Lancet Healthy Longevity最新文献

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Barriers to accessing cataract surgery 白内障手术的障碍。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-02-01 Epub Date: 2026-03-03 DOI: 10.1016/j.lanhl.2026.100838
The Lancet Healthy Longevity
{"title":"Barriers to accessing cataract surgery","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2026.100838","DOIUrl":"10.1016/j.lanhl.2026.100838","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 2","pages":"Article 100838"},"PeriodicalIF":14.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370477","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}
引用次数: 0
Repeated measures of physical activity before dementia diagnosis in community-dwelling older adults: a longitudinal study 在社区居住的老年人痴呆诊断前重复测量身体活动:一项纵向研究。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-02-01 Epub Date: 2026-03-09 DOI: 10.1016/j.lanhl.2026.100824
Shahram Oveisgharan MD , Jingyun Yang PhD , Tianhao Wang PhD , David A Bennett MD , Aron S Buchman MD
{"title":"Repeated measures of physical activity before dementia diagnosis in community-dwelling older adults: a longitudinal study","authors":"Shahram Oveisgharan MD ,&nbsp;Jingyun Yang PhD ,&nbsp;Tianhao Wang PhD ,&nbsp;David A Bennett MD ,&nbsp;Aron S Buchman MD","doi":"10.1016/j.lanhl.2026.100824","DOIUrl":"10.1016/j.lanhl.2026.100824","url":null,"abstract":"<div><h3>Background</h3><div>Many studies have reported that a single measure of physical activity in older adults is associated with incident dementia. In this study, we examined repeated measures of physical activity to determine if this association with incident dementia varied.</div></div><div><h3>Methods</h3><div>Participants were from a community-based longitudinal study of older adults (the Rush Memory and Aging Project [MAP]). MAP participants were recruited from retirement centres and subsidised long-term care facilities across northeastern Illinois (USA). Physical activity level was extracted from biennial multiday wrist-wearing sensor recordings. Dementia diagnosis was based on neuropsychological test scores, clinical history, and examination. Joint modelling integrating a linear mixed-effects model and a Cox model was used to prospectively test the association of repeated measures of physical activity and dementia, and a time-varying effects model was used to retrospectively examine the association of dementia with repeated measures of physical activity before dementia diagnosis.</div></div><div><h3>Findings</h3><div>Our analyses included 972 older adults (mean age 80·5 years, SD 7·3) with frequent (mean 4·9, SD 2·6) biennial measurements of physical activity. 745 (77%) of 972 participants were female and 227 (23%) were male. 286 (29%) of the 972 participants developed dementia, which was clinically diagnosed as Alzheimer’s disease. Although the joint model indicated an association between physical activity and incident dementia (hazard ratio [HR] 0·78, 95% CI 0·69–0·88; p&lt;0·0001), the model accuracy was stronger for physical activity closer to dementia diagnosis. Baseline physical activity was not related to the risk of dementia more than 7 years after baseline (HR 1·00, 95% CI 0·69–1·45; p=0·99), whereas physical activity at year 6 was (0·55, 0·37–0·80; p=0·0021). In a time-varying effects model, repeated physical activity was not associated with incident dementia except during the last 2 years before dementia diagnosis.</div></div><div><h3>Interpretation</h3><div>Physical activity might be a modifiable protective factor for dementia in old age. However, analyses of repeated measures of physical activity suggest that further work is needed to define the timing of the beneficial effects of physical activity relative to the onset of dementia.</div></div><div><h3>Funding</h3><div>National Institutes of Health.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 2","pages":"Article 100824"},"PeriodicalIF":14.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445291","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}
