Juliana S Oliveira PhD , Prof Catherine Sherrington PhD , Prof Stephen R Lord PhD , Giane C Camara MPhil , Shannon Colley BA , Courtney A West MHC , Abby Haynes PhD , Heidi Gilchrist PhD , Wing S Kwok PhD , Louise MN Pearce PhD , Geraldine Wallbank BAppSc , Mallory Trent PhD , Prof Adrian Bauman PhD , Anne C Grunseit PhD , Prof Kaarin J Anstey PhD , Prof Anne Tiedemann PhD
{"title":"The effect of an Iyengar yoga-based exercise programme versus a seated yoga relaxation programme on falls in people aged 60 years and older (SAGE): a pragmatic, two-arm, parallel randomised controlled trial","authors":"Juliana S Oliveira PhD , Prof Catherine Sherrington PhD , Prof Stephen R Lord PhD , Giane C Camara MPhil , Shannon Colley BA , Courtney A West MHC , Abby Haynes PhD , Heidi Gilchrist PhD , Wing S Kwok PhD , Louise MN Pearce PhD , Geraldine Wallbank BAppSc , Mallory Trent PhD , Prof Adrian Bauman PhD , Anne C Grunseit PhD , Prof Kaarin J Anstey PhD , Prof Anne Tiedemann PhD","doi":"10.1016/j.lanhl.2025.100749","DOIUrl":"10.1016/j.lanhl.2025.100749","url":null,"abstract":"<div><h3>Background</h3><div>Exercises targeting balance and strength are proven to prevent falls. Yoga is growing in popularity and can improve balance and mobility in older adults, but its effects on falls have not been rigorously tested. In this study, we aimed to compare the effects of Iyengar yoga-based exercise and seated relaxation yoga on the rate of falls among older adults.</div></div><div><h3>Methods</h3><div>This pragmatic, two-arm, parallel randomised controlled trial recruited Australian community-dwelling people aged 60 years and older who were not currently practising yoga and who lived independently. Participants were randomly assigned (1:1) to the intervention (Iyengar yoga-based exercise) or control (seated relaxation yoga) group using a computer-generated sequence. Participants and yoga instructors were unmasked, but research staff verifying falls data and assessing goal attainment were masked to group allocation. Intervention participants received 80 supervised, 1-h, twice-weekly yoga classes over 12 months, and were encouraged to undertake unsupervised practice on 2 additional days per week. Control participants attended two 1-h supervised workshops focused on seated breathing and stretching. Most classes were held online due to the COVID-19 pandemic. The primary outcome was fall rate per year. Secondary outcomes were mental wellbeing, physical activity, quality of life, balance self-confidence, physical function, sleep quality, pain, and goal attainment, all assessed in the intention-to-treat population. The study protocol was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001183178).</div></div><div><h3>Findings</h3><div>Between Oct 3, 2019, and Oct 28, 2021, 2182 older adults expressed their interest in participating, 810 were assessed for eligibility, 110 were excluded, and 700 were randomly assigned to either the Iyengar yoga exercise programme or the control group (seated yoga relaxation programme; 350 participants per group). The mean age of participants was 67 years (SD 5·2), and 570 (81%) were female and 130 (19%) were male. Six intervention participants reported musculoskeletal-related adverse events associated with the yoga programme, and no serious adverse events occurred. Contrary to expectations, there was a higher fall rate in the intervention group than in the control group (0·87 <em>vs</em> 0·64 falls per person-year; incidence rate ratio 1·33 [95% CI 1·01–1·75; p=0·044]). The intervention improved the number of hours per week of planned physical activity (mean difference 0·96 h per week [95% CI 0·43–1·49]; p<0·0001), self-reported balance confidence (mean difference 2·94 [0·60–5·28]; p=0·014), and goal attainment (mean difference 0·60 [0·26–0·94]; p=0·0006). No significant between-group differences were identified for other secondary outcomes.</div></div><div><h3>Interpretation</h3><div>This Iyengar yoga-based programme should not be recommended for fall prevention in its ","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100749"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179234","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 lack of legacy benefits of low-dose aspirin: the ASPREE study","authors":"Katrina Davis , Sevil Yasar","doi":"10.1016/j.lanhl.2025.100769","DOIUrl":"10.1016/j.lanhl.2025.100769","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100769"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226163","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}
