Lancet Healthy Longevity最新文献

{"title":"Gynaecological health of women in nursing homes.","authors":"Gaëlle Berhault-Delinde, Moustapha Drame, Maturin Tabue-Teguo","doi":"10.1016/j.lanhl.2025.100721","DOIUrl":"https://doi.org/10.1016/j.lanhl.2025.100721","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100721"},"PeriodicalIF":13.4,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095185","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":"Physical activity, sedentary behaviour, and intrinsic capacity at older ages: get active!","authors":"Lina Ma","doi":"10.1016/j.lanhl.2025.100687","DOIUrl":"10.1016/j.lanhl.2025.100687","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100687"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144018","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":"Sex and socioeconomic differences in 15-year prevalence trends for modifiable dementia risk factors in Australia: a cross-sectional, time series analysis","authors":"Heidi J Welberry PhD ,&nbsp;Prof Louisa R Jorm PhD ,&nbsp;Kim M Kiely PhD ,&nbsp;Hamidul Huque PhD ,&nbsp;Prof Ruth Peters PhD ,&nbsp;Prof Kaarin J Anstey PhD","doi":"10.1016/j.lanhl.2025.100711","DOIUrl":"10.1016/j.lanhl.2025.100711","url":null,"abstract":"<div><h3>Background</h3><div>Potentially modifiable risk factors could account for approximately 45% of dementia cases globally. For targeted prevention, understanding population-specific patterns of risk is essential. We aimed to track changes in dementia prevalence across Australia, and calculate population attributable fractions of dementia, for 12 risk factors (ie, low education, hypertension, obesity, high cholesterol, smoking, high alcohol intake, poor diet, physical inactivity, hearing loss, depression, diabetes, and social isolation).</div></div><div><h3>Methods</h3><div>In this cross-sectional, time series analysis we calculated the prevalence of dementia using five national Australian health surveys from 2007–08 to 2022. Adjusted prevalence ratios and combined population attributable fractions were estimated. Population subgroups were defined by sex and socioeconomic disadvantage (lowest 40% household income <em>vs</em> highest 60%). Results were disaggregated by life-stage (mid-life aged 45–64 years and late life aged 65–84 years).</div></div><div><h3>Findings</h3><div>In mid-life, the sample sizes ranged from 4100 in 2022 to 5589 in 2017–18 and in late-life from 2799 in 2011–12 to 3762 in 2017–18. Smoking, high alcohol intake, physical inactivity, hearing loss, and low education in mid-life decreased and obesity, depression, and poor diet increased; resulting in no change in population attributable fraction (47·2% [95% CI 46·5–48·0] in 2007–08 and 46·9% [45·9–47·7] in 2022). High alcohol intake, physical inactivity, and low education in late-life decreased; depression and poor diet increased; and there was no change in population attributable fraction (51·5% [50·9–52·5] in 2007–08 and 51·4% [50·7–52·4] in 2022). In mid-life, modifiable risk was higher among low-income groups and males and depression was the leading modifiable risk factor in 2022, disproportionately affecting low-income households and females.</div></div><div><h3>Interpretation</h3><div>The modifiable population attributable fraction of dementia in Australia in the past 15 years remained stable, but the profile of risk has changed. Low-income groups (compared with high-income groups) have substantially higher modifiable risk and targeted multidomain interventions could help reduce disparities.</div></div><div><h3>Funding</h3><div>National Health and Medical Research.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100711"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144162539","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":"The ethical allocation of dementia prevention responsibility","authors":"Gilbert Knaggs ,&nbsp;Joyce Siette","doi":"10.1016/j.lanhl.2025.100718","DOIUrl":"10.1016/j.lanhl.2025.100718","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100718"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043970","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":"Association between physical activity and sedentary behaviour and changes in intrinsic capacity in Spanish older adults (Seniors-ENRICA-2): a prospective population-based study","authors":"Juan Luis Sánchez-Sánchez PhD ,&nbsp;Rosario Ortolá MD PhD ,&nbsp;Prof Jose R Banegas MD PhD ,&nbsp;Prof Alejandro Lucia MD PhD ,&nbsp;Prof Fernando Rodríguez-Artalejo MD PhD ,&nbsp;Mercedes Sotos-Prieto PhD ,&nbsp;Pedro L Valenzuela PhD","doi":"10.1016/j.lanhl.2024.100681","DOIUrl":"10.1016/j.lanhl.2024.100681","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Intrinsic capacity—the composite of all the physical and mental capacities of an individual—has been proposed by WHO as a marker of healthy ageing. However, the association of movement behaviours (physical activity and sedentary behaviour) with intrinsic capacity remains largely unexplored. We aimed to prospectively analyse the association of movement behaviours with intrinsic capacity in older adults.