Lancet Healthy Longevity最新文献

{"title":"Social health and subsequent cognitive functioning in people aged 50 years and older: examining the mediating roles of depressive symptoms and inflammatory biomarkers in two European longitudinal studies","authors":"Jean Stafford PhD , Serhiy Dekhtyar PhD , Anna-Karin Welmer PhD , Davide L Vetrano PhD , Giulia Grande PhD , Erika J Laukka PhD , Anna Marseglia PhD , Vanessa Moulton PhD , Rosie Mansfield PhD , Yiwen Liu PhD , Ke Ning PhD , Prof Karin Wolf-Ostermann PhD , Prof Henry Brodaty DSc , Suraj Samtani PhD , Prof Mohammad Arfan Ikram PhD , René Melis PhD , Prof Joanna Rymaszewska PhD , Dorota Szcześniak PhD , Giorgio Di Gessa PhD , Prof Marcus Richards PhD , Jane Maddock PhD","doi":"10.1016/S2666-7568(24)00046-1","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00046-1","url":null,"abstract":"<div><h3>Background</h3><p>Social health markers, including marital status, contact frequency, network size, and social support, have been shown to be associated with cognition. However, the mechanisms underlying these associations remain poorly understood. We investigated whether depressive symptoms and inflammation mediated associations between social health and subsequent cognition.</p></div><div><h3>Methods</h3><p>In the English Longitudinal Study of Ageing (ELSA), a nationally representative longitudinal study in England, UK, we sampled 7136 individuals aged 50 years or older living in private households without dementia at baseline or at the intermediate mediator assessment timepoint, who had recorded information on at least one social health marker and potential mediator. We used four-way decomposition to examine to what extent depressive symptoms, C-reactive protein, and fibrinogen mediated associations between social health and subsequent standardised cognition (verbal fluency and delayed and immediate recall), including cognitive change, with slopes derived from multilevel models (12-year slope). We examined whether findings were replicated in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), a population-based longitudinal study in Sweden, in a sample of 2604 individuals aged 60 years or older living at home or in institutions in Kungsholmen (central Stockholm) without dementia at baseline or at the intermediate mediator assessment timepoint (6-year slope). Social health exposures were assessed at baseline, potential mediators were assessed at an intermediate timepoint (wave 2 in ELSA and 6-year follow-up in SNAC-K); cognitive outcomes were assessed at a single timepoint (wave 3 in ELSA and 12-year follow-up in SNAC-K), and cognitive change (between waves 3 and 9 in ELSA and between 6-year and 12-year follow-ups in SNAC-K).</p></div><div><h3>Findings</h3><p>The study sample included 7136 participants from ELSA, of whom 3962 (55·5%) were women and 6934 (97·2%) were White; the mean baseline age was 63·8 years (SD 9·4). Replication analyses included 2604 participants from SNAC-K, of whom 1604 (61·6%) were women (SNAC-K did not collect ethnicity data); the mean baseline age was 72·3 years (SD 10·1). In ELSA, we found indirect effects via depressive symptoms of network size, positive support, and less negative support on subsequent verbal fluency, and of positive support on subsequent immediate recall (pure indirect effect [PIE] 0·002 [95% CI 0·001–0·003]). Depressive symptoms also partially mediated associations between less negative support and slower decline in immediate recall (PIE 0·001 [0·000–0·002]) and in delayed recall (PIE 0·001 [0·000–0·002]), and between positive support and slower decline in immediate recall (PIE 0·001 [0·000–0·001]). We did not observe mediation by inflammatory biomarkers. Findings of mediation by depressive symptoms in the association between positive support and verbal fluency and between","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 5","pages":"Pages e356-e369"},"PeriodicalIF":13.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000461/pdfft?md5=4d7163a6c39e22e92bc32235385197ba&pid=1-s2.0-S2666756824000461-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Schema therapy for older adults?","authors":"Erkki Isometsä","doi":"10.1016/S2666-7568(24)00027-8","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00027-8","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e237-e238"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000278/pdfft?md5=9fb44cfc6d65ee7334c272f77302d99b&pid=1-s2.0-S2666756824000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting social connections across the life course","authors":"The Lancet Healthy Longevity","doi":"10.1016/S2666-7568(24)00047-3","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00047-3","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Page e236"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000473/pdfft?md5=217e70530d6f6fef60310c145d2110d6&pid=1-s2.0-S2666756824000473-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mediating role of neuroimaging-derived biological brain age in the association between risk factors for dementia and