Augusto J Mendes PhD , Federica Ribaldi PhD , Ozge Sayin MSc , Giorgi Khachvani MD , Roberta Mulargia MD , Gabriele Volpara MA , Giulia Remoli MD , Umberto Nencha MD , Stefano Gianonni-Luza MD , Stefano Cappa MD , Giovanni B Frisoni MD
{"title":"Single-domain and multidomain lifestyle interventions for the prevention of cognitive decline in older adults who are cognitively unimpaired: a systematic review and network meta-analysis","authors":"Augusto J Mendes PhD , Federica Ribaldi PhD , Ozge Sayin MSc , Giorgi Khachvani MD , Roberta Mulargia MD , Gabriele Volpara MA , Giulia Remoli MD , Umberto Nencha MD , Stefano Gianonni-Luza MD , Stefano Cappa MD , Giovanni B Frisoni MD","doi":"10.1016/j.lanhl.2025.100762","DOIUrl":"10.1016/j.lanhl.2025.100762","url":null,"abstract":"<div><h3>Background</h3><div>Preventing cognitive impairment in older adults is a public health priority. Although multidomain interventions have shown promise as preventive strategies, the optimal combination of interventions remains unclear. This network meta-analysis aimed to compare and rank the relative efficacy of single-domain and multidomain lifestyle interventions for the prevention of cognitive impairment in older adults who are cognitively unimpaired.</div></div><div><h3>Methods</h3><div>We did a systematic review and network meta-analysis of randomised controlled trials (RCTs) published in PubMed and Embase from inception until the date of our search on May 7, 2024 following a preregistered protocol in PROSPERO (CRD42024601975). We included RCTs in older adults who are cognitively unimpaired evaluating lifestyle interventions targeting diet, physical exercise, cognitive training, social activity, and health education, either alone or in combination. The primary outcome was global cognition, analysed using random-effects network meta-analysis, reporting standardised mean differences (SMDs) and 95% CIs, and compared against health education, active control, or no intervention. Subgroup analyses explored potential age-related differences and the effect of intervention duration. Risk of bias was assessed using Cochrane Risk of Bias 2, and publication bias was evaluated by assessing funnel plot asymmetry.</div></div><div><h3>Findings</h3><div>Of the 10 200 citations identified and 1183 full texts screened for eligibility, we identified 109 eligible RCTs, including 23 010 participants (median age 70·1 years [IQR 68·7–73·8], 14 957 [65%] female and 8053 [35%] male). Compared with health education, significant improvements in global cognition were found for physical exercise and cognitive training combined (SMD 0·26 [95% CI 0·10–0·42; p=0·0011); cognitive training alone (SMD 0·21 [0·08–0·33]; p=0·00092); diet, physical exercise, cognitive training, and health education combined (SMD 0·14 [0·02–0·27]; p=0·028); and physical exercise alone (SMD 0·14 [0·05–0·22]; p=0·0014). Random-effects models using active control and no intervention as comparators yielded similarly significant effects for the aforementioned interventions, with effect sizes in the same order. Risk of bias was high in 44 (40%) studies, and publication bias was suggested in studies comparing interventions with health education.</div></div><div><h3>Interpretation</h3><div>Several single-domain and multidomain lifestyle interventions are efficacious at modulating global cognition in older adults who are cognitively unimpaired, with the combination of physical exercise and cognitive training demonstrating the strongest effect. Combining lifestyle interventions might enhance efficacy, but increased number of domains does not automatically translate into greater cognitive benefits. These findings support lifestyle interventions as key components of prevention strategies; however, the","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100762"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187114","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}