引用次数: 0
Thank you to The Lancet Healthy Longevity statistical and peer reviewers in 2025 感谢《柳叶刀健康长寿》杂志2025年的统计数据和同行评审。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-01-01 Epub Date: 2026-01-22 DOI: 10.1016/j.lanhl.2026.100818
The Lancet Healthy Longevity Editors
{"title":"Thank you to The Lancet Healthy Longevity statistical and peer reviewers in 2025","authors":"The Lancet Healthy Longevity Editors","doi":"10.1016/j.lanhl.2026.100818","DOIUrl":"10.1016/j.lanhl.2026.100818","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 1","pages":"Article 100818"},"PeriodicalIF":14.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146047066","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}
引用次数: 0
A global gap in autonomy assessment among older adults: a COSMIN systematic review 老年人自主性评估的全球差距:COSMIN系统综述。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-01-01 Epub Date: 2026-02-10 DOI: 10.1016/j.lanhl.2025.100814
Masoud Rahmati PhD , Thomas Renou MSc , Sibylle Del Duca MSc , Houria El Ouazzani PhD , Marie Anastasie Aim PhD , Prof Lee Smith PhD , Prof Dong Keon Yon PhD , Prof Pascal Auquier PhD , Prof Laurent Boyer PhD , Karine Baumstarck PhD
{"title":"A global gap in autonomy assessment among older adults: a COSMIN systematic review","authors":"Masoud Rahmati PhD ,&nbsp;Thomas Renou MSc ,&nbsp;Sibylle Del Duca MSc ,&nbsp;Houria El Ouazzani PhD ,&nbsp;Marie Anastasie Aim PhD ,&nbsp;Prof Lee Smith PhD ,&nbsp;Prof Dong Keon Yon PhD ,&nbsp;Prof Pascal Auquier PhD ,&nbsp;Prof Laurent Boyer PhD ,&nbsp;Karine Baumstarck PhD","doi":"10.1016/j.lanhl.2025.100814","DOIUrl":"10.1016/j.lanhl.2025.100814","url":null,"abstract":"<div><div>Autonomy is increasingly recognised as the basis of healthy ageing and person-centred care; however, it remains under-represented in clinical assessments and policy. We systematically reviewed patient-reported outcome measures and clinician-reported outcome measures of autonomy in adults aged 60 years and older (older adults), following the consensus-based standards for the selection of health measurement instruments (COSMIN) methodology (PROSPERO CRD42025640772). Across 116 studies involving 861 338 older adults in 42 countries, 50 instruments were evaluated for structural validity, reliability, internal consistency, cross-cultural validity, and responsiveness. High-quality evidence supported structural validity in 29 instruments, internal consistency in 33, and test–retest reliability in 17, whereas content validity and responsiveness were often insufficient. 14 instruments met the COSMIN category A criteria (ie, instruments with sufficient content validity and at least low-quality evidence for sufficient internal consistency, indicating that they are reliable and suitable for recommendation) and were recommended for research and clinical use. Substantial gaps remain, particularly in cross-cultural validity and responsiveness of the tested instruments, highlighting the need for internationally aligned, culturally robust, and co-created tools. Health authorities should adopt validated measures to assess autonomy, guide policy, and ensure equitable resource allocation.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 1","pages":"Article 100814"},"PeriodicalIF":14.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195754","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}
引用次数: 0
Defining and addressing loneliness in older adults with cancer: an international Delphi consensus from the Multinational Association of Supportive Care in Cancer Geriatrics Study Group 定义和解决老年癌症患者的孤独感:来自癌症老年病学研究小组多国支持护理协会的国际德尔菲共识。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-01-01 Epub Date: 2026-01-07 DOI: 10.1016/j.lanhl.2025.100811
Enrique Soto-Perez-de-Celis PhD , Kristen R Haase PhD , Prof Sriram Yennu MD , Etienne Brain PhD , Chad Yixian Han PhD , Prof Jørn Herrstedt MD , Ayumu Matsuoka PhD , Joana Marinho PhD , Lewis Mustian BS , Sophie Pilleron PhD , Imogen Ramsey PhD , Christopher Steer MD , Prof Matti Aapro MD
