Lancet Healthy Longevity最新文献

{"title":"Delirium, long-term conditions, and incident dementia in older adults admitted to hospital for emergency care in Lothian, Scotland: a population-based cohort study","authors":"Rose S Penfold BMBCh ,&nbsp;Clare MacRae PhD ,&nbsp;Prof Elizabeth L Sampson ,&nbsp;Prof Daniel HJ Davis ,&nbsp;Atul Anand PhD ,&nbsp;Prof E Wesley Ely ,&nbsp;Prof Bruce Guthrie ,&nbsp;Prof Alasdair MJ MacLullich PhD","doi":"10.1016/j.lanhl.2026.100832","DOIUrl":"10.1016/j.lanhl.2026.100832","url":null,"abstract":"<div><h3>Background</h3><div>Delirium is strongly associated with subsequent dementia, but this is often assumed to reflect underlying associations of baseline health with dementia. We examined the associations of delirium on admission with incident dementia across the spectrum of long-term conditions (LTCs).</div></div><div><h3>Methods</h3><div>We conducted a retrospective population-based cohort study using linked primary care and hospital data for emergency admissions of patients aged 65 years or older in Lothian, Scotland, from April 1, 2017, to April 1, 2020. Delirium on admission was assessed at the bedside for all patients using the 4AT, categorised as delirium (4AT ≥4) or no delirium (4AT 0–3). The primary outcome was incident dementia, with all-cause mortality as a secondary outcome. Associations of delirium, number of LTCs (categorised as 0–1 LTCs; 2–4 LTCs; 5–6 LTCs; and ≥7 LTCs), and their interaction with incident dementia and mortality were examined using unadjusted and adjusted Fine–Gray subdistribution hazards regression and Cox proportional hazards models.</div></div><div><h3>Findings</h3><div>Of 23 558 people without pre-existing dementia, 4135 (17·6%) had an admission with delirium. Mean age was 78·9 years (SD 8·1) and 12 826 (54·4%) patients were female. Delirium was associated with higher incident dementia risk. The relative risk was highest in those without multiple LTCs (MLTCs; adjusted subdistribution hazard ratio [aHR] 3·38 [95% CI 2·46–4·63]) and decreased with an increasing number of LTCs. Delirium was also associated with increased mortality, regardless of the number of LTCs. In those without MLTCs, delirium was associated with higher early mortality (≤90 days: aHR 4·23 [95% CI 3·27–5·49]) and late mortality (&gt;90 days: 1·64 [1·33–2·03]).</div></div><div><h3>Interpretation</h3><div>Delirium is strongly associated with incident dementia in older adults across the LTC spectrum, with the highest relative risk in people without MLTCs. Findings support routine delirium assessment on hospital admission for all older adults and highlight the need to further investigate neurodegenerative mechanisms in delirium.</div></div><div><h3>Funding</h3><div>Wellcome Trust.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 3","pages":"Article 100832"},"PeriodicalIF":14.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582405","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":"Risk factors for early-onset and late-onset dementia: a prospective cohort study","authors":"Katherine Giorgio MS ,&nbsp;John J Stephen MPH ,&nbsp;Maxwell Mansolf PhD ,&nbsp;Elizabeth A Peterson MPH ,&nbsp;Prof Alden L Gross PhD ,&nbsp;Emily M Briceño PhD ,&nbsp;Prof Deborah A Levine MD MPH ,&nbsp;Catherine Helmer MD PhD ,&nbsp;Prof Stéphanie Debette MD PhD ,&nbsp;Aïcha Soumaré PhD ,&nbsp;Prof M Arfan Ikram MD PhD ,&nbsp;Frank J Wolters PhD ,&nbsp;Prof Sudha Seshadri MD ,&nbsp;Claudia L Satizabal PhD ,&nbsp;Jayandra Jung Himali PhD ,&nbsp;Lenore J Launer PhD ,&nbsp;David Li PhD ,&nbsp;Djass Mbangdadji MS ,&nbsp;Prof Donald M Lloyd-Jones MD ,&nbsp;Prof Farzaneh A Sorond MD PhD ,&nbsp;Sanaz Sedaghat PhD","doi":"10.1016/j.lanhl.2026.100831","DOIUrl":"10.1016/j.lanhl.2026.100831","url":null,"abstract":"<div><h3>Background</h3><div>Early-onset dementia (onset before age 65 years) is an important health concern, but much of our understanding of its risk factors is inferred from studies of late-onset dementia (onset after age 65 years). We investigated associations between several demographic, clinical, and lifestyle factors with early-onset dementia and compared those estimates against their associations with late-onset dementia.