Lancet Healthy Longevity最新文献

{"title":"Occurrence, associated factors, and outcomes of delirium in patients in an adult acute general medicine service in England: a 10-year longitudinal, observational study","authors":"Jasmine Ming Gan MBBS ,&nbsp;Emily Louise Boucher BHSc ,&nbsp;Nicola Georgia Lovett MD ,&nbsp;Sophie Roche BM BCh ,&nbsp;Sarah Catherine Smith MBBS ,&nbsp;Sarah Tamsin Pendlebury DPhil","doi":"10.1016/j.lanhl.2025.100731","DOIUrl":"10.1016/j.lanhl.2025.100731","url":null,"abstract":"<div><h3>Background</h3><div>Reliable estimates of delirium occurrence and outcomes are necessary to inform hospital services, research, and policy, but inclusive cohorts with long-term follow-up are scarce. We aimed to assess the age-specific occurrence of delirium in acute general (internal) medicine, associated factors, and 10-year outcomes stratified by age and comorbid dementia status.</div></div><div><h3>Methods</h3><div>This longitudinal, observational study was done at the John Radcliffe Hospital (Oxford, UK). We included consecutive adult patients aged 16 years and older in an acute general (internal) medicine service over six 8-week periods (between Sept 4, 2010, and Nov 15, 2018). Delirium was diagnosed prospectively using the Confusion Assessment Method and Diagnostic and Statistical Manual of Mental Disorders, fourth edition, criteria and subcategorised as prevalent (≤48 h of admission) or incident (&gt;48 h postadmission). Odds ratios adjusted (_adjORs) for demographics, comorbidity, frailty, and illness severity were calculated for binarised outcomes and adjusted hazard ratios (_adjHRs) were calculated for time to death.</div></div><div><h3>Findings</h3><div>1846 patients were admitted to acute general (internal) medicine (mean age 68·2 years [SD 20·0], age range 16–102 years), 426 (23% [95% CI 21–25]) of whom had delirium (prevalent n=290 [68%], incident n=73 [17%], both prevalent and incident n=63 [15%]), of whom 134 (31·5%) had dementia. 950 (51·5%) patients were female, 895 (48·5%) were male, and sex data were missing for one patient. Delirium increased with age, from six (2% [95% CI 1–4]) of 340 patients younger than 50 years and 31 (9% [6–13]) of 333 patients at age 50–64 years to 57 (20% [16–25]) of 281 at age 65–74 years, 245 (35% [31–38]) of 704 at age 75–89 years, and 87 (46% [39–54]) of 188 at age 90 years and older. Of the 37 patients younger than 65 years who had delirium, 28 (76%) had an underlying neurological or neuropsychiatric disorder. In those aged 65 years or older, delirium was overall associated (all p&lt;0·001, age and sex adjusted) with dementia (_adjOR 3·63 [95% CI 2·65–4·98]), pre-admission dependency (2·63 [2·02–3·43]), comorbidity burden (1·04 [1·02–1·05]), and frailty (moderate <em>vs</em> low risk 3·62 [2·70–4·85] and high <em>vs</em> low risk 11·85 [7·24–19·42]), with stronger associations in patients without comorbid dementia than in those with comorbid dementia. Delirium predicted inpatient stay longer than 7 days (_adjOR 2·48 [1·84–3·35]), discharge care needs (2·41 [1·70–3·40]), and mortality during admission (2·45 [1·52–3·94]). The increased risk of death in the delirium group was highest in the immediate postadmission period and attenuated thereafter, but was maintained for up to 10 years of follow-up (_adjHR 2·03 [95% CI 1·40–2·97] for 30-day mortality <em>vs</em> 1·52 [1·30–1·77] for 10-year mortality). Excess inpatient mortality was highest i","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100731"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757865","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":"Violence across the life course and physical and mental health trajectories in later life: a 13-year population-based cohort study in England","authors":"Anastasia Fadeeva PhD ,&nbsp;Polina Obolenskaya PhD ,&nbsp;Estela Capelas Barbosa PhD ,&nbsp;Prof Gene Feder MD ,&nbsp;Prof Sally McManus MSc","doi":"10.1016/j.lanhl.2025.100738","DOIUrl":"10.1016/j.lanhl.2025.100738","url":null,"abstract":"<div><h3>Background</h3><div>Evidence shows that violence in childhood affects health in adulthood, and violence in adulthood is associated with worse health. However, the extent to which violence-related health disparities persist into later life and whether the gap between victims and non-victims narrows, remains stable, or widens over time are unclear. This study aimed to examine the long-term effects of childhood and lifetime violence on health trajectories in older age.