Lancet Healthy Longevity最新文献

{"title":"Effect of recipient age on prioritisation for liver transplantation in the UK: a population-based modelling study","authors":"Anthony Attia BSc MBChB , Jamie Webb MSci , Katherine Connor PhD MRCS , Chris J C Johnston PhD FRCS , Michael Williams PhD MRCP , Tim Gordon-Walker PhD MRCP , Ian A Rowe PhD MRCP , Prof Ewen M Harrison PhD FRCS , Ben M Stutchfield PhD FRCS","doi":"10.1016/S2666-7568(24)00044-8","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00044-8","url":null,"abstract":"<div><h3>Background</h3><p>Following the introduction of an algorithm aiming to maximise life-years gained from liver transplantation in the UK (the transplant benefit score [TBS]), donor livers were redirected from younger to older patients, mortality rate equalised across the age range and short-term waiting list mortality reduced. Understanding age-related prioritisation has been challenging, especially for younger patients and clinicians allocating non-TBS-directed livers. We aimed to assess age-related prioritisation within the TBS algorithm by modelling liver transplantation prioritisation based on data from a UK transplant unit and comparing these data with other regions.</p></div><div><h3>Methods</h3><p>In this population-based modelling study, serum parameters and age at liver transplantation assessment of patients attending the Scottish Liver Transplant Unit, Edinburgh, UK, between December, 2002, and November, 2023, were combined with representative synthetic data to model TBS survival predictions, which were compared according to age group (25–49 years <em>vs</em> ≥60 years), chronic liver disease severity, and disease cause. Models for end-stage liver disease (UKELD [UK], MELD [Eurotransplant region], and MELD 3.0 [USA]) were used as validated comparators of liver disease severity.</p></div><div><h3>Findings</h3><p>Of 2093 patients with chronic liver disease, 1808 (86%) had complete datasets and liver disease parameters consistent with eligibility for the liver transplant waiting list in the UK (UKELD ≥49). Disease severity as assessed by UKELD, MELD, and MELD 3.0 did not differ by age (median UKELD scores of 56 for patients aged ≥60 years <em>vs</em> 56 for patients aged 25–49 years; MELD scores of 16 <em>vs</em> 16; and MELD 3.0 scores of 18 <em>vs</em> 18). TBS increased with advancing age (R=0·45, p<0·0001). TBS predicted that transplantation in patients aged 60 years or older would provide a two-fold greater net benefit at 5 years than in patients aged 25–49 years (median TBS 1317 [IQR 1116–1436] in older patients <em>vs</em> 706 [411–1095] in younger patients; p<0·0001). Older patients were predicted to have shorter survival without transplantation than younger patients (263 days [IQR 144–473] in older patients <em>vs</em> 861 days [448–1164] in younger patients; p<0·0001) but similar survival after transplantation (1599 days [1563–1628] <em>vs</em> 1573 days [1525–1614]; p<0·0001). Older patients could reach a TBS for which a liver offer was likely below minimum criteria for transplantation (UKELD <49), whereas many younger patients were required to have high–urgent disease (UKELD >60). US and Eurotransplant programmes did not prioritise according to age.</p></div><div><h3>Interpretation</h3><p>The UK liver allocation algorithm prioritises older patients for transplantation by predicting that advancing age increases the benefit from liver transplantation. Restricted follow-up and biases in waiting list data m","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 5","pages":"Pages e346-e355"},"PeriodicalIF":13.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000448/pdfft?md5=acbdb963c3b53eb418988f20277b6a46&pid=1-s2.0-S2666756824000448-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824572","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":"Future policy and research for advance care planning in dementia: consensus recommendations from an international Delphi panel of the European Association for Palliative Care","authors":"Miharu Nakanishi PhD ,&nbsp;Sandra Martins Pereira PhD ,&nbsp;Lieve Van den Block PhD ,&nbsp;Deborah Parker PhD ,&nbsp;Karen Harrison-Dening PhD ,&nbsp;Paola Di Giulio MSc ,&nbsp;Jürgen In der Schmitten MD ,&nbsp;Philip J Larkin PhD ,&nbsp;Ninoslav Mimica PhD ,&nbsp;Rebecca L Sudore MD ,&nbsp;Iva Holmerová PhD ,&nbsp;Ida J Korfage PhD ,&nbsp;Jenny T van der Steen PhD ,&nbsp;European Association for Palliative Care","doi":"10.1016/S2666-7568(24)00043-6","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00043-6","url":null,"abstract":"<div><p>Advance care planning (ACP) is increasingly recognised in the global agenda for dementia care. The European Association for Palliative Care (EAPC) Taskforce on ACP in Dementia aimed to provide recommendations for policy initiatives and future research. We conducted a four-round Delphi study with a 33-country panel of 107 experts between September, 2021, and June, 2022, that was approved by the EAPC Board. Consensus was achieved on 11 recommendations concerning the regulation of advance directives, equity of access, and dementia-inclusive approaches and conversations to express patients' values. Identified research gaps included the need for an evidence-based dementia-specific practice model that optimises engagement and communication with people with fluctuating and impaired capacity and their families to support decision making, while also empowering people to adjust their decisions if their goals or preferences change over time. Policy gaps included insufficient health services frameworks for dementia-inclusive practice. The results highlight the need for more evidence and policy development that support inclusive ACP practice models.