Mohamad I Nasser PhD , Anya Burton PhD , Hannah Wilson PhD , Tadios Manyanga MSc , Tafadzwa Madanhire PhD , Prudance Mushayavanhu FCS Orthopaedics , Munyaradzi Ndekwere FCS Orthopaedics , Joseph Chipanga , Samuel Hawley PhD , Simon Matthew Graham PhD , James Masters PhD , Kate A Ward PhD , Matthew L Costa PhD , Rashida A Ferrand PhD , Celia L Gregson FRCP
{"title":"Impact of hip fracture on survival, disability, pain, and health-related quality of life in Zimbabwe: a prospective cohort study","authors":"Mohamad I Nasser PhD , Anya Burton PhD , Hannah Wilson PhD , Tadios Manyanga MSc , Tafadzwa Madanhire PhD , Prudance Mushayavanhu FCS Orthopaedics , Munyaradzi Ndekwere FCS Orthopaedics , Joseph Chipanga , Samuel Hawley PhD , Simon Matthew Graham PhD , James Masters PhD , Kate A Ward PhD , Matthew L Costa PhD , Rashida A Ferrand PhD , Celia L Gregson FRCP","doi":"10.1016/j.lanhl.2025.100766","DOIUrl":"10.1016/j.lanhl.2025.100766","url":null,"abstract":"<div><h3>Background</h3><div>The population in Africa is ageing, and fragility fractures increasing. We assessed 1-year health outcomes following hip fracture in older adults in Zimbabwe.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, a cohort of adults aged 40 years or older with hip fracture, presenting to hospitals in Harare (two public and five private hospitals) between Oct 15, 2021, and Oct 14, 2022, were followed up for 12 months. The primary outcome was survival, analysed with Kaplan–Meier curves at different timepoints (30 days, 120 days, 6–8 months, and 12 months after case identification), overall and stratified by age (<70 years <em>vs</em> ≥70 years), delay to presentation (no delay [≤2 weeks] <em>vs</em> delay [>2 weeks]), and facility type and operative management. We also quantified health-related quality of life (HRQoL), measured with 5-level EQ-5D (EQ-5D-5L), hip pain, self-reported from 0 (none) to 5 (all the time) and measured as interference with walking and sleep (1 [no interference] to 10 [complete interference]), as per the Brief Pain Inventory, and disability, measured with the WHO Disability Assessment Schedule version 2.0 (WHODAS).</div></div><div><h3>Findings</h3><div>Of 196 patients with hip fracture (96 [49%] female, 100 [51%] male; median age 74 years [IQR 62·5–83]), 162 (83%) had had a fragility fracture (low-energy trauma). In total, 173 (88%) were managed in a public hospital, of whom 96 (55%) received operative hip fixation. In contrast, all of the 23 (12%) managed in private facilities had an operation. After 12 months, 55 (29%) had died (49 [42%] of 117 patients aged ≥70 years, and six [9%] of 70 patients aged <70 years). In public hospitals, 31 (42%) of 73 non-operated patients died, compared with 18 (19%) of 93 patients who were operated on. Overall, survival declined to 88% (95% CI 82–92) by 30 days and to 71% (64–77) by 12 months. The probability of survival was lower in patients aged 70 years or older than in those younger than 70 years (mortality hazard ratio for ≥70 years 6·10, 95% CI 2·61−14·22). The mean HRQoL utility score decreased from 0·81 (95% CI 0·80–0·83) pre-fracture to 0·29 (0·25–0·34) at 30 days post fracture. Minimal recovery was seen after 120 days (0·34, 0·29–0·39). By 12 months, 97 (97%) of 100 patients alive and able to provide data still reported pain from their hip injury. Post-fracture disability was almost universal, with only two (2%) of 100 patients being disability-free (WHODAS=0) by 12 months.</div></div><div><h3>Interpretation</h3><div>Following hip fracture, survival and quality of life decreased substantially in the study population. These findings reveal the need for the implementation of guidelines to standardise care and improve operative capacity to manage the predicted rise in fractures in this region.</div></div><div><h3>Funding</h3><div>Wellcome Trust.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100766"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287362","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}
