Lancet Healthy Longevity最新文献

{"title":"The UN Decade of Healthy Ageing (2021-30) for people living with HIV.","authors":"Giovanni Guaraldi, Jovana Milic, Eduardo Gnoatto Perondi, Ana Catarina Rodrigues Gonçalves, Cristina Mussini, Marco Antonio de Avila Vitoria, Matteo Cesari","doi":"10.1016/j.lanhl.2024.100643","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100643","url":null,"abstract":"<p><p>The Decade of Healthy Ageing (2021-30; the Decade), proclaimed by the UN in 2020, is a global initiative aimed at fostering collaborations to transform the world into a better place to live and grow older in. The Decade presents a positive vision of ageing, discarding the stereotypes of diseases and disabilities and promoting focus on capacities and abilities. This approach will help to foster a more inclusive world and, consequently, care systems, which value the dignity of each individual. Although the initiative represents a resource for the global population, the Decade also provides a unique opportunity for the large community of people living with HIV in terms of increased visibility and long-term solutions for their specific ageing-related health issues. This Personal View focuses on the relevance of the Decade in improving the lives of people in the HIV community, the rationale for a stronger engagement of people living with HIV in this initiative, and the potential to reduce global disparities between the HIV community and the general population and among different global regions.</p>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100643"},"PeriodicalIF":13.4,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393897","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":"Early integration of palliative care versus standard cardiac care for patients with heart failure (EPCHF): a multicentre, parallel, two-arm, open-label, randomised controlled trial","authors":"Mahmoud Balata MD ,&nbsp;Prof Lukas Radbruch MD ,&nbsp;Michaela Hesse MD ,&nbsp;Prof Ralf Westenfeld MD ,&nbsp;Martin Neukirchen MD ,&nbsp;Prof Roman Pfister MD ,&nbsp;Yann-Nicolas Batzler MD ,&nbsp;Can Öztürk MD ,&nbsp;Refik Kavsur MD ,&nbsp;Vedat Tiyerili MD ,&nbsp;Prof Birgitta Weltermann MD ,&nbsp;Robert Pölsler MD ,&nbsp;Prof Thomas Standl MD ,&nbsp;Prof Georg Nickenig MD ,&nbsp;Prof Marc Ulrich Becher MD ,&nbsp;Heart Failure Network Rhineland","doi":"10.1016/j.lanhl.2024.08.006","DOIUrl":"10.1016/j.lanhl.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure is a substantial global health concern that severely affects patients' quality of life. We aimed to compare the effects of early integration of palliative care (EIPC) and standard cardiac care on health status and mood of patients with non-terminal heart failure.</div></div><div><h3>Methods</h3><div>EPCHF was a multicentre, parallel, two-arm, open-label, randomised controlled trial carried out at University Hospital Bonn and University Hospital Düsseldorf in Germany. Eligible patients (aged 18 years or older) had heart failure, with New York Heart Association class II or more and NT-proBNP concentrations greater than or equal to 400 pg/mL. Patients were randomly assigned (1:1) to receive EIPC with standard cardiac care or standard cardiac care alone. Randomisation was computer-generated with allocation concealment, variable block sizes, and stratification by investigational site. The primary endpoints were health status and mood, measured every 3 months over 12 months using the Functional Assessment of Chronic Illness Therapy–Palliative Care (FACIT–PAL) and the Kansas City Cardiomyopathy Questionnaire (KCCQ), analysed by intention to treat. This trial is registered with DRKS.de, DRKS00013922.</div></div><div><h3>Findings</h3><div>Between May 21, 2019, and Nov 15, 2021, 843 patients were assessed for eligibility, 205 of whom were enrolled (100 assigned to EIPC and 105 assigned to standard cardiac care). 143 (70%) patients were male and 62 (30%) were female. Over 12 months, both groups significantly improved in FACIT–PAL and KCCQ Overall Summary Score (OSS) with no significant differences between the groups (FACIT–PAL adjusted mean difference 0·98 points [95% CI –1·28 to 3·23]; p=0·40; KCCQ-OSS adjusted mean difference –2·06 points [–7·89 to 3·78]; p=0·49). Nine (9%) patients in the EIPC group and seven (7%) patients in the standard cardiac care group died from any cause, with no significant differences in time to death between the two groups (hazard ratio [HR] 1·32 [95% CI 0·49 to 3·54]; p=0·58). 22 (22%) patients in the EIPC group and 21 (21%) patients in the standard cardiac care group were hospitalised at least once due to heart failure, with no significant differences in time to heart-failure-related hospitalisation between the two groups (HR 1·09 [0·61 to 1·98]; p=0·77). 