{"title":"More than simply leftovers: a new link between remnant cholesterol and dementia","authors":"Nil Saez-Calveras , Makoto Ishii","doi":"10.1016/S2666-7568(24)00133-8","DOIUrl":"10.1016/S2666-7568(24)00133-8","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 8","pages":"Pages e506-e507"},"PeriodicalIF":13.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001338/pdfft?md5=2f0f091f6a869cfc16afde190bf27303&pid=1-s2.0-S2666756824001338-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789345","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}
Roxanna Short PhD , Prof Ben Carter PhD , Alessia Verduri PhD , Eleanor Barton MBBS , Prof Nick Maskell PhD , Jonathan Hewitt MBBS
{"title":"The effect of frailty on mortality and hospital admission in patients with benign pleural disease in Wales: a cohort study","authors":"Roxanna Short PhD , Prof Ben Carter PhD , Alessia Verduri PhD , Eleanor Barton MBBS , Prof Nick Maskell PhD , Jonathan Hewitt MBBS","doi":"10.1016/S2666-7568(24)00114-4","DOIUrl":"10.1016/S2666-7568(24)00114-4","url":null,"abstract":"<div><h3>Background</h3><p>Pleural disease is common, representing 5% of the acute medical workload, and its incidence is rising, partly due to the ageing population. Frailty is an important feature and little is known about disease progression in patients with frailty and pleural disease. We aimed to examine the effect of frailty on mortality and other relevant outcomes in patients diagnosed with pleural disease.</p></div><div><h3>Methods</h3><p>In this cohort study in Wales, the national Secure Anonymised Information Linkage databank was used to identify a cohort of individuals diagnosed with non-malignant pleural disease between Jan 1, 2005, and March 1, 2023, who were not known to have left Wales. Frailty was assessed at diagnosis of pleural disease using an electronic Frailty Index. The primary outcome was time from diagnosis to all-cause mortality for all patients. Data were analysed using multilevel mixed-effects Cox proportional hazards regression adjusting for the prespecified covariates of age, sex, Welsh Index of Multiple Deprivation quintile, smoking status, comorbidity, and subtype of pleural disease.</p></div><div><h3>Findings</h3><p>54 566 individuals were included in the final sample (median age 66 years [IQR 47–77]; 26 477 [48·5%] were female and 28 089 [51·5%] were male). By the end of the study period, 25 698 (47·1%) participants had died, with a median follow-up of 1·0 years (IQR 0·2–3·6). There was an association between frailty and all-cause mortality, which increased as frailty worsened. Compared with fit individuals, there was increasing mortality for those with mild frailty (adjusted hazard ratio 1·11 [95% CI 1·08–1·15]; p<0·0001), moderate frailty (1·25 [1·20–1·31]; p<0·0001), and severe frailty (1·36 [1·28–1·44]; p<0·0001).</p></div><div><h3>Interpretation</h3><p>Independent of age and comorbidities, frailty status at diagnosis of pleural disease appeared to be useful as a prognostic indicator. Patients with moderate or severe frailty had a rapid decline in health. Future patients should be assessed for frailty at the time of diagnosis of pleural disease and might benefit from optimised care and advance care planning.</p></div><div><h3>Funding</h3><p>Cardiff University’s Wellcome Trust iTPA funding award.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 8","pages":"Pages e534-e541"},"PeriodicalIF":13.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001144/pdfft?md5=2f401def887dd9f7d9c22595ef2fda05&pid=1-s2.0-S2666756824001144-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890277","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":"Highlights of the 2024 Annual Scientific Meeting of the American Geriatrics Society","authors":"Sophie Raeder","doi":"10.1016/S2666-7568(24)00113-2","DOIUrl":"10.1016/S2666-7568(24)00113-2","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 7","pages":"Page e453"},"PeriodicalIF":13.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001132/pdfft?md5=2bd40a251846d8639c8c7bf2b622459c&pid=1-s2.0-S2666756824001132-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471220","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}
