American Journal of Preventive Medicine最新文献

{"title":"The Influence of Firearm Dealer Openings and Closings on Local Shootings in the U.S.","authors":"Daniel C Semenza, Ian A Silver, Richard Stansfield, Brielle Savage","doi":"10.1016/j.amepre.2025.108079","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108079","url":null,"abstract":"<p><strong>Introduction: </strong>Firearm dealer presence and density are associated with rates of local firearm violence, a significant threat to public safety and collective well-being in the U.S. However, the authors are unaware of any studies that have examined how dealer presence and absence influence shooting rates over time using longitudinal data.</p><p><strong>Methods: </strong>This study investigates the relationship between licensed firearm dealer presence and firearm violence using longitudinal data from over 20,000 census tracts in the 100 largest cities in the U.S. from 2015 to 2022. The analysis was conducted in 2025. The association between licensed firearm dealer openings and closings and total shooting rates was analyzed across 1-, 2-, and 3-year lag periods to account for differences in how dealer presence influences local firearm violence dynamics over time.</p><p><strong>Results: </strong>Findings demonstrate that neighborhoods with newly opened firearm dealers experience increases in shootings that sustain after 2 and 3 years. No significant effects were found for firearm dealer closings.</p><p><strong>Conclusions: </strong>The results highlight a complex temporal dynamic, suggesting that firearm availability through licensed firearm dealers may influence patterns of shootings within communities, particularly when new dealers open in neighborhoods without a prior dealer presence over time.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108079"},"PeriodicalIF":4.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The combined impact of campus and state alcohol policies on college drinking and harms.","authors":"Pamela J Trangenstein, Timothy S Naimi, Ziming Xuan, Raimee H Eck, Thomas K Greenfield, Sally Casswell, David H Jernigan","doi":"10.1016/j.amepre.2025.108143","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108143","url":null,"abstract":"<p><strong>Introduction: </strong>Little is known about what policies and practices may prevent alcohol-related harms to others (AHTOs). This study tested whether campus alcohol policies were associated with alcohol use and AHTOs among college students and whether these associations differ in states with weak vs. strong alcohol policies.</p><p><strong>Methods: </strong>This cross-sectional study used data from a 2021 probability-based survey of United States college students. The main predictor was a campus alcohol policy score (CAPS) that combined 33 policies. Alcohol use outcomes included past 30-day volume and binge drinking frequency, and analyses with alcohol use outcomes included 968 students who drink. In 2024, models with AHTO outcomes used data from 1,737 students (comprising abstainers and those who drink alcohol) and three AHTOs: verbal, physical and sexual. Models also assessed interactions between campus and state alcohol policy scores.</p><p><strong>Results: </strong>Stronger CAPSs were associated with lower alcohol volumes (IRR = 0.91, 95% CI = 0.86, 0.97, p=0.003) and lower odds of verbal AHTOs (aOR = 0.86, 95% CI = 0.75, 0.98, p = 0.022). Associations between CAPSs and binge frequency, verbal AHTOs, and sexual AHTOS were only significant in states with weak policies, while the association between CAPSs and alcohol volumes held across state policy environments.</p><p><strong>Conclusions: </strong>Student drinking and rates of AHTOs were lower on campuses with stronger alcohol policies. CAPSs were associated with lower volume overall, and with reduced binge drinking and verbal and sexual AHTOs in states with weaker policies. Findings highlight the importance of campus alcohol policies in such states.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108143"},"PeriodicalIF":4.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of legalizing recreational cannabis sales on cannabis use and cannabis-related disorder among presentations to a psychiatric emergency service.","authors":"Cheryl Y S Foo, Kevin Potter, Abigail C Wright, A Eden Evins, Abigail L Donovan, Sharon Levy, Kim T Mueser, Corinne Cather","doi":"10.1016/j.amepre.2025.108142","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108142","url":null,"abstract":"<p><strong>Introduction: </strong>Limited research exists on the impact of changing cannabis policies on psychiatric populations, who are especially vulnerable to the negative effects of substance use. This study examined changes in cannabis use and cannabis-related disorders across age groups of psychiatric emergency presentations following the start of recreational cannabis sales in Massachusetts.