Lancet Healthy Longevity最新文献

{"title":"Clinical and cost-effectiveness of a home-based health promotion intervention for older people with mild frailty in England: a multicentre, parallel-group, randomised controlled trial","authors":"Prof Kate Walters PhD , Rachael Frost PhD , Christina Avgerinou PhD , Sarah Kalwarowsky MSc , Prof Claire Goodman PhD , Prof Andrew Clegg MD , Louise Marston PhD , Shengning Pan PhD , Jane Hopkins MA , Claire Jowett , Rekha Elaswarapu , Benjamin Gardner DPhil , Farah Mahmood MSc , Matthew Prescott , Gillian Thornton , Prof Dawn A Skelton PhD , Rebecca L Gould PhD , Prof Claudia Cooper PhD , Prof Vari M Drennan PhD , Kalpa Kharicha PhD , Prof Rachael Hunter PhD","doi":"10.1016/j.lanhl.2024.100670","DOIUrl":"10.1016/j.lanhl.2024.100670","url":null,"abstract":"<div><h3>Background</h3><div>Health promotion for people with mild frailty has the potential to improve health outcomes, but such services are scarce in practice. We developed a personalised, home-based, behaviour change, health promotion intervention (HomeHealth) and assessed its clinical effectiveness and cost-effectiveness in maintaining independent functioning in activities of daily living in older adults with mild frailty.</div></div><div><h3>Methods</h3><div>This trial was an individual, multicentre, parallel-group, randomised controlled trial done in England. Participants were mainly recruited from general practices in three different areas of England (the London north Thames region, east and north Hertfordshire, and west Yorkshire). Participants were individuals residing in the community who were registered with a general practice, 65 years and older with mild frailty (scoring 5 on the CFS), with a life expectancy of more than 6 months, and with capacity to consent to participate. We excluded adults residing in nursing or care homes, those with moderate-to-severe frailty or with no frailty, those receiving palliative care, and those already case managed (eg, receiving a similar ongoing intervention from the voluntary sector or community service). Eligible participants were randomly assigned 1:1 to either the HomeHealth intervention or to treatment as usual. HomeHealth is a multidomain health promotion intervention delivered by the voluntary sector at home in six sessions over 6 months. The primary outcome was independent functioning (assessed using the modified Barthel Index [BI]) at 12 months. Outcome assessments were masked and were analysed by intention to treat using linear mixed models. Incremental costs and quality-adjusted life-years (QALYs) were calculated using seemingly unrelated regression and bootstrapping. The trial is registered on the ISRCTN registry (ISRCTN54268283).</div></div><div><h3>Findings</h3><div>We recruited 388 participants between Jan 8, 2021 and July 2, 2022 (mean age 81 years, SD 6·5; 249 (64%) of 388 were women and 139 (36%) were men). 195 participants were randomly assigned to HomeHealth and 193 to treatment as usual. Median follow-up was 363 days (IQR 356–370) in the HomeHealth group and 362 days (IQR 355–373) in the treatment-as-usual group. HomeHealth did not improve BI scores at 12 months (mean difference 0·250, 95% CI –0·932 to 1·432). HomeHealth was superior to treatment as usual with a negative point estimate for incremental costs (–£796; 95% CI –2016 to 424) and positive point estimate for incremental QALYs (0·009, –0·021 to 0·039). There were 55 serious adverse events in the HomeHealth group and 85 in the treatment-as-usual group; none were intervention related.</div></div><div><h3>Interpretation</h3><div>HomeHealth is a safe intervention with a high probability of cost-effectiveness, driven by a reduction in unplanned hospital admissions. HomeHealth should be considered as a health promotion interv","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 2","pages":"Article 100670"},"PeriodicalIF":13.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520141","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":"The life course approach: setting the stage for healthy ageing","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2025.100686","DOIUrl":"10.1016/j.lanhl.2025.100686","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100686"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053550","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":"Whom to target and when to intervene: insights from the Early Palliative Care in Heart Failure Trial","authors":"Moritz Blum , Felix Schönrath","doi":"10.1016/j.lanhl.2024.100671","DOIUrl":"10.1016/j.lanhl.2024.100671","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100671"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081491","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":"Merits