</div></div><div><h3>Methods</h3><div>Data from five community-based longitudinal cohort studies from the UK and USA were pooled and rigorously harmonised: UK Biobank, Atherosclerosis Risk in Communities Study, Framingham Heart Study, Multi-Ethnic Study of Atherosclerosis, and Whitehall II Study. Dementia was ascertained via hospitalisation and death records with or without clinical assessments according to each cohort’s protocol. Risk factors included sex, self-reported race or ethnicity (Hispanic, White, Black, Asian, and Other), low education, hypertension, diabetes, obesity, hypercholesterolaemia, depression, alcohol overconsumption, smoking, and physical inactivity. Cox regression models, with age as the timescale and time-varying coefficients, were fitted to estimate hazard ratios (HRs) for early-onset dementia and late-onset dementia and to test whether the HRs differed by age of onset.</div></div><div><h3>Findings</h3><div>In 544 442 participants, there were 807 incident early-onset dementia cases and 14 253 incident late-onset dementia cases over a median follow-up of 13·7 years (IQR 12·9–14·4). Female participants had a lower hazard of early-onset dementia compared with males (HR 0·70 [95% CI 0·61–0·80]). Black versus White race (1·61 [1·23–2·11]), grade school education or less (1·99 [1·67–2·38]), diabetes (2·45 [1·99–3·03]), depression (2·73 [2·34–3·20]), smoking (1·86 [1·56–2·22]), obesity (1·24 [1·04–1·48]), physical inactivity (1·33 [1·11–1·59]), and alcohol overconsumption (1·22 [1·01–1·47]) were independently associated with higher hazards of early-onset dementia. Hypertension stage 1 (HR 1·19 [95% CI 0·97–1·47]), hypertension stage 2 (1·16 [0·94–1·43]), and hypercholesterolaemia (1·11 [0·92–1·34]) had positive effect estimates but were not statistically significant. All risk factors had stronger associations with early-onset dementia than with late-onset dementia except race, physical inactivity, and alcohol overconsumption.</div></div><div><h3>Interpretation</h3><div>Our findings demonstrate the importance of modifiable risk factors in the development of early-onset dementia and guide future research for identifying high-priority targets for primary prevention.</div></div><div><h3>Funding</h3><div>US National Institutes of Health, the National Institute for Neurologic Disorders and Stroke, and the National Institute of Aging.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 3","pages":"Article 100831"},"PeriodicalIF":14.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623826","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":"Prediction models for overall survival and all-cause mortality risk in older adults with cancer: a systematic review","authors":"Pauline Duquenne PhD ,&nbsp;Gabor Liposits MD ,&nbsp;Cassandra O Vonnes DNP ,&nbsp;Erna Navarrete MSc ,&nbsp;Adolfo Gonzalez Serrano PhD ,&nbsp;Florence Canoui-Poitrine MD ,&nbsp;Joana Marinho PhD ,&nbsp;Baran Akagündüz MD ,&nbsp;Kristen R Haase PhD ,&nbsp;Haydee C Verduzco-Aguirre MD ,&nbsp;Juan Li PhD ,&nbsp;Colm Mac Eochagáin MB ,&nbsp;Enrique Soto-Perez-de-Celis MD ,&nbsp;Ana Patricia Ayala MIS ,&nbsp;Joosje C Baltussen MD ,&nbsp;Kavita Kantilal BSc ,&nbsp;Kumud Kantilal PhD ,&nbsp;Chan Wing-Lok MD ,&nbsp;Andrea Perez de Acha MD ,&nbsp;Shelby Meckstroth MD ,&nbsp;Sophie Pilleron PhD","doi":"10.1016/j.lanhl.2026.100829","DOIUrl":"10.1016/j.lanhl.2026.100829","url":null,"abstract":"<div><div>Mortality risk prediction models can support decision making in older adults with cancer; however, existing models are associated with a high risk of bias. This systematic review assessed published prediction models for overall and all-cause mortality in adults with cancer aged 65 years or older. We searched for publications in Ovid Embase, Ovid Medline, Cochrane CENTRAL, and EBSCO CINAHL on Nov 25, 2022, and updated the search on Feb 24, 2024. We included 250 studies, of which 182 (72·8%) reported both model development and internal validation. 176 (70·4%) of 250 models predicted overall survival; 40 (16·0%) models focused on lung cancer and 30 (12·0%) models on colorectal cancer. 43 (17·2%) models were specifically developed for older adults; 138 (55·2%) models did not incorporate geriatric variables such as comorbidities, nutrition, and cognition. Risk of bias was high in all models, largely owing to inappropriate handling of continuous predictors, univariable selection of predictors, and inadequate control for overfitting. These limitations preclude clinical use. Future models predicting overall and all-cause mortality in older adults with cancer should adhere to existing methodological guidelines and incorporate geriatric domains.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 3","pages":"Article 100829"},"PeriodicalIF":14.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147515236","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":"Point-of-care technology and lung ultrasound in ageing societies: towards integrated respiratory care beyond hospital walls","authors":"Chukwuma Okoye","doi":"10.1016/j.lanhl.2026.100840","DOIUrl":"10.1016/j.lanhl.2026.100840","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 3","pages":"Article 100840"},"PeriodicalIF":14.