cognitive decline in middle-aged and older individuals without cognitive impairment: a cohort study","authors":"Irene Cumplido-Mayoral MSc , Anna Brugulat-Serrat PhD , Gonzalo Sánchez-Benavides PhD , Armand González-Escalante MSc , Federica Anastasi PhD , Marta Milà-Alomà PhD , David López-Martos MSc , Muge Akinci MSc , Carles Falcón PhD , Mahnaz Shekari MSc , Raffaele Cacciaglia PhD , Eider M Arenaza-Urquijo PhD , Carolina Minguillón PhD , Karine Fauria PhD , José Luis Molinuevo MD PhD , Marc Suárez-Calvet MD PhD , Oriol Grau-Rivera MD PhD , Verónica Vilaplana PhD , Juan Domingo Gispert PhD , N VILOR TEJEDOR","doi":"10.1016/S2666-7568(24)00025-4","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00025-4","url":null,"abstract":"<div><h3>Background</h3><p>Neuroimaging-based brain-age delta has been shown to be a mediator linking cardiovascular risk factors to cognitive function. We aimed to assess the mediating role of brain-age delta in the association between modifiable risk factors of dementia and longitudinal cognitive decline in middle-aged and older individuals who are asymptomatic, stratified by Alzheimer's disease pathology. We also explored whether the mediation effect is specific to cognitive domain.</p></div><div><h3>Methods</h3><p>In this cohort study, we included participants from the ALFA+ cohort aged between 45 years and 65 years who were cognitively unimpaired and who had available structural MRI, cerebrospinal fluid β-amyloid (Aβ)42 and Aβ40 measurements obtained within 1 year of each other, modifiable risk factors assessment, and cognitive evaluation over 3 years. Participants were recruited from the Barcelonaβeta Brain Research Center (Barcelona, Spain). Included individuals underwent a first assessment between Oct 25, 2016, and Jan 28, 2020, and a follow-up cognitive assessment 3·28 (SD 0·27) years later. We computed brain-age delta and composites of different cognitive function domains (preclinical Alzheimer's cognitive composite [PACC], attention, executive function, episodic memory, visual processing, and language). We used partial least squares path modelling to explore mediation effects in the associations between modifiable risk factors (including cardiovascular, mental health, mood, metabolic or endocrine history, and alcohol use) and changes in cognitive composites. To assess the role of Alzheimer's disease pathology, we computed separate models for Aβ-negative and Aβ-positive individuals.</p></div><div><h3>Findings</h3><p>Of the 419 participants enrolled in ALFA+, 302 met our inclusion criteria, of which 108 participants were classified as Aβ-positive and 194 as Aβ-negative. In Aβ-positive individuals, brain-age delta partially mediated (percent mediation proportion 15·73% [95% CI 14·22–16·66]) the association between modifiable risk factors and decline in overall cognition (across cognitive domains). Brain-age delta fully mediated (mediation proportion 28·03% [26·25–29·21]) the effect of modifiable risk factors on the PACC, wherein increased values for risk factors correlated with an older brain-age delta, and, consequently, an older brain-age delta was linked to greater PACC decline. This effect appears to be primarily driven by memory decline. Mediation was not significant in Aβ-negative individuals (3·52% [0·072–4·17]) on PACC, although path coefficients were not significantly different from those in the Aβ-positive group.</p></div><div><h3>Interpretation</h3><p>Our findings suggest that brain-age delta captures the association between modifiable risk factors and longitudinal cognitive decline in middle-aged and older people. In asymptomatic middle-aged and older individuals who are Aβ-positive, the pathology might be the strongest driver","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e276-e286"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000254/pdfft?md5=75d672e45c0205b8026417d069b00a22&pid=1-s2.0-S2666756824000254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Group schema therapy combined with psychomotor therapy for older adults with a personality disorder: an open-label, multicentre, randomised controlled trial","authors":"Martine S Veenstra-Spruit MSc ,&nbsp;Renske Bouman MSc ,&nbsp;Silvia DM van Dijk PhD ,&nbsp;Antoinette DI van Asselt PhD ,&nbsp;Prof Sebastiaan PJ van Alphen PhD ,&nbsp;Dorothee H Veenstra MSc ,&nbsp;Marije de Ruiter MSc ,&nbsp;Saskia E Troost MD ,&nbsp;Monique W Lammers MD ,&nbsp;Frank Vulker MSc ,&nbsp;Maureen MJ Smeets-Janssen MD ,&nbsp;Rob HS van den Brink PhD ,&nbsp;Prof Richard C Oude Voshaar MD","doi":"10.1016/S2666-7568(24)00001-1","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00001-1","url":null,"abstract":"<div><h3>Background</h3><p>Although several types of psychotherapy effectively reduce psychological distress associated with personality disorders, randomised controlled trials (RCT) have systematically excluded older patients. We aimed to examine the effectiveness of group schema therapy combined with psychomotor therapy (GST + PMT) in later life compared with treatment as usual (TAU).