</p><p><strong>Methods: </strong>Cross-sectional electronic health records from 7350 unique presentations to a psychiatric emergency service in a tertiary care hospital in Massachusetts were analyzed. Logistic regressions estimated changes in rates of urine tetrahydrocannabinol (THC) positivity and cannabis-related disorder ICD-10 diagnosis codes (F12.X) from pre-commercialization (01/01/2017-11/19/2018) to post-commercialization (11/20/2018-12/31/2019) across different age groups (12-17, 18-25, 26-49, 50-70 years), controlling for sex, race, and ethnicity.</p><p><strong>Results: </strong>Rates of THC positivity increased significantly from pre- to post-commercialization (32.4% to 36.3%, p<.001), but not rates of cannabis-related disorder (10.5% to 11.7%). Adolescents (12-17 years) had the largest increase in THC positivity (5% to 17.3%, AOR=4.32 [2.15, 8.68]) whereas adults (26-49 years) experienced a modest increase (37.7% to 42.5%, AOR=1.24 [1.08, 1.42]). Only the adolescent group had a significant increase in cannabis-related disorders (3.2% to 12.1%, AOR=4.63 [1.97, 10.87]).</p><p><strong>Conclusions: </strong>Commercialization of recreational cannabis sales may disproportionately affect adolescents with psychiatric illnesses or vulnerabilities, resulting in an increased need for psychiatric emergency care. Further research is needed to examine the impact of cannabis policies on this population to inform targeted prevention efforts.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108142"},"PeriodicalIF":4.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationships of Changing State Cannabis Policies with Alcohol Policy Effectiveness and Alcohol or Cannabis Involvement in Motor Vehicle Fatalities.","authors":"Timothy S Naimi, Jinhui Zhao, Marlene C Lira, Rosalie Liccardo Pacula","doi":"10.1016/j.amepre.2025.108137","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108137","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol use is an established and important risk factor for motor vehicle crashes (MVCs) and crash fatalities. The liberalization of cannabis policy across U.S. states could impact MVC fatalities involving alcohol or the co-use of alcohol and cannabis.</p><p><strong>Methods: </strong>Mortality data were from the Fatality Analysis Reporting System in 50 states and Washington DC from 2010-2019. State-year Alcohol Policy Scores (APS) and Cannabis Policy Scores (CPS) were used as measures of policy exposure in multivariable mixed logistic regression models to estimate the adjusted odds ratio (AOR) of two blood alcohol concentration (BAC) thresholds and/or any detectable tetrahydrocannabinol involvement in crash fatalities.</p><p><strong>Results: </strong>In fully adjusted models, a 10-percentage point increase in APS (representing more robust alcohol control policies) was associated with a 6.3% lower risk of a BAC> 0.00% (AOR: 0.937, 95% CI: 0.886-0.991) or involvement at a BAC ≥0.08% (AOR: 0.938, 95 CI: 0.888-0.992) among MVC decedents. However, there were no significant independent association between CPS and alcohol involvement. A 10-percentage point increase in CPS (representing more robust cannabis control policies) was associated with reduced odds of cannabis involvement (AOR: 0.956, 95% CI: 0.922, 0.991) or alcohol and cannabis co-involvement (AOR: 0.962, 95% CI: 0.928, 0.997).</p><p><strong>Conclusions: </strong>More restrictive alcohol policies and cannabis policies were associated with reduced odds of MVC fatalities involving alcohol or cannabis, respectively. Cannabis policies did not affect protective associations between alcohol policies and alcohol involvement. However, more restrictive cannabis policies were protective for co-involvement of alcohol and cannabis.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108137"},"PeriodicalIF":4.5,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between socioeconomic status and healthy lifestyle with depressive symptoms in older adults: Evidence from five prospective cohort studies.","authors":"Xinfeng Wang, Xin Ye, Yingyao Chen","doi":"10.1016/j.amepre.2025.108138","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108138","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is a common illness that may severely limit psychosocial functioning and diminish quality of life. The complex interplay between socioeconomic status (SES), lifestyle behaviors, and depression remains insufficiently elucidated. This study aimed to investigate whether healthy lifestyles mediate the relationship between SES and depression.