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677207","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 death in people with vision impairment from cataracts before treatment: a case study from Kenya","authors":"Prof Andrew Bastawrous PhD ,&nbsp;Yamna Ouchtar PhD ,&nbsp;Michael Gichangi MSc ,&nbsp;Monicah Bitok MSc ,&nbsp;Hillary Rono PhD ,&nbsp;Stuart Keel PhD ,&nbsp;Prof Allen Foster PhD ,&nbsp;Prof Matthew Burton PhD","doi":"10.1016/j.lanhl.2025.100800","DOIUrl":"10.1016/j.lanhl.2025.100800","url":null,"abstract":"<div><h3>Background</h3><div>Cataract remains the leading cause of blindness globally, which substantially affects quality of life and economic productivity. Despite being a highly cost-effective intervention, cataract surgery remains inaccessible to many, especially in low-resource settings. This study presents a dynamic model that aims to estimate the number of people who will die before receiving cataract surgery, using Kenya as a case study.</div></div><div><h3>Methods</h3><div>We developed a dynamic simulation model to project the national cataract backlog, surgical interventions, and mortality over a 50-year period (1990–2040). The model integrates demographic and epidemiological data, alongside key parameters including age-specific cataract incidence, severity progression, mortality risk, and surgical throughput. Sensitivity analysis was done to estimate the effect of different cataract surgical rates.</div></div><div><h3>Findings</h3><div>At current surgical capacity, the model estimates that 280 400 (77%) of 360 000 individuals on Kenya’s cataract backlog in 2025 will die before receiving surgery, with 236 400 (66%) dying before 2030. Sensitivity analysis shows that doubling cataract surgical rates could enable an additional 24 000 people to receive treatment before death, representing a 16% reduction in untreated mortality. A ten-fold increase (cataract surgical rates of 7020 surgeries per million people per year) would nearly eliminate deaths among those awaiting surgery.</div></div><div><h3>Interpretation</h3><div>This model provides a comprehensive view of the national cataract burden by incorporating incidence, surgical capacity, and mortality estimates for untreated cases. It underscores the urgent need for expanded cataract surgery capacity and improved access to care. The model offers actionable insights for policy makers and health system planners aiming to reduce avoidable blindness and prevent premature deaths from treatable conditions.</div></div><div><h3>Funding</h3><div>The Wellcome Trust and Fred Hollows Foundation.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 2","pages":"Article 100800"},"PeriodicalIF":14.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195777","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 effects of daily low-dose aspirin on white matter hyperintensity lesions and retinal vascular calibre in healthy older adults: the ENVIS-ion exploratory neuroimaging substudy of the ASPREE randomised clinical trial","authors":"Walter P Abhayaratna MBBS PhD ,&nbsp;Prof Christopher M Reid PhD ,&nbsp;Katherine L Webb MA ,&nbsp;Prof Rory Wolfe PhD ,&nbsp;Ruth E Trevaks PhD ,&nbsp;Liubov Robman MBBS PhD ,&nbsp;Stephanie A Ward MBBS PhD ,&nbsp;Prof Meng Law MD ,&nbsp;Ben Sinclair PhD ,&nbsp;Scott Kolbe PhD ,&nbsp;Marc M Budge MBBS ,&nbsp;Prof Tien Y Wong MBBS PhD ,&nbsp;Prof Andrew Tonkin MD ,&nbsp;Prof John J McNeil MBBS PhD ,&nbsp;Prof Elsdon Storey MBBS DPhil ,&nbsp;Robyn L Woods PhD","doi":"10.1016/j.lanhl.2025.100815","DOIUrl":"10.1016/j.lanhl.2025.100815","url":null,"abstract":"<div><h3>Background</h3><div>Cerebral small vessel disease and alterations in retinal vascular calibre (RVC) are recognised precursors of stroke, dementia, and cognitive decline. We aimed to assess the effect of low-dose aspirin on white matter hyperintensity (WMH), a marker of cerebral small vessel disease, and changes in RVC.</div></div><div><h3>Methods</h3><div>We conducted a prospectively planned exploratory neurovascular substudy (ENVIS-ion) of the Aspirin in Reducing Events in the Elderly (ASPREE) double-blinded randomised clinical trial of 19 114 older adults (aged ≥70 years), who had no previous cardiovascular disease, stroke, or cognitive impairment at baseline. Participants were allocated to daily enteric-coated aspirin 100 mg or matching placebo using computer-generated randomisation and underwent MRI of the brain and fundus photography at two clinical trials sites in Australia at baseline and after 3 years. WMH and RVC measures were assessed by graders blinded to study treatment allocation. The effects of aspirin on total and regional WMH volumes (as a percentage of total brain volume) and RVC over time were analysed using linear models. ASPREE is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT01038583</span><svg><path></path></svg></span>, and the International Standard Randomised Controlled Trial Number Registry, ISRCTN83772183.