Lancet Healthy Longevity最新文献

{"title":"Adapted EXTREME regimen in the first-line treatment of fit, older patients with recurrent or metastatic head and neck squamous cell carcinoma (ELAN-FIT): a multicentre, single-arm, phase 2 trial","authors":"Prof Joël Guigay MD , Hervé Le Caer MD , François-Régis Ferrand MD , Lionel Geoffrois MD , Esma Saada-Bouzid MD , Jérôme Fayette MD , Christian Sire MD , Didier Cupissol MD , Emmanuel Blot MD , Pierre Guillet MD , Julien Pavillet MD , Laurence Bozec MD , Olivier Capitain MD , Frédéric Rolland MD , Philippe Debourdeau MD , Yoann Pointreau MD , Claire Falandry MD , Stéphane Lopez MD , Alexandre Coutte MD , Thierry Chatellier MD , Anne Aupérin PhD","doi":"10.1016/S2666-7568(24)00048-5","DOIUrl":"10.1016/S2666-7568(24)00048-5","url":null,"abstract":"<div><h3>Background</h3><p>A standard treatment for fit, older patients with recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) is yet to be established. In the previous EXTREME trial, few older patients were included. We aimed to evaluate the efficacy and tolerance of an adapted EXTREME regimen in fit, older patients with recurrent or metastatic HNSCC.</p></div><div><h3>Methods</h3><p>This single-arm, phase 2 study was done at 22 centres in France. Eligible patients were aged 70 years or older and assessed as not frail (fit) using the ELAN Geriatric Evaluation (EGE) and had recurrent or metastatic HNSCC in the first-line setting that was not eligible for local therapy (surgery or radiotherapy), and an Eastern Cooperative Oncology Group performance status of 0–1. The adapted EXTREME regimen consisted of six cycles of fluorouracil 4000 mg/m<sup>2</sup> on days 1–4, carboplatin with an area under the curve of 5 on day 1, and cetuximab on days 1, 8, and 15 (400 mg/m<sup>2</sup> on cycle 1–day 1, and 250 mg/m<sup>2</sup> subsequently), all intravenously, with cycles starting every 21 days. In patients with disease control after two to six cycles, cetuximab 500 mg/m<sup>2</sup> was continued once every 2 weeks as maintenance therapy until disease progression or unacceptable toxicity. Granulocyte colony-stimulating factor was systematically administered and erythropoietin was recommended during chemotherapy. The study was based on the two-stage Bryant and Day design, combining efficacy and toxicity endpoints. The primary efficacy endpoint was objective response rate at week 12 after the start of treatment, assessed by central review (with an unacceptable rate of ≤15%). The primary toxicity endpoint was morbidity, defined as grade 4–5 adverse events, or cutaneous rash (grade ≥3) that required cetuximab to be discontinued, during the chemotherapy phase, or a decrease in functional autonomy (Activities of Daily Living score decrease ≥2 points from baseline) at 1 month after the end of chemotherapy (with an unacceptable morbidity rate of >40%). Analysis of the coprimary endpoints, and of safety in the chemotherapy phase, was based on the per-protocol population, defined as eligible patients who received at least one cycle of the adapted EXTREME regimen. Safety in the maintenance phase was assessed in all patients who received at least one dose of cetuximab as maintenance therapy. The study is registered with <span>ClinicalTrials.gov</span><svg><path></path></svg>, <span>NCT01864772</span><svg><path></path></svg>, and is completed.</p></div><div><h3>Findings</h3><p>Between Sept 27, 2013, and June 20, 2018, 85 patients were enrolled, of whom 78 were in the per-protocol population. 66 (85%) patients were male and 12 (15%) were female, and the median age was 75 years (IQR 72–79). The median number of chemotherapy cycles received was five (IQR 3–6). Objective response at week 12 was observed in 31 patients (40% [95% CI 30–51]) and morbidit","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Pages e392-e405"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000485/pdfft?md5=062ae4d43cb205d5927b8c841bb6c7de&pid=1-s2.0-S2666756824000485-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959269","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":"Eldecalcitol for sarcopenia prevention in adults with prediabetes","authors":"Honglian Luo , Jiafeng Zhang , Xianhua Li , Tuo Li , Wei Shen","doi":"10.1016/S2666-7568(24)00091-6","DOIUrl":"10.1016/S2666-7568(24)00091-6","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Page