Almar A L Kok, Martijn Huisman, Erik J Giltay, Gabriela Lunansky
{"title":"Adopting a complex systems approach to functional ageing: bridging the gap between gerontological theory and empirical research.","authors":"Almar A L Kok, Martijn Huisman, Erik J Giltay, Gabriela Lunansky","doi":"10.1016/j.lanhl.2024.100673","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100673","url":null,"abstract":"<p><p>Functional ageing, related to but distinct from biological and environmental systems, is defined as the changes in physical, psychological, cognitive, and social functioning, as well as behavioural factors of individuals as they age. In this Personal View, we propose that a complex systems perspective to functional ageing can show how outcomes such as quality of life and longevity, and success in prevention and treatment, emerge from dynamic interactions among these domains, rather than from single causes. We support this view in three ways. First, we explain how three key principles of complex systems science-namely, resilience, non-linearity, and heterogeneity-apply to functional ageing. Second, we show how established gerontological theories and geriatric models align with these principles. Third, we illustrate the use of novel methodological tools available from complex systems science for studying functional ageing. Finally, we offer a glossary of key concepts and recommendations for researchers to adopt this perspective in future studies on functional ageing.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100673"},"PeriodicalIF":13.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sunyoung Kim, Soeun Kim, Selin Woo, Jiyeon Oh, Yejun Son, Louis Jacob, Pinar Soysal, Jungha Park, Liang-Kung Chen, Dong Keon Yon
{"title":"Temporal trends and patterns in mortality from falls across 59 high-income and upper-middle-income countries, 1990-2021, with projections up to 2040: a global time-series analysis and modelling study.","authors":"Sunyoung Kim, Soeun Kim, Selin Woo, Jiyeon Oh, Yejun Son, Louis Jacob, Pinar Soysal, Jungha Park, Liang-Kung Chen, Dong Keon Yon","doi":"10.1016/j.lanhl.2024.100672","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100672","url":null,"abstract":"<p><strong>Background: </strong>Deaths related to falls are a substantial public health problem worldwide, and insight into trends and differences in global fall-related deaths can be valuable for identifying prevention strategies and developing effective policies. Thus, we aimed to estimate global fall-related mortality rate trends and forecast future fall-related deaths.</p><p><strong>Methods: </strong>In this global time-series analysis and modelling study, we investigated temporal trends in fall-related mortality rates from 1990 to 2021 using the WHO Mortality Database, following the GATHER guidelines, and forecasted trends until 2040 across 59 high-income and upper-middle-income countries. We focused on identifying specific patterns of variation in mortality rates across different age groups, sexes, and income levels based on World Bank country classification. We analysed temporal trends and patterns using a locally weighted scatter plot smoother curve presented by age-standardised mortality rates (ASMRs), and future projections were calculated based on Bayesian age-period-cohort analysis. We performed a decomposition analysis to identify variations in fall-related deaths by examining factors such as population growth, ageing, and epidemiological changes.</p><p><strong>Findings: </strong>Fall-related mortality rates per 100 000 people declined from 23·21 (95% CI 21·30 to 25·12) in 1990 to 11·01 (9·94 to 12·08) in 2009, increasing to 12·50 (10·36 to 14·64) by 2021. Throughout the period from 1990 to 2021, fall-related mortality rates were consistently higher among men, individuals in high-income countries, and older adults. The results represent a clear pattern in fall-related mortality rates according to sex, income level, and age group. ASMRs exhibited varying patterns, with an initial decrease of 43·83% (from 11·54 [95% CI 9·33 to 13·76] in 1990 to 6·48 [95% CI 5·28 to 7·68] in 2005) in upper-middle-income countries with a subsequent rise of 49·69% to 9·70 (9·33 to 13·76) in 2021, with a 17·81% increase among women (from 9·04 in 2009 to 10·65 in 2021), and with a 1434·8% increase in individuals aged 85 years and older (from 5·00 [-4·94 to 14·94] in 1992 to 76·74 [62·10 to 91·39] in 2021). Furthermore, ASMRs showed a positive correlation with Socio-demographic Index (β=42·29 [10·26 to 74·32]; p<0·011), the Environmental Performance Index (β=0·19 [0·05 to 0·33]; p=0·0090), and the reverse Gini coefficient (β=22·58 [0·45 to 44·72]; p=0·046). Projections indicate that the fall-related mortality rate is expected to rise from 14·80 (95% credible intervals, 14·04 to 15·59) per 100 000 people in 2021 to 19·48 (7·02 to 98·84) by 2040. The increase in fall-related deaths from 1990 to 2040 can be attributed to the growth in population, because the absolute number of fall-related deaths has risen despite a declining rate.</p><p><strong>Interpretation: </strong>Temporal trend in fall-related deaths declined from 1990 to 2009, followed by an increase in","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100672"},"PeriodicalIF":13.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Olivia Monton, Emmanuel F Drabo, Shannon Fuller, Fabian M Johnston