70 (70%) patients in the EIPC group and 62 (59%) in the standard cardiac care group had any adverse events (p=0·10).</div></div><div><h3>Interpretation</h3><div>In this open-label, randomised clinical trial, standard cardiac care, featuring guideline-directed optimisation of medical therapy and regular 3-monthly follow-ups was found to be as effective as when combined with EIPC in improving health status and mood in patients with non-terminal heart failure. Future clinical practices should consider EIPC based on individual patient needs.</div></div><div><h3>Funding</h3><div>Federal Ministry of Education and Research.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100637"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376138","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":"Use of biomarkers in the diagnosis of Alzheimer’s disease in adults with intellectual disability","authors":"Aoife McFeely MB ,&nbsp;Antoinette O’Connor MB PhD ,&nbsp;Prof Sean P Kennelly MB PhD","doi":"10.1016/j.lanhl.2024.100639","DOIUrl":"10.1016/j.lanhl.2024.100639","url":null,"abstract":"<div><div>People with intellectual disability are a vulnerable cohort who face challenges accessing health care. Compared with the general population, people with intellectual disability have an elevated risk of developing dementia, which often presents at a younger age and with atypical symptoms. The lifelong cognitive and functional difficulties faced by people with intellectual disability further complicate the diagnostic process. Specialised intellectual disability memory services and evaluation using reliable biomarkers of neurodegeneration are needed to improve diagnostic and prognostic certainty in this group. Inadequate specialist services and paucity of research on biomarkers in this population hinders progress and impedes the delivery of adequate health care. Although cerebrospinal fluid-based biomarkers and radiological biomarkers are used routinely in the evaluation of Alzheimer’s disease in the general population, biological variation within the clinically heterogenous group of people with intellectual disability could affect the clinical utility of existing biomarkers. As disease-modifying therapies become available for the treatment of early Alzheimer’s disease, and hopefully other neurodegenerative conditions in the future, biomarkers will serve as gatekeepers to establish the eligibility for such therapies. Inadequate representation of adults with intellectual disability in biomarker research will result in their exclusion from treatment with disease-modifying therapies, thus perpetuating the inequity in health care that is already faced by this group. The aim of this Series paper is to summarise current evidence on the application of biomarkers for Alzheimer’s disease in a population with intellectual disability (that is not attributable to Down syndrome) and suspected cognitive decline.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100639"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381805","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":"Mental health deserves attention at all ages","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2024.100650","DOIUrl":"10.1016/j.lanhl.2024.100650","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100650"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476502","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":"Clinical effectiveness of DREAMS START (Dementia Related Manual for Sleep; Strategies for Relatives) versus usual care for people with dementia and their carers: a single-masked, phase 3, parallel-arm, superiority randomised controlled trial","authors":"Prof Penny Rapaport PhD ,&nbsp;Sarah Amador PhD ,&nbsp;Mariam O Adeleke PhD ,&nbsp;Prof Julie A Barber PhD ,&nbsp;Prof Sube Banerjee MD ,&nbsp;Prof Georgina Charlesworth PhD ,&nbsp;Chris Clarke DClinPsy ,&nbsp;Prof Colin A Espie DSc ,&nbsp;Lina Gonzalez MSc ,&nbsp;Rossana Horsley GradCert ,&nbsp;Prof Rachael Hunter MSc ,&nbsp;Prof Simon D Kyle PhD ,&nbsp;Monica Manela BM ,&nbsp;Malgorzata Raczek PhD ,&nbsp;Prof Zuzana Walker MD ,&nbsp;Lucy Webster PhD ,&nbsp;Hang Yuan PhD ,&nbsp;Prof Gill Livingston MD","doi":"10.1016/j.lanhl.2024.08.004","DOIUrl":"10.1016/j.lanhl.2024.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances are common and distressing for people with dementia and their families. Non-pharmacological interventions should be first-line management, avoiding harmful pharmacological side-effects, but there is none with known effectiveness. We aimed to establish whether DREAMS START, a multicomponent intervention, reduced sleep disturbance in people with dementia living at home compared with usual care.