Juan Luis Sánchez-Sánchez PhD , Wan-Hsuan Lu PhD , Daniel Gallardo-Gómez MSc , Borja del Pozo Cruz PhD , Philipe de Souto Barreto PhD , Alejandro Lucia MD , Pedro L Valenzuela PhD
{"title":"Association of intrinsic capacity with functional decline and mortality in older adults: a systematic review and meta-analysis of longitudinal studies","authors":"Juan Luis Sánchez-Sánchez PhD , Wan-Hsuan Lu PhD , Daniel Gallardo-Gómez MSc , Borja del Pozo Cruz PhD , Philipe de Souto Barreto PhD , Alejandro Lucia MD , Pedro L Valenzuela PhD","doi":"10.1016/S2666-7568(24)00092-8","DOIUrl":"10.1016/S2666-7568(24)00092-8","url":null,"abstract":"<div><h3>Background</h3><p>Together with environmental factors, intrinsic capacity (the composite of all the physical and mental capacities of an individual) has been proposed as a marker of healthy ageing. However, whether intrinsic capacity predicts major clinical outcomes is unclear. We aimed to explore the association of intrinsic capacity with functional decline and mortality in older adults.</p></div><div><h3>Methods</h3><p>In this systematic review and meta-analysis, we conducted a systematic search in MEDLINE (via PubMed), Scopus, and Web of Science from database inception to Feb 14, 2024, of observational longitudinal studies conducted in older adults (age ≥60 years) assessing the association of intrinsic capacity with impairment in basic activities of daily living (BADL) or instrumental activities of daily living (IADL) or risk of mortality. Estimates were extracted by two reviewers (JLS-S and W-HL) and were pooled using three-level meta-analytic models. The quality of each study was independently assessed by two authors (JLS-S and PLV) using the Newcastle–Ottawa Scale for longitudinal studies. Heterogeneity was evaluated using the <em>I</em><sup>2</sup> indicator at two levels: within-study (level 2) and between-study (level 3) variation. For associations between intrinsic capacity and IADL and BADL, we transformed data (standardised β coefficients and odds ratios [ORs]) into Pearson product moment correlation coefficients (<em>r</em>) using Pearson and Digby formulas to allow comparability across studies. For associations between intrinsic capacity and risk of mortality, hazard ratios (HRs) with 95% CIs were extracted from survival analyses. This study is registered with PROSPERO, CRD42023460482.</p></div><div><h3>Findings</h3><p>We included 37 studies (206 693 participants; average age range 65·3–85·9 years) in the systematic review, of which 31 were included in the meta-analysis on the association between intrinsic capacity and outcomes; three studies (2935 participants) were included in the meta-analysis on the association between intrinsic capacity trajectories and longitudinal changes in BADL or IADL. Intrinsic capacity was inversely associated with longitudinal impairments in BADL (Pearson's <em>r</em> –0·12 [95% CI –0·19 to –0·04]) and IADL (–0·24 [–0·35 to –0·13]), as well as with mortality risk (hazard ratio 0·57 [95% CI 0·51 to 0·63]). An association was also found between intrinsic capacity trajectories and impairment in IADL (but not in BADL), with maintained or improved intrinsic capacity over time associated with a lower impairment in IADL (odds ratio 0·37 [95% CI 0·19 to 0·71]). There was no evidence of publication bias (Egger's test p>0·05) and there was low between-study heterogeneity (<em>I</em><sup>2</sup>=18·4%), though within-study (<em>I</em><sup>2</sup>=63·2%) heterogeneity was substantial.</p></div><div><h3>Interpretation</h3><p>Intrinsic capacity is inversely associated with functional decline and mortality","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 7","pages":"Pages e480-e492"},"PeriodicalIF":13.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000928/pdfft?md5=b688ecb698cd1d4ebbeecbdf43357fce&pid=1-s2.0-S2666756824000928-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471218","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}