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The Seniors-ENRICA-2 prospective, population-based study included a cohort of male and female community-dwelling older adults aged 65–94 years living in Spain. Accelerometer-based levels of sedentary, light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) were assessed at baseline. An intrinsic capacity composite score (with higher scores indicating higher intrinsic capacity) was calculated at baseline and at two follow-up assessments across six domains: vitality (handgrip strength, appetite, and weight loss), cognition (Mini-Mental State Examination), psychological (Geriatric Depression Scale), locomotion (Short Physical Performance Battery), vision, and hearing.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between Dec 2, 2015, and Nov 23, 2017, 3273 participants were recruited to the Seniors-ENRICA-2 study. 2477 (75·7%) of 3273 participants had complete data for movement behaviours and intrinsic capacity at baseline and were therefore included in the analyses. 1314 (53·0%) of 2477 participants were female and 1163 (47·0%) were male. 1463 (59·1%) of 2477 participants provided follow-up data over a median of 2·3 years (IQR 2·1 to 2·5) and 940 over 5·5 years (5·2 to 5·8). When analysed as a continuous variable, higher levels of MVPA (mean percentage change [MPC] per 15 min 0·63%, 95% CI 0·06 to 1·21), but not LPA (–0·39%,–0·85 to 0·07), were associated with improvements in intrinsic capacity during follow-up, whereas higher levels of sedentary behaviour were associated with declines in intrinsic capacity (–0·29%, –0·57 to –0·01). Analyses by tertiles of physical activity confirmed that the highest (MPC 4·83%, 95% CI 1·98 to 7·75) and intermediate (5·44%, 2·52 to 8·45) tertiles of MVPA were associated with improvements in intrinsic capacity compared with the lowest tertile. By contrast, compared with the highest tertile, the lowest (MPC 5·48%, 95% CI 2·88 to 8·02) and intermediate (5·73%, 3·16 to 8·22) tertiles of sedentary behaviour were associated with improvements in intrinsic capacity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Sedentary behaviour was associated with a reduction of intrinsic capacity, and MVPA (but not LPA) was associated with an improvement in intrinsic capacity in older adults. Our findings support the importance of promoting physical activity and reducing sedentary behaviour for healthy ageing.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, French Agence Nationale de la Recherch","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100681"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143859","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":"Blood biomarkers of Alzheimer’s disease and 12-year muscle strength trajectories in community-dwelling older adults: a cohort study","authors":"Alice M Ornago MD ,&nbsp;Elena Pinardi MD ,&nbsp;Giulia Grande PhD ,&nbsp;Martina Valletta MD ,&nbsp;Amaia Calderón-Larrañaga PhD ,&nbsp;Sarah Andersson MSc ,&nbsp;Riccardo Calvani PhD ,&nbsp;Anna Picca PhD ,&nbsp;Emanuele Marzetti PhD ,&nbsp;Prof Bengt Winblad PhD ,&nbsp;Claudia Fredolini PhD ,&nbsp;Prof Giuseppe Bellelli MD ,&nbsp;Davide L Vetrano PhD","doi":"10.1016/j.lanhl.2025.100715","DOIUrl":"10.1016/j.lanhl.2025.100715","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Age-related muscle function decline is a major impediment to healthy ageing. We aimed to investigate the association between a panel of Alzheimer’s disease-related biomarkers and longitudinal trajectories of muscle strength, while exploring the influence of cognitive function.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this cohort study, we gathered data from the Swedish National study on Aging and Care in Kungsholmen (SNAC-K), an ongoing prospective study that includes adults aged 60 years and older, from central Stockholm, Sweden. We included data from baseline to the fourth follow-up (March 21, 2001, to Dec 31, 2016). Seven Alzheimer’s disease-related blood biomarkers were measured in dementia-free, community dwelling participants: total tau, phosphorylated tau181 (p-tau181), phosphorylated tau217 (p-tau217), amyloid β 40 and 42, neurofilament light chain, and glial fibrillary acidic protein (GFAP). Muscle strength was measured through the handgrip strength and chair-stand tests. Linear mixed models were used to explore the association between baseline Alzheimer’s disease-related biomarkers and muscle strength trajectories.