Lancet Healthy Longevity最新文献

{"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":"10.1016/j.lanhl.2024.100640","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 11","pages":"Article 100640"},"PeriodicalIF":13.4,"publicationDate":"2024-11-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The views and experiences of older adults regarding digital mental health interventions: a systematic review of qualitative studies","authors":"Ruoyu Yin MPhil ,&nbsp;Laura Martinengo PhD ,&nbsp;Prof Helen Elizabeth Smith PhD ,&nbsp;Mythily Subramaniam PhD ,&nbsp;Konstadina Griva PhD ,&nbsp;Lorainne Tudor Car PhD","doi":"10.1016/j.lanhl.2024.08.007","DOIUrl":"10.1016/j.lanhl.2024.08.007","url":null,"abstract":"<div><div>This systematic review aimed to synthesise qualitative evidence on the views and experiences of older adults in using digital mental health interventions (DMHIs) for the prevention or self-management of mental disorders. We searched PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Web of Science, PsycINFO, and the first 100 results of Google Scholar for eligible studies and we included 37 papers reporting 35 studies in this Review. Most DMHIs were delivered using mobile apps (n=11), websites (n=6), and video-conferencing tools (n=6). The use of DMHIs in older adults was affected by negative perceptions about ageing and mental health, the digital divide (eg, insufficient digital literacy), personal factors (eg, motivation) and health status, interpersonal influences (eg, guidance and encouragement), intervention features (eg, pace and content), technology-related factors (eg, accessibility), and the perceived benefits and risks of using DMHIs. Future DMHIs for older adults should involve other stakeholders such as health-care professionals, provide content relevant to the needs of older people, be more accessible, and address concerns about privacy and confidentiality.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 11","pages":"Article 100638"},"PeriodicalIF":13.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568575","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":"Frailty screening with comprehensive geriatrician-led multidisciplinary assessment for older adults during emergency hospital attendance in Ireland (SOLAR): a randomised controlled trial","authors":"Aoife Leahy PhD ,&nbsp;Louise Barry PhD ,&nbsp;Gillian Corey MHSC ,&nbsp;Aoife Whiston PhD ,&nbsp;Helen Purtill PhD ,&nbsp;Elaine Shanahan MD ,&nbsp;Denys Shchetkovsky MB BCh ,&nbsp;Damien Ryan MB BCh ,&nbsp;Monica O’Loughlin RGN ,&nbsp;Prof Margaret O'Connor MB BCh BAO ,&nbsp;Rose Galvin PhD","doi":"10.1016/j.lanhl.2024.100642","DOIUrl":"10.1016/j.lanhl.2024.100642","url":null,"abstract":"<div><h3>Background</h3><div>Multidisciplinary comprehensive geriatric assessment (CGA) improves outcomes in hospitalised older adults but there is limited evidence on its effectiveness in the emergency department. We aimed to assess the benefits of CGA in the emergency department for older adults living with frailty.</div></div><div><h3>Methods</h3><div>In this randomised controlled trial, we enrolled older adults (≥75 years) who presented to the emergency department with medical complaints at University Hospital Limerick (Limerick, Ireland). Participants screened positive for frailty on the Identification of Seniors at Risk screening tool (score ≥2). Patients requiring resuscitation as well as those with COVID-19, psychiatric, surgical, or trauma complaints were excluded. Participants were randomly allocated 1:1 to geriatrician-led multidisciplinary CGA and management or usual care. Outcome assessors were masked to treatment allocation. The primary efficacy outcome was time spent in the emergency department, defined as the time from registration on the computer database until time of discharge or admission to an inpatient ward in the intention-to-treat population. This study is registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT04629690</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>Between Nov 9, 2020, and May 13, 2021, we recruited 228 patients. 113 participants were included in the intervention group (mean age 82·4 years [SD 4·9]; 63 [56%] women; 113 [100%] White Irish) and 115 in the control group (83·1 [5·6]; 61 [53%]; 112 [97%]). Median time in the emergency department was 11·5 h (IQR 5–27) in the intervention group and 20 h (7–29) in the control group (median difference [Hodges–Lehmann estimator] 3·1 h [95% CI 0·6–7·5]; p=0·013). There were no adverse events related to the intervention.</div></div><div><h3>Interpretation</h3><div>Geriatrician-led multidisciplinary assessment of older adults living with frailty was associated with reduced time spent in the emergency department setting at index visit and lower rates of nursing home admission, greater increases in quality of life, and lower decreases in function at both 30 days and 180 days. Multicentre trials are needed to confirm the external validity of the findings. This study provides an evidence base for similar teams in an emergency department setting.</div></div><div><h3>Funding</h3><div>Health Research Board (ILP-HSR-2017–014).</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 11","pages":"Article 100642"},"PeriodicalIF":13.