Lancet Healthy Longevity最新文献

{"title":"Highlights of the EuGMS congress 2024.","authors":"Philippa Harris","doi":"10.1016/j.lanhl.2024.100657","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100657","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100657"},"PeriodicalIF":13.4,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645076","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":"Frailty screening with comprehensive geriatrician-led multidisciplinary assessment for older adults during emergency hospital attendance in Ireland (SOLAR): a randomised controlled trial.","authors":"Aoife Leahy, Louise Barry, Gillian Corey, Aoife Whiston, Helen Purtill, Elaine Shanahan, Denys Shchetkovsky, Damien Ryan, Monica O'Loughlin, Margaret O'Connor, Rose Galvin","doi":"10.1016/j.lanhl.2024.100642","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100642","url":null,"abstract":"<p><strong>Background: </strong>Multidisciplinary comprehensive geriatric assessment (CGA) improves outcomes in hospitalised older adults but there is limited evidence on its effectiveness in the emergency department. We aimed to assess the benefits of CGA in the emergency department for older adults living with frailty.</p><p><strong>Methods: </strong>In this randomised controlled trial, we enrolled older adults (≥75 years) who presented to the emergency department with medical complaints at University Hospital Limerick (Limerick, Ireland). Participants screened positive for frailty on the Identification of Seniors at Risk screening tool (score ≥2). Patients requiring resuscitation as well as those with COVID-19, psychiatric, surgical, or trauma complaints were excluded. Participants were randomly allocated 1:1 to geriatrician-led multidisciplinary CGA and management or usual care. Outcome assessors were masked to treatment allocation. The primary efficacy outcome was time spent in the emergency department, defined as the time from registration on the computer database until time of discharge or admission to an inpatient ward in the intention-to-treat population. This study is registered with ClinicalTrials.gov, NCT04629690.</p><p><strong>Findings: </strong>Between Nov 9, 2020, and May 13, 2021, we recruited 228 patients. 113 participants were included in the intervention group (mean age 82·4 years [SD 4·9]; 63 [56%] women; 113 [100%] White Irish) and 115 in the control group (83·1 [5·6]; 61 [53%]; 112 [97%]). Median time in the emergency department was 11·5 h (IQR 5-27) in the intervention group and 20 h (7-29) in the control group (median difference [Hodges-Lehmann estimator] 3·1 h [95% CI 0·6-7·5]; p=0·013). There were no adverse events related to the intervention.</p><p><strong>Interpretation: </strong>Geriatrician-led multidisciplinary assessment of older adults living with frailty was associated with reduced time spent in the emergency department setting at index visit and lower rates of nursing home admission, greater increases in quality of life, and lower decreases in function at both 30 days and 180 days. Multicentre trials are needed to confirm the external validity of the findings. This study provides an evidence base for similar teams in an emergency department setting.</p><p><strong>Funding: </strong>Health Research Board (ILP-HSR-2017-014).</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100642"},"PeriodicalIF":13.4,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629669","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":"Rethinking emergency care for older adults living with frailty.","authors":"Stephanie Denise M Sison, Dae Hyun Kim","doi":"10.1016/j.lanhl.2024.100653","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100653","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100653"},"PeriodicalIF":13.4,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629678","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":"Navigating complex care for older women with HIV: role of geriatrician support.","authors":"Luxey Sirisegaram, Kristina Marie Kokorelias, Alice Zhabokritsky, Sharon Walmsley","doi":"10.1016/j.lanhl.2024.100649","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100649","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100649"},"PeriodicalIF":13.4,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629676","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":"Integrating immunisation into a global strategy for healthy ageing.","authors":"Anna Odone, Giacomo Pietro Vigezzi","doi":"10.1016/j.lanhl.2024.100654","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100654","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100654"},"PeriodicalIF":13.4,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629673","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":"Early geriatric assessment and management in older patients with Clostridioides difficile infection in Denmark (CLODIfrail): a randomised trial.","authors":"Tone Rubak, Simon Mark Dahl Baunwall, Merete Gregersen, Sara Ellegaard Paaske, Malene Asferg, Ishay Barat, Joanna Secher-Johnsen, Mikael Groth Riis, Jeppe Bakkestrøm Rosenbæk, Troels Kjærskov Hansen, Marianne Ørum, Claire J Steves, Hanne Veilbæk, Christian Lodberg Hvas, Else Marie Skjøde Damsgaard","doi":"10.1016/j.lanhl.2024.100648","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100648","url":null,"abstract":"<p><strong>Background: </strong>Clostridioides difficile infection causes diarrhoea and colitis. Older patients with C difficile infection are often frail and have comorbidities, leading to high mortality rates. The frailty burden in older people might restrict access to treatments, such as C difficile infection-specific antibiotics and faecal microbiota transplantation. We aimed to investigate the clinical effects of early comprehensive geriatric assessment (CGA) and frailty evaluation, including home visits and assessment for faecal microbiota transplantation, in older patients with C difficile infection.</p><p><strong>Methods: </strong>In this randomised, quality improvement trial with a pragmatic design, patients from the Central Denmark Region aged 70 years or older with a positive PCR test for C difficile toxin were randomly assigned (1:1) to CGA or standard care, both with equal access to faecal microbiota transplantation. Patients and investigators were unmasked to treatment. The primary outcome was 90-day mortality, and was compared in the study groups according to the intention-to-treat principle. The study is registered with ClinicalTrials.gov, NCT05447533.