Mikaela Bloomberg PhD , Prof Jamie Brown PhD , Giorgio Di Gessa PhD , Feifei Bu PhD , Prof Andrew Steptoe DSc
{"title":"Cognitive decline before and after mid-to-late-life smoking cessation: a longitudinal analysis of prospective cohort studies from 12 countries","authors":"Mikaela Bloomberg PhD , Prof Jamie Brown PhD , Giorgio Di Gessa PhD , Feifei Bu PhD , Prof Andrew Steptoe DSc","doi":"10.1016/j.lanhl.2025.100753","DOIUrl":"10.1016/j.lanhl.2025.100753","url":null,"abstract":"<div><h3>Background</h3><div>Whether short-term improvements in cognitive performance observed following smoking cessation are transient or if longer-term cognitive trajectories are also improved is unclear, particularly when adults are middle-aged or older at smoking cessation. We examined whether long-term cognitive trajectories improved following mid-to-late-life smoking cessation.</div></div><div><h3>Methods</h3><div>In this longitudinal study, we used data from three nationally representative cohort studies from 12 countries including 18 years of cognitive data (2002–20). Participants who quit smoking during follow-up were matched with an equal number of continuing smokers according to key demographic, socioeconomic, and cognitive criteria. We used piecewise linear mixed models to examine memory and fluency decline before and after smoking cessation and during a comparable time period in continuing smokers.</div></div><div><h3>Findings</h3><div>We included data from 9436 participants who smoked (4718 [50·0%] smokers who quit matched with 4718 [50·0%] continuing smokers, aged 40–89 years, with 4886 [51·8%] women and 4550 [48·2%] men). In the six years before smoking cessation, matched smokers who quit and continuing smokers had similar rates of memory and fluency decline (difference in memory decline [smokers who quit–continuing smokers] –0·03 SDs [95% CI –0·06 to 0·01], p=0·16; difference in fluency decline –0·01 [–0·04 to 0·03], p=0·76). In the six years following smoking cessation, smokers who quit had memory and fluency scores that declined more slowly than continuing smokers (difference in memory decline 0·05 SDs [0·00–0·10], p=0·036; difference in fluency decline 0·05 SDs [0·01–0·10], p=0·030). Coefficients for interaction with age at smoking cessation suggested results did not differ by age at smoking cessation (p>0·05 for all).</div></div><div><h3>Interpretation</h3><div>In middle-aged and older smokers with initially similar cognitive trajectories, smokers who quit subsequently had more favourable trajectories than continuing smokers regardless of age at cessation. As older adults are less likely than younger people to attempt smoking cessation, improvements in long-term cognitive trajectories might provide an additional motivation to quit.</div></div><div><h3>Funding</h3><div>National Institute on Aging, National Institute for Health and Care Research.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100753"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309379","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}
Reynalda Córdova PhD , Prof Jihye Kim PhD , Alysha S Thompson PhD , Hwayoung Noh PhD , Sanam Shah PhD , Christina C Dahm PhD , Christopher F Jensen MSc , Lene Mellemkjær PhD , Prof Anne Tjønneland PhD , Verena Katzke PhD , Charlotte Le Cornet PhD , Christine El-Khoury MSc , Prof Matthias B Schulze DrPH , Giovanna Masala MD , Claudia Agnoli MSc , Vittorio Simeon PhD , Rosario Tumino PhD , Fulvio Ricceri PhD , Prof W M Monique Verschuren PhD , Prof Yvonne T van der Schouw PhD , Heinz Freisling PhD
