher cognitive impairment risk (adjust odds ratio (OR) = 2.15, 95% confidence interval = 1.21–3.83) than those without frailty and higher DDS. Older adults with cognitive prefrailty or cognitive frailty were associated with lower DDS, and frailty with lower DDS was associated with worsening cognitive function.     

Association of Frailty Status and Dietary Patterns in a Nationally Representative Sample of United States Adults with Olfactory Dysfunction

Background: Olfactory dysfunction (OD) is a strong, independent predictor of frailty and mortality risk. This study evaluated the association of dietary patterns and frailty status in older adults with OD. Methods: This cross-sectional study utilized the 2013–2014 National Health and Nutrition Examination Survey. Dietary patterns (DPs) characteristic of OD were derived using exploratory factor analysis (EFA). Multiple logistic regressions adjusted for demographics and frailty risk factors assessed the association of DPs with two frailty metrics: the frailty index (FI) and physical frailty (PF). Results: EFA yielded six distinct DPs in persons with OD. The protein/selenium (OR 0.82 [95% CI 0.74–0.92], p = 0.041) and β-carotene/vitamin A DPs (OR 0.76 [95% CI 0.66–0.88], p = 0.028) were independently associated with frailty by FI. Only the protein/selenium DP (OR 0.82 [95% CI 0.74–0.92], p = 0.036) was associated with frailty by PF. No DPs were associated with either frailty measure in normosmic persons. Conclusions: Dietary patterns high in protein/selenium and β-carotene/vitamin A are associated with lower frailty prevalence in adults with OD. While the relationship between OD and frailty is likely multifaceted, these findings suggest that dietary patterns are uniquely associated with frailty in older adults with OD.     

Cognitive Frailty as a Predictor of Future Falls in Older Adults: A Systematic Review and Meta-Analysis

ObjectivesTo examine the association between cognitive frailty and the risk of future falls among older adults.DesignSystematic review and meta-analysis.Setting and ParticipantsOlder people aged ≥60 years with cognitive frailty from community, hospital, or both.MethodsPubMed, EMBASE, Web of Science, the Cochrane Library, Wanfang Database, China Knowledge Resource Integrated Database (CNKI), Weipu Database (VIP), and Chinese Biomedical Database (CBM) were searched for relevant studies published from the inception of the database until June 14, 2022. Stata 16.0 software was used to perform the meta-analysis. A random effects model was used to pool the prevalence of falls in older adults over age 60 years with cognitive frailty and the strength of the association between cognitive frailty and falls [odds ratios (ORs) and 95% CIs]. Quality assessment, heterogeneity, and sensitivity analyses were also conducted. A study protocol was registered in PROSPERO (CRD42022331323).ResultsThe review included 18 studies in qualitative synthesis, 14 of which were in meta-analysis. Eleven sets of cross-sectional data involving 23,025 participants and 5 sets of longitudinal data involving 11,924 participants were used in the meta-analysis. The results showed that the overall prevalence of falls in 1742 people with cognitive frailty was 36.3% (95% CI 27.9-44.8, I² = 93.4%). Longitudinal study results showed that cognitively frail individuals had a higher risk of falls (OR 3.02, 95% CI 2.11-4.32, I² = 0.0%, P = .406), compared to robust participants without cognitive impairment; physically frail people (alone) had a moderate risk of falls (OR 2.16, 95% CI 1.42-3.30, I² = 9.7%, P = .351); cognitively impaired people (alone) had a lower risk of falls (OR 1.36, 95% CI 1.03-1.79, I² = 0.0%, P = .440). Among cross-sectional studies, cognitive frailty was associated with the risk of falls (OR 2.74, 95% CI 2.20-3.40, I² = 53.1%, P = .019). Although high heterogeneity was noted among 11 cross-sectional studies reporting ORs, the sensitivity analysis showed that no single study significantly affected the final pooled results.Conclusions and ImplicationsThis systematic review and meta-analysis confirms the findings that cognitive frailty was demonstrated to be a significant predictor of future falls in older adults. However, further prospective investigations are warranted.     

Order of Onset of Physical Frailty and Cognitive Impairment and Risk of Repeated Falls in Community-Dwelling Older Adults

ObjectivesTo examine whether physical frailty onset before, after, or in concert with cognitive impairment is differentially associated with fall incidence in community-dwelling older adults.DesignA longitudinal observational study.Setting and ParticipantsData from 1337 older adults age ≥65 years and free of physical frailty or cognitive impairment at baseline were obtained from the National Health Aging Trends Study (2011‒2017), a nationally representative cohort study of US older adult Medicare beneficiaries.MethodsParticipants were assessed annually for frailty (physical frailty phenotype) and cognitive impairment (bottom quintile of clock drawing test or immediate and delayed recall; or proxy-report of diagnosis of dementia or AD8 score of ≥2). Incident falls were ascertained annually via self-report. Multinomial logistic regression was performed to estimate the association between order of first onset of cognitive impairment and/or frailty and incident single or repeated falls in the 1-year interval following their first onset.ResultsOf the 1,337, 832 developed cognitive impairment first (termed “CI first”), 286 developed frailty first (termed “frailty first”) and 219 had co-occurrence of cognitive impairment and frailty within one year (termed “CI-frailty co-occurrence”) over 5 years. Overall, 491 (34.5%) had at least 1 fall during the 1-year interval following the onset of physical frailty and/or cognitive impairment. After adjustment, “CI-frailty co-occurrence” was associated with a more than 2-fold increased risk of repeated falls than “CI first” (odds ratio 2.35, 95% confidence interval 1.51‒3.67; P < .001). No significant difference was found between participants with “frailty first” and “CI first” (P = .07). In addition, the order of onset was not associated with risk of a single fall.Conclusions and ImplicationsOlder adults experiencing “CI-frailty co-occurrence” had the greatest risk of repeated falls compared with those with “CI first” and “frailty first”. Fall risk screening should consider the order and timing of onset of physical frailty and cognitive impairment.     