e389"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000916/pdfft?md5=23158a79062520c12e030fee64338dd5&pid=1-s2.0-S2666756824000916-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200937","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":"Understanding the needs of forcibly displaced people","authors":"The Lancet Healthy Longevity","doi":"10.1016/S2666-7568(24)00097-7","DOIUrl":"10.1016/S2666-7568(24)00097-7","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Page e379"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000977/pdfft?md5=3dc2fc65c44f8a65d37305ad693862cd&pid=1-s2.0-S2666756824000977-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200963","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":"Are mobile health applications the answer to dementia risk reduction?","authors":"Janice M Ranson","doi":"10.1016/S2666-7568(24)00095-3","DOIUrl":"10.1016/S2666-7568(24)00095-3","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Pages e386-e387"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000953/pdfft?md5=37bbf2a12ba3ac72bc042f0528b4b9ed&pid=1-s2.0-S2666756824000953-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200935","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":"Long-term effects of APOEε4 on mortality","authors":"Ya-Ru Zhang , Jin-Tai Yu","doi":"10.1016/S2666-7568(24)00093-X","DOIUrl":"10.1016/S2666-7568(24)00093-X","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Pages e384-e385"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266675682400093X/pdfft?md5=9c81f91bceae82a8c77dda00b1e4389e&pid=1-s2.0-S266675682400093X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200938","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":"Value-based motivational strategies combined with technology to encourage a lifestyle that helps to prevent dementia","authors":"Prof Stefan Klöppel MD ,&nbsp;Esther Brill MSc ,&nbsp;Prof Giovanni B Frisoni MD ,&nbsp;Prof Dag Aarsland PhD ,&nbsp;Prof Verena Klusmann-Weißkopf PhD","doi":"10.1016/S2666-7568(24)00069-2","DOIUrl":"10.1016/S2666-7568(24)00069-2","url":null,"abstract":"<div><p>Lifestyles aimed at reducing dementia risk typically combine physical and cognitive training, nutritional adaptations, and, potentially, an augmentation in social interactions. Interventions at the population level are essential but should be complemented by individual efforts. For efficacy, lasting changes to an individual's lifestyle are needed, necessitating robust motivation and volition. Acting in accordance with one's values is assumed to be rewarding, leading to improved motivation and volition, and produces stable behaviour–outcome relationships. To this end, future preventive endeavours might first evaluate an individual's extant lifestyle, preferences, and values, including considerations of age-related changes to ensure these values remain a motivational source. Digital technology can support lifestyle goals and be targeted to support an individual's values. A digital platform could implement situation-specific, sensing-based feedback to alert users to a target situation (eg, opportunity for exercise) coupled with (smartphone-based) feedback on the extent of accomplished behavioural change to support individually set goals and facilitate their adjustment depending on whether these goals are achieved. This use of the motivational impetus of values, coupled with interpersonal techniques, such as motivational interviewing and SMART goal setting, in combination with sensor technology and just-in-time adaptive interventions, is assumed to hold high potential for dementia prevention.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Pages e443-e446"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000692/pdfft?md5=39521d05722395615b75776036cff03f&pid=1-s2.0-S2666756824000692-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200964","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 need to include older patients with head and neck cancer in clinical trials","authors":"Leandro Luongo Matos ,&nbsp;Luiz Paulo Kowalski","doi":"10.1016/S2666-7568(24)00067-9","DOIUrl":"10.1016/S2666-7568(24)00067-9","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Pages