of the social return on investment methodology for assessing the value of palliative care programmes","authors":"Olivia Monton MD ScM ,&nbsp;Emmanuel F Drabo PhD ,&nbsp;Shannon Fuller MS ,&nbsp;Fabian M Johnston MD MHS","doi":"10.1016/j.lanhl.2024.100669","DOIUrl":"10.1016/j.lanhl.2024.100669","url":null,"abstract":"<div><div>Despite the widely accepted benefits of palliative care for individuals with serious illnesses and their families, the utilisation of this approach remains low. Although an increased use of palliative care services can increase the value of health-care spending by providing comprehensive wraparound services to support care, the economic evidence required to implement, promote, and engage in palliative care models on a wide scale eludes the affected individuals, health-care providers, payers, and policy makers. This gap in evidence is partly owing to the methodological limitations of standard value-assessment frameworks, which do not capture important societal dimensions of the value generated by palliative care. This Personal View proposes the adoption of value-assessment frameworks that incorporate broader dimensions of social value into the evaluation of palliative care programmes. We focus on the social return on investment methodology as an example of a value-assessment framework that can complement standard frameworks to better capture the social impact and all-around benefits of palliative care.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100669"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013103","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":"Frailism: a scoping review exploring discrimination against people living with frailty","authors":"Philip Braude MBBS ,&nbsp;Emma Grace Lewis PhD ,&nbsp;Steve Broach KC MA ,&nbsp;Edward Carlton PhD ,&nbsp;Sarah Rudd MSc ,&nbsp;Jean Palmer ,&nbsp;Richard Walker MD ,&nbsp;Prof Ben Carter PhD ,&nbsp;Prof Jonathan Benger MD","doi":"10.1016/j.lanhl.2024.100651","DOIUrl":"10.1016/j.lanhl.2024.100651","url":null,"abstract":"<div><div>People living with frailty can experience discrimination, but unlike the characteristics of age and disability, frailty is not protected by law. Frailty is a clinical syndrome associated with ageing in which health deficits increase a person’s vulnerability to illness, disability, and death. This scoping review, conducted by a team of methodologists, clinicians, lawyers, and patients, aimed to investigate the extent of discrimination against people living with frailty described in health-care literature. We searched five health-care databases from inception up to June, 2022, and grey literature, to identify 144 texts. The texts were classified by the types of discrimination (direct discrimination, indirect discrimination, harassment, and victimisation) and inductively developed into contextual themes. The median age of the participants was 77 years (IQR 69·9–82·0), and 65·4% were women. The most common types of discrimination were direct (in 90 [63%]), indirect (in 66 [46%]), and harassment (in one [1%]) of the 144 texts, with no instances of victimisation reported. Nine themes of discriminatory actions were developed. Discrimination against people living with frailty overlapped with discrimination based on established protected characteristics, including age, disability, race, and sex. Evidence indicated that frailty discrimination replaces, mediates, masks, and potentiates age discrimination. Discrimination against people with frailty seemed to be both an independent event and one that interacts with established protected characteristics. Future research should focus on preventing frailty-based discrimination and establishing whether frailty should be considered a new protected characteristic by law.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100651"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and management of frailty in individuals living with dementia: expert recommendations for clinical practice","authors":"Miguel Germán Borda MD PhD ,&nbsp;Prof Francesco Landi MD PhD ,&nbsp;Prof Tommy Cederholm MD PhD ,&nbsp;Luis Carlos Venegas-Sanabria MD PhD ,&nbsp;Prof Gustavo Duque MD PhD ,&nbsp;Prof Hidetaka Wakabayashi MD PhD ,&nbsp;George E Barreto PhD ,&nbsp;Isabel Rodriguez-Sanchez MD PhD ,&nbsp;Marco Canevelli MD PhD ,&nbsp;Carlos Cano-Gutierrez MD ,&nbsp;Mario Ulises Pérez-Zepeda MD PhD ,&nbsp;Lindsay Wallace PhD ,&nbsp;Prof Kenneth Rockwood MD ,&nbsp;Mario Salas-Carrillo MD ,&nbsp;Martha Gjestsen PhD ,&nbsp;Prof Ingelin Testad PhD ,&nbsp;Prof Clive Ballard MD PhD ,&nbsp;Prof Dag Aarsland MD PhD ,&nbsp;IPEFUND","doi":"10.1016/j.lanhl.2024.100666","DOIUrl":"10.1016/j.lanhl.2024.100666","url":null,"abstract":"<div><div>Frailty