</div></div><div><h3>Methods</h3><div>We conducted a phase 3, two-arm, multicentre, parallel-arm, superiority randomised controlled trial with masked outcome assessment, recruiting dyads of people with dementia and sleep disturbance and family carers from community settings. Randomisation to the DREAMS START intervention (plus usual treatment) or usual treatment was conducted at dyadic level, blocked, and stratified by site, with a web-based system assigning allocation. DREAMS START is a six-session, manualised intervention delivered face to face or remotely by non-clinically trained graduates over an approximately 3-month period. The primary outcome was sleep disturbance measured by the Sleep Disorders Inventory (SDI) at 8 months. Analyses were on the intention-to-treat population. This trial is registered with ISRCTN 13072268.</div></div><div><h3>Findings</h3><div>Between Feb 24, 2021, and March 5, 2023, 377 dyads were randomly assigned (1:1), 189 to usual treatment and 188 to intervention. The mean age of participants with dementia was 79·4 years (SD 9·0), and 206 (55%) were women. The mean SDI score at 8 months was lower in the intervention group compared with the usual treatment group (15·16 [SD 12·77], n=159, <em>vs</em> 20·34 [16·67], n=163]; adjusted difference in means –4·70 [95% CI –7·65 to –1·74], p=0·002). 17 (9%) people with dementia in the intervention group and 17 (9%) in the control group died during the trial; the deaths were unrelated to the intervention.</div></div><div><h3>Interpretation</h3><div>To our knowledge, DREAMS START is the first multicomponent intervention to improve the sleep of people living at home with dementia more than usual clinical care. It had sustained effectiveness beyond intervention delivery. The intervention’s delivery by non-clinically trained graduates increases the potential for implementation within health services, adding to usual clinical care.</div></div><div><h3>Funding</h3><div>National Institute for Health and Care Research Health Technology Assessment.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100635"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376125","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":"A retinal biomarker of biological age based on composite clinical phenotypic information","authors":"Ruiyang Li ,&nbsp;Haotian Lin","doi":"10.1016/S2666-7568(24)00109-0","DOIUrl":"10.1016/S2666-7568(24)00109-0","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100603"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373108","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":"Challenges in the practical implementation of blood biomarkers for Alzheimer’s disease","authors":"Prof Michael Schöll PhD ,&nbsp;Inge M W Verberk PhD ,&nbsp;Marta del Campo PhD ,&nbsp;Constance Delaby PhD ,&nbsp;Joseph Therriault PhD ,&nbsp;Joyce R Chong PhD ,&nbsp;Sebastian Palmqvist PhD ,&nbsp;Daniel Alcolea PhD","doi":"10.1016/j.lanhl.2024.07.013","DOIUrl":"10.1016/j.lanhl.2024.07.013","url":null,"abstract":"<div><div>Blood biomarkers have emerged as accessible, cost-effective, and highly promising tools for advancing the diagnostics of Alzheimer’s disease. However, transitioning from cerebrospinal fluid biomarkers to blood biomarkers—eg, to verify amyloid β pathology—requires careful consideration. This Series paper highlights the main challenges in the implementation of blood biomarkers for Alzheimer’s disease in different possible contexts of use. Despite the robustness of measuring blood biomarker concentrations, the widespread adoption of blood biomarkers requires rigorous standardisation efforts to address inherent challenges in diverse contexts of use. The challenges include understanding the effect of pre-analytical and analytical conditions, potential confounding factors, and comorbidities that could influence outcomes of blood biomarkers and their use in diverse populations. Additionally, distinct scenarios present their own specific challenges. In memory clinics, the successful integration of blood biomarkers in diagnostic tests will require well-established diagnostic accuracy and comprehensive assessments of the effect of blood biomarkers on the diagnostic confidence and patient management of clinicians. In primary care settings, and even more when implemented in population-based screening programmes for which no experience with any biomarkers for Alzheimer’s disease currently exists, the implementation of blood biomarkers will be challenged by the need for education of primary care clinical staff and clear guidelines. However, despite the challenges, blood biomarkers hold great promise for substantially enhancing the diagnostic accuracy and effectively streamlining referral processes, leading to earlier diagnosis and access to treatments. The ongoing efforts that are shaping the integration of blood biomarkers across diverse clinical settings pave the way towards precision medicine in Alzheimer’s disease.