{"title":"Defining and addressing loneliness in older adults with cancer: an international Delphi consensus from the Multinational Association of Supportive Care in Cancer Geriatrics Study Group","authors":"Enrique Soto-Perez-de-Celis PhD ,&nbsp;Kristen R Haase PhD ,&nbsp;Prof Sriram Yennu MD ,&nbsp;Etienne Brain PhD ,&nbsp;Chad Yixian Han PhD ,&nbsp;Prof Jørn Herrstedt MD ,&nbsp;Ayumu Matsuoka PhD ,&nbsp;Joana Marinho PhD ,&nbsp;Lewis Mustian BS ,&nbsp;Sophie Pilleron PhD ,&nbsp;Imogen Ramsey PhD ,&nbsp;Christopher Steer MD ,&nbsp;Prof Matti Aapro MD","doi":"10.1016/j.lanhl.2025.100811","DOIUrl":"10.1016/j.lanhl.2025.100811","url":null,"abstract":"<div><div>Loneliness is a growing public health concern among older adults (aged 65 and older) but remains understudied and under-recognised in geriatric oncology. This Health Policy paper presents survey-based Delphi consensus statements developed by a global panel of experts from the Multinational Association of Supportive Care in Cancer Geriatrics Study Group on the definition, assessment, and management of loneliness in older adults with cancer, to inform research and clinical practice. A consensus was reached on the definitions of loneliness, emphasising upon both emotional and social components, and including contextual factors such as life events and community structures. Multidisciplinary assessment using brief evaluation tools at the time of cancer diagnosis was highlighted. Community-based interventions such as support groups, home visits, and psychological counselling were prioritised over technology-driven approaches for future research. Outcomes considered the most relevant for research on loneliness included quality of life, treatment adherence, and survival. These statements could guide future clinical and research initiatives targeting loneliness in geriatric oncology.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 1","pages":"Article 100811"},"PeriodicalIF":14.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949283","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}
引用次数: 0
Transgender ageing in Thailand: from visibility to recognition in healthy longevity 泰国的跨性别老龄化:从健康长寿的可见性到认可度。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-01-01 Epub Date: 2026-01-21 DOI: 10.1016/j.lanhl.2025.100813
Suchanan Chieowisaman , Krit Pongpirul
{"title":"Transgender ageing in Thailand: from visibility to recognition in healthy longevity","authors":"Suchanan Chieowisaman ,&nbsp;Krit Pongpirul","doi":"10.1016/j.lanhl.2025.100813","DOIUrl":"10.1016/j.lanhl.2025.100813","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 1","pages":"Article 100813"},"PeriodicalIF":14.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146044378","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}
引用次数: 0
The Lancet Healthy Longevity: looking to the future 柳叶刀健康长寿:展望未来。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-01-01 Epub Date: 2026-01-29 DOI: 10.1016/j.lanhl.2026.100821
The Lancet Healthy Longevity
{"title":"The Lancet Healthy Longevity: looking to the future","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2026.100821","DOIUrl":"10.1016/j.lanhl.2026.100821","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 1","pages":"Article 100821"},"PeriodicalIF":14.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146100794","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}
引用次数: 0
International trends and social disparities in pain of adults aged 50 years and older in 22 countries across Europe, Asia, and the Americas: a longitudinal population-based study 欧洲、亚洲和美洲22个国家50岁及以上成年人疼痛的国际趋势和社会差异:一项基于人口的纵向研究
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-01-01 Epub Date: 2025-12-31 DOI: 10.1016/j.lanhl.2025.100808