e380-e381"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000679/pdfft?md5=d47beaf8f967069cf29bbb7b27caa713&pid=1-s2.0-S2666756824000679-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140959271","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":"Prevention of dementia using mobile phone applications (PRODEMOS): a multinational, randomised, controlled effectiveness–implementation trial","authors":"Prof Eric P Moll van Charante MD ,&nbsp;Marieke P Hoevenaar-Blom PhD ,&nbsp;Manshu Song PhD ,&nbsp;Prof Sandrine Andrieu MD ,&nbsp;Linda Barnes RGN ,&nbsp;Cindy Birck PhD ,&nbsp;Rachael Brooks BA ,&nbsp;Nicola Coley PhD ,&nbsp;Esmé Eggink PhD ,&nbsp;Jean Georges PhD ,&nbsp;Melanie Hafdi PhD ,&nbsp;Prof Willem A van Gool MD ,&nbsp;Ron Handels PhD ,&nbsp;Haifeng Hou PhD ,&nbsp;Prof Jihui Lyu MD ,&nbsp;Prof Yixuan Niu MD ,&nbsp;Libin Song BSc ,&nbsp;Prof Wenzhi Wang PhD ,&nbsp;Prof Youxin Wang PhD ,&nbsp;Anders Wimo PhD ,&nbsp;Xi Wei","doi":"10.1016/S2666-7568(24)00068-0","DOIUrl":"10.1016/S2666-7568(24)00068-0","url":null,"abstract":"<div><h3>Background</h3><p>The expected increase of dementia prevalence in the coming decades will mainly be in low-income and middle-income countries and in people with low socioeconomic status in high-income countries. This study aims to reduce dementia risk factors in underserved populations at high-risk using a coach-supported mobile health (mHealth) intervention.</p></div><div><h3>Methods</h3><p>This open-label, blinded endpoint, hybrid effectiveness–implementation randomised controlled trial (RCT) investigated whether a coach-supported mHealth intervention can reduce dementia risk in people aged 55–75 years of low socioeconomic status in the UK or from the general population in China with at least two dementia risk factors. The primary effectiveness outcome was change in cardiovascular risk factors, ageing, and incidence of dementia (CAIDE) risk score from baseline to after 12–18 months of intervention. Implementation outcomes were coverage, adoption, sustainability, appropriateness, acceptability, fidelity, feasibility, and costs assessed using a mixed-methods approach. All participants with complete data on the primary outcome, without imputation of missing outcomes were included in the analysis (intention-to-treat principle). This trial is registered with ISRCTN, ISRCTN15986016, and is completed.</p></div><div><h3>Findings</h3><p>Between Jan 15, 2021, and April 18, 2023, 1488 people (601 male and 887 female) were randomly assigned (734 to intervention and 754 to control), with 1229 (83%) of 1488 available for analysis of the primary effectiveness outcome. After a mean follow-up of 16 months (SD 2·5), the mean CAIDE score improved 0·16 points in the intervention group versus 0·01 in the control group (mean difference –0·16, 95% CI –0·29 to –0·03). 1533 (10%) invited individuals responded; of the intervention participants, 593 (81%) of 734 adopted the intervention and 367 (50%) of 734 continued active participation throughout the study. Perceived appropriateness (85%), acceptability (81%), and fidelity (79%) were good, with fair overall feasibility (53% of intervention participants and 58% of coaches), at low cost. No differences in adverse events between study arms were found.</p></div><div><h3>Interpretation</h3><p>A coach-supported mHealth intervention is modestly effective in reducing dementia risk factors in those with low socioeconomic status in the UK and any socioeconomic status in China. Implementation is challenging in these populations, but those reached actively participated. Whether this intervention will result in less cognitive decline and dementia requires a larger RCT with long follow-up.</p></div><div><h3>Funding</h3><p>EU Horizon 2020 Research and Innovation Programme and the National Key R&amp;D Programmes of China.</p></div><div><h3>Translation</h3><p>For the Mandarin translation of the abstract see Supplementary Materials section.