</div></div><div><h3>Methods</h3><div>The English Longitudinal Study of Ageing is one of the only cohort studies to cover violence across the lifespan alongside health trajectories in later life. Data were collected every 2 years between 2006 and 2019 and experiences of violence and limiting long-standing illness or disability (LLSID) were self-reported. We used logistic multilevel regressions and growth curve modelling to examine associations between parental physical abuse in childhood, lifetime physical or sexual violence, and any violence across the life course, with subsequent change in LLSID and depressive symptoms in later life, adjusted for demographic (age, gender, marital status, and region), socioeconomic (education, occupational class, tenure, and financial hardship), and social (household size and caregiving) attributes. Depressive symptoms were measured with the Centre for Epidemiological Studies Depression scale.</div></div><div><h3>Findings</h3><div>Of the 9771 participants who responded to the questionnaire, 6171 answered all three questions about experiences of violence and were included in this cohort. Any experience of violence was consistently associated with worse health in older age, including depression scale score of at least 4 (men: adjusted odds ratio 1·99, 95% CI 1·34–2·94; women: 1·38, 1·02–1·86) and LLSID (men: 1·74, 1·08–2·81; women: 2·15, 1·45–3·17). The patterns were evident in men and women.</div></div><div><h3>Interpretation</h3><div>Physical and mental health disadvantages associated with experiencing violence in childhood and adulthood are sustained throughout later life. There was little evidence that health disparities between victims and non-victims reduce over time. Preventing violence in both childhood and adulthood could promote healthy ageing.</div></div><div><h3>Funding</h3><div>UK Prevention Research Partnership.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100738"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757866","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":"Associations between life course exposure to ambient air pollution with cognition and later-life brain structure: a population-based study of the 1946 British Birth Cohort","authors":"Thomas Canning MSc ,&nbsp;Jorge Arias-de la Torre PhD ,&nbsp;Helen L Fisher Prof ,&nbsp;John Gulliver Prof ,&nbsp;Anna L Hansell Prof ,&nbsp;Rebecca Hardy Prof ,&nbsp;Stephani L Hatch Prof ,&nbsp;Ian S Mudway PhD ,&nbsp;Amy Ronaldson PhD ,&nbsp;Molly Cartlidge MSc ,&nbsp;Sarah-Naomi James PhD ,&nbsp;Sarah E Keuss PhD ,&nbsp;Jonathan M Schott FMedSci ,&nbsp;Marcus Richards PhD ,&nbsp;Ioannis Bakolis Prof","doi":"10.1016/j.lanhl.2025.100724","DOIUrl":"10.1016/j.lanhl.2025.100724","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Previous research has linked higher exposure to air pollution to increased cognitive impairment at older ages. We aimed to extend the existing evidence in this area by incorporating exposures across the life course in addition to measures of cognition and brain structural imaging in participants at midlife to older age.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;For this population-based study, we used data from the Medical Research Council National Survey of Health and Development (NSHD; also known as the 1946 British Birth Cohort) and a neuroimaging substudy of the NSHD known as Insight 46. Participants were recruited after birth in a single week during March, 1946. Our objectives were to assess whether exposure to air pollutants in midlife (age 45–64 years) was associated with poorer processing speed and poorer verbal memory between the ages of 43 years and 69 years, and whether exposures were associated with poorer cognitive state and brain structure outcomes at age 69–71 years. Air pollution exposure data were available for nitrogen dioxide (NO&lt;sub&gt;2&lt;/sub&gt;; ages 45–64 years); particulate matter with diameter less than 10 μm (PM&lt;sub&gt;10&lt;/sub&gt;; ages 55–64 years); and nitrogen oxides (NO&lt;sub&gt;x&lt;/sub&gt;) and particulate matter with diameters less than 2·5 μm (PM&lt;sub&gt;2·5&lt;/sub&gt;) and between 2·5 μm and less than 10 μm (PM&lt;sub&gt;coarse&lt;/sub&gt;) and particulate matter absorbance (PM&lt;sub&gt;2·5&lt;/sub&gt;abs) as a measure of black carbon absorption (ages 60–64 years), with adjustments for early-life exposures to black smoke and sulphur dioxide. Verbal memory was tested with a 15-item recall task and processing speed with a visual search task at ages 43, 53, 60–64, and 69 years. The Addenbrooke’s