Prof Esteban Calvo PhD , Jose T Medina MS , Hanna Grol-Prokopczyk PhD , Prof Katherine Keyes PhD , Prof Alvaro Castillo-Carniglia PhD , Antonia Díaz-Valdés PhD , Tamara Otzen PhD , Robin Richardson PhD , Prof Silvia Martins PhD
{"title":"International trends and social disparities in pain of adults aged 50 years and older in 22 countries across Europe, Asia, and the Americas: a longitudinal population-based study","authors":"Prof Esteban Calvo PhD ,&nbsp;Jose T Medina MS ,&nbsp;Hanna Grol-Prokopczyk PhD ,&nbsp;Prof Katherine Keyes PhD ,&nbsp;Prof Alvaro Castillo-Carniglia PhD ,&nbsp;Antonia Díaz-Valdés PhD ,&nbsp;Tamara Otzen PhD ,&nbsp;Robin Richardson PhD ,&nbsp;Prof Silvia Martins PhD","doi":"10.1016/j.lanhl.2025.100808","DOIUrl":"10.1016/j.lanhl.2025.100808","url":null,"abstract":"<div><h3>Background</h3><div>The experience of pain is highly prevalent among older adults worldwide. This study aimed to compare trends and social disparities in pain for middle aged and older adults (ie, those aged ≥50 years) across countries to help identify high-pain or high-disparity hotspots needing intervention, and low-pain or low-disparity locations or timepoints from which policy and practice lessons could be drawn.</div></div><div><h3>Methods</h3><div>Country-specific pain trends were estimated using longitudinal logistic regressions on harmonised data for 212 904 adults aged older than 50 years observed repeatedly from 1998 to 2018 in 22 countries across three continents.</div></div><div><h3>Findings</h3><div>Unadjusted pain prevalence was 43·21% (95% CI 43·10–43·33) across all countries and years pooled. Instrument-adjusted prevalence ranged from 26·70% (95% CI 25·52–27·88; Netherlands, 2006) to 59·20% (58·02–60·38; France, 2016). Over the decade 2006–16, when most countries were observed, prevalence substantially increased in 15 countries (12·01 percentage points), decreased in China (6·60 percentage points), and remained steady in six countries. Prevalence was higher among women, those with less education (ie, completed less than high school), and older respondents (those aged &gt;60 years), though disparities varied substantially across countries. Disparities widened over time in some countries (eg, Spain), but remained stable, declined, or reversed in others (eg, Sweden). In 2016, Denmark had the lowest overall pain disparity index, while South Korea had the highest.</div></div><div><h3>Interpretation</h3><div>There was a substantial increase in pain prevalence among middle aged and older adults in most countries studied. Cross-country, temporal, and sociodemographic variation indicates pain should be treated as a population public health issue.</div></div><div><h3>Funding</h3><div>Agencia Nacional de Investigación y Desarrollo, National Institute on Aging.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 1","pages":"Article 100808"},"PeriodicalIF":14.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896765","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}
引用次数: 0
Hypofractionated split-course versus standard radiotherapy in frail older patients with head and neck squamous-cell carcinoma (ELAN-RT trial): a non-inferiority, multicentre, open-label, randomised controlled trial 低分割分割疗程与标准放疗在虚弱的老年头颈部鳞状细胞癌患者中的对比(ELAN-RT试验):一项非劣效性、多中心、开放标签、随机对照试验。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-01-01 Epub Date: 2026-02-16 DOI: 10.1016/j.lanhl.2025.100812
Cécile Ortholan MD , Anne Aupérin PhD , Prof Yungan Tao MD , Sophie Renard MD , Yoann Pointreau MD , Cédrik Lafond MD , Guillaume Bera MD , Pierre Boisselier MD , Karen Benezery MD , Séverine Racadot MD , Prof Florence Huguet MD , Marc Bollet MD , Antoine Laurent Braccini MD , Cédric Khoury MD , Stéphane Jacquot MD , Julie Villa MD , Laurent Martin MD , Alessia Di Rito MD , Nadia Wiazzane MD , Aurore Goineau MD , Xu-Shan Sun MD