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100630"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381804","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":"Application of a deep-learning marker for morbidity and mortality prediction derived from retinal photographs: a cohort development and validation study","authors":"Simon Nusinovici PhD ,&nbsp;Tyler Hyungtaek Rim MD ,&nbsp;Hengtong Li MS ,&nbsp;Marco Yu PhD ,&nbsp;Mihir Deshmukh MS ,&nbsp;Ten Cheer Quek BEng ,&nbsp;Geunyoung Lee MS ,&nbsp;Crystal Chun Yuen Chong MS ,&nbsp;Qingsheng Peng MD ,&nbsp;Can Can Xue PhD ,&nbsp;Zhuoting Zhu MD ,&nbsp;Emily Y Chew MD ,&nbsp;Charumathi Sabanayagam PhD ,&nbsp;Prof Tien-Yin Wong PhD ,&nbsp;Yih-Chung Tham PhD ,&nbsp;Prof Ching-Yu Cheng MD","doi":"10.1016/S2666-7568(24)00089-8","DOIUrl":"10.1016/S2666-7568(24)00089-8","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Biological ageing markers are useful to risk stratify morbidity and mortality more precisely than chronological age. In this study, we aimed to develop a novel deep-learning-based biological ageing marker (referred to as RetiPhenoAge hereafter) using retinal images and PhenoAge, a composite biomarker of phenotypic age.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We used retinal photographs from the UK Biobank dataset to train a deep-learning algorithm to predict the composite score of PhenoAge. We used a deep convolutional neural network architecture with multiple layers to develop our deep-learning-based biological ageing marker, as RetiPhenoAge, with the aim of identifying patterns and features in the retina associated with variations of blood biomarkers related to renal, immune, liver functions, inflammation, and energy metabolism, and chronological age. We determined the performance of this biological ageing marker for the prediction of morbidity (cardiovascular disease and cancer events) and mortality (all-cause, cardiovascular disease, and cancer) in three independent cohorts (UK Biobank, the Singapore Epidemiology of Eye Diseases [SEED], and the Age-Related Eye Disease Study [AREDS] from the USA). We also compared the performance of RetiPhenoAge with two other known ageing biomarkers (hand grip strength and adjusted leukocyte telomere length) and one lifestyle factor (physical activity) for risk stratification of mortality and morbidity. We explored the underlying biology of RetiPhenoAge by assessing its associations with different systemic characteristics (eg, diabetes or hypertension) and blood metabolite levels. We also did a genome-wide association study to identify genetic variants associated with RetiPhenoAge, followed by expression quantitative trait loci mapping, a gene-based analysis, and a gene-set analysis. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and corresponding 95% CIs for the associations between RetiPhenoAge and the different morbidity and mortality outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Retinal photographs for 34 061 UK Biobank participants were used to train the model, and data for 9429 participants from the SEED cohort and for 3986 participants from the AREDS cohort were included in the study. RetiPhenoAge was associated with all-cause mortality (HR 1·92 [95% CI 1·42–2·61]), cardiovascular disease mortality (1·97 [1·02–3·82]), cancer mortality (2·07 [1·29–3·33]), and cardiovascular disease events (1·70 [1·17–2·47]), independent of PhenoAge and other possible confounders. Similar findings were found in the two independent cohorts (HR 1·67 [1·21–2·31] for cardiovascular disease mortality in SEED and 2·07 [1·10–3·92] in AREDS). RetiPhenoAge had stronger associations with mortality and morbidity than did hand grip strength, telomere length, and physical activity. We identified two genetic variants that were significantly associated with RetiPhenoAge (single","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100593"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373109","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":"Long-term air pollution exposure and incident physical disability in older US adults: a cohort study","authors":"Jiaqi Gao PhD ,&nbsp;Carlos F Mendes de Leon PhD ,&nbsp;Boya Zhang PhD ,&nbsp;Jennifer Weuve ScD ,&nbsp;Kenneth M Langa PhD ,&nbsp;Jennifer D'Souza PhD ,&nbsp;Adam Szpiro PhD ,&nbsp;Jessica Faul PhD ,&nbsp;Joel D Kaufman MD ,&nbsp;Richard Hirth PhD ,&nbsp;Sara D Adar ScD","doi":"10.1016/j.lanhl.2024.07.012","DOIUrl":"10.1016/j.lanhl.2024.07.012","url":null,"abstract":"<div><h3>Background</h3><div>Disability is a key marker of overall physical health in older adults and is often preceded by chronic disease. Although air pollution is a well recognised risk factor for multiple chronic diseases, its association with physical disability has not been well characterised. We investigated the associations of air pollutants with physical disability in a large cohort representative of older adults in the USA.</div></div><div><h3>Methods</h3><div>We used biennial data on incident activities of daily living (ADL) disability collected from respondents of the Health and Retirement Survey between 2000 and 2016. As part of the Environmental Predictors of Cognitive Health and Aging study, we estimated 10-year average PM_2·5, PM₁₀_–_2·5, nitrogen dioxide (NO₂), and ozone (O₃) concentrations at participant residences before each survey using spatiotemporal prediction models. We used a time-varying, weighted Cox model to estimate hazard ratios (HRs) for incident physical disability per interquartile increase of air pollution with detailed adjustments for confounders.</div></div><div><h3>Findings</h3><div>Among 15 411 respondents aged 65 years and older (mean age 70·2 [SD 6·5] years; 55% female, 45% male), 48% of respondents reported newly having ADL disability during a mean follow-up of 7·9 years (SD 4·7). In fully adjusted models, we found greater risks of ADL disability associated with higher concentrations of PM_2·5 (HR 1·03 per 3·7 μg/m³ [95% CI 0·99–1·08], p=0·16), PM₁₀_–_2·5 (1·05 per 4·9 μg/m³ [1·00–1·11], p=0·022), and NO₂ (1·03 per 7·5 ppb [0·99–1·08]. p=0·064), although not all these associations were statistically significant. In contrast, O₃ was associated with a lower risk of ADL disability (0·95 per 3·7 ppb [0·91–1·00], p=0·030). In a multi-pollutant model, associations were similar to the single-pollutant models for PM₁₀_–_2·5 (1·05 per 4·9 μg/m³ [1·00–1·11], p=0·041) and O₃ (0·94 per 3·7 ppb [0·88–1·01], p=0·083).</div></div><div><h3>Interpretation</h3><div>Our findings suggest that air pollution might be an underappreciated risk factor for physical disability in later life, although additional research is needed.</div></div><div><h3>Funding</h3><div>National Institutes of Environmental Health Sciences and National Institute on Aging.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100629"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142355554","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":"Biomarkers of neurodegeneration across the Global South","authors":"Eimear McGlinchey PhD ,&nbsp;Claudia Duran-Aniotz PhD ,&nbsp;Prof Rufus Akinyemi MD ,&nbsp;Faheem Arshad MD ,&nbsp;Eduardo R Zimmer PhD ,&nbsp;Hanna Cho MD ,&nbsp;Boluwatife Adeleye Adewale MD ,&nbsp;Agustin Ibanez PhD","doi":"10.1016/S2666-7568(24)00132-6","DOIUrl":"10.1016/S2666-7568(24)00132-6","url":null,"abstract":"<div><div>Research on neurodegenerative diseases has predominantly focused on high-income countries in the Global North. This Series paper describes the state of biomarker evidence for neurodegeneration in the Global South, including Latin America, Africa, and countries in south, east, and southeast Asia. Latin America shows growth in fluid biomarker and neuroimaging research, with notable advancements in genetics. Research in Africa focuses on genetics and cognition but there is a paucity of data on fluid and neuroimaging biomarkers. South and east Asia, particularly India and China, has achieved substantial progress in plasma, neuroimaging, and genetic studies. However, all three regions face several challenges in the form of a lack of harmonisation, insufficient funding, and few comparative studies both within the Global South, and between the Global North and Global South. Other barriers include scarce infrastructure, lack of knowledge centralisation, genetic and cultural diversity, sociocultural stigmas, and restricted access to tools such as PET scans. However, the diverse ethnic, genetic, economic, and cultural backgrounds in the Global South present unique opportunities for bidirectional learning, underscoring the need for global collaboration to enhance the understanding of dementia and brain health.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100616"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381803","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}