Cognitive Examination III (ACE-III), a measure of cognitive state, was conducted at age 69 years. Whole-brain, ventricular, hippocampal, and white matter hyperintensity volumes were assessed by MRI at age 69–71 years. Generalised linear models and generalised mixed linear models were used to explore associations between pollution exposure, cognitive measures, and brain structural outcomes, adjusted for sociodemographic factors including smoking status and neighbourhood deprivation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Between the ages of 43 years and 69 years, we included 1534 NSHD participants in the verbal memory and processing speed analysis. Of 2148 participants who underwent testing during the wave of follow-up in 2015–16, at age 69 years, 1761 were included in the ACE-III analysis. Of the 502 NSHD participants recruited into the Insight 46 substudy, 453 were included in the analysis. Higher exposure to NO&lt;sub&gt;2&lt;/sub&gt; and PM&lt;sub&gt;10&lt;/sub&gt; was associated with slower processing speed between the ages of 43 years and 69 years (NO&lt;sub&gt;2&lt;/sub&gt; β −8·121 [95% CI −10·338 to −5·905 per IQR increase in exposure]; PM&lt;sub&gt;10&lt;/sub&gt; β −4·518 [−6·680 to −2·357]). Higher exposure to all tested pollutants was associated with lower ACE-III score at age 69 years (eg,","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100724"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675949","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":"Discontinuation of menopausal hormone therapy and risk of fracture: nested case–control studies using routinely collected primary care data","authors":"Yana Vinogradova PhD ,&nbsp;Barbara Iyen PhD ,&nbsp;Prof Tahir Masud MRCP ,&nbsp;Lauren Taylor BMBS ,&nbsp;Prof Joe Kai MD","doi":"10.1016/j.lanhl.2025.100729","DOIUrl":"10.1016/j.lanhl.2025.100729","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Women benefit from reduced fracture risk while using menopausal hormone therapy. However, information on risks after stopping menopausal hormone therapy is scarce and inconsistent, with no information on longer-term fracture risk as women age. We aimed to produce robust estimates of fracture risk among past users for the longest possible period after discontinuing therapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We did a nested case–control study using UK primary and secondary care data from the Clinical Practice Research Datalink, with the underlying cohorts CPRD GOLD and Aurum. Women, aged 40 years and older, registered with a primary care practice between Jan 1, 1998, and Feb 28, 2023, and with a first record for any fracture, were matched at the fracture index date with up to five female controls with no fracture history, who were of the same age and registered at the same general practice. Menopausal hormone therapy-related fracture risks were assessed using conditional logistic regression adjusted for demographics, family history, menopausal symptoms, comorbidities, and other medications.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;In total, 648 747 women (500 692 from Aurum and 148 055 from GOLD databases) with a first fracture record during the study period were matched to 2 357 125 women with no previous or contemporaneous fracture record. Age of average fracture cases was 68·5 years (SD 14·0), 3·2% were recorded as being from minority ethnic populations, and about a quarter of patients were older than 80 years. 140 410 (21·6%) cases used menopausal hormone therapy for a median of 3·6 years (IQR 1·3–6·8) and 515 917 (21·9%) controls used it for a median of 3·9 years (1·4–7·3). Compared with never-use, overall fracture risk was reduced for current use (oestrogen-only odds ratio [OR] 0·76 [95% CI 0·74–0·78], oestrogen–progestogen OR 0·75 [0·73–0·76]), became higher 1–10 years after discontinuation (oestrogen-only OR 0·99 [0·98–1·01], oestrogen–progestogen OR 1·06 [1·05–1·08]), but was again lower for more than 10 years post-cessation (oestrogen-only OR 0·93 [0·91–0·94], oestrogen–progestogen OR 0·95 [0·94–0·96]). Risk levels varied by menopausal hormone therapy type and by duration of treatment. Estimated extra fracture cases per 10 000 women-years 1–10 years after oestrogen–progestogen treatment were equivalent to 14 cases for less than 5 years menopausal hormone therapy exposure and five cases for 5 or more years of exposure. However, for more than 10 years after discontinuation, we estimated three fewer fracture cases for those on oestrogen–progestogen