{"title":"Merits of the social return on investment methodology for assessing the value of palliative care programmes.","authors":"Olivia Monton, Emmanuel F Drabo, Shannon Fuller, Fabian M Johnston","doi":"10.1016/j.lanhl.2024.100669","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100669","url":null,"abstract":"<p><p>Despite the widely accepted benefits of palliative care for individuals with serious illnesses and their families, the utilisation of this approach remains low. Although an increased use of palliative care services can increase the value of health-care spending by providing comprehensive wraparound services to support care, the economic evidence required to implement, promote, and engage in palliative care models on a wide scale eludes the affected individuals, health-care providers, payers, and policy makers. This gap in evidence is partly owing to the methodological limitations of standard value-assessment frameworks, which do not capture important societal dimensions of the value generated by palliative care. This Personal View proposes the adoption of value-assessment frameworks that incorporate broader dimensions of social value into the evaluation of palliative care programmes. We focus on the social return on investment methodology as an example of a value-assessment framework that can complement standard frameworks to better capture the social impact and all-around benefits of palliative care.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100669"},"PeriodicalIF":13.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dannii Yuen-Lan Yeung, Da Jiang, Lisa Marie Warner, Namkee G Choi, Rainbow Tin Hung Ho, Jojo Yan Yan Kwok, Kee-Lee Chou
{"title":"The effects of volunteering on loneliness among lonely older adults: the HEAL-HOA dual randomised controlled trial.","authors":"Dannii Yuen-Lan Yeung, Da Jiang, Lisa Marie Warner, Namkee G Choi, Rainbow Tin Hung Ho, Jojo Yan Yan Kwok, Kee-Lee Chou","doi":"10.1016/j.lanhl.2024.100664","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100664","url":null,"abstract":"<p><strong>Background: </strong>Previous randomised controlled trials have largely relied on self-reported volunteer work to assess the effects of volunteering and have rarely provided structured volunteering activities during the intervention period. The present study aimed to investigate the effects of social volunteering work over 12 months on loneliness among older adults during the COVID-19 pandemic.</p><p><strong>Methods: </strong>A dual randomised controlled trial was done in Hong Kong to investigate the long-term effects of telephone-delivered psychosocial interventions by older Chinese volunteers who were screened as lonely, for older adult recipients who had low income, lived alone, felt lonely, and were digitally excluded. Participants were included if they were aged 50-70 years; had provided consent to be trained and serve as a volunteer for at least 2 h per week for 6 months; had at least 3 years of secondary school education; had no severe self-reported physical, mental, or cognitive health problems; were not working full or part-time; had engaged in formal volunteering fewer than four times within the past year; and were lonely (ie, had a score of at least 6 on the three-item UCLA Loneliness Scale). Participants were allocated into either the volunteering or control group (psychoeducation programme) using a random number method. The details of group allocation were concealed as the research assistant responsible for randomisation was different to the research assistants responsible for recruitment and assessments (who were masked to the condition). Following a 6-week training, the volunteers delivered a psychosocial intervention to older intervention recipients for 6 months. The primary outcome was loneliness measured with the 20-item UCLA Loneliness Scale and the De Jong Gierveld (DJG) Loneliness Scales at 6 months and 12 months. Assessments were performed before training (baseline; T1), at 6 months (T2), and at 12 months after training (T3). The intention-to-treat principle was used to compare the effects of volunteering between the two groups. The trial was registered in the Clinical Trials Registry of the University of Hong Kong Clinical Trials Centre (HKUCTR-2929). This trial has completed.</p><p><strong>Findings: </strong>Between May 3, 2021, and Oct 6, 2022, a total of 375 individuals were recruited to the trial, including 84 males (22%) and 291 females (78%). 185 were randomly assigned to the volunteering group (56 to deliver a mindfulness intervention, 65 to deliver a behavioural activation intervention, and 64 to deliver a befriending intervention) and 190 were assigned to the control group. 311 (83%) of 375 participants were 60 years or older (median 64 years [SD 4·86]). Participants in the volunteering group reported a significantly lower level of loneliness at T2 (d<sub>ppc2</sub> ranged from -0·41 to -0·70) compared with T1 than participants in the control condition. There was a significant decrease in loneliness meas","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100664"},"PeriodicalIF":13.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Risk prediction for health outcomes in type 2 diabetes: utility of a polysocial risk score?","authors":"Frank Qian, Samia Mora","doi":"10.1016/j.lanhl.2024.100677","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100677","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100677"},"PeriodicalIF":13.4,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elburg van Boetzelaer, Lekha Rathod, Patrick Keating, Umberto Pellecchia, Sunita Sharma, Jason Nickerson, Judith van de Kamp, Oscar H Franco, James Smith, Favila Escobio, Joyce L Browne