</div></div><div><h3>Findings</h3><div>Between April, 2010, and April, 2012, 610 participants from the eligible ASPREE cohort of 2346 individuals were enrolled in the ENVIS-ion substudy. Of the 610 participants (mean age 75·2 years [SD 4·1], 289 [47%] male and 321 [53%] female), 312 were assigned to receive aspirin and 298 to placebo. Over 3 years, the aspirin group had a greater increase in the percentage of deep WMH (β 0·14 [95% CI 0·01 to 0·27]) but there was no difference between aspirin and placebo groups in changes from baseline to 3 years in total brain WMH (0·05 [–0·02 to 0·11]) or periventricular WMH (0·03 [–0·03 to 0·09]). There was no evidence of an aspirin effect on RVC. The rate of major haemorrhage was higher in the aspirin arm for the ASPREE study (hazard ratio 1·38, 95% CI 1·18 to 1·62).</div></div><div><h3>Interpretation</h3><div>In this exploratory study, there was no evidence that low-dose aspirin in healthy older adults had any effect on RVC or attenuated the progression of WMH during a 3-year period.</div></div><div><h3>Funding</h3><div>National Health and Medical Research Council of Australia.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 2","pages":"Article 100815"},"PeriodicalIF":14.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207932","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":"Incidental findings and duty-of-care protocols in cardiovascular magnetic resonance among older adults: a prospective population-based study from MyoFit46","authors":"Matthew Webber PhD ,&nbsp;Fiona Chan MBBC ,&nbsp;Constantin-Cristian Topriceanu MBBS ,&nbsp;Emma Martin MSc ,&nbsp;George Joy PhD ,&nbsp;Jonathan Bennett MBBS ,&nbsp;Debbie Falconer MBBS ,&nbsp;Franca Morselli MD ,&nbsp;Hunain Shiwani BMBS ,&nbsp;Pablo Gonzalez MSc ,&nbsp;Lee Hamill Howes BSc ,&nbsp;Andrew Wong PhD ,&nbsp;Alicja Rapala BSc ,&nbsp;Steven Bandula MBBS ,&nbsp;Rhodri H Davies PhD ,&nbsp;Prof Peter Kellman PhD ,&nbsp;Iain Pierce PhD ,&nbsp;Michele Orini PhD ,&nbsp;Rebecca Hardy PhD ,&nbsp;Prof Nishi Chaturvedi PhD ,&nbsp;Gabriella Captur PhD","doi":"10.1016/j.lanhl.2026.100823","DOIUrl":"10.1016/j.lanhl.2026.100823","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Incidental findings are often found in imaging research, especially in older people (aged ≥75 years). Understanding their prevalence is essential to inform consent and disclosure protocols as well as anticipate onward investigation balanced against minimising unnecessary anxiety and health-care burden. The aim of this study was to determine the prevalence of incidental findings in a population-based sample of individuals aged 75–77 years using cardiovascular magnetic resonance (CMR) imaging and to inform duty-of-care frameworks for their reporting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;MyoFit46 was a prospective imaging cohort substudy of the National Survey of Health and Development (NSHD) study. Participants were prospectively recruited from the NSHD study, between May 18, 2020, and March 15, 2024, and underwent 3-Tesla contrast-enhanced CMR. An incidental finding was defined as a previously unknown abnormality that had not been identified by the participant or the research team before the study date. Incidental findings were classified into cardiac, non-cardiac, and clinical, and predefined according to the required urgency of follow-up as routine (reported to participants and their general practitioners within 28 days) or or immediate (reported within 48 hours). This study is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT05455125&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Of 505 participants prospectively recruited, 484 (96%) completed a full CMR scan. Of these, 432 (89%) had at least one incidental finding, including 58 (12%) immediate and 429 (89%) routine findings. Incidental findings were more common in male participants than in female participants (routine: 250 [92%] of 271 men &lt;em&gt;vs&lt;/em&gt; 182 [85%] of 213 women, p=0·018; immediate: 39 [14%] of 271 men &lt;em&gt;vs&lt;/em&gt; 19 [9%] of 213 women, p=0·069). The commonest routine cardiac incidental finding was late gadolinium enhancement (145 [43%] of 334 participants) and the commonest immediate cardiac finding was a left ventricular ejection fraction lower than 40% (seven [2%] of 334 participants). Non-cardiac incidental findings were predominantly routine (203 [42%] of 484) whereas immediate non-cardiac incidental findings were very uncommon (four [1%] of 484). Clinical findings were found in 201 (42%) of 484 participants, of which 28 (6%) were classified as immediate and 187 (39%) classified as routine.