</p><p><strong>Methods: </strong>Data were drawn from five nationally representative cohort studies across 20 countries between 2008 and 2018: the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), the Survey of Health, Ageing and Retirement in Europe (SHARE), the China Health and Retirement Longitudinal Study (CHARLS), and the Korean Longitudinal Study of Aging (KLoSA). SES was derived using latent class analysis of education, income, and wealth. A composite healthy lifestyle score, based on smoking, alcohol consumption, physical activity, and social participation, categorized participants into unfavorable, intermediate, or favorable lifestyle groups. Depression was assessed using CES-D or EURO-D scales. Cox proportional hazards models, with random-effects models for pooling, were used to examine the association between SES and depressive symptoms. Causal mediation analysis evaluated the mediating roles of intermediate and unfavorable lifestyles in the SES-depression relationship. Analyses were conducted in 2025.</p><p><strong>Results: </strong>Of 48,760 participants, 14,320 developed depressive symptoms. Low SES was associated with higher depression risk (pooled HR 1.41, 95% CI 1.37-1.45). Unfavorable lifestyle mediated 62.8% of the SES-depression association, and intermediate lifestyle mediated 6.0%. The highest risk was observed in those with both low SES and unfavorable lifestyle (pooled HR 2.47, 95% CI 2.34-2.60).</p><p><strong>Conclusions: </strong>Unfavorable lifestyle substantially mediated the association between low SES and depression, highlighting the importance of lifestyle interventions to reduce socioeconomic disparities. Country-level heterogeneity underscores the need for context-specific strategies.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108138"},"PeriodicalIF":4.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cannabis and alcohol co-use and HIV biomedical intervention engagement among Black sexual/gender minority (BSGM) people: A day-level analysis.","authors":"Yen-Tyng Chen, Justin Knox, Ellen Almirol, Ella Remund Wiger, Jade Pagkas-Bather, Jimi Huh, Tammy Chung, Devin English, Dustin T Duncan, John A Schneider","doi":"10.1016/j.amepre.2025.108144","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108144","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabis and alcohol are the most frequently used substances among Black sexual/gender minority (BSGM) people and co-use of these substances is surging. Little work exists on the association of cannabis/alcohol co-use with HIV prevention and care engagement in this population. We examined daily associations of cannabis/alcohol co-use with pre-exposure prophylaxis (PrEP) and antiretroviral (ARV) medications use, in the context of hazardous alcohol and cannabis use, among BSGM.</p><p><strong>Methods: </strong>Daily use of cannabis, alcohol, and PrEP/ARV were assessed via 14-day ecological momentary assessment (EMA) in the Neighborhoods and Networks Part 2 (N2P2) cohort study of BSGM in Chicago (2022-2024). Generalized estimating equations models were used to examine day-level associations between cannabis/alcohol co-use and following day PrEP/ARV use.</p><p><strong>Results: </strong>Across 5,729 days for 521 participants with ≥1 EMA responses, cannabis/alcohol co-use, cannabis-only use, alcohol-only use, and no substance use occurred on 19.8%, 36.5%, 6.3%, and 34.9% days, respectively. Among participants who reported hazardous alcohol use (AUDIT≥8), on cannabis-only days, participants were more likely to report following day PrEP/ARV use (aRR=1.54; 95% CI=1.00, 2.38). Among participants with no hazardous alcohol use, alcohol-only use day was associated with greater following day PrEP/ARV use (aRR=1.34; 95% CI=1.02, 1.76). Cannabis/alcohol co-use was not associated with PrEP/ARV use, regardless of hazardous alcohol or cannabis use status.</p><p><strong>Conclusions: </strong>Heterogeneity exists regarding associations between cannabis/alcohol co-use and PrEP/ARV use among BSGM, depending on individuals' hazardous alcohol use status. Future research should collect fine-grained contextual data on cannabis/alcohol co-use to examine mechanisms by which co-use influences HIV care engagement.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108144"},"PeriodicalIF":4.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"YRacial and Ethnic Differences in Suicide Mortality among 12-25 Year Olds Following Medical and Recreational Cannabis Legalization in the United States.","authors":"Christopher J Hammond, Madison Hyer, Anne E Boustead, Rheanna Platt, Andrea S Young, Mary A Fristad, Danielle L Steelesmith, Guy Brock, Deborah S Hasin, Cynthia A Fontanella","doi":"10.1016/j.amepre.2025.108141","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108141","url":null,"abstract":"<p><strong>Introduction: </strong>Cannabis legalization has often been framed as social justice reform in the US, but may have unintended downstream outcomes that vary by race and ethnicity. One such outcome is suicide, which is rising among US youth and associated with cannabis use. This study examined associations between state medical and recreational cannabis law (MCL and RCL) enactment and changes in suicide mortality by race and ethnicity in US youth.