{"title":"Hypofractionated split-course versus standard radiotherapy in frail older patients with head and neck squamous-cell carcinoma (ELAN-RT trial): a non-inferiority, multicentre, open-label, randomised controlled trial","authors":"Cécile Ortholan MD ,&nbsp;Anne Aupérin PhD ,&nbsp;Prof Yungan Tao MD ,&nbsp;Sophie Renard MD ,&nbsp;Yoann Pointreau MD ,&nbsp;Cédrik Lafond MD ,&nbsp;Guillaume Bera MD ,&nbsp;Pierre Boisselier MD ,&nbsp;Karen Benezery MD ,&nbsp;Séverine Racadot MD ,&nbsp;Prof Florence Huguet MD ,&nbsp;Marc Bollet MD ,&nbsp;Antoine Laurent Braccini MD ,&nbsp;Cédric Khoury MD ,&nbsp;Stéphane Jacquot MD ,&nbsp;Julie Villa MD ,&nbsp;Laurent Martin MD ,&nbsp;Alessia Di Rito MD ,&nbsp;Nadia Wiazzane MD ,&nbsp;Aurore Goineau MD ,&nbsp;Xu-Shan Sun MD","doi":"10.1016/j.lanhl.2025.100812","DOIUrl":"10.1016/j.lanhl.2025.100812","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The standard treatment for older patients (aged ≥70 years) with localised, unresectable head and neck squamous-cell carcinoma is standard fractionated radiotherapy (SF-RT). However, its high toxicity and multiple fractions lead physicians to deliver tailored hypofractionated split-course radiotherapy (HSC-RT). The aim of the study was to compare these two radiotherapy methods in older patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;This non-inferiority, multicentre, open-label, randomised controlled trial was done in 30 treating centres (cancer centres, university and general hospitals, and private clinics) across France and Monaco. Patients aged 70 years or older, assessed as frail by geriatric evaluation, with stage II–IV head and neck squamous-cell carcinoma and in curative intent were randomly assigned (1:1) to receive either SF-RT (70 Gy, 35 fractions over 7 weeks) or HSC-RT (55 Gy, 20 fractions, two courses of 2 weeks with 2 weeks stop). Randomisation was done by minimisation, and physicians and patients were not masked to the treatment group. The primary endpoint was the proportion of patients alive with complete locoregional response at 6 months, analysed in all randomly assigned patients (intention-to-treat population). The non-inferiority margin was set at 16%. The study was sponsored by the Groupe d'Oncologie Radiothérapie Tête et Cou (GORTEC) and 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;NCT01864850&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;Between Oct 21, 2013, and Aug 22, 2018, 102 patients were randomly assigned to the HSC-RT group and 100 patients to the SF-RT group. One patient in the HSC-RT group refused treatment and follow-up and so was excluded, resulting in 101 patients in the HSC-RT group. Median age was 82 years (IQR 77–86); 145 (72%) were male and 56 (28%) were female. Median follow-up for overall survival was 56·6 months (IQR 41–69). In the intent-to-treat population, 35 (35%) of 101 patients were alive with complete locoregional response at 6 months in the HSC-RT group versus 33 (33%) of 100 patients in the SF-RT group (difference +2%, 95% CI –11 to 15). In the per-protocol population, 35 (36%) of 97 patients were alive with complete locoregional response at 6 months in the HSC-RT group versus 33 (35%) of 95 patients in the SF-RT group (difference +1%, –12 to 15). Median overall survival was 13·0 months (95% CI 10·3 to 17·0) in the HSC-RT group versus 18·9 months (14·3 to 30·9) in the SF-RT group (hazard ratio 1·32, 95% CI 0·97 to 1·81). Eight patients died between radiotherapy start and 30 days after radiotherapy end (five [5%] in the HSC-RT group and three [3%] in the SF-RT group). One patient in the HSC-RT group had a grade 4 adverse event (kidney failure), as did four in the SF-RT group (two mucositis, one septic shock, and one hemiplegia). Acute adverse events grade 3–5 occurred in 33 (36%) of 9","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 1","pages":"Article 100812"},"PeriodicalIF":14.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228958","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}
引用次数: 0
Delirium and adverse clinical outcomes: a matched cohort study in the UK Biobank 谵妄和不良临床结果:英国生物银行的匹配队列研究。
IF 14.6