Association Between Frailty and Cognitive Impairment: Cross-Sectional Data From Toulouse Frailty Day Hospital

Background

A consensus panel, based on epidemiologic evidence, argued that physical frailty is often associated with cognitive impairment, possibly because of common underlying pathophysiological mechanisms. The concepts of cognitive frailty and motoric cognitive risk were recently proposed in literature and may represent a prodromal stage for neurodegenerative diseases. The purpose of this study was to analyze the relationship between cognition and the components of the physical phenotype of frailty.

The Influence of Dysphagia on Nutritional and Frailty Status among Community-Dwelling Older Adults

Malnutrition is a core symptom of the frailty cycle in older adults. The purpose of this study was to investigate whether dysphagia influences nutrition or frailty status in community-dwelling older adults. The study participants were 320 Japanese community-dwelling older adults aged ≥65 years. All participants completed a questionnaire survey that included items on age, sex, family structure, self-rated health, nutritional and frailty status, and swallowing function. Nutritional status was categorized as malnourished, at risk of malnutrition, and well-nourished based on the Mini Nutrition Assessment-Short Form. The participants were then classified into a malnutrition (malnourished/at risk) or a well-nourished group (well-nourished). Frailty was assessed using the Cardiovascular Health Study criteria. The participants were then divided into a frailty (frail/pre-frail) or a non-frailty group (robust). Dysphagia was screened using the 10-item Eating Assessment Tool. Multiple logistic regression analysis was conducted to determine whether dysphagia was associated with nutritional or frailty status. The results revealed that dysphagia influenced both nutrition (odds ratio [OR]: 4.0; 95% confidence interval [CI]: 1.9–8.2) and frailty status (OR: 2.3; 95% CI: 1.0–5.2); therefore, the swallowing function would be an important factor for community-dwelling older adults on frailty prevention programs.     

Prevalence and risk factors of the co-occurrence of physical frailty and cognitive impairment in Chinese community-dwelling older adults

This cross-sectional study aimed to determine the prevalence of the co-occurrence of physical frailty and cognitive impairment and to identify its associated demographic, psychosocial and behavioural factors. Participants were recruited from 32 neighbourhoods using multistage sampling method in Xuhui District, Shanghai, China. A total of 1585 older adults were included who lived in community, were 75 years or older and without a clinical diagnosis of dementia. Based on the presences of frailty (using the modified frailty phenotype criteria) and/or cognitive impairment (using Chinese version Mini-Mental Status Examination stratified by educational level), the participants were classified into four groups: normal, cognitive impairment alone, frailty alone and co-occurrence. Multinomial logistic regression analyses were conducted to identify the demographic, psychosocial (depression, social participation and social support) and behavioural (sedentary lifestyle and sleep problems) characteristics associated with the co-occurrence of physical frailty and cognitive impairment. The prevalence of frailty alone, cognitive impairment alone and the co-occurrence of physical frailty and cognitive impairment in the study sample were 7%, 26.94% and 7.19% respectively. The results of multinomial logistic regression show the following characteristics significantly associated with the co-occurrence of physical frailty and cognitive impairment: advanced age (81–85 years old, Odds Ratio, OR = 1.99, 95% CI = 1.10–3.59; 86 years or older, OR = 6.43, 95% CI = 3.66–11.29), number of co-morbidities (OR = 1.34, 95% CI = 1.01–1.77), depression (OR = 3.88, 95% CI = 2.39–6.29), social participation (OR = 0.61, 95% CI = 0.39–0.96), sedentary lifestyle (OR = 2.69, 95% CI = 1.66–4.34) and sleep problems (insomnia occasionally, OR = 1.84, 95% CI = 1.07–3.17; insomnia every day, OR = 2.38, 95% CI = 1.33–4.26). The co-occurrence of physical frailty and cognitive impairment is a prevalent health issue in oldest old community-dwelling older adults. Advanced age, co-morbidity, depression, sedentary lifestyle and sleep problems are risk factors for cognitive frailty while good social participation may have a protective effect on it.     

我国老年人认知衰弱转移规律及其影响因素研究

目的:了解我国老年人认知衰弱转移规律及其影响因素,为制定认知衰弱早期干预措施提供科学依据。方法:利用中国健康与养老追踪调查2011、2013和2015年3期数据,将个体健康状态划分为健壮-认知正常、认知障碍、躯体衰弱、认知衰弱4种,构建多状态Markov模型,探索认知衰弱转移规律及其影响因素。结果:共纳入3 470例老...