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629669","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":"10.1016/j.lanhl.2024.100641","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 11","pages":"Article 100641"},"PeriodicalIF":13.4,"publicationDate":"2024-11-01","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights of the EuGMS congress 2024","authors":"Philippa Harris","doi":"10.1016/j.lanhl.2024.100657","DOIUrl":"10.1016/j.lanhl.2024.100657","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 11","pages":"Article 100657"},"PeriodicalIF":13.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645076","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":"Early integration of palliative care versus standard cardiac care for patients with heart failure (EPCHF): a multicentre, parallel, two-arm, open-label, randomised controlled trial","authors":"Mahmoud Balata MD ,&nbsp;Prof Lukas Radbruch MD ,&nbsp;Michaela Hesse MD ,&nbsp;Prof Ralf Westenfeld MD ,&nbsp;Martin Neukirchen MD ,&nbsp;Prof Roman Pfister MD ,&nbsp;Yann-Nicolas Batzler MD ,&nbsp;Can Öztürk MD ,&nbsp;Refik Kavsur MD ,&nbsp;Vedat Tiyerili MD ,&nbsp;Prof Birgitta Weltermann MD ,&nbsp;Robert Pölsler MD ,&nbsp;Prof Thomas Standl MD ,&nbsp;Prof Georg Nickenig MD ,&nbsp;Prof Marc Ulrich Becher MD ,&nbsp;Heart Failure Network Rhineland","doi":"10.1016/j.lanhl.2024.08.006","DOIUrl":"10.1016/j.lanhl.2024.08.006","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure is a substantial global health concern that severely affects patients' quality of life. We aimed to compare the effects of early integration of palliative care (EIPC) and standard cardiac care on health status and mood of patients with non-terminal heart failure.</div></div><div><h3>Methods</h3><div>EPCHF was a multicentre, parallel, two-arm, open-label, randomised controlled trial carried out at University Hospital Bonn and University Hospital Düsseldorf in Germany. Eligible patients (aged 18 years or older) had heart failure, with New York Heart Association class II or more and NT-proBNP concentrations greater than or equal to 400 pg/mL. Patients were randomly assigned (1:1) to receive EIPC with standard cardiac care or standard cardiac care alone. Randomisation was computer-generated with allocation concealment, variable block sizes, and stratification by investigational site. The primary endpoints were health status and mood, measured every 3 months over 12 months using the Functional Assessment of Chronic Illness Therapy–Palliative Care (FACIT–PAL) and the Kansas City Cardiomyopathy Questionnaire (KCCQ), analysed by intention to treat. This trial is registered with DRKS.de, DRKS00013922.</div></div><div><h3>Findings</h3><div>Between May 21, 2019, and Nov 15, 2021, 843 patients were assessed for eligibility, 205 of whom were enrolled (100 assigned to EIPC and 105 assigned to standard cardiac care). 143 (70%) patients were male and 62 (30%) were female. Over 12 months, both groups significantly improved in FACIT–PAL and KCCQ Overall Summary Score (OSS) with no significant differences between the groups (FACIT–PAL adjusted mean difference 0·98 points [95% CI –1·28 to 3·23]; p=0·40; KCCQ-OSS adjusted mean difference –2·06 points [–7·89 to 3·78]; p=0·49). Nine (9%) patients in the EIPC group and seven (7%) patients in the standard cardiac care group died from any cause, with no significant differences in time to death between the two groups (hazard ratio [HR] 1·32 [95% CI 0·49 to 3·54]; p=0·58). 22 (22%) patients in the EIPC group and 21 (21%) patients in the standard cardiac care group were hospitalised at least once due to heart failure, with no significant differences in time to heart-failure-related hospitalisation between the two groups (HR 1·09 [0·61 to 1·98]; p=0·77). 70 (70%) patients in the EIPC group and 62 (59%) in the standard cardiac care group had any adverse events (p=0·10).</div></div><div><h3>Interpretation</h3><div>In this open-label, randomised clinical trial, standard cardiac care, featuring guideline-directed optimisation of medical therapy and regular 3-monthly follow-ups was found to be as effective as when combined with EIPC in improving health status and mood in patients with non-terminal heart failure. Future clinical practices should consider EIPC based on individual patient needs.</div></div><div><h3>Funding</h3><div>Federal Ministry of Education and Research.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100637"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of biomarkers in the diagnosis of Alzheimer’s disease in adults with intellectual disability","authors":"Aoife McFeely MB ,&nbsp;Antoinette O’Connor MB PhD ,&nbsp;Prof Sean P Kennelly MB PhD","doi":"10.1016/j.lanhl.2024.100639","DOIUrl":"10.1016/j.lanhl.2024.100639","url":null,"abstract":"<div><div>People with intellectual disability are a vulnerable cohort who face challenges accessing health care. Compared with the general population, people with intellectual disability have an elevated risk of developing dementia, which often presents at a younger age and with atypical symptoms. The lifelong cognitive and functional difficulties faced by people with intellectual disability further complicate the diagnostic process. Specialised intellectual disability memory services and evaluation using reliable biomarkers of neurodegeneration are needed to improve diagnostic and prognostic certainty in this group. Inadequate specialist services