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;CMR and baseline assessments revealed that incidental findings are common in imaging research in adults aged 75 years and older, underscoring the need for robust duty-of-care frameworks to ensure timely, ethical, and appropriate management of these findings in older age. These findings provide a population benchmark that can inform the design, governance, and resource planning of future large-scale imaging studies in ageing cohorts.&lt;/div&gt;&lt;","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 2","pages":"Article 100823"},"PeriodicalIF":14.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378839","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":"Responsible use of artificial intelligence in the provision of long-term care for older people: a care-centric approach","authors":"Caroline Emmer De Albuquerque Green PhD ,&nbsp;Tyler Reinmund MSc ,&nbsp;Prof Kate Hamblin PhD ,&nbsp;Prof Samir K Sinha MD DPhil","doi":"10.1016/j.lanhl.2026.100817","DOIUrl":"10.1016/j.lanhl.2026.100817","url":null,"abstract":"<div><div>Current approaches to the role of artificial intelligence (AI) in the provision of long-term care for older people are largely framed around solving perceived problems in the sector, such as managing workforce shortages by driving greater efficiency through the automation of administrative and care tasks. Although such approaches might highlight some benefits of AI, they tend to overlook broader contextual and ethical implications within the complex structures of care systems. Thus, such narrow approaches can compromise care quality and pose risks for care recipients, caregivers, and care services. In this Personal View, we advocate for an alternative, care-centric approach to AI in long-term care, grounded in co-production and rooted in the view that care is a human need tied to wellbeing, dignity, equality, and human rights. We propose a definition of the responsible use of AI in long-term care with values of care at the forefront. We propose to use this definition as a starting point to drive AI policy and practice, rather than focusing on perceived problems, while also acknowledging and addressing tensions identified during the recent co-creation of responsible AI guidelines for the UK.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 2","pages":"Article 100817"},"PeriodicalIF":14.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146259502","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 impact of exercise interventions on domains of quality of life in women diagnosed with breast cancers during chemotherapy treatment: a meta-analytic review","authors":"LaShae D Rolle MPH ,&nbsp;Soyeon Ahn PhD ,&nbsp;Elle M Mezzio BS ,&nbsp;Madalyn Wheeler MSEd ,&nbsp;Loren Yavelberg PhD ,&nbsp;Carmen J Calfa MD ,&nbsp;Sophia H L George PhD ,&nbsp;Kathryn H Schmitz PhD ,&nbsp;Tracy E Crane PhD","doi":"10.1016/j.lanhl.2026.100819","DOIUrl":"10.1016/j.lanhl.2026.100819","url":null,"abstract":"<div><h3>Background</h3><div>Exercise can improve quality of life in women undergoing chemotherapy for breast cancer, but evidence of the most effective intervention characteristics remains inconclusive. The aim of this study was to determine the effect of exercise on quality of life in women with breast cancer during chemotherapy and examine whether its relationship varies by described exercise modality, dose, and other study characteristics.</div></div><div><h3>Methods</h3><div>In this systematic review and meta-analysis, a systematic search of five electronic databases (PubMed, Embase, Web of Science, Cochrane Library, and MEDLINE) from Jan 1, 2005, to May 24, 2025, identified randomised controlled trials evaluating exercise interventions and constructs of quality of life in women undergoing chemotherapy for breast cancer. Standardised mean differences (Hedges' g) were calculated and pooled using three-level random-effects models accounting for dependent effect sizes, and potential moderators were examined.