Dina Goodman-Palmer PhD , Prof Carolyn Greig PhD , Sandra Agyapong-Badu PhD , Prof Miles D Witham PhD , Collin F Payne PhD , Mamadou Bountogo MD , Boubacar Coulibaly PhD , Pascal Geldsetzer ScD , Guy Harling ScD , Maxime Inghels PhD , Jennifer Manne-Goehler ScD , Lucienne Ouermi MD , Ali Sie PhD , Prof Justine I Davies MD
{"title":"Frailty progression in adults aged 40 years and older in rural Burkina Faso: a longitudinal, population-based study","authors":"Dina Goodman-Palmer PhD , Prof Carolyn Greig PhD , Sandra Agyapong-Badu PhD , Prof Miles D Witham PhD , Collin F Payne PhD , Mamadou Bountogo MD , Boubacar Coulibaly PhD , Pascal Geldsetzer ScD , Guy Harling ScD , Maxime Inghels PhD , Jennifer Manne-Goehler ScD , Lucienne Ouermi MD , Ali Sie PhD , Prof Justine I Davies MD","doi":"10.1016/S2666-7568(24)00096-5","DOIUrl":"10.1016/S2666-7568(24)00096-5","url":null,"abstract":"<div><h3>Background</h3><p>Little is known about ageing and frailty progression in low-income settings. We aimed to describe frailty changes over time in individuals living in rural Burkina Faso and to assess which sociodemographic, disability, and multimorbidity factors are associated with frailty progression and mortality.</p></div><div><h3>Methods</h3><p>This longitudinal, population-based study was conducted at the Nouna Health and Demographic Surveillance Systems (HDSS) site in northwestern Burkina Faso. Eligible participants were aged 40 years or older and had been primarily resident in a household within the HDSS area for at least the past 6 months before the baseline survey and were selected from the 2015 HDSS household census using a stratified random sample of adults living in unique households within the area. Participants were interviewed in their homes in 2018 (baseline), 2021 (follow-up), or both. We derived the Fried frailty score for each participant at each timepoint using data on grip strength, gait speed, self-reported weight loss, self-reported exhaustion, and physical activity, and described changes in frailty status (no frailty, pre-frailty, or frailty) between 2018 and 2021. We used multivariate regression models to assess factors (ie, sex, age, marital status, educational attainment, wealth quintile, WHO Disability Assessment Schedule (WHODAS) score, and multimorbidity) associated with frailty progression (either worsening frailty status or dying, compared with frailty status remaining the same or improving) and with mortality, and developed sequential models: unadjusted, adjusting for sociodemographic factors (sex, age, marital status, educational attainment, and wealth quintile), and adjusting for sociodemographic factors, disability, and multimorbidity.</p></div><div><h3>Findings</h3><p>Between May 25 and July 19, 2018, and between July 1 and Aug 22, 2021, 5952 individuals were invited to participate: 1709 (28·7%) did not consent, 1054 (17·8%) participated in 2018 only and were lost to follow-up, 1214 (20·4%) participated in 2021 only, and 1975 (33·2%) were included in both years or died between years. Of 1967 participants followed up with complete demographic data, 190 (9·7%) were frail or unable to complete the frailty assessment in 2018, compared with 77 (3·9%) in 2021. Between 2018 and 2021, frailty status improved in 567 (28·8%) participants and worsened in 327 (16·6%), and 101 (5·1%) participants died. The relative risk of frailty status worsening or of dying (compared with frailty impRoving or no change) increased with age and WHODAS score, whereas female sex appeared protective. After controlling for all sociodemographic factors, multimorbidity, and WHODAS score, odds of mortality were 1·07 (odds ratio 2·07, 95% CI 1·05–4·09) times higher among pre-frail individuals and 1·1 (2·21, 0·90–5·41) times higher among frail individuals than among non-frail individuals.</p></div><div><h3>Interpretation</h3><p>Frailty sta","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 7","pages":"Pages e493-e502"},"PeriodicalIF":13.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000965/pdfft?md5=47de85b8a01f69fad948af73b6c0f100&pid=1-s2.0-S2666756824000965-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471219","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}