and paucity of research on biomarkers in this population hinders progress and impedes the delivery of adequate health care. Although cerebrospinal fluid-based biomarkers and radiological biomarkers are used routinely in the evaluation of Alzheimer’s disease in the general population, biological variation within the clinically heterogenous group of people with intellectual disability could affect the clinical utility of existing biomarkers. As disease-modifying therapies become available for the treatment of early Alzheimer’s disease, and hopefully other neurodegenerative conditions in the future, biomarkers will serve as gatekeepers to establish the eligibility for such therapies. Inadequate representation of adults with intellectual disability in biomarker research will result in their exclusion from treatment with disease-modifying therapies, thus perpetuating the inequity in health care that is already faced by this group. The aim of this Series paper is to summarise current evidence on the application of biomarkers for Alzheimer’s disease in a population with intellectual disability (that is not attributable to Down syndrome) and suspected cognitive decline.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100639"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health deserves attention at all ages","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2024.100650","DOIUrl":"10.1016/j.lanhl.2024.100650","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100650"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical effectiveness of DREAMS START (Dementia Related Manual for Sleep; Strategies for Relatives) versus usual care for people with dementia and their carers: a single-masked, phase 3, parallel-arm, superiority randomised controlled trial","authors":"Prof Penny Rapaport PhD ,&nbsp;Sarah Amador PhD ,&nbsp;Mariam O Adeleke PhD ,&nbsp;Prof Julie A Barber PhD ,&nbsp;Prof Sube Banerjee MD ,&nbsp;Prof Georgina Charlesworth PhD ,&nbsp;Chris Clarke DClinPsy ,&nbsp;Prof Colin A Espie DSc ,&nbsp;Lina Gonzalez MSc ,&nbsp;Rossana Horsley GradCert ,&nbsp;Prof Rachael Hunter MSc ,&nbsp;Prof Simon D Kyle PhD ,&nbsp;Monica Manela BM ,&nbsp;Malgorzata Raczek PhD ,&nbsp;Prof Zuzana Walker MD ,&nbsp;Lucy Webster PhD ,&nbsp;Hang Yuan PhD ,&nbsp;Prof Gill Livingston MD","doi":"10.1016/j.lanhl.2024.08.004","DOIUrl":"10.1016/j.lanhl.2024.08.004","url":null,"abstract":"<div><h3>Background</h3><div>Sleep disturbances are common and distressing for people with dementia and their families. Non-pharmacological interventions should be first-line management, avoiding harmful pharmacological side-effects, but there is none with known effectiveness. We aimed to establish whether DREAMS START, a multicomponent intervention, reduced sleep disturbance in people with dementia living at home compared with usual care.</div></div><div><h3>Methods</h3><div>We conducted a phase 3, two-arm, multicentre, parallel-arm, superiority randomised controlled trial with masked outcome assessment, recruiting dyads of people with dementia and sleep disturbance and family carers from community settings. Randomisation to the DREAMS START intervention (plus usual treatment) or usual treatment was conducted at dyadic level, blocked, and stratified by site, with a web-based system assigning allocation. DREAMS START is a six-session, manualised intervention delivered face to face or remotely by non-clinically trained graduates over an approximately 3-month period. The primary outcome was sleep disturbance measured by the Sleep Disorders Inventory (SDI) at 8 months. Analyses were on the intention-to-treat population. This trial is registered with ISRCTN 13072268.</div></div><div><h3>Findings</h3><div>Between Feb 24, 2021, and March 5, 2023, 377 dyads were randomly assigned (1:1), 189 to usual treatment and 188 to intervention. The mean age of participants with dementia was 79·4 years (SD 9·0), and 206 (55%) were women. The mean SDI score at 8 months was lower in the intervention group compared with the usual treatment group (15·16 [SD 12·77], n=159, <em>vs</em> 20·34 [16·67], n=163]; adjusted difference in means –4·70 [95% CI –7·65 to –1·74], p=0·002). 17 (9%) people with dementia in the intervention group and 17 (9%) in the control group died during the trial; the deaths were unrelated to the intervention.</div></div><div><h3>Interpretation</h3><div>To our knowledge, DREAMS START is the first multicomponent intervention to improve the sleep of people living at home with dementia more than usual clinical care. It had sustained effectiveness beyond intervention delivery. The intervention’s delivery by non-clinically trained graduates increases the potential for implementation within health services, adding to usual clinical care.</div></div><div><h3>Funding</h3><div>National Institute for Health and Care Research Health Technology Assessment.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100635"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retinal biomarker of biological age based on composite clinical phenotypic information","authors":"Ruiyang Li ,&nbsp;Haotian Lin","doi":"10.1016/S2666-7568(24)00109-0","DOIUrl":"10.1016/S2666-7568(24)00109-0","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 10","pages":"Article 100603"},"PeriodicalIF":13.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}