</p><p><strong>Methods: </strong>Suicide deaths (N= 113,512) from the 2000-2019 National Vital Statistics System (NVSS) death files for 12-25 year-olds were examined in relation to time-varying cannabis law status, across racial and ethnic subgroups, using a staggered-adoption difference-in-difference approach that controlled for time-varying state-level and individual-level covariates. NVSS data were obtained in 2022. Analyses were conducted from June 2024 to July 2025.</p><p><strong>Results: </strong>Unadjusted annual suicide rates were 9.7, 12.8, and 16.7 per 100,000 youth for no-CL, MCL, and RCL states, respectively. Significant Race/Ethnicity-by-CL effects were observed. Asian/Pacific Islander youth living in MCL and RCL states had increased incident rate ratios (IRR) for suicide deaths compared to Asian/Pacific Islander youth living in No-CL states (MCL: IRR=1.30; 95% CI,1.13-1.50; RCL: IRR=1.42; 95%CI,1.20-1.67). Hispanic youth living in RCL states had increased suicide deaths when compared to Hispanic youth living in MCL states (IRR=1.15; 95%CI,1.04-1.27) and No-CL states (IRR=1.32; 95%CI,1.03-1.71). CL-related differences in suicides for American Indian/Alaska Native and Non-Hispanic Black and White youth were nonsignificant. Findings were consistent across sensitivity analyses.</p><p><strong>Conclusions: </strong>MCL and RCL were associated with increased suicide deaths in Asian/Pacific Islander and Hispanic youth. Mechanisms through which CLs differentially impact suicide mortality among youth of different racial and ethnic backgrounds warrant further study and should inform legislative reform.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108141"},"PeriodicalIF":4.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remnant cholesterol, C-reactive protein, and risks of lung cancer morbidity and mortality among women: a prospective cohort study.","authors":"Ranran Qie, Hongwei Liu, Yin Liu, Xiaoli Guo, Qiong Chen, Huifang Xu, Xiaoyang Wang, Hong Wang, Ruihua Kang, Cheng Cheng, Mengfei Zhao, Liyang Zheng, Shuzheng Liu, ShaoKai Zhang","doi":"10.1016/j.amepre.2025.108140","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108140","url":null,"abstract":"<p><strong>Introduction: </strong>Previous studies have highlighted the importance of blood lipid levels in lung cancer. However, evidence of the association between remnant cholesterol (RC) and lung cancer remains scarce. This study aimed to investigate the association of RC with lung cancer morbidity and mortality and to evaluate their joint effects with C-reactive protein (CRP) in women.</p><p><strong>Methods: </strong>This prospective cohort study included 198,154 women initially without cancer from the UK Biobank. RC was calculated as non-high-density lipoprotein cholesterol minus the measured low-density lipoprotein cholesterol. Cox models were adopted to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the incidence of lung cancer. Data was collected between 2006 and 2022 and analyzed in 2025.</p><p><strong>Results: </strong>During a median follow-up of 11.80-13.90 years, 1552 lung cancer cases and 1074 related deaths were identified. RC was positively associated with lung cancer morbidity and mortality in a linear manner, with respective HRs (95% CIs) of 1.50 (1.23-1.82) and 1.40 (1.11-1.77) in quartile 4. Compared with the low RC/low CRP group, the risk of incident lung cancer and lung cancer mortality increased by 115% and 102%, respectively, in the high RC/high CRP group. The cumulative risks of lung cancer by age 80 years were higher in the high RC/high CRP group than in the low RC/low CRP group (morbidity: 3.64% vs. 1.56%; mortality: 1.97% vs. 0.82%).</p><p><strong>Conclusions: </strong>This study found linear and positive associations of RC with lung cancer morbidity and mortality among women. The combination of high RC and CRP conferred the highest relative and absolute risks. These findings highlighted the importance of considering the combination of RC and CRP levels for the primary prevention of lung cancer and selection of high-risk populations for lung cancer screening among women.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108140"},"PeriodicalIF":4.