Prof Mika Kivimäki FMedSci , Philipp Frank PhD , Jaana Pentti MSc , Xiaolin Xu PhD , Prof Jussi Vahtera MD , Jenni Ervasti PhD , Solja T Nyberg PhD , Joni V Lindbohm MD , Prof Markus Jokela PhD , Prof Linda Partridge FMedSci
{"title":"Obesity and risk of diseases associated with hallmarks of cellular ageing: a multicohort study","authors":"Prof Mika Kivimäki FMedSci , Philipp Frank PhD , Jaana Pentti MSc , Xiaolin Xu PhD , Prof Jussi Vahtera MD , Jenni Ervasti PhD , Solja T Nyberg PhD , Joni V Lindbohm MD , Prof Markus Jokela PhD , Prof Linda Partridge FMedSci","doi":"10.1016/S2666-7568(24)00087-4","DOIUrl":"10.1016/S2666-7568(24)00087-4","url":null,"abstract":"<div><h3>Background</h3><p>Ageing hallmarks, characterising features of cellular ageing, have a role in the pathophysiology of many age-related diseases. We examined whether obesity is associated with an increased risk of developing such hallmark-related diseases.</p></div><div><h3>Methods</h3><p>In this multicohort study, we included people aged 38–72 years with data on weight, height, and waist circumference measured during a clinical examination at baseline between March 13, 2006, and Oct 1, 2010, from the UK Biobank with follow-up until Nov 12, 2021. To test reproducibility of the findings (replication analysis), we used data from people aged 40 years or older included in the Finnish Public Sector study and the Finnish Health and Social Support study who responded to the study surveys, had data on BMI, and were successfully linked to electronic health records from national registers up to Dec 31, 2016. Obesity and clinical characteristics were assessed at baseline. Via linkage to national health records, participants were followed up for 83 diseases related to nine ageing hallmarks (genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication). Outcomes were the first instance of hallmark-related disease, in addition to co-occurrence of three or more hallmark-related diseases and mortality.</p></div><div><h3>Findings</h3><p>496 530 adults (mean age 57·0 years [SD 8·1]) from the UK Biobank were included in the primary analysis, and 83 249 (mean age 48·2 years [6·4]) adults from the Finnish cohorts were included in the replication analysis. Median follow-up was 12·7 years (IQR 12·0–13·4) in the UK Biobank and 14·0 years (8·0–15·0) in the Finnish cohorts. After adjusting for demographic characteristics, lifestyle factors, and depression, UK Biobank participants with obesity (BMI ≥30·0 kg/m<sup>2</sup>) had a 1·40 (95% CI 1·38–1·41) times higher hazard ratio for the first hallmark-related disease than those with a healthy weight (BMI 18·5–24·9 kg/m<sup>2</sup>). The corresponding hazard ratios for three co-occurring diseases were 2·92 (95% CI 2·64–3·22) for deregulated nutrient sensing, 2·73 (2·46–3·02) for telomere attrition, 2·33 (2·10–2·60) for epigenetic alterations, 2·30 (2·14–2·48) for mitochondrial dysfunction, 2·23 (2·04–2·45) for stem cell exhaustion, 2·02 (1·89–2·16) for altered intercellular communication, 2·01 (1·89–2·15) for cellular senescence, 1·83 (1·67–2·00) for loss of proteostasis, and 1·39 (1·27–1·52) for genomic instability. These findings were replicated in the Finnish cohorts. In both studies, the associations between other risk factors (low education, unhealthy dietary factors [available only in the UK Biobank], smoking, high alcohol consumption, physical inactivity, and depression) and hallmark-related diseases were weaker than those with obesity. 45–60% of t","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 7","pages":"Pages e454-e463"},"PeriodicalIF":13.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000874/pdfft?md5=5dbd86ff2a160f3a1ac7676bb4fa3351&pid=1-s2.0-S2666756824000874-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471222","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}