Lancet Healthy Longevity最新文献

{"title":"Frailism: a scoping review exploring discrimination against people living with frailty.","authors":"Philip Braude, Emma Grace Lewis, Steve Broach Kc, Edward Carlton, Sarah Rudd, Jean Palmer, Richard Walker, Ben Carter, Jonathan Benger","doi":"10.1016/j.lanhl.2024.100651","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100651","url":null,"abstract":"<p><p>People living with frailty can experience discrimination, but unlike the characteristics of age and disability, frailty is not protected by law. Frailty is a clinical syndrome associated with ageing in which health deficits increase a person's vulnerability to illness, disability, and death. This scoping review, conducted by a team of methodologists, clinicians, lawyers, and patients, aimed to investigate the extent of discrimination against people living with frailty described in health-care literature. We searched five health-care databases from inception up to June, 2022, and grey literature, to identify 144 texts. The texts were classified by the types of discrimination (direct discrimination, indirect discrimination, harassment, and victimisation) and inductively developed into contextual themes. The median age of the participants was 77 years (IQR 69·9-82·0), and 65·4% were women. The most common types of discrimination were direct (in 90 [63%]), indirect (in 66 [46%]), and harassment (in one [1%]) of the 144 texts, with no instances of victimisation reported. Nine themes of discriminatory actions were developed. Discrimination against people living with frailty overlapped with discrimination based on established protected characteristics, including age, disability, race, and sex. Evidence indicated that frailty discrimination replaces, mediates, masks, and potentiates age discrimination. Discrimination against people with frailty seemed to be both an independent event and one that interacts with established protected characteristics. Future research should focus on preventing frailty-based discrimination and establishing whether frailty should be considered a new protected characteristic by law.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100651"},"PeriodicalIF":13.4,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980214","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":"Associations between adverse pregnancy outcomes and cognitive impairment and dementia: a systematic review and meta-analysis.","authors":"Eliza C Miller, Patrick Conley, Mohammad Alirezaei, Katrin Wolfova, Mitzi M Gonzales, Zaldy S Tan, Sarah E Tom, Lynn M Yee, Adam M Brickman, Natalie A Bello","doi":"10.1016/j.lanhl.2024.100660","DOIUrl":"10.1016/j.lanhl.2024.100660","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Individuals with adverse pregnancy outcomes have an increased risk of cerebrovascular disease, but the association between adverse pregnancy outcomes and cognitive impairment and dementia is less well established. We aimed to synthesise, combine, and assess the growing body of data examining the associations between adverse pregnancy outcomes and mild cognitive impairment and dementia in parous women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this systematic review and meta-analysis, we searched PubMed (MEDLINE), Web of Science, and Embase from database inception up to July 18, 2024, with no language restrictions, for observational studies or clinical trials that reported mild cognitive impairment or dementia as outcomes and included female individuals or women who had an adverse pregnancy outcome, including hypertensive disorders of pregnancy, gestational diabetes, stillbirth, fetal growth restriction, preterm birth, or placental abruption. We excluded studies of men, nulliparous women, women with pre-pregnancy conditions associated with impaired cognition, and studies examining cognitive impairment within 6 months of pregnancy. Database searches were supplemented by manual review of the reference lists of included studies. If studies met eligibility criteria but did not have sufficient data for meta-analysis (ie, did not report a summary statistic or a hazard ratio [HR] for outcome estimation), they were included in the systematic review and excluded from the meta-analysis. After removing duplicates, two investigators independently screened titles and abstracts using Covidence software, with potentially eligible studies undergoing full-text review by the same reviewers, with further review by a third reviewer and disagreements resolved by discussion and group consensus. Study quality was assessed and summary statistics extracted by two reviewers independently. The primary outcomes of our study were mild cognitive impairment, all-cause dementia, Alzheimer's disease, and vascular dementia. Heterogeneity was measured using the Q test and I&lt;sup&gt;2&lt;/sup&gt; statistic, and we used random-effects models with inverse-variance weighting to assess the association between adverse pregnancy outcome and primary outcomes with sufficient meta-analysable data via pooled adjusted HRs and 95% CIs. The study protocol was registered with PROSPERO, CRD42023453511.