</p></div><div><h3>Methods</h3><p>We did an open-label, multicentre, RCT in eight outpatient clinics for geriatric psychiatry in the Netherlands. Adults aged 60 years or older with a full or subthreshold cluster B or C personality disorder according to DSM criteria were included and randomly assigned 1:1 to GST + PMT or TAU by an independent researcher applying a computer-generated sequence per study site when 8 to 16 patients had given informed consent; investigators and interviewers were kept blinded until end of follow-up. Included individuals received 20 weekly sessions of GST + PMT or TAU with 1 year of follow-up. The primary outcome was psychological distress, measured with the 53-item Brief Symptom Inventory. The trial was registered with International Clinical Trials Registry Platform, NTR6621.</p></div><div><h3>Findings</h3><p>Of the 145 study participants recruited between Feb 21, 2018, and Jan 21, 2020, 102 patients (median age of 69 years [IQR 63–71], 62 [61%] female) who concluded therapy before the COVID-19 pandemic (cutoff March 20, 2020) were included in the intention-to-treat analysis (51 in each study group), because COVID-19 measures substantially disrupted delivery of group therapy. GST + PMT significantly improved psychological distress compared with TAU over the 6-month treatment period (Cohen's <em>d</em> 0·42, 95% CI 0·16 to 0·68; p=0·0016). The pre-post effect of GST + PMT remained stable during follow-up, whereas patients receiving TAU further improved, resulting in a non-significant difference between groups at 1 year (Cohen's <em>d</em> 0·21, 95% CI –0·07 to 0·48; p=0·14). No patients reported adverse events.</p></div><div><h3>Interpretation</h3><p>Psychotherapy focused on personality disorders is effective in later life, resulting in a faster improvement in psychopathology than TAU. Future studies should focus on increasing effectiveness by intensifying or prolonging treatment.</p></div><div><h3>Funding</h3><p>Netherlands Organization for Health Research and Development.</p></div><div><h3>Translation</h3><p>For the Dutch translation of the abstract see Supplementary Materials section.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e245-e254"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000011/pdfft?md5=3f188184674d7d5927e0a8759dab8fc8&pid=1-s2.0-S2666756824000011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging modifiable risk factors and cognitive decline: the mediating role of brain age","authors":"Marcella Montagnese ,&nbsp;Timothy Rittman","doi":"10.1016/S2666-7568(24)00042-4","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00042-4","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e243-e244"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000424/pdfft?md5=4eea5e01095545201a7baa81af014954&pid=1-s2.0-S2666756824000424-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social connection and end-of-life outcomes among older people in 19 countries: a population-based longitudinal study","authors":"Prof Lara Pivodic PhD ,&nbsp;Prof Lieve Van den Block PhD ,&nbsp;Fedja Pivodic MSc","doi":"10.1016/S2666-7568(24)00011-4","DOIUrl":"10.1016/S2666-7568(24)00011-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Social connection is a key determinant of health, but its role in shaping end-of-life outcomes is poorly understood. We examined changes in structure, function, and quality components of social connection in older people's last years of life, and the extent to which social connection predicts end-of-life outcomes (ie, symptoms, health-care utilisation, and place of death).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This study used longitudinal data of representative samples from across 18 European countries and Israel in the Survey of Health, Ageing, and Retirement in Europe (SHARE), the largest European cohort study of people aged 50 years or older. We included deceased participants of waves 4 and 6 (which contained social network modules) for whom a proxy provided an end-of-life interview. We did paired sample &lt;em&gt;t&lt;/em&gt;-tests (for continuous variables), Wilcoxon signed-rank tests (for ordinal variables), and McNemar's tests (for non-ordinal categorical variables) to assess changes in structure, function, and quality components of social connection between waves 4 and 6. To examine social connection as a predictor of end-of-life outcomes, we used social connection data from wave 6 core interviews and end-of-life interviews from wave 7, conducted with a proxy respondent covering the deceased participant's last year of life. End-of-life outcomes included symptoms (pain, breathlessness, and anxiety or sadness) in the last month of life, health-care utilisation in the last year of life, and place of death. We conducted a mixed-effects logistic regression analysis per social connection measure, for each end-of-life outcome.