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Religious Traditions Exhibit Heterogeneous Effects on Vaccination Uptake: A U.S. County-Level Regression Analysis Supporting Tailored Health Outreach.","authors":"Cory Anderson, Shuai Zhou, Guangqing Chi","doi":"10.1016/j.amepre.2025.108139","DOIUrl":"https://doi.org/10.1016/j.amepre.2025.108139","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether specific religious traditions-rather than just \"religion\" itself-demonstrate significant associations with COVID-19 vaccination rates.</p><p><strong>Method: </strong>This study analyzes county-level COVID-19 vaccination data (2021-2022) matched with religious composition data from the 2020 U.S. Religion Census for six major religious traditions. The analysis uses negative binomial regression to examine how religious adherence is associated with vaccination rates, controlling for other variables.</p><p><strong>Results: </strong>Catholic and Mainline Protestant populations showed significant positive associations with vaccination rates (+12.4% and +25.1% respectively), while Evangelical Protestant populations demonstrated significant negative associations (-12.9%). Associations persisted when controlling for other variables, including political ideology, with Republican voting preference emerging as the strongest predictor across all religious traditions (coefficients ranging from -55.6% to -93.7%). Mormon, Black Protestant, and Muslim populations showed no significant associations, including in national and region-specific analyses.</p><p><strong>Conclusions: </strong>Religious traditions influence preventive health measures through limited but significant group-specific processes. Church-sect positioning partially explains these patterns, with historically culturally-integrated traditions showing greater receptivity to vaccination than those maintaining some cultural tension. Given the contrasts in associations across religious traditions, public health outreach approaches should consider context of specific religious traditions rather than merely approaching \"religion\" as a monolithic variable.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"108139"},"PeriodicalIF":4.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Long-Term Blood Pressure With Frailty Progression in Older Adults: A Prospective Cohort Study.","authors":"Yinfen Xu, Qiyuan Lv, Yi Liu, Yimo Li, Fenfen Gao, Dan Zhou, Huilin Ji, Ruoting Ge, Jiahe Tian, Yun Lai, Linhui Zhu, Yuxin Chen, Rui Liu, Xiaodong Liu, Shumei Ma, Fang Shi","doi":"10.1016/j.amepre.2025.107735","DOIUrl":"10.1016/j.amepre.2025.107735","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension is associated with an increased risk of frailty; however, the role of cumulative blood pressure and blood pressure variability in frailty remains underexplored. This study aims to investigate the association between long-term blood pressure and the progression of frailty in older adults.</p><p><strong>Methods: </strong>This study analyzed data from the Chinese Longitudinal Healthy Longevity Survey. Cox regression and linear mixed-effects model were used to assess the association between long-term blood pressure and frailty.</p><p><strong>Results: </strong>The longitudinal study included 3,758 participants. The highest quartiles of cumulative systolic blood pressure, cumulative diastolic blood pressure, systolic blood pressure variability, diastolic blood pressure variability, and pulse pressure variability were associated with an increased risk of frailty. Specifically, the HR (95% CI) for the highest quartiles compared to the lowest were 1.228 (1.067, 1.413) for cumulative systolic blood pressure, 1.201 (1.044, 1.382) for cumulative diastolic blood pressure, 1.220 (1.066, 1.396) for systolic blood pressure variability, 1.224 (1.099, 1.440) for diastolic blood pressure variability, and 1.250 (1.090, 1.432) for pulse pressure variability, cumulative blood pressure and blood pressure variability exhibited significant interactions with time in frailty index (FI) progression. The highest quartile of cumulative systolic blood pressure showed an annual frailty index increase of 0.018 compared to the lowest quartile, while cumulative diastolic blood pressure (β: 0.012), systolic blood pressure variability (β: 0.012), and pulse pressure variability (β: 0.014) were also associated with frailty index progression.</p><p><strong>Conclusions: </strong>Higher cumulative blood pressure and blood pressure variability are associated with an increased frailty index over time. In adults aged ≥65 years, cumulative blood pressure and blood pressure variability may serve as early indicators of frailty. These findings highlight the need for a stratified approach to frailty management that considers long-term blood pressure patterns in older adults.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107735"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}