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Of 11 251 publications identified, 15 studies (including 7 347 202 participants) met inclusion criteria for the systematic review, and 11 studies (6 263 431 participants) had sufficient data for meta-analysis. A history of any adverse pregnancy outcome was associated with higher risk of all-cause dementia (adjusted HR 1·32 [95% CI 1·17-1·49]; I&lt;sup&gt;2&lt;/sup&gt;= 80%), Alzheimer's disease (1·26 [1·04-1·53]; I&lt;sup&gt;2&lt;/sup&gt;=63%), and vascular dementia (1·94 [1·70-2·21]; I&lt;sup&gt;2&lt;/sup&gt;=0%). A history of any hypertensive disorder of pregnancy was significantly ass","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100660"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830194","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":"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":"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":"2024-12-01","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":"Midlife matters: metabolic syndrome and the risk of dementia.","authors":"Michal Schnaider Beeri, Yian Gu","doi":"10.1016/j.lanhl.2024.100659","DOIUrl":"10.1016/j.lanhl.2024.100659","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100659"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751817","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 interplay of ageing and rheumatic diseases.","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2024.100674","DOIUrl":"10.1016/j.lanhl.2024.100674","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100674"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872919","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":"Prevalence of dementia among Indigenous populations of countries with a very high Human Development Index: a systematic review.","authors":"Antonia J Clarke, Maja Christensen, Anna H Balabanski, Angela Dos Santos, Peter A Barber, Alex Brown, Matire Harwood, Christina Storm Mienna, Donald K Warne, Marwan Ahmed, Judith M Katzenellenbogen, Adrienne Withall, Kylie Radford, Amy G Brodtmann","doi":"10.1016/j.lanhl.2024.100658","DOIUrl":"10.1016/j.lanhl.2024.100658","url":null,"abstract":"<p><p>Dementia is a health priority for Indigenous peoples. Here, we reviewed studies on the prevalence of dementia or cognitive impairment among Indigenous populations from countries with a very high Human Development Index (≥0·8). Quality was assessed using the Joanna Briggs Institute risk-of-bias tool and CONSolIDated critERia for strengthening the reporting of health research involving Indigenous peoples (CONSIDER), with oversight provided by an Indigenous Advisory Board. After screening, 23 studies were included in the Review. Relative to the respective non-Indigenous populations, greater age-standardised prevalence ratios were observed in the Australian Aboriginal and Torres Strait Islander (2·5-5·2), Aotearoa-New Zealand Māori (1·2-2·0), and Singaporean Malay (1·3-1·7) populations, and greater crude prevalence ratios were observed in the Canadian First Nation (1·3), Singaporean Malay (2·3), Malaysian Melanau (1·7-4·0), American Indian and Alaska Native (1·0-3·2), and Chamorro of Guam (1·2-2·0) populations. The prevalence ratios were greater across younger age groups, predominantly comprising those younger than 70 years. 14 studies presented a moderate risk of bias and few studies reported Indigenous involvement. Despite improved management of risk factors, a greater prevalence of dementia persists in Indigenous populations, overall and at younger ages than in non-Indigenous populations. Future epidemiological work involving Indigenous populations should uphold and prioritise Indigenous perspectives.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100658"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878126","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":"Next generation brain health: transforming global research and public health to promote prevention of dementia and reduce its risk in young adult populations.","authors":"Francesca R Farina, Katie Bridgeman, Sarah Gregory, Lucía Crivelli, Isabelle F Foote, Otto-Emil I Jutila, Ludmila Kucikova, Luciano I Mariano, Kim-Huong Nguyen, Tony Thayanandan, Funmi Akindejoye, Joe Butler, Ismael L Calandri, Giedrė Čepukaitytė, Scott T Chiesa, Walter D Dawson, Kay Deckers, Vanessa De la Cruz-Góngora, Maria-Eleni Dounavi, Ishtar Govia, Edmarie Guzmán-Vélez, Shimaa A Heikal, Tanisha G Hill-Jarrett, Agustín Ibáñez, Bryan D James, Eimear McGlinchey, Donncha S Mullin, Graciela Muniz-Terrera, Maritza Pintado Caipa, Esraa M Qansuwa, Louise Robinson, Antonella Santuccione Chadha, Oliver M Shannon, Li Su, Wendy Weidner, Laura Booi","doi":"10.1016/j.lanhl.2024.100665","DOIUrl":"10.1016/j.lanhl.2024.100665","url":null,"abstract":"<p><p>Efforts to prevent dementia can benefit from precision interventions delivered to the right population at the right time; that is, when the potential to reduce risk is the highest. Young adults (aged 18-39 years) are a neglected population in dementia research and policy making despite being highly exposed to several known modifiable risk factors. The risk and protective factors that have the biggest effect on dementia outcomes in young adulthood, and how these associations differ across regions and groups, still remain unclear. To address these uncertainties, the Next Generation Brain Health team convened a multidisciplinary expert group representing 15 nations across six continents. We identified several high-priority modifiable factors in young adulthood and devised five key recommendations for promoting brain health, ranging from individual to policy levels. Increasing research and policy focus on brain health across the life course, inclusive of younger populations, is the next crucial step in the efforts to prevent dementia at the global level.