</p><p><strong>Findings: </strong>Between Sept 1, 2022, and May 3, 2023, we randomly assigned 217 patients to CGA (n=109) or standard care (n=108). The median patient age was 78 years (IQR 74-84). 116 (53%) of 217 patients were female and 101 (47%) were male. 16 (15%; 95% CI 9-23) of 109 patients in the CGA group and 22 (20%; 14-29) of 108 patients in the standard-care group died within 90 days (odds ratio 0·66, 95% CI 0·32-1·38. No serious adverse events or deaths related to patient assessment or faecal microbiota transplantation were recorded in either group. Deaths directly attributable to C difficile infection were lower in the CGA group (seven [44%] of 16 deaths vs 18 [82%] of 22 deaths in the standard-care group; p=0·020).</p><p><strong>Interpretation: </strong>Older patients who received CGA had a 90-day mortality rate similar to that of patients who received standard care, but with fewer deaths directly attributable to C difficile infection.</p><p><strong>Funding: </strong>Innovation Fund Denmark, Novo Nordisk Foundation, and Helsefonden.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100648"},"PeriodicalIF":13.4,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565117","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":"Global landscape of COVID-19 vaccination programmes for older adults: a descriptive study.","authors":"Wen Zheng, Jiayi Dong, Zhiyuan Chen, Xiaowei Deng, Qianhui Wu, Lance E Rodewald, Hongjie Yu","doi":"10.1016/j.lanhl.2024.100646","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100646","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To minimise severe cases and deaths from COVID-19 among high-risk populations such as older adults (aged 60 years and older), it is crucial to monitor and update vaccination strategies. In this study, we aim to provide a global profile of the current COVID-19 vaccination programmes for older adults, including vaccination policies, coverage rates, and vaccine demand.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We used publicly available data on the COVID-19 vaccines used, vaccination schedules, indicated age groups, and age-specific country-level vaccine coverage, updated through to July 20, 2024. Data on vaccination policy were extracted from publicly available sources in the following priority: (1) official sources (ie, government websites, health department websites, and official reports); (2) resources integrated by institutions or organisations (ie, European Center for Disease Prevention and Control, Africa Center for Disease Prevention and Control, and COVAX); and (3) cross-validated news and media reports derived from government or health department sources. We estimated coverage gaps to achievement of two specific objectives: (1) immunising 100% of older adults with primary series and a booster dose, as per WHO's goal; and (2) surpassing WHO's goal by administering one extra booster dose to 80% of older adults or achieving 80% coverage of a 2023-24 series vaccine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;192 countries reported their use of COVID-19 vaccines for older people, of which 71 vaccine products have been used for older adults and 79 countries have deployed 22 vaccines containing components against variants of concern; 122 countries offered a second booster dose or a special booster dose, while others used only primary series or one booster dose. 96 countries prioritised older people for vaccination. Among countries with available data, the median proportion of individuals completing a primary series was 81% (IQR 58·3-92·0), for a first booster was 53% (14·1-81·7), for a second booster was 44·3% (13·5-69·7), and for a 2023-24 series vaccination was 23·6% (6·6-52·4), with large differences by region. Coverage of the second booster and the 2023-24 series was lower in individuals aged 60-70 years than in older age groups. To achieve the WHO target of 100% coverage for older populations with primary series and a booster dose, 1·01 doses per person are required, and to attain an 80% coverage for a second booster or 2023-24 series, surpassing WHO's goal, 1·43 doses per person are required.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;Progress of COVID-19 vaccination programmes for older adults is uneven across countries, emphasising an ongoing challenge to achieve vaccine equity for this high-risk age group. Therefore, it is essential to establish robust and timely vaccination surveillance systems, especially to facilitate data-driven policies that promote COVID-19 vaccination campaigns worldwide.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Funding: &lt;/strong&gt;Ke","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100646"},"PeriodicalIF":13.4,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629671","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 views and experiences of older adults regarding digital mental health interventions: a systematic review ofqualitative studies.","authors":"Ruoyu Yin, Laura Martinengo, Helen Elizabeth Smith, Mythily Subramaniam, Konstadina Griva, Lorainne Tudor Car","doi":"10.1016/j.lanhl.2024.08.007","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.08.007","url":null,"abstract":"<p><p>This systematic review aimed to synthesise qualitative evidence on the views and experiences of older adults in using digital mental health interventions (DMHIs) for the prevention or self-management of mental disorders. We searched PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, PsycINFO, and the first 100 results of Google Scholar for eligible studies and we included 37 papers reporting 35 studies in this Review. Most DMHIs were delivered using mobile apps (n=11), websites (n=6), and video-conferencing tools (n=6). The use of DMHIs in older adults was affected by negative perceptions about ageing and mental health, the digital divide (eg, insufficient digital literacy), personal factors (eg, motivation) and health status, interpersonal influences (eg, guidance and encouragement), intervention features (eg, pace and content), technology-related factors (eg, accessibility), and the perceived benefits and risks of using DMHIs. Future DMHIs for older adults should involve other stakeholders such as health-care professionals, provide content relevant to the needs of older people, be more accessible, and address concerns about privacy and confidentiality.