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 5","pages":"Pages e370-e378"},"PeriodicalIF":13.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000436/pdfft?md5=9a2904f9de4562236a4221ffe1b97a26&pid=1-s2.0-S2666756824000436-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824545","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":"Heart failure treatment and mortality in older people: beyond clinical trials","authors":"Marco Zuin ,&nbsp;Gianluca Rigatelli ,&nbsp;Claudio Bilato","doi":"10.1016/S2666-7568(24)00060-6","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00060-6","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 5","pages":"Pages e306-e307"},"PeriodicalIF":13.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000606/pdfft?md5=88be7bd821871f86c649c09deb4b15fa&pid=1-s2.0-S2666756824000606-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824628","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":"Where is the perfect triangle in the liver allocation system?","authors":"Kazunari Sasaki ,&nbsp;Marc L Melcher","doi":"10.1016/S2666-7568(24)00064-3","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00064-3","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 5","pages":"Pages e310-e311"},"PeriodicalIF":13.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000643/pdfft?md5=e08f8eb43981dffe4b834d25fdf5643e&pid=1-s2.0-S2666756824000643-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824629","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":"Social health and subsequent cognitive functioning in people aged 50 years and older: examining the mediating roles of depressive symptoms and inflammatory biomarkers in two European longitudinal studies","authors":"Jean Stafford PhD ,&nbsp;Serhiy Dekhtyar PhD ,&nbsp;Anna-Karin Welmer PhD ,&nbsp;Davide L Vetrano PhD ,&nbsp;Giulia Grande PhD ,&nbsp;Erika J Laukka PhD ,&nbsp;Anna Marseglia PhD ,&nbsp;Vanessa Moulton PhD ,&nbsp;Rosie Mansfield PhD ,&nbsp;Yiwen Liu PhD ,&nbsp;Ke Ning PhD ,&nbsp;Prof Karin Wolf-Ostermann PhD ,&nbsp;Prof Henry Brodaty DSc ,&nbsp;Suraj Samtani PhD ,&nbsp;Prof Mohammad Arfan Ikram PhD ,&nbsp;René Melis PhD ,&nbsp;Prof Joanna Rymaszewska PhD ,&nbsp;Dorota Szcześniak PhD ,&nbsp;Giorgio Di Gessa PhD ,&nbsp;Prof Marcus Richards PhD ,&nbsp;Jane Maddock PhD","doi":"10.1016/S2666-7568(24)00046-1","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00046-1","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Social health markers, including marital status, contact frequency, network size, and social support, have been shown to be associated with cognition. However, the mechanisms underlying these associations remain poorly understood. We investigated whether depressive symptoms and inflammation mediated associations between social health and subsequent cognition.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In the English Longitudinal Study of Ageing (ELSA), a nationally representative longitudinal study in England, UK, we sampled 7136 individuals aged 50 years or older living in private households without dementia at baseline or at the intermediate mediator assessment timepoint, who had recorded information on at least one social health marker and potential mediator. We used four-way decomposition to examine to what extent depressive symptoms, C-reactive protein, and fibrinogen mediated associations between social health and subsequent standardised cognition (verbal fluency and delayed and immediate recall), including cognitive change, with slopes derived from multilevel models (12-year slope). We examined whether findings were replicated in the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), a population-based longitudinal study in Sweden, in a sample of 2604 individuals aged 60 years or older living at home or in institutions in Kungsholmen (central Stockholm) without dementia at baseline or at the intermediate mediator assessment timepoint (6-year slope). Social health exposures were assessed at baseline, potential mediators were assessed at an intermediate timepoint (wave 2 in ELSA and 6-year follow-up in SNAC-K); cognitive outcomes were assessed at a single timepoint (wave 3 in ELSA and 12-year follow-up in SNAC-K), and cognitive change (between waves 3 and 9 in ELSA and between 6-year and 12-year follow-ups in SNAC-K).