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The baseline SNAC-K cohort included 3363 individuals, of whom 1953 participants were included in our analyses (mean age 70·2 [SD 9·1] years; 780 [39·9%] male and 1173 [60·1%] female participants). In adjusted models, higher concentrations of p-tau181 (β per year 0·93 [95% CI 0·71 to 1·16]; p&lt;0·0001), p-tau217 (β per year 1·31 [1·03 to 1·58]; p&lt;0·0001), neurofilament light chain (β per year 0·76 [0·56 to 0·96]; p&lt;0·0001), and GFAP (β per year 0·37 [0·21 to 0·53]; p&lt;0·0001) were associated with an accelerated decline of chair-stand performance over time. The adjustment for Mini-Mental State Examination (MMSE) score led to the attenuation of these associations. Higher concentrations of p-tau181 (β per year –0·12 [95% CI –0·17 to –0·07]; p&lt;0·0001), p-tau217 (β per year –0·13 [–0·20 to –0·07]; p&lt;0·0001), and neurofilament light chain (β per year –0·05 [–0·09 to –0·001]; p=0·047) were also associated with faster handgrip strength decline, with no attenuation after adjusting for MMSE score. Sex-specific differences were observed, with female participants showing a stronger association between biomarker concentrations and muscle strength decline than male participants, particularly in the chair-stand test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Our findings suggest that blood Alzheimer’s disease-related biomarkers might help estimate progressive muscle strength decline among older adults, elucidating the influence of brain pathology and cognitive ageing on this association. These Alzheimer’s disease-related biomarkers could aid in identifying individuals for early intervention to prevent sarcopenia.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;The Swedish Research Council, the Swedish Ministry of Health and Social Affairs, and the County Councils and Mun","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100715"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143904","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":"Cost–utility analysis of the DREAMS START intervention for people living with dementia and their carers: a within-trial economic evaluation","authors":"Lina Gonzalez MSc ,&nbsp;Prof Penny Rapaport PhD ,&nbsp;Prof Gill Livingston MD ,&nbsp;Sarah Amador PhD ,&nbsp;Mariam O Adeleke PhD ,&nbsp;Prof Julie A Barber PhD ,&nbsp;Prof Sube Banerjee MD ,&nbsp;Prof Georgina Charlesworth PhD ,&nbsp;Chris Clarke DClinPsy ,&nbsp;Prof Colin A Espie DSc ,&nbsp;Prof Simon D Kyle PhD ,&nbsp;Malgorzata Raczek PhD ,&nbsp;Prof Zuzana Walker MD ,&nbsp;Lucy Webster PhD ,&nbsp;Monica Manela BM ,&nbsp;Prof Rachael Maree Hunter MSc","doi":"10.1016/j.lanhl.2025.100708","DOIUrl":"10.1016/j.lanhl.2025.100708","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;People living at home with dementia frequently have disturbed sleep. The multicomponent, non-pharmacological intervention DREAMS START has shown to be effective at improving sleep in this population. We aimed to conduct a cost–utility analysis of DREAMS START compared with treatment as usual (TAU).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This economic evaluation within a single-masked, phase 3, parallel-arm, superiority randomised controlled trial involved dyads of people with dementia and sleep disturbance and their family carer. Participants were recruited from the National Health Service and the Join Dementia Research service in England. Dyads were randomly assigned (1:1) to receive the DREAMS START intervention (plus TAU) or TAU. Randomisation was blocked, with stratification by site, and a web-based system was used for allocation. Researchers collecting outcome data were masked to allocation group. The primary outcome was sleep disturbance measured by the Sleep Disorders Inventory (SDI) at 8 months. At baseline, 4 months, and 8 months, family carers completed the 5-level EuroQoL 5 dimensions (EQ-5D-5L) proxy, the Dementia Quality of Life Instrument (DEMQOL)-Proxy, and EQ-5D-5L questionnaires, and resource use for the patient and family carer was measured. We calculated the probability that the DREAMS START intervention is cost-effective from a health and personal social services perspective and from a wider societal perspective for a range of decision thresholds per quality-adjusted life-year (QALY) gained using the EQ-5D-5L scores to calculate QALYs and imputing missing data, reported with a cost-effectiveness acceptability curve. This trial was registered with ISRCTN, 13072268, and is complete.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;From Feb 24, 2021, to March 5, 2023, we randomly assigned 377 dyads: 188 to the intervention group and 189 to the TAU group. The mean age of participants with dementia was 79⋅4 years (SD 9⋅0), 206 (55%) of whom were women and 171 (45%) were men. As previously reported, the mean SDI score at 8 months was lower in the intervention group than in the TAU group (adjusted difference in means –4·70 [95% CI –7·65 to –1·74], p=0·002). The mean incremental difference in health and personal social services costs was £59 less per dyad (95% CI −5168 to 5050) and, when incorporating wider societal costs, was £116 less per dyad (−5769 to 5536) for the intervention group than the TAU group, although these figures were non-significant. The mean incremental difference in QALYs per person with dementia was 0·016 more (95% CI 0·000 to 0·033) for the intervention group than for the TAU group, indicating no significant difference in quality of life. At a £20 000 per QALY gained decision threshold, there was a 78% probability that DREAMS START is cost-effective, compared with TAU.