Lancet Healthy Longevity最新文献

{"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}

{"title":"Oral health: integral component of overall health and important determinant of ageing.","authors":"Yau-Hua Yu","doi":"10.1016/j.lanhl.2024.100641","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100641","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100641"},"PeriodicalIF":13.4,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476503","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":"Sensory loss rehabilitation among people with dementia: a low-risk strategy to enhance quality of life.","authors":"Danielle S Powell, Nicholas S Reed","doi":"10.1016/j.lanhl.2024.100640","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.100640","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100640"},"PeriodicalIF":13.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401512","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":"Hearing and vision rehabilitation for people with dementia in five European countries (SENSE-Cog): a randomised controlled trial.","authors":"Iracema Leroi, Christopher J Armitage, Elizabeth M Camacho, Anna Pavlina Charalambous, J P Connelly, Fofi Constantinidou, Renaud David, Piers Dawes, Rachel A Elliott, Mark Hann, Alison Holden, Emma Hooper, Sean P Kennelly, Evangelia Kontogianni, Brian A Lawlor, Julie Longobardi, Luke Paterson, Antonis M Politis, David Reeves, Christine Schwimmer, Chryssoula Thodi, Mark Worthington, Wai Kent Yeung, Eric Frison","doi":"10.1016/j.lanhl.2024.07.008","DOIUrl":"https://doi.org/10.1016/j.lanhl.2024.07.008","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The effect of hearing and vision difficulties on the risk of developing dementia and worsening outcomes in people already living with dementia is well established. We evaluated the clinical impact of a hearing and vision rehabilitation and support programme on quality of life in people with mild-to-moderate dementia and concurrent sensory difficulties.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a parallel-group, multicentre, observer-blind, superiority randomised controlled trial in seven older adult clinics in five European countries (Cyprus, France, Greece, Ireland, and the UK). People with mild-to-moderate dementia with adult-acquired hearing difficulties, vision difficulties, or both were randomly assigned (1:1) along with their care partner to an 18-week home-basedsensory support intervention (SSI) of tailored hearing and vision rehabilitation and support, or to care as usual. Randomisation was blocked (block size of four, six, or eight) and stratified by country, with allocation assigned via a remote web-based system. The SSI included: full hearing assessment, vision assessment, or both; fitting of hearing aids, glasses, or other sensory aids; and home-based support from a sensory support therapist to assist adherence and uptake of sensory aids, foster social networking, and optimise the home sensory environment. Care as usual involved no additional intervention beyond services normally available to people with dementia at the respective sites. The primary outcome was health-related quality of life (Dementia Quality of Life Instrument [DEMQoL]) score at 36 weeks, reported as an adjusted mean difference. Analyses were done according to the intention-to-treat principle. This trial is registered with the ISRCTN Registry, ISRCTN17056211.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Between May 4, 2018, and May 6, 2021, 252 people with mild-to-moderate dementia were randomly assigned, of whom 251 (n=126 in the SSI group and n=125 in the care as usual group) were included in the analysis. The mean age of participants was 79·6 years (SD 5·8), and 132 (53%) were women. After a median follow-up time of 37·7 weeks (IQR 36·2-39·0), the mean DEMQoL score was 92·8 (SD 15·2) in the SSI group and 92·8 (14·0) in the care as usual group (adjusted difference 0·18, 95% CI -2·13 to 2·30, p=0·87). Among 114 adverse events reported for 56 (44%) participants in the SSI group, ten events in nine participants were related or possibly related to the intervention (medical device pain or discomfort n=6, ear pain n=1, scratch to the ear n=1, sore eye n=1, redness n=1; all of grade 1). Serious adverse events were reported for 25 (20%) participants in the SSI group and 16 (13%) in the care as usual group. Six (5%) participants in the SSI group and five (4%) in the care as usual group died. None of the serious adverse events or deaths were related to the study intervention or procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interpretation: &lt;/strong&gt;This study showed no imp","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":" ","pages":"100625"},"PeriodicalIF":13.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401511","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":"Effect of frailty on effectiveness and safety of GLP-1 receptor agonists versus SGLT2 inhibitors in people with type 2 diabetes in Taiwan: a retrospective, nationwide, longitudinal study","authors":"Prof Fei-Yuan Hsiao PhD ,&nbsp;Elise Chia-Hui Tan PhD ,&nbsp;Lin-Chieh Meng MS ,&nbsp;Yi-Chin Lin PharmD MS ,&nbsp;Ho-Min Chen MS ,&nbsp;Shang-Ting Guan PharmD ,&nbsp;Prof Der-Cherng Tarng MD PhD ,&nbsp;Prof Chih-Yuan Wang MD PhD ,&nbsp;Prof Liang-Kung Chen","doi":"10.1016/j.lanhl.2024.07.004","DOIUrl":"10.1016/j.lanhl.2024.07.