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;The study sample included 7136 participants from ELSA, of whom 3962 (55·5%) were women and 6934 (97·2%) were White; the mean baseline age was 63·8 years (SD 9·4). Replication analyses included 2604 participants from SNAC-K, of whom 1604 (61·6%) were women (SNAC-K did not collect ethnicity data); the mean baseline age was 72·3 years (SD 10·1). In ELSA, we found indirect effects via depressive symptoms of network size, positive support, and less negative support on subsequent verbal fluency, and of positive support on subsequent immediate recall (pure indirect effect [PIE] 0·002 [95% CI 0·001–0·003]). Depressive symptoms also partially mediated associations between less negative support and slower decline in immediate recall (PIE 0·001 [0·000–0·002]) and in delayed recall (PIE 0·001 [0·000–0·002]), and between positive support and slower decline in immediate recall (PIE 0·001 [0·000–0·001]). We did not observe mediation by inflammatory biomarkers. Findings of mediation by depressive symptoms in the association between positive support and verbal fluency and between","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 5","pages":"Pages e356-e369"},"PeriodicalIF":13.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000461/pdfft?md5=4d7163a6c39e22e92bc32235385197ba&pid=1-s2.0-S2666756824000461-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140824638","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":"Schema therapy for older adults?","authors":"Erkki Isometsä","doi":"10.1016/S2666-7568(24)00027-8","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00027-8","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e237-e238"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000278/pdfft?md5=9fb44cfc6d65ee7334c272f77302d99b&pid=1-s2.0-S2666756824000278-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320392","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":"Supporting social connections across the life course","authors":"The Lancet Healthy Longevity","doi":"10.1016/S2666-7568(24)00047-3","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00047-3","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Page e236"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000473/pdfft?md5=217e70530d6f6fef60310c145d2110d6&pid=1-s2.0-S2666756824000473-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320391","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 mediating role of neuroimaging-derived biological brain age in the association between risk factors for dementia and cognitive decline in middle-aged and older individuals without cognitive impairment: a cohort study","authors":"Irene Cumplido-Mayoral MSc ,&nbsp;Anna Brugulat-Serrat PhD ,&nbsp;Gonzalo Sánchez-Benavides PhD ,&nbsp;Armand González-Escalante MSc ,&nbsp;Federica Anastasi PhD ,&nbsp;Marta Milà-Alomà PhD ,&nbsp;David López-Martos MSc ,&nbsp;Muge Akinci MSc ,&nbsp;Carles Falcón PhD ,&nbsp;Mahnaz Shekari MSc ,&nbsp;Raffaele Cacciaglia PhD ,&nbsp;Eider M Arenaza-Urquijo PhD ,&nbsp;Carolina Minguillón PhD ,&nbsp;Karine Fauria PhD ,&nbsp;José Luis Molinuevo MD PhD ,&nbsp;Marc Suárez-Calvet MD PhD ,&nbsp;Oriol Grau-Rivera MD PhD ,&nbsp;Verónica Vilaplana PhD ,&nbsp;Juan Domingo Gispert PhD ,&nbsp;N VILOR TEJEDOR","doi":"10.1016/S2666-7568(24)00025-4","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00025-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Neuroimaging-based brain-age delta has been shown to be a mediator linking cardiovascular risk factors to cognitive function. We aimed to assess the mediating role of brain-age delta in the association between modifiable risk factors of dementia and longitudinal cognitive decline in middle-aged and older individuals who are asymptomatic, stratified by Alzheimer's disease pathology. We also explored whether the mediation effect is specific to cognitive domain.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this cohort study, we included participants from the ALFA+ cohort aged between 45 years and 65 years who were cognitively unimpaired and who had available structural MRI, cerebrospinal fluid β-amyloid (Aβ)42 and Aβ40 measurements obtained within 1 year of each other, modifiable risk factors assessment, and cognitive evaluation over 3 years. Participants were recruited from the Barcelonaβeta Brain Research Center (Barcelona, Spain). Included individuals underwent a first assessment between Oct 25, 2016, and Jan 28, 2020, and a follow-up cognitive assessment 3·28 (SD 0·27) years later. We computed brain-age delta and composites of different cognitive function domains (preclinical Alzheimer's cognitive composite [PACC], attention, executive function, episodic memory, visual processing, and language). We used partial least squares path modelling to explore mediation effects in the associations between modifiable risk factors (including cardiovascular, mental health, mood, metabolic or endocrine history, and alcohol use) and changes in cognitive composites. To assess the role of Alzheimer's disease pathology, we computed separate models for Aβ-negative and Aβ-positive individuals.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;Of the 419 participants enrolled in ALFA+, 302 met our inclusion criteria, of which 108 participants were classified as Aβ-positive and 194 as Aβ-negative. In Aβ-positive individuals, brain-age delta partially mediated (percent mediation proportion 15·73% [95% CI 14·22–16·66]) the association between modifiable risk factors and decline in overall cognition (across cognitive domains). Brain-age delta fully mediated (mediation proportion 28·03% [26·25–29·21]) the effect of modifiable risk factors on the PACC, wherein increased values for risk factors correlated with an older brain-age delta, and, consequently, an older brain-age delta was linked to greater PACC decline. This effect appears to be primarily driven by memory decline. Mediation was not significant in Aβ-negative individuals (3·52% [0·072–4·17]) on PACC, although path coefficients were not significantly different from those in the Aβ-positive group.