therapy for less than 5 years exposure and 13 fewer fracture cases for those with 5 or more years of exposure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;We have observed an attenuation of fracture risk after discontinuing menopausal hormone therapy, which manifests after an initial sharp rise. Fracture risk generally increases with age, but after discontinuation of m","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100729"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144718798","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":"Rethinking delirium: beyond a syndrome of older age","authors":"Davide Liborio Vetrano ,&nbsp;Alessandra Marengoni","doi":"10.1016/j.lanhl.2025.100751","DOIUrl":"10.1016/j.lanhl.2025.100751","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100751"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757979","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":"Method-specific suicide mortality rates among older adults in 47 countries and territories, 1996–2021, with projections to 2050: a global time series and modelling study","authors":"Hanseul Cho MD ,&nbsp;Soeun Kim MSc ,&nbsp;Yejun Son MSc ,&nbsp;Wonwoo Jang MD ,&nbsp;Hyeon Jin Kim PhD ,&nbsp;Hayeon Lee PhD ,&nbsp;Sooji Lee MD ,&nbsp;Jiyeon Oh MD ,&nbsp;Prof Jiseung Kang PhD ,&nbsp;Alexander C Tsai MD ,&nbsp;Ann K Shinn MD ,&nbsp;Prof Guillaume Fond MD ,&nbsp;Prof Laurent Boyer MD ,&nbsp;Prof Marco Solmi MD ,&nbsp;Prof Selin Woo PhD ,&nbsp;Prof Dong Keon Yon MD ,&nbsp;Prof Paolo Fusar-Poli MD","doi":"10.1016/j.lanhl.2025.100719","DOIUrl":"10.1016/j.lanhl.2025.100719","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Suicide rates are highest among older adults, yet comprehensive global studies are limited. This study aimed to estimate suicide mortality rates among older adults aged 65 years and older across 47 countries and territories from 1996 to 2021, including analyses by suicide method, project future rates to 2050, and identify associated factors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The study adhered to the Guidelines for Accurate and Transparent Health Estimates Reporting. We extracted suicide mortality data of older adults (≥65 years) across 47 countries and territories from the WHO Mortality Database for the period 1996–2021. We first estimated suicide mortality rates using a locally estimated scatterplot smoothing curve from 1996 to 2021, conducting subanalyses by sex, age subgroup, and suicide method. We then estimated future projections of suicide mortality rates to 2050 via Bayesian age-period-cohort (BAPC) modelling. We also performed a decomposition analysis using the Das Gupta method to identify factors contributing to changes in suicide death numbers between 1996 and 2021. Finally, we examined associations between suicide mortality rates in 2021 or the most recent available year and country-level indicators (poverty rate, disability-adjusted life-year [DALY] rates for alcohol use disorders and mental disorders, civilian firearm ownership, and pesticide use per cropland).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A total of 687 443 older adults who died by suicide (75·2% men, 24·8% women) were included in the analysis. The suicide mortality rate among adults aged 65 years and older was 15·99 deaths per 100 000 (95% CI 14·19–17·80) in 2021, significantly higher than the all-age suicide mortality rate of 10·87 deaths per 100 000 (9·86–11·87) in 2021 (p&lt;0·0001). Firearms were more frequently used by older adults who died by suicide, compared with the total population (14·91% &lt;em&gt;vs&lt;/em&gt; 9·88%, respectively; p&lt;0·0001). The firearm-related suicide mortality rate among older adults was 2·44 per 100 000 (95% CI 2·00–2·89) in 2021, approximately twice that of individuals of all ages (1·09 per 100 000; 0·88–1·31; p&lt;0·0001). There was an overall decline in suicide mortality rates among older adults from 1996 to 2021 (average annual percentage change [AAPC] –1·51 per 100 000; 95% CI –1·52 to –1·50), which was more pronounced among women (AAPC –2·24 per 100 000; –2·28 to –2·21) than in men (AAPC –1·45 per 100 000; –1·48 to –1·42; p&lt;0·0001). Older age subgroups had smaller AAPCs (p&lt;0·0001 for comparisons across all age subgroups). Notably, among adults aged 80 years and older, the suicide mortality rate by firearm showed no statistically significant change between 1996 and 2021. BAPC model projections suggest a slowing in the decline of suicide mortality rates among older