{"title":"Health needs of older people and age-inclusive health care in humanitarian emergencies in low-income and middle-income countries: a systematic review.","authors":"Elburg van Boetzelaer, Lekha Rathod, Patrick Keating, Umberto Pellecchia, Sunita Sharma, Jason Nickerson, Judith van de Kamp, Oscar H Franco, James Smith, Favila Escobio, Joyce L Browne","doi":"10.1016/j.lanhl.2024.100663","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100663","url":null,"abstract":"<p><p>Health needs of older people in humanitarian settings are poorly documented, negatively affecting the appropriateness of health services they receive. This Review identified the major health needs of older people across humanitarian contexts, including non-communicable diseases and mental health conditions (eg, psychological distress and depression). Barriers to health care of older people included inaccessibility of health-care services; shortage of appropriate health care; insufficient availability of medications and medical equipment; poor geriatric expertise of health-care staff, health policy makers, and health authorities; and age discrimination by health-care personnel. Individual factors included low mobility, poor health literacy, dependence on others for access to care, and self-directed ageism. The participation of older people in shaping health-care services was highlighted as a facilitator of age-inclusive care. Several understudied areas related to the health needs of older people in humanitarian emergencies in low-income and middle-income countries were exposed. We urge governments, academic institutions, humanitarian organisations, and other health-care providers to focus their response and research efforts on the health needs of older people in conflict settings; the health needs of older people in humanitarian emergencies in understudied regions; and on neglected issues such as communicable diseases, cancer, neurocognitive disorders, sexual and reproductive health, genitourinary conditions, and nutrition. The participation of older people in the design, implementation, and evaluation of health-care services is essential to ensure accessibility, appropriateness, and acceptability of care.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100663"},"PeriodicalIF":13.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel Germán Borda, Francesco Landi, Tommy Cederholm, Luis Carlos Venegas-Sanabria, Gustavo Duque, Hidetaka Wakabayashi, George E Barreto, Isabel Rodriguez-Sanchez, Marco Canevelli, Carlos Cano-Gutierrez, Mario Ulises Pérez-Zepeda, Lindsay Wallace, Kenneth Rockwood, Mario Salas-Carrillo, Martha Gjestsen, Ingelin Testad, Clive Ballard, Dag Aarsland
{"title":"Assessment and management of frailty in individuals living with dementia: expert recommendations for clinical practice.","authors":"Miguel Germán Borda, Francesco Landi, Tommy Cederholm, Luis Carlos Venegas-Sanabria, Gustavo Duque, Hidetaka Wakabayashi, George E Barreto, Isabel Rodriguez-Sanchez, Marco Canevelli, Carlos Cano-Gutierrez, Mario Ulises Pérez-Zepeda, Lindsay Wallace, Kenneth Rockwood, Mario Salas-Carrillo, Martha Gjestsen, Ingelin Testad, Clive Ballard, Dag Aarsland","doi":"10.1016/j.lanhl.2024.100666","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100666","url":null,"abstract":"<p><p>Frailty complicates the care of individuals with dementia, increasing their vulnerability to adverse outcomes. This Personal View presents expert recommendations for managing frailty in individuals with dementia, aimed at health-care providers, particularly those in primary care. We conducted a rapid literature review followed by a consensus process involving 18 international experts on dementia and frailty. The experts identified key areas, including diagnosis of frailty, assessment of nutritional status and nutritional management, physical activity, prevention of falls, and polypharmacy management. The recommendations emphasise early identification of frailty and a comprehensive, interdisciplinary approach to care that aims to maintain the individual's daily functioning, quality of life, and independence. The recommendations highlight the importance of tailored interventions, regular monitoring, and the integration of psychosocial support into the therapeutic approach. These recommendations address a crucial gap in existing clinical guidelines, offering practical guidance for clinicians managing frailty in individuals with dementia.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100666"},"PeriodicalIF":13.4,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}