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;p&gt;Our findings suggest that brain-age delta captures the association between modifiable risk factors and longitudinal cognitive decline in middle-aged and older people. In asymptomatic middle-aged and older individuals who are Aβ-positive, the pathology might be the strongest driver","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e276-e286"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000254/pdfft?md5=75d672e45c0205b8026417d069b00a22&pid=1-s2.0-S2666756824000254-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320390","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":"Group schema therapy combined with psychomotor therapy for older adults with a personality disorder: an open-label, multicentre, randomised controlled trial","authors":"Martine S Veenstra-Spruit MSc ,&nbsp;Renske Bouman MSc ,&nbsp;Silvia DM van Dijk PhD ,&nbsp;Antoinette DI van Asselt PhD ,&nbsp;Prof Sebastiaan PJ van Alphen PhD ,&nbsp;Dorothee H Veenstra MSc ,&nbsp;Marije de Ruiter MSc ,&nbsp;Saskia E Troost MD ,&nbsp;Monique W Lammers MD ,&nbsp;Frank Vulker MSc ,&nbsp;Maureen MJ Smeets-Janssen MD ,&nbsp;Rob HS van den Brink PhD ,&nbsp;Prof Richard C Oude Voshaar MD","doi":"10.1016/S2666-7568(24)00001-1","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00001-1","url":null,"abstract":"<div><h3>Background</h3><p>Although several types of psychotherapy effectively reduce psychological distress associated with personality disorders, randomised controlled trials (RCT) have systematically excluded older patients. We aimed to examine the effectiveness of group schema therapy combined with psychomotor therapy (GST + PMT) in later life compared with treatment as usual (TAU).</p></div><div><h3>Methods</h3><p>We did an open-label, multicentre, RCT in eight outpatient clinics for geriatric psychiatry in the Netherlands. Adults aged 60 years or older with a full or subthreshold cluster B or C personality disorder according to DSM criteria were included and randomly assigned 1:1 to GST + PMT or TAU by an independent researcher applying a computer-generated sequence per study site when 8 to 16 patients had given informed consent; investigators and interviewers were kept blinded until end of follow-up. Included individuals received 20 weekly sessions of GST + PMT or TAU with 1 year of follow-up. The primary outcome was psychological distress, measured with the 53-item Brief Symptom Inventory. The trial was registered with International Clinical Trials Registry Platform, NTR6621.</p></div><div><h3>Findings</h3><p>Of the 145 study participants recruited between Feb 21, 2018, and Jan 21, 2020, 102 patients (median age of 69 years [IQR 63–71], 62 [61%] female) who concluded therapy before the COVID-19 pandemic (cutoff March 20, 2020) were included in the intention-to-treat analysis (51 in each study group), because COVID-19 measures substantially disrupted delivery of group therapy. GST + PMT significantly improved psychological distress compared with TAU over the 6-month treatment period (Cohen's <em>d</em> 0·42, 95% CI 0·16 to 0·68; p=0·0016). The pre-post effect of GST + PMT remained stable during follow-up, whereas patients receiving TAU further improved, resulting in a non-significant difference between groups at 1 year (Cohen's <em>d</em> 0·21, 95% CI –0·07 to 0·48; p=0·14). No patients reported adverse events.</p></div><div><h3>Interpretation</h3><p>Psychotherapy focused on personality disorders is effective in later life, resulting in a faster improvement in psychopathology than TAU. Future studies should focus on increasing effectiveness by intensifying or prolonging treatment.</p></div><div><h3>Funding</h3><p>Netherlands Organization for Health Research and Development.</p></div><div><h3>Translation</h3><p>For the Dutch translation of the abstract see Supplementary Materials section.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e245-e254"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000011/pdfft?md5=3f188184674d7d5927e0a8759dab8fc8&pid=1-s2.0-S2666756824000011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320389","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":"Bridging modifiable risk factors and cognitive decline: the mediating role of brain age","authors":"Marcella Montagnese ,&nbsp;Timothy Rittman","doi":"10.1016/S2666-7568(24)00042-4","DOIUrl":"https://doi.org/10.1016/S2666-7568(24)00042-4","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 4","pages":"Pages e243-e244"},"PeriodicalIF":13.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000424/pdfft?md5=4eea5e01095545201a7baa81af014954&pid=1-s2.0-S2666756824000424-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140320665","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}