</div></div><div><h3>Findings</h3><div>21 randomised controlled trials (3024 participants) were included. Overall, exercise interventions showed a significant positive effect on constructs of quality of life (ḡ=0·434 [95% CI 0·272–0·595], p&lt;0·0001). Substantial heterogeneity was observed (<em>I</em>²=55·76%). Described exercise modality significantly moderated effects (test statistic 3 for moderator differences 28·85, p&lt;0·0001), with aerobic exercise (ḡ=0·482 [95% CI 0·272–0·595], p&lt;0·0001), combined aerobic-strength training (ḡ=0·397 [0·156–0·639], p=0·0001), and strength-alone (ḡ=0·335 [0·002–0·669], p&lt;0·049) showing significant benefits. This study is retrospectively registered with PROSPERO (CRD420251044479).</div></div><div><h3>Interpretation</h3><div>Exercise interventions significantly affect quality of life in women with breast cancer during chemotherapy. Aerobic and combined aerobic–strength training both showed significant benefits. Further research is needed to establish optimal exercise prescriptions.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 2","pages":"Article 100819"},"PeriodicalIF":14.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147322338","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":"Multidomain post-stroke cognitive impairment: development and validation of a clinical prediction model","authors":"Andrea Kusec PhD ,&nbsp;Kym I E Snell PhD ,&nbsp;Prof Nele Demeyere PhD","doi":"10.1016/j.lanhl.2026.100820","DOIUrl":"10.1016/j.lanhl.2026.100820","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Post-stroke cognitive impairment (PSCI) is highly prevalent across multiple domains. Individualised PSCI prognosis has mainly been researched using dementia-specific outcomes instead of stroke-specific outcomes, and existing models often use predictors not routinely available in electronic health records. We aimed to develop and externally validate clinical prediction models for overall PSCI via use of a stroke-specific cognitive outcome, using acute PSCI and data routinely collected in stroke care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this prediction model development and validation study, we used data from a cohort of participants with stroke who were consecutively recruited from the acute stroke ward of the John Radcliffe Hospital (Oxford, UK) for the Oxford Cognitive Screening Programme (OCS-Recovery study). Participants completed the Oxford Cognitive Screen (OCS; comprising 12 subtasks covering six cognitive domains) acutely and at the 6-month follow-up. The outcome was binarised (impaired &lt;em&gt;vs&lt;/em&gt; unimpaired). The selected predictors for the logistic regression models were available in electronic health records and conceptually relevant to post-stroke cognition. Logistic regression models were fitted with mandatory clinically relevant predictors (age, sex assigned at birth, stroke severity, education, stroke hemisphere, and acute PSCI) and data-driven predictors (acute mood difficulties, length of stay in acute care, and multimorbidity). We conducted backward elimination on multiply imputed data to remove non-significant (p&gt;0·10) data-driven predictors. Internal validation used bootstrapping to obtain optimism-adjusted performance estimates. The same internal validation procedure was followed for a continuous prediction model, using proportion of OCS tasks impaired as the outcome. For external validation, we used the OCS-Care dataset, comprising data from a stroke cohort with mild severity PSCI. Performance measures included discrimination (eg, C-statistic), calibration, and goodness-of-fit. Overall binary PSCI model performance was further evaluated within subgroups by age range, sex assigned at birth, first versus recurrent stroke, and acute PSCI severity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between March 20, 2012, and March 9, 2020, 430 participants recruited to the OCS-Recovery study completed the OCS acutely and at 6-months after stroke. All participants attempted the OCS, with 400 (93%) completing at least ten of 12 subtasks. The overall binary PSCI model had good optimism-adjusted performance (C-statistic 0·76 [95% CI 0·71–0·80]), with similar external validation performance (0·74 [0·68–0·80]). Model performance did not vary by sex assigned at birth but was best in adults younger than 60 years (0·76 [0·62–0·86]) with moderate-to-severe acute PSCI (0·72 [0·60–0·81]).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Stroke-specific cognition prediction models can offer more meaningful PSCI prognoses t","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 2","pages":"Article 100820"},"PeriodicalIF":14.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147373105","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}