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;Data were collected in 2011–12 for wave 4, 2015–16 for wave 6, and 2017–18 for wave 7. We studied 3356 individuals (mean age at death was 79·7 years [SD 10·2]), with interviews conducted, on average, 4·6 (1·2) years (wave 4) and 1·1 (0·7) years (wave 6) before death. From wave 4 to wave 6, the following changes in social connection were observed: proportion of married or partnered participants (from 1406 [60·9%] of 2310 to 1438 [57·1%] of 2518; p&lt;0·0001), receiving personal care or practical help (from 781 [37·2%] of 2099 to 1334 [53·1%] of 2512; p&lt;0·0001), loneliness (from mean 1·4 [SD 0·5] to 1·5 [0·6]; p&lt;0·0001; scale 1–3), satisfaction with social network (from 8·8 [1·67] to 8·7 [1·7]; p=0·037; scale 0–10), and emotional closeness to social network (eg, from 1883 [88·8%] of 2121 to 1710 [91·3%] of 1872 participants who indicated being either very close or extremely close to social network members; p&lt;0·0001). Higher levels of loneliness at wave 6 predicted a greater likelihood of experiencing symptoms in the last month of life (odds ratio range across symptoms: 1·29 [95% CI 1·08–1·55] to 1·58 [1·32–1·89]). Being married (1·32 [1·03–1·68]) or receiving personal care or practical help (1·25 [1·04–1·49]) predicted death in hospital.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e264-e275"},"PeriodicalIF":13.1,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000114/pdfft?md5=bd00b9848ee49e7aabb3a1b77c13426f&pid=1-s2.0-S2666756824000114-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global crisis of loneliness: a call for contextualised, mechanistic research","authors":"Hannah M O'Rourke","doi":"10.1016/S2666-7568(24)00030-8","DOIUrl":"10.1016/S2666-7568(24)00030-8","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e241-e242"},"PeriodicalIF":13.1,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000308/pdfft?md5=2feaec3240af9681c9224768ca8f9ce0&pid=1-s2.0-S2666756824000308-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involuntary closures of for-profit care homes in England by the Care Quality Commission","authors":"Anders Bach-Mortensen PhD ,&nbsp;Benjamin Goodair MSc ,&nbsp;Michelle Degli Esposti PhD","doi":"10.1016/S2666-7568(24)00008-4","DOIUrl":"10.1016/S2666-7568(24)00008-4","url":null,"abstract":"<div><p>Adult social care services in England are struggling, and sometimes failing, to supply the quality of care deserved by the most vulnerable people in society. The Care Quality Commission (CQC) is responsible for protecting the recipients of this crucial public service. Their strongest enforcement is the ability to cancel the registration—the legal right to operate—of a health or social care provider. Using novel data from the CQC, we show that the proportion of care home closures due to CQC enforcements, relative to all closures, is increasing. Since 2011, 816 care homes (representing 19 918 registered beds) have been involuntarily closed by the CQC. Our results show that effectively all involuntary closures (804/816) occurred in for-profit care homes. This data emphasises the need for a comprehensive assessment of the impact of for-profit provision on the quality and sustainability of adult social care in England.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e297-e302"},"PeriodicalIF":13.1,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000084/pdfft?md5=a9aa35d516035b1845f62591e51e415c&pid=1-s2.0-S2666756824000084-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review","authors":"Kathryn Nicholson PhD ,&nbsp;Winnie Liu BSc ,&nbsp;Daire Fitzpatrick MD ,&nbsp;Kate Anne Hardacre BMSc ,&nbsp;Sarah Roberts MD ,&nbsp;Jennifer Salerno PhD ,&nbsp;Prof Saverio Stranges MD PhD ,&nbsp;Martin Fortin MD MSc ,&nbsp;Prof Dee Mangin MBCHB DPH","doi":"10.1016/S2666-7568(24)00007-2","DOIUrl":"10.1016/S2666-7568(24)00007-2","url":null,"abstract":"<div><p>Multimorbidity (multiple conditions) and polypharmacy (multiple medications) are increasingly common, yet there is a need to better understand the prevalence of co-occurrence. In this systematic review, we examined the prevalence of multimorbidity and polypharmacy among adults (≥18 years) and older adults (≥65 years) in clinical and community settings. Six electronic databases were searched, and 87 studies were retained after two levels of screening. Most studies focused on adults 65 years and older and were done in population-based community settings. Although the operational definitions of multimorbidity and polypharmacy varied across studies, consistent cut-points (two or more conditions and five or more medications) were used across most studies. In older adult samples, the prevalence of multimorbidity ranged from 4·8% to 93·1%, while the prevalence of polypharmacy ranged from 2·6% to 86·6%. High heterogeneity between studies indicates the need for more consistent reporting of specific lists of conditions and medications used in operational definitions.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e287-e296"},"PeriodicalIF":13.1,"publicationDate":"2024-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000072/pdfft?md5=8a7dd41890037b965e15a057ab456b6c&pid=1-s2.0-S2666756824000072-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}