{"title":"Plant-based dietary patterns and age-specific risk of multimorbidity of cancer and cardiometabolic diseases: a prospective analysis","authors":"Reynalda Córdova PhD , Prof Jihye Kim PhD , Alysha S Thompson PhD , Hwayoung Noh PhD , Sanam Shah PhD , Christina C Dahm PhD , Christopher F Jensen MSc , Lene Mellemkjær PhD , Prof Anne Tjønneland PhD , Verena Katzke PhD , Charlotte Le Cornet PhD , Christine El-Khoury MSc , Prof Matthias B Schulze DrPH , Giovanna Masala MD , Claudia Agnoli MSc , Vittorio Simeon PhD , Rosario Tumino PhD , Fulvio Ricceri PhD , Prof W M Monique Verschuren PhD , Prof Yvonne T van der Schouw PhD , Heinz Freisling PhD","doi":"10.1016/j.lanhl.2025.100742","DOIUrl":"10.1016/j.lanhl.2025.100742","url":null,"abstract":"<div><h3>Background</h3><div>It is currently unknown whether plant-based dietary patterns influence disease progression to multimorbidity after an initial non-communicable disease, and whether the associated risk of multimorbidity varies with age. This study aimed to investigate associations of plant-based diets with the risk of multimorbidity, defined as the co-occurrence of at least two chronic diseases in an individual (either cancer at any site, cardiovascular disease, or type 2 diabetes).</div></div><div><h3>Methods</h3><div>This prospective cohort study used data from EPIC and UK Biobank across six European countries, with participants aged 35–70 years at recruitment. We excluded participants from these cohorts who had cancer, cardiovascular disease, or type 2 diabetes at baseline or those with missing data on diet or health outcomes. Data on dietary habits were assessed either at baseline through a validated dietary questionnaire about habits in the previous 12 months or through several 24-h recall questionnaires during approximately a year of follow-up. Multistate modelling with Cox regression was used to estimate the risk of multimorbidity according to a healthful plant-based diet index (hPDI) and, separately, an unhealthful plant-based diet index (uPDI). Risk differences in adults younger than 60 years and those age 60 years and older were estimated.</div></div><div><h3>Findings</h3><div>407 618 participants (226 324 from EPIC and 181 294 from UK Biobank) were included in this study. During a median follow-up time of 10·9 years in EPIC and 11·4 years in UK Biobank, 6604 cancer–cardiometabolic multimorbidity events occurred in both cohorts combined. A ten-point increment of the hPDI score was associated with a lower risk of multimorbidity, with a hazard ratio (HR) of 0·89 (95% CI 0·83–0·96) in EPIC and 0·81 (0·76–0·86) in UK Biobank. This inverse association was marginally weaker in older adults than in middle-aged adults in both cohorts. In UK Biobank, a ten-point increment of the hPDI score was associated with multivariable-adjusted HRs of 0·71 (95% CI 0·65–0·79) in adults younger than 60 years and 0·86 (0·80–0·92) in those aged 60 years and older (p<sub>interaction</sub>=0·0016). The respective HRs in EPIC were 0·86 (95% CI 0·78–0·95) and 0·92 (0·84–1·02; p<sub>interaction</sub>=0·32). A higher adherence to an unhealthy plant-based diet was positively associated with multimorbidity risk in UK Biobank (HR per ten-point increment of uPDI 1·22, 95% CI 1·16–1·29), but this was not replicated in EPIC (1·00, 0·94–1·08).</div></div><div><h3>Interpretation</h3><div>A healthy plant-based diet might reduce the burden of multimorbidity of cancer and cardiometabolic diseases among middle-aged and older adults.</div></div><div><h3>Funding</h3><div>The Korean Government (Ministry of Science and ICT).</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 8","pages":"Article 100742"},"PeriodicalIF":14.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972167","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":"Screening and management of frailty among people experiencing homelessness","authors":"Salmaan Z Kamal , Katherine Diaz Vickery","doi":"10.1016/j.lanhl.2025.100760","DOIUrl":"10.1016/j.lanhl.2025.100760","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 8","pages":"Article 100760"},"PeriodicalIF":14.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972252","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}