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;GLP-1 receptor agonists and SGLT2 inhibitors are increasingly being used in people with type 2 diabetes on the basis of findings from randomised clinical trials; however, little is known of whether clinical outcomes are affected by frailty in real-world settings. We aimed to compare the clinical effectiveness and safety of GLP-1 receptor agonists and SGLT2 inhibitors in managing type 2 diabetes, with a specific focus on stratifying people by their frailty status.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this retrospective, nationwide, longitudinal study, we identified people (aged ≥20 years) with type 2 diabetes who newly initiated either a GLP-1 receptor agonist or an SGLT2 inhibitor during the period Jan 1, 2017 to Dec 31, 2019 from the Taiwan National Health Insurance database. Individuals were excluded if they had been diagnosed with cancer, received dialysis for kidney failure, or had prescriptions for a GLP-1 receptor agonist or an SGLT2 inhibitor, within 1 year before the index date. Mortality data were collected from the Taiwan National Death Registry. Eligible individuals were categorised into three frailty subgroups—fit, mild frailty, and moderate or severe frailty—on the basis of the multimorbidity frailty index. Propensity score matching (1:1) was used to balance covariates between recipients of GLP-1 receptor agonists and SGLT2 inhibitors among each frailty subgroup. Clinical outcomes of interest included three-point major adverse cardiovascular events (non-fatal acute myocardial infarction, non-fatal stroke, and fatal cardiovascular disease), all-cause mortality, hospitalisation for heart failure, dialysis or renal transplant, severe diabetic foot complications, retinopathy, hospitalisation for severe hyperglycaemia, and hospitalisation for severe hypoglycaemia. The association between the use of a GLP-1 receptor agonist versus an SGLT2 inhibitor and the risk of the outcomes of interest among each frailty subgroup was examined using a subdistribution hazard model.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;We identified 320 210 people with type 2 diabetes, of whom 280 163 met the eligibility criteria, who initiated either a GLP-1 receptor agonist (n=22 968; mean age 57·7 years [SD 13·9], 11 338 [49·4%] were female, and 11 630 [50·6%] were male) or SGLT2 inhibitor (n=257 195; mean age 58·8 years [12·3], 107 988 [42·0%] were female, and 149 207 [58·0%] were male) during 2017–19. After matching, 11 882, 7210, and 3414 pairs of GLP-1 receptor agonist and SGLT2 inhibitor users were assigned in the fit, mild frailty, and moderate or severe frailty subgroups. All clinical outcomes were comparable between users of GLP-1 receptor agonists and SGLT2 inhibitors among each frailty subgroup, except for a higher risk of hospitalisation for severe hyperglycaemia with GLP-1 receptor agonists than with SGLT2 inhibitors in the mild frailty subgroup (subdistribution hazard ratio 1·25 [95% CI 1·13–1·38]; p&lt;0·0001) and a higher risk of d","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100621"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001375/pdfft?md5=e893d77bc3881c4e4d26dc5179146936&pid=1-s2.0-S2666756824001375-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272878","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":"Improving health-related quality of life after kidney transplantation using lifestyle interventions","authors":"Roemer J Janse ,&nbsp;Yvette Meuleman","doi":"10.1016/j.lanhl.2024.07.010","DOIUrl":"10.1016/j.lanhl.2024.07.010","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100627"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001430/pdfft?md5=b9ef50fa11daa29e39a67a7641e67bff&pid=1-s2.0-S2666756824001430-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272945","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":"Association between Geriatric 8 frailty and health-related quality of life in older patients with cancer (PROGNOSIS-G8): a Danish single-centre, prospective cohort study","authors":"Helena Møgelbjerg Ditzel MD ,&nbsp;Ann-Kristine Weber Giger MD PhD ,&nbsp;Cecilia Margareta Lund MD PhD ,&nbsp;Prof Henrik Jørn Ditzel MD DMSc ,&nbsp;Sören Möller PhD ,&nbsp;Prof Per Pfeiffer MD PhD ,&nbsp;Prof Jesper Ryg MD PhD ,&nbsp;Prof Marianne Ewertz MD DMSc ,&nbsp;Trine Lembrecht Jørgensen MD PhD","doi":"10.1016/S2666-7568(24)00118-1","DOIUrl":"10.1016/S2666-7568(24)00118-1","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Health-related quality of life (HRQoL) is highly valued among older adults with cancer. The Geriatric 8 screening tool identifies individuals with frailty, but its association with HRQoL remains sparsely investigated. Herein, we evaluate whether Geriatric 8 frailty is associated with short-term and long-term HRQoL in older patients with cancer.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this Danish single-centre, prospective cohort study, patients aged 70 years and older, referred to oncological assessment for solid cancers, were screened with the Geriatric 8. Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) Quality-of-Life Core 30 (QLQ-C30) and Elderly 14 (ELD14) questionnaires at baseline, 3 months, 6 months, 9 months, and 12 months. Patient characteristics were obtained from medical records. Differences in mean global health status and QoL (GHS), measured using the two seven-point Likert scale questions from the EORTC QLQ-C30 regarding overall health and QoL during the past week, between patients with frailty (defined as a Geriatric 8 score of ≤14) and without frailty within 12 months were the primary outcome. Secondary outcomes were differences in the mean EORTC Summary Score comprised of all questions from the QLQ-C30 except for those included in the GHS and a question concerning financial difficulties, and five functional (physical, role, and social functioning, maintaining purpose, and family support from the EORTC QLQ-C30 and the EORTC-QLQ-ELD14), and five symptom scales (fatigue, pain, mobility, future worries, and burden of illness from the EORTC-QLQ-C30 and the EORTC-QLQ-ELD14). Analyses were done using linear mixed models. All primary and secondary outcomes were adjusted for gender, treatment intent, and cancer type and the primary outcome was also assessed by means of a responder analysis.