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100638"},"PeriodicalIF":13.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568575","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":"Effect of oral health on functional disability and mortality in older adults in Japan: a cohort study.","authors":"Takafumi Abe, Kazumichi Tominaga, Hisaaki Saito, Jun Shimizu, Norikuni Maeda, Ryouji Matsuura, Yukio Inoue, Yuichi Ando, Yuhei Matsuda, Takahiro Kanno, Shozo Yano, Minoru Isomura","doi":"10.1016/j.lanhl.2024.08.005","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.08.005","url":null,"abstract":"<p><strong>Background: </strong>Oral health has previously shown associations with functional disability and mortality. We aimed to explore the associations of various aspects of oral health status with functional disability and mortality using survival analysis, as well as the relative magnitudes of the impact of these aspects on outcomes.</p><p><strong>Methods: </strong>We obtained data for individuals aged 75 years and older in Shimane, Japan, who had at least one oral health check-up between April 1, 2016, and March 31, 2022 under Japan's long-life medical care system insurance system. Those with missing data or with functional disability at baseline were excluded. 13 aspects of oral health status were assessed by dentists or dental hygienists as part of the check-up (using protocols provided by the Japan Dental Association and the Japanese Ministry of Health, Labour and Welfare): number of remaining teeth, subjective masticatory performance, objective masticatory performance, periodontal tissue status, functional dysphagia, tongue mobility, articulation, oral hygiene, number of decayed teeth, inadaptation of dentures of the upper jaw and lower jaw (considered separately), oral mucosal disease, and dry mouth. Multivariate Cox proportional hazards models were used to analyse the associations between each aspect of oral health and functional disability and mortality, with fully adjusted models adjusting for sex, age, BMI, medical history, or a propensity score derived from these covariates. Population-attributable fractions (PAFs) were calculated to assess the differential impacts of these oral health status aspects on outcome occurrence.</p><p><strong>Findings: </strong>Of the 24 619 individuals who had an oral health check-up during the study period, 21 881 individuals were included in the analysis of functional disability (9175 [41·93%] men, 12 706 [58·07%] women, mean age 78·31 years [SD 2·88], mean follow-up 41·43 months [20·80]), and 22 747 individuals in the analysis of mortality (9722 [42·74%] men, 13 025 [57·26%] women, mean age 78·34 years [2·89], mean follow-up 42·63 months [20·58]). All 13 aspects of oral health status showed significant associations with the occurrence of mortality, while functional disability was associated with 11 aspects (excluding oral mucosal disease and dry mouth) in the fully adjusted model. Based on PAFs, of all oral health aspects assessed, objective masticatory performance had the greatest impact on both functional disability (PAF 23·10% [95% CI 20·42-25·69] for the lowest and 10·62% [8·18-12·99] for the second-lowest quartile of performance) and mortality (16·47% [13·44-19·40] and 8·90% [5·87-11·82]).</p><p><strong>Interpretation: </strong>Various aspects of oral health are associated with mortality and functional disability. Maintaining good oral health in older adults might help to reduce these outcomes.</p><p><strong>Funding: </strong>None.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100636"},"PeriodicalIF":13.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476501","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":"Defining the role and reach of a geriatrician.","authors":"Matteo Cesari, Jotheeswaran Amuthavalli Thiyagarajan, Antonio Cherubini, Miguel Angel Acanfora, Prasert Assantachai, Mario Barbagallo, Mamadou Coume, Theresa Diaz, Nicholas Fuggle, Sonia Ouali Hammami, Kenneth Madden, Radmila Matijevic, Jean-Pierre Michel, Mirko Petrovic, Cornel Sieber, Nicola Veronese, Finbarr C Martin, Anshu Banerjee, John W Rowe","doi":"10.1016/j.lanhl.2024.100644","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100644","url":null,"abstract":"<p><p>Population ageing is a global occurrence. Unfortunately, the shortage of health professionals with geriatric competencies is a major factor restricting high-quality care for older people worldwide. Strengthening the knowledge and skills of the health workforce to better respond to the needs of older people is a major global priority. Geriatricians can play a pivotal role in reorienting care for older people towards an integrated and person-centred care system focused on functional ability, preventive strategies, and age-friendly services. The current scenario requires efforts to be directed towards establishing a standardised competency-based definition of a geriatrician to allow for an accurate estimation of the existing workforce with adequate training in geriatrics as crucial resources to facilitate the paradigm shift. This Personal View, supported by the International Association of Gerontology and Geriatrics and the European Geriatric Medicine Society, proposes a standardised definition of a geriatrician based on expected competencies and roles and a precise description of the essential features of geriatric medicine. By reducing ambiguities and offering a competency-based framework, the current standardisation approach is expected to facilitate better support, monitoring, and allocation of resources for improving care for older people worldwide.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100644"},"PeriodicalIF":13.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393896","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}