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;DREAMS START is likely to be cost-effective. Given its clinical effectiveness, we reco","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100708"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144012","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":"Chronic disease accumulation: aetiological basis, the unexplained remainder, and the way ahead","authors":"Saurav Basu","doi":"10.1016/j.lanhl.2025.100716","DOIUrl":"10.1016/j.lanhl.2025.100716","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100716"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143905","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":"Measuring ageism","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2025.100727","DOIUrl":"10.1016/j.lanhl.2025.100727","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100727"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143963","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":"Observed and hidden factors underlying the accumulation of chronic diseases across eight major organ systems: a longitudinal birth cohort study","authors":"Markus J Haapanen DMedSc ,&nbsp;Jenni Niku PhD ,&nbsp;Tuija M Mikkola PhD ,&nbsp;Davide L Vetrano PhD ,&nbsp;Amaia Calderón-Larrañaga PhD ,&nbsp;Serhiy Dekhtyar PhD ,&nbsp;Prof Eero Kajantie DMedSc ,&nbsp;Prof Mikaela B von Bonsdorff PhD ,&nbsp;Prof Johan G Eriksson DMedSc","doi":"10.1016/j.lanhl.2025.100710","DOIUrl":"10.1016/j.lanhl.2025.100710","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Although individual risk factors have been linked to specific diseases, the cumulative effect of life-course factors on the accumulation of multiple chronic diseases remains unclear. This study aimed to quantify the extent to which measured and unmeasured factors explain disease burden across eight major organ systems.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We did a longitudinal analysis of a population-based birth cohort of individuals born at Helsinki University Central Hospital (Helsinki, Finland) between 1934 and 1944, who attended child welfare clinics in the city, were living in Finland in 1971, and were included in the random subsample undergoing clinical investigations between 2001 and 2004. We tracked chronic disease accumulation across eight organ systems for 30 years from hospital inpatient and outpatient records. Measured life-course factors (including age, sex, early life factors, adult lifestyle, clinical characteristics, biomarkers, and socioeconomic status) were assessed from birth until late midlife. Unmeasured factors were estimated to capture influences beyond measured factors. Multidimensional linear mixed models assessed the contribution of measured and unmeasured factors to organ-specific disease accumulation (the main outcome for this study), accounting for interdependence across organ systems.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;We included data from 2003 people, collected from Jan 1, 1934, to Dec 31, 2017, in this analysis. The upper limit in disease accumulation explained by measured and unmeasured life-course factors ranged from 24·5–86·3% across eight organ systems, and was 48·3% for the total number of all diseases. Most (20·1–82·0%) of this variance was attributable to unmeasured factors. Of measured factors, clinical characteristics and biomarkers explained the largest proportion of disease accumulation (mean 30·3%; SD 15·3%; range 13·6–55·1%), followed by age (22·2%; 22·9%; 0·2–75·7%), early life factors (20·8%; 11·6%; 2·0–38·2%), lifestyle (15·8%; 10·2%; 6·8–35·6%), socioeconomic factors (8·5%; 7·1%; 0·8–17·4%), and sex (2·4%; 3·4%; 0·01–9·2%). Age, BMI, fasting blood glucose, and systolic blood pressure accelerated disease accumulation across multiple organ systems. Each decade of ageing increased disease accumulation 1·28–2·06 times. A 1-SD increase in BMI predicted a 1·28–1·72-times increase in cardiovascular, gastrointestinal, metabolic, musculoskeletal, and respiratory diseases. A 1-SD increase in fasting blood glucose predicted a 1·14–1·35-times increase in cardiovascular, metabolic, neurological, and sensory diseases; a 1-SD increase in systolic blood pressure predicted a 1·16-times increase in cardiovascular diseases and a 1·39-times increase in metabolic diseases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Measured and unmeasured life-course factors explain up to three-quarters of chronic disease accumulation across systems, with the remainder probably influenced by chance. K","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 5","pages":"Article 100710"},"PeriodicalIF":13.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143969","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}