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100665"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883066","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":"Intervention accelerator to prevent and respond to abuse of older people: insights from key promising interventions.","authors":"Laura Campo-Tena, Aresya Farzana, David Burnes, Titus A Chan, Wan Yuen Choo, Mélanie Couture, Fatemeh Estebsari, Minying He, Jeffrey H Herbst, Christelle Sibdou Liliane Kafando, Joshua Lachs, George Rouamba, Marie-Madeleine Simbreni, Louis To, Hau Yan Wan, Elsie Yan, Yongjie Yon, Christopher Mikton","doi":"10.1016/j.lanhl.2024.100647","DOIUrl":"10.1016/j.lanhl.2024.100647","url":null,"abstract":"<p><p>Globally, abuse of older people (AOP) affects one in six individuals aged 60 years and older every year. Despite the widespread prevalence of AOP, evidence-based interventions for preventing and responding to this issue are insufficient. To address this gap, WHO proposed an initiative to accelerate the development of effective interventions for AOP across all country income levels. In the first phase, the initiative identified 89 promising interventions across a total of 101 evaluations or descriptions, which led to the creation of a public database. Most interventions targeted physical, psychological, and financial abuse and neglect, were implemented in the USA, and focused on victims or potential victims. These interventions were primarily delivered by social workers and nurses, usually in health-care facilities and community centres. Face-to-face delivery was common. Additionally, 28 (28%) of the 101 evaluations used randomised controlled trial designs. The results of this Review can be used to identify interventions that are ready for a rigorous outcome evaluation.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100647"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11682911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142839824","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":"Geriatricians-on-the-Move for sustainable ageing.","authors":"Anton De Spiegeleer, Bart De Spiegeleer","doi":"10.1016/j.lanhl.2024.100661","DOIUrl":"10.1016/j.lanhl.2024.100661","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100661"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822671","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":"Role of age and exposure duration in the association between metabolic syndrome and risk of incident dementia: a prospective cohort study.","authors":"Danial Qureshi, Robert Luben, Shabina Hayat, Robert Talarico, Naomi E Allen, Elżbieta Kuźma, Thomas J Littlejohns","doi":"10.1016/j.lanhl.2024.100652","DOIUrl":"10.1016/j.lanhl.2024.100652","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Metabolic syndrome could be a modifiable risk factor for dementia. However, the effects of age and duration of exposure to metabolic syndrome on dementia risk remains underexplored. The aim of this study was to determine whether the association between metabolic syndrome and risk of dementia differs across mid-life versus late-life, and to explore how duration of metabolic syndrome affects this risk.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a population-based prospective study using data from the European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk) cohort. Metabolic syndrome was defined as having at least three of the following: elevated waist circumference, triglycerides, blood pressure, or glycated haemoglobin, or reduced HDL cholesterol. Incident all-cause dementia was ascertained through hospital inpatient, death, and mental health-care records. In full-cohort analyses, we studied 20 150 adults without dementia aged 50-79 years who attended baseline assessments. Cox proportional hazards models were used to estimate the association between metabolic syndrome and dementia in the full sample, and in mid-life (50-59 years and 60-69 years) and late-life (70-79 years). To assess duration of metabolic syndrome, group-based trajectory analysis was performed on 12 756 participants who attended at least two health assessments over 20 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The mean age of participants was 62·6 years (SD 7·5), and 10 857 (54%) were female. Over 25 years of follow-up (mean 18·8 years [SD 6·3]), 2653 (13%) participants developed dementia. In the full cohort, metabolic syndrome was associated with an increased risk of dementia (hazard ratio 1·11, 95% CI 1·01-1·21). In age-specific analyses, the association was similar for participants in late mid-life (age 60-69 years: 1·21, 1·05-1·39) and, although non-significant, in early mid-life (age 50-59 years: 1·12, 0·87-1·43), but attenuated for participants in late-life (age 70-79 years: 0·96, 0·81-1·14). A linear trend was observed between the number of metabolic syndrome components and dementia risk in those aged 60-69 years (p&lt;sub&gt;trend&lt;/sub&gt;=0·0040), but not in other age groups. In trajectory analysis, a prolonged duration of metabolic syndrome was associated with a significantly increased risk of developing dementia (1·26, 1·13-1·40) when compared to those with consistently low metabolic syndrome. No association was found for increasing metabolic syndrome (1·01, 0·88-1·17).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;These findings provide insights into how certain age windows and time periods might differentially affect dementia risk in the context of metabolic syndrome, and highlight the importance of considering age and duration of exposure to metabolic syndrome when devising dementia prevention strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Funding: &lt;/strong&gt;Canadian Institutes of Health Research-Institute of Aging, Oxford Population Health, and the Nicolaus","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100652"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755739","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}