adults to 2050. Decomposition analysis indicated that compared with 1996, the total number of suicides in 2021 increased by 7781 deaths primarily","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100719"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638299","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":"Time to focus on solutions for social disconnection","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2025.100755","DOIUrl":"10.1016/j.lanhl.2025.100755","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100755"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709190","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":"Effectiveness of post-discharge exercise interventions in older adults following acute hospitalisation: a systematic review and meta-analysis","authors":"Paula Etayo-Urtasun MSc ,&nbsp;Mikel Izquierdo PhD ,&nbsp;Mikel L Sáez de Asteasu PhD","doi":"10.1016/j.lanhl.2025.100730","DOIUrl":"10.1016/j.lanhl.2025.100730","url":null,"abstract":"<div><h3>Background</h3><div>Acute hospitalisation is a recognised risk factor for adverse outcomes in older adults, including hospital-associated disability. Post-discharge exercise interventions might mitigate physical and cognitive decline, although the few meta-analyses performed previously present limitations. This systematic review and meta-analysis aimed to evaluate the effect of post-discharge exercise interventions on health-related outcomes in older adults.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Scopus, Web of Science, and ScienceDirect was conducted following PRISMA 2020 guidelines on May 16, 2025. Randomised controlled trials published from Jan 1, 2000, to May 16, 2025, were included. These studies assessed the effectiveness of muscular strength and endurance exercises in older adults (aged 60 years and older) discharged from acute hospitalisation. There were no language filters. Two reviewers independently screened studies using the PICOS framework, extracted data from published reports, and assessed methodological quality using the Physiotherapy Evidence Database scale. Data were pooled using a random-effects model. This systematic review and meta-analysis is registered with PROSPERO, CRD42025630147.</div></div><div><h3>Findings</h3><div>The search yielded 2868 results, of which 17 articles (1458 participants) met inclusion criteria, with a mean Physiotherapy Evidence Database score of 7·3 (SD 0·9) out of 10, indicating moderate to high quality. Post-discharge exercise significantly improved physical function (standardised mean difference [SMD] 0·78 [95% CI 0·52 to 1·05], p&lt;0·0001). No significant effects were observed for health-related quality of life (SMD 0·23 [−0·04 to 0·51], p=0·098) or readmission risk (risk ratio 0·64 [95% CI 0·39 to 1·05], p=0·076). Exercise effects on functional independence, cognitive function, frailty, and mortality were synthesised descriptively due to insufficient data for meta-analysis. The main sources of heterogeneity were the outcome assessment tools and the exercise protocols. No evidence of risk of bias was found using either selection models (p&gt;0·05) or Egger’s test (p&gt;0·05) for any of the outcomes.</div></div><div><h3>Interpretation</h3><div>Post-discharge exercise interventions are effective at improving physical function in older adults following acute hospitalisation; however, effects on other health-related outcomes remain inconclusive. Future studies should establish optimal post-discharge exercise modalities, dosages, and delivery strategies tailored to individual patient needs. Advancing these priorities could improve patient outcomes and health-care system efficiency.</div></div><div><h3>Funding</h3><div>None.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100730"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ethical allocation of dementia prevention responsibility","authors":"Richard Armitage","doi":"10.1016/j.lanhl.2025.100732","DOIUrl":"10.1016/j.lanhl.2025.100732","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100732"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ethical allocation of dementia prevention responsibility–Authors’ reply","authors":"Joyce Siette ,&nbsp;Gilbert Knaggs","doi":"10.1016/j.lanhl.2025.100733","DOIUrl":"10.1016/j.lanhl.2025.100733","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 7","pages":"Article 100733"},"PeriodicalIF":14.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512588","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}