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;Between June 1, 2020 and Oct 15, 2021, 1398 eligible patients were screened with the Geriatric 8 (908 [65%] with frailty and 490 [35%] without frailty) and provided medical record data. Of these patients, 707 (51%) also provided HRQoL data (437 [62%] with frailty and 270 [38%] without frailty). When adjusted, patients with frailty had poorer GHS (–15·1, 95% CI –18·5 to –11·6; p&lt;0·0001) at baseline and throughout follow-up (3 months –7·4, –11·0 to –3·7, p=0·0001; 6 months –11·7, –15·5 to –7·9, p&lt;0·0001; 9 months –10·4, –14·3 to –6·5, p&lt;0·0001; 12 months –10·4, –14·6 to –6·2, p&lt;0·0001) compared to patients without frailty. Adjusted summary scores were also poorer for patients with frailty (–9·9, 95% CI –12·1 to –7·6; p&lt;0·0001) compared to patients without frailty at baseline and throughout follow-up (3 months –8·2, –10·5 to –5·8, p=0·0001; 6 months –9·0, –11·4 to –6·6, p&lt;0·0001; 9 months –9·2, –11·7 to –6·8, p&lt;0·0001; 12 months –8·9, –11·5 to –6·3, p&lt;0·0001). Patients with frailty had significantly worse physical and role functioning","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100612"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001181/pdfft?md5=535fb239e0e39156a71823a9ffaf776a&pid=1-s2.0-S2666756824001181-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112841","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":"Psychosocial pathways linking differences in socioeconomic status to symptoms of depression","authors":"Larissa Zwar","doi":"10.1016/j.lanhl.2024.07.009","DOIUrl":"10.1016/j.lanhl.2024.07.009","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100626"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001429/pdfft?md5=feca87aea0a11b8f7dc3c5c07e122d86&pid=1-s2.0-S2666756824001429-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112842","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":"Benefits of population-level interventions for dementia risk factors: an economic modelling study for England","authors":"Prof Naaheed Mukadam PhD ,&nbsp;Robert Anderson MA ,&nbsp;Sebastian Walsh MPhil ,&nbsp;Raphael Wittenberg MSc ,&nbsp;Prof Martin Knapp PhD ,&nbsp;Prof Carol Brayne PhD ,&nbsp;Prof Gill Livingston MD","doi":"10.1016/S2666-7568(24)00117-X","DOIUrl":"10.1016/S2666-7568(24)00117-X","url":null,"abstract":"<div><h3>Background</h3><p>Individual-level interventions for dementia risk factors could reduce costs associated with dementia and some are cost-effective. We aimed to estimate the cost-effectiveness of population-level interventions for tackling dementia risk factors.</p></div><div><h3>Methods</h3><p>In this economic modelling study, we included recommended population-based interventions from a previously published review article for which there was consistent and robust evidence of effectiveness in tackling a dementia risk factor (tobacco smoking, excess alcohol use, hypertension, obesity, air pollution, and head injury). We only included interventions if they had not been introduced in England or were in place but could be extended. The interventions studied were increases in tobacco pricing, minimum pricing for alcohol, raising alcohol price, salt reduction policies, sugar reduction policies, low emission zones, and compulsory helmet use for cycling by children (aged 5–18 years). We used published intervention effect sizes and relative risks for each risk factor and a Markov model to estimate progression to dementia in populations with and without the intervention, looking at lifetime risk, in the population of England.</p></div><div><h3>Findings</h3><p>We estimated that reductions in excess alcohol use through minimum unit pricing would lead to cost-savings of £280 million and 4767 quality-adjusted life-years (QALYs) gained over an indefinite succession of age cohorts. Reformulation of food products to reduce salt would lead to cost-savings of £2·4 billion and 39 433 QALYs gained and reformulation to reduce sugar would lead to cost-savings of £1·046 billion and 17 985 QALYs gained. Reducing dementia risk from air pollution by introducing low emission zones in English cities with a population of 100 000 or more (that do not already impose restrictions) would lead to £260 million cost-savings and 5119 QALYs gained. Raising cigarette prices by 10% to reduce dementia risk from smoking would lead to 2277 QALYs gained and cost-savings of £157 million. Making bicycle helmets compulsory for children (aged 5–18 years) to reduce dementia risk from head injury would lead to cost-savings of £91 million and 1554 QALYs gained.</p></div><div><h3>Interpretation</h3><p>Population-level interventions could help tackle life course dementia risk and save costs.</p></div><div><h3>Funding</h3><p>UK National Institute for Health and Care Research Three Schools dementia research programme.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100611"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266675682400117X/pdfft?md5=11cf8662075dd2811b0c703f0114287f&pid=1-s2.0-S266675682400117X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890275","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}