Lancet Healthy Longevity Pub Date : 2026-01-01 Epub Date: 2026-02-09 DOI: 10.1016/j.lanhl.2025.100816
Markus J Haapanen MD PhD , David D Ward PhD , Alison M Mudge MBBS PhD , Emily H Gordon MBBS PhD , Frederick A Graham BNurs PhD , Prof Kenneth Rockwood MD , Prof Ruth E Hubbard MD
{"title":"Delirium and adverse clinical outcomes: a matched cohort study in the UK Biobank","authors":"Markus J Haapanen MD PhD ,&nbsp;David D Ward PhD ,&nbsp;Alison M Mudge MBBS PhD ,&nbsp;Emily H Gordon MBBS PhD ,&nbsp;Frederick A Graham BNurs PhD ,&nbsp;Prof Kenneth Rockwood MD ,&nbsp;Prof Ruth E Hubbard MD","doi":"10.1016/j.lanhl.2025.100816","DOIUrl":"10.1016/j.lanhl.2025.100816","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Delirium complicates up to one in four hospitalisations among older adults, but its clinical sequelae beyond cognitive impairment, functional decline, and mortality are not well characterised. Whether delirium signals broader multisystem vulnerability leading to later adverse outcomes remains uncertain. We aimed to examine the association of in-hospital delirium with the occurrence of a range of adverse outcomes during later hospitalisations in the UK.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a matched cohort study among hospitalised UK Biobank participants recruited in England, Scotland, and Wales in 2006–10 with linked hospital inpatient records collected from Jan 1, 1997 to Oct 31, 2022. We matched 14 909 individuals with delirium (1:1) to hospitalised control individuals without delirium by age, sex, Hospital Frailty Risk Score, primary diagnosis, episode length of stay, and intensive care unit length of stay of the index episode. The primary outcome was the risk of adverse clinical outcomes following delirium. Delirium was identified by ICD-10 codes, with exposure intensity defined as the number of episodes within 12 months of the index admission. Adverse clinical outcomes were selected based on existing literature and included incident events occurring during subsequent hospitalisations: falls, fractures (any and hip), pressure injury, urinary and faecal incontinence, myocardial infarction, heart failure, stroke, venous thromboembolism, pulmonary embolism, acute kidney injury, gastrointestinal bleeding, pneumonia, and sepsis. Fine–Gray subdistribution hazard models accounted for death as a competing risk and adjusted for socioeconomic covariates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Over a maximum follow-up of 26 years, the median time to event was 1·2 years (IQR 0·2–3·3) in the delirium group and 1·3 years (0·3–3·6) in the control group. Delirium was associated with a higher risk of 12 of the 15 adverse clinical outcomes than no delirium, which were urinary incontinence (subdistribution hazard ratio 2·01 [95% CI 1·78–2·28]), falls (1·96 [1·78–2·17]), pressure injury (1·72 [1·53–1·93]), acute kidney injury (1·71 [1·57–1·86]), sepsis (1·67 [1·52–1·84]), hip fracture (1·66 [1·39–2·00]), stroke (1·62 [1·41–1·87]), overall fractures (1·56 [1·40–1·74]), pneumonia (1·53 [1·41–1·65]), faecal incontinence (1·53 [1·31–1·78]), heart failure (1·31 [1·18–1·45]), and gastrointestinal bleeding (1·23 [1·09–1·38]). Each additional episode was associated with a 6–17% higher risk. Findings were consistent across sensitivity analyses excluding individuals with short follow-up, those with prevalent dementia, and the least well-matched pairs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;In-hospital delirium was consistently and dose-responsively associated with a range of adverse outcomes, independent of frailty and pre-existing dementia, supporting its recognition as a sentinel event indicating longer-term vulnerability.&lt;/","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"7 1","pages":"Article 100816"},"PeriodicalIF":14.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146182769","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}
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