Daniel R Morales PhD , Prof Bruce Guthrie PhD , Thomas J Downes MPhil , Prof David A McAllister MD , Peter Hanlon PhD
{"title":"Applicability of the electronic frailty index in younger and older adults in England: a population-based cohort study","authors":"Daniel R Morales PhD , Prof Bruce Guthrie PhD , Thomas J Downes MPhil , Prof David A McAllister MD , Peter Hanlon PhD","doi":"10.1016/j.lanhl.2025.100752","DOIUrl":"10.1016/j.lanhl.2025.100752","url":null,"abstract":"<div><h3>Background</h3><div>The electronic frailty index (eFI) was developed in older adults (aged ≥65 years). There are currently no validated frailty scores in clinical practice for younger adults (aged 18–64 years). The aim of this study was to examine whether the eFI score in younger adults had similar or different associations with adverse health outcomes compared with older adults.</div></div><div><h3>Methods</h3><div>In this population-based cohort study, electronic health records from the UK Clinical Practice Research Datalink GOLD database were analysed. We used a cross-section of patients on Nov 30, 2015, who were alive and had been registered with a general practice for at least 2 years before data capture. Patients were stratified into younger adults (aged 18–64 years, n=708 235; 49·4% female) and older adults (aged 65–95 years, n=231 819; 54·3% female). For all included patients, eFI score, prevalence of individual eFI deficits, and eFI frailty category were calculated. For the main outcomes, crude and age–sex adjusted hazard ratios (HRs) were calculated for 1-year and 3-year mortality and emergency hospitalisation for each group compared with adults defined by the eFI as fit.</div></div><div><h3>Findings</h3><div>The prevalence of eFI-defined frailty was higher in older adults than younger adults. Specifically, in older adults, 77 290 (33·3%) of 231 819 had mild frailty, 44 523 (19·2%) had moderate frailty, and 22 572 (9·7%) had severe frailty. For younger adults, 76 991 (10·9%) of 708 235 had mild frailty, 12 552 (1·8%) had moderate frailty, and 2088 (0·3%) had severe frailty. Adjusted HRs for both 1-year mortality and 1-year emergency hospitalisation in younger adults with mild, moderate, and severe frailty were greater than in older adults with equivalent frailty categorisation. Specifically, compared with fit older adults, age–sex adjusted 1-year mortality HRs were 1·94 (95% CI 1·80–2·09) in older adults with mild frailty, 2·99 (2·77–3·22) with moderate frailty, and 4·03 (3·72–4·36) with severe frailty. Compared with fit younger adults, age–sex adjusted 1-year mortality HRs were 3·15 (2·80–3·55) in younger adults with mild frailty, 5·88 (4·95–6·98) with moderate frailty, and 12·61 (9·76–16·30) with severe frailty (Z score p<0·001 for all comparisons). Compared with fit older adults, age–sex adjusted HRs for 1-year emergency hospitalisation were 2·30 (2·22–2·39) in older adults with mild frailty, 4·09 (3·94–4·25) with moderate frailty, and 6·76 (6·50–7·03) with severe frailty. Compared with fit younger adults, age–sex adjusted HRs for 1-year emergency hospitalisation were 3·16 (3·07–3·25) in younger adults with mild frailty, 6·64 (6·34–6·94) with moderate frailty, and 13·02 (12·04–14·09) with severe frailty (Z score p<0·001 for all comparisons). Similar associations were observed for 3-year mortality and emergency hospitalisation.</div></div><div><h3>Interpretation</h3><div>Similarly to older adults, the eFI identifies you","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 8","pages":"Article 100752"},"PeriodicalIF":14.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972238","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":"Advances in our understanding of how to prevent suicide in older men","authors":"Stuart Leske , Kylie King","doi":"10.1016/j.lanhl.2025.100758","DOIUrl":"10.1016/j.lanhl.2025.100758","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 8","pages":"Article 100758"},"PeriodicalIF":14.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972226","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}