complicates the care of individuals with dementia, increasing their vulnerability to adverse outcomes. This Personal View presents expert recommendations for managing frailty in individuals with dementia, aimed at health-care providers, particularly those in primary care. We conducted a rapid literature review followed by a consensus process involving 18 international experts on dementia and frailty. The experts identified key areas, including diagnosis of frailty, assessment of nutritional status and nutritional management, physical activity, prevention of falls, and polypharmacy management. The recommendations emphasise early identification of frailty and a comprehensive, interdisciplinary approach to care that aims to maintain the individual’s daily functioning, quality of life, and independence. The recommendations highlight the importance of tailored interventions, regular monitoring, and the integration of psychosocial support into the therapeutic approach. These recommendations address a crucial gap in existing clinical guidelines, offering practical guidance for clinicians managing frailty in individuals with dementia.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100666"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907605","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":"Strengthening social connections to address loneliness in older adults","authors":"Fang Yang ,&nbsp;Danan Gu","doi":"10.1016/j.lanhl.2025.100682","DOIUrl":"10.1016/j.lanhl.2025.100682","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100682"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042099","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":"Risk prediction for health outcomes in type 2 diabetes: utility of a polysocial risk score?","authors":"Frank Qian ,&nbsp;Samia Mora","doi":"10.1016/j.lanhl.2024.100677","DOIUrl":"10.1016/j.lanhl.2024.100677","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100677"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967149","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":"The effects of volunteering on loneliness among lonely older adults: the HEAL-HOA dual randomised controlled trial","authors":"Prof Dannii Yuen-Lan Yeung PhD ,&nbsp;Da Jiang PhD ,&nbsp;Prof Lisa Marie Warner PhD ,&nbsp;Prof Namkee G Choi PhD ,&nbsp;Prof Rainbow Tin Hung Ho PhD ,&nbsp;Jojo Yan Yan Kwok PhD ,&nbsp;Prof Kee-Lee Chou PhD","doi":"10.1016/j.lanhl.2024.100664","DOIUrl":"10.1016/j.lanhl.2024.100664","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Previous randomised controlled trials have largely relied on self-reported volunteer work to assess the effects of volunteering and have rarely provided structured volunteering activities during the intervention period. The present study aimed to investigate the effects of social volunteering work over 12 months on loneliness among older adults during the COVID-19 pandemic.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A dual randomised controlled trial was done in Hong Kong to investigate the long-term effects of telephone-delivered psychosocial interventions by older Chinese volunteers who were screened as lonely, for older adult recipients who had low income, lived alone, felt lonely, and were digitally excluded. Participants were included if they were aged 50–70 years; had provided consent to be trained and serve as a volunteer for at least 2 h per week for 6 months; had at least 3 years of secondary school education; had no severe self-reported physical, mental, or cognitive health problems; were not working full or part-time; had engaged in formal volunteering fewer than four times within the past year; and were lonely (ie, had a score of at least 6 on the three-item UCLA Loneliness Scale). Participants were allocated into either the volunteering or control group (psychoeducation programme) using a random number method. The details of group allocation were concealed as the research assistant responsible for randomisation was different to the research assistants responsible for recruitment and assessments (who were masked to the condition). Following a 6-week training, the volunteers delivered a psychosocial intervention to older intervention recipients for 6 months. The primary outcome was loneliness measured with the 20-item UCLA Loneliness Scale and the De Jong Gierveld (DJG) Loneliness Scales at 6 months and 12 months. Assessments were performed before training (baseline; T1), at 6 months (T2), and at 12 months after training (T3). The intention-to-treat principle was used to compare the effects of volunteering between the two groups. The trial was registered in the Clinical Trials Registry of the University of Hong Kong Clinical Trials Centre (HKUCTR-2929). This trial has completed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between May 3, 2021, and Oct 6, 2022, a total of 375 individuals were recruited to the trial, including 84 males (22%) and 291 females (78%). 