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Pages e431-e442"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000680/pdfft?md5=347ab4be77fe24ccc214ac7df12a2777&pid=1-s2.0-S2666756824000680-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065018","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":"Population attributable fractions of modifiable risk factors for dementia: a systematic review and meta-analysis","authors":"Prof Blossom C M Stephan PhD ,&nbsp;Louie Cochrane MSc ,&nbsp;Aysegul Humeyra Kafadar MSc ,&nbsp;Jacob Brain MSc ,&nbsp;Elissa Burton PhD ,&nbsp;Prof Bronwyn Myers PhD ,&nbsp;Prof Carol Brayne MD ,&nbsp;Aliya Naheed PhD ,&nbsp;Prof Kaarin J Anstey PhD ,&nbsp;Ammar W Ashor PhD ,&nbsp;Prof Mario Siervo PhD","doi":"10.1016/S2666-7568(24)00061-8","DOIUrl":"10.1016/S2666-7568(24)00061-8","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;More than 57 million people have dementia worldwide. Evidence indicates a change in dementia prevalence and incidence in high-income countries, which is likely to be due to improved life-course population health. Identifying key modifiable risk factors for dementia is essential for informing risk reduction and prevention strategies. We therefore aimed to estimate the population attributable fraction (PAF) for dementia associated with modifiable risk factors.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this systematic review and meta-analysis, we searched Embase, MEDLINE, and PsycINFO, via Ovid, from database inception up to June 29, 2023, for population-derived or community-based studies and reviews reporting a PAF value for one or more modifiable risk factor for later-life dementia (prevalent or incident dementia in people aged ≥60 years), with no restrictions on dementia subtype, the sex or baseline age of participants, or the period of study. Articles were independently screened for inclusion by four authors, with disagreements resolved through consensus. Data including unweighted and weighted PAF values (weighted to account for communality or overlap in risk) were independently extracted into a predefined template by two authors and checked by two other authors. When five or more unique studies investigated a given risk factor or combination of the same factors, random-effects meta-analyses were used to calculate a pooled PAF percentage estimate for the factor or combination of factors. The review protocol was registered on PROSPERO, CRD42022323429.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;4024 articles were identified, and 74 were included in our narrative synthesis. Overall, PAFs were reported for 61 modifiable risk factors, with sufficient data available for meta-analysis of 12 factors (n=48 studies). In meta-analyses, the highest pooled unweighted PAF values were estimated for low education (17·2% [95% CI 14·4–20·0], p&lt;0·0001), hypertension (15·8% [14·7–17·1], p&lt;0·0001), hearing loss (15·6% [10·3–20·9], p&lt;0·0001), physical inactivity (15·2% [12·8–17·7], p&lt;0·0001), and obesity (9·4% [7·3–11·7], p&lt;0·0001). According to weighted PAF values, low education (9·3% [6·9–11·7], p&lt;0·0001), physical inactivity (7·3% [3·9–11·2], p=0·0021), hearing loss (7·2% [5·2–9·7], p&lt;0·0001), hypertension (7·1% [5·4–8·8], p&lt;0·0001), and obesity (5·3% [3·2–7·4], p=0·0001) had the highest pooled estimates. When low education, midlife hypertension, midlife obesity, smoking, physical inactivity, depression, and diabetes were combined (Barnes and Yaffe seven-factor model; n=9 studies), the pooled unweighted and weighted PAF values were 55·0% (46·5–63·5; p&lt;0·0001) and 32·0% (26·6–37·5; p&lt;0·0001), respectively. The pooled PAF values for most individual risk factors were higher in low-income and middle-income countries (LMICs) versus high-income countries.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;p&gt;Governments need to invest in a li","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Pages e406-e421"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000618/pdfft?md5=cb707008c5477ab286a5261b3c99539f&pid=1-s2.0-S2666756824000618-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200940","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":"Eldecalcitol for sarcopenia prevention in adults with prediabetes – Authors' reply","authors":"Tetsuya Kawahara ,&nbsp;Gen Suzuki ,&nbsp;Shoichi Mizuno","doi":"10.1016/S2666-7568(24)00090-4","DOIUrl":"10.1016/S2666-7568(24)00090-4","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 6","pages":"Pages e390-e391"},"PeriodicalIF":13.1,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000904/pdfft?md5=781d4f5b925904436931b85f4f7d414e&pid=1-s2.0-S2666756824000904-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200936","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}