185 were randomly assigned to the volunteering group (56 to deliver a mindfulness intervention, 65 to deliver a behavioural activation intervention, and 64 to deliver a befriending intervention) and 190 were assigned to the control group. 311 (83%) of 375 participants were 60 years or older (median 64 years [SD 4·86]). Participants in the volunteering group reported a significantly lower level of loneliness at T2 (&lt;em&gt;d&lt;/em&gt;&lt;sub&gt;&lt;em&gt;ppc2&lt;/em&gt;&lt;/sub&gt; ranged from −0·41 to −0·70) compared with T1 than participants in the control condition. There was a significant de","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100664"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042120","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":"Temporal trends and patterns in mortality from falls across 59 high-income and upper-middle-income countries, 1990–2021, with projections up to 2040: a global time-series analysis and modelling study","authors":"Prof Sunyoung Kim MD ,&nbsp;Soeun Kim MSc ,&nbsp;Prof Selin Woo PhD ,&nbsp;Jiyeon Oh MD ,&nbsp;Yejun Son MSc ,&nbsp;Prof Louis Jacob MD ,&nbsp;Prof Pinar Soysal MD ,&nbsp;Prof Jungha Park MD ,&nbsp;Prof Liang-Kung Chen MD ,&nbsp;Dong Keon Yon MD","doi":"10.1016/j.lanhl.2024.100672","DOIUrl":"10.1016/j.lanhl.2024.100672","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Deaths related to falls are a substantial public health problem worldwide, and insight into trends and differences in global fall-related deaths can be valuable for identifying prevention strategies and developing effective policies. Thus, we aimed to estimate global fall-related mortality rate trends and forecast future fall-related deaths.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In this global time-series analysis and modelling study, we investigated temporal trends in fall-related mortality rates from 1990 to 2021 using the WHO Mortality Database, following the GATHER guidelines, and forecasted trends until 2040 across 59 high-income and upper-middle-income countries. We focused on identifying specific patterns of variation in mortality rates across different age groups, sexes, and income levels based on World Bank country classification. We analysed temporal trends and patterns using a locally weighted scatter plot smoother curve presented by age-standardised mortality rates (ASMRs), and future projections were calculated based on Bayesian age–period–cohort analysis. We performed a decomposition analysis to identify variations in fall-related deaths by examining factors such as population growth, ageing, and epidemiological changes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Fall-related mortality rates per 100 000 people declined from 23·21 (95% CI 21·30 to 25·12) in 1990 to 11·01 (9·94 to 12·08) in 2009, increasing to 12·50 (10·36 to 14·64) by 2021. Throughout the period from 1990 to 2021, fall-related mortality rates were consistently higher among men, individuals in high-income countries, and older adults. The results represent a clear pattern in fall-related mortality rates according to sex, income level, and age group. ASMRs exhibited varying patterns, with an initial decrease of 43·83% (from 11·54 [95% CI 9·33 to 13·76] in 1990 to 6·48 [95% CI 5·28 to 7·68] in 2005) in upper-middle-income countries with a subsequent rise of 49·69% to 9·70 (9·33 to 13·76) in 2021, with a 17·81% increase among women (from 9·04 in 2009 to 10·65 in 2021), and with a 1434·8% increase in individuals aged 85 years and older (from 5·00 [−4·94 to 14·94] in 1992 to 76·74 [62·10 to 91·39] in 2021). Furthermore, ASMRs showed a positive correlation with Socio-demographic Index (β=42·29 [10·26 to 74·32]; p&lt;0·011), the Environmental Performance Index (β=0·19 [0·05 to 0·33]; p=0·0090), and the reverse Gini coefficient (β=22·58 [0·45 to 44·72]; p=0·046). Projections indicate that the fall-related mortality rate is expected to rise from 14·80 (95% credible intervals, 14·04 to 15·59) per 100 000 people in 2021 to 19·48 (7·02 to 98·84) by 2040. The increase in fall-related deaths from 1990 to 2040 can be attributed to the growth in population, because the absolute number of fall-related deaths has risen despite a declining rate.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Temporal trend in fall-related deaths declined from 1990 to 2009, followed by","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100672"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029631","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}