Communications medicine最新文献

{"title":"Utilising digital contact tracing during a pandemic to measure contact trends by risk group.","authors":"Liang En Wee, Jeremy Wei Quan Chan, Calvin Chiew, Russ Li, Zheng Jie Marc Ho, Vernon Lee, David Lye, Kelvin Bryan Tan","doi":"10.1038/s43856-026-01763-8","DOIUrl":"https://doi.org/10.1038/s43856-026-01763-8","url":null,"abstract":"<p><strong>Background: </strong>Monitoring contact patterns is important for assessing impact of public-health-and-social-measures (PHSM) during a pandemic, but existing methods, such as contact surveys or mobility data, have limitations. While the COVID-19 pandemic provided impetus for population-wide adoption of digital-contact-tracing (DCT), prior studies that utilised DCT to evaluate contact patterns evaluated temporal variations, lacking granularity pertaining to impact in at-risk groups.</p><p><strong>Methods: </strong>Population-wide DCT data was utilised to construct a cohort of SARS-CoV-2-infected community-dwelling adults (N = 544,259), evaluating temporal trends in contact patterns up to 5 days prior to positive SARS-CoV-2 test. Average contact number recorded on DCT was aggregated across four phases (baseline; tightened measures; relaxed measures; Omicron-surge). Incidence-rate-ratios (IRR) of average contacts was then compared across various phases, with the baseline phase as reference, via generalised linear models with a Poisson distribution. Results were stratified by vaccination status, comorbidities and occupation.</p><p><strong>Results: </strong>Over the 8-month study period, we observe a downtrend in average contacts, versus baseline. Amongst fully-vaccinated cases, average contacts fall from 5.93 at baseline to 4.68 during tightened-measures (IRR = 0.78[95%CI = 0.77-0.79]), then increase to 5.23 when measures are relaxed, albeit still below baseline (IRR = 0.86[95%CI = 0.85-0.87]), and finally drop to 3.51 during Omicron (IRR = 0.58[95%CI = 0.57-0.58]). PHSM consistently impacts non-household contact, but does not initially affect household contact, which declines only during Omicron emergence, despite no change in PHSM. Frail individuals with comorbidities have higher non-household close-contacts, as do essential/frontline workers.</p><p><strong>Conclusion: </strong>DCT data can provide insight into contact patterns and enable assessment of PHSM's impact over pandemic phases.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The strategic importance of mRNA vaccine technologies in Africa for achieving public health independence.","authors":"Patrick B Arbuthnot, Kristie M Bloom, Dylan M Kairuz, Connor Stockley, Robin Klintworth, Charles B de Koning, Abdullah Ely","doi":"10.1038/s43856-026-01768-3","DOIUrl":"10.1038/s43856-026-01768-3","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407175","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":"Geospatial analysis reveals similar HIV-1 drug resistance patterns among antiretroviral therapy-experienced children and adolescents (0-17 years) of South Africa.","authors":"Lilishia Gounder, Moherndran Archary, Aabida Khan, Kerusha Govender, Raveen Parboosing, Kogieleum Naidoo, Benjamin Chimukangara","doi":"10.1038/s43856-026-01770-9","DOIUrl":"https://doi.org/10.1038/s43856-026-01770-9","url":null,"abstract":"<p><strong>Background: </strong>HIV-1 drug resistance (HIVDR) complicates antiretroviral therapy (ART) in children and adolescents living with HIV (CALWH), particularly in high-prevalence areas such as KwaZulu-Natal, South Africa. This study describes trends in HIVDR and patterns by drug class and geographic location among ART-experienced CALWH in KwaZulu-Natal.</p><p><strong>Methods: </strong>We analysed 914 routine HIV-1 genotypic resistance tests (GRTs) obtained between January 2018 and June 2022 from 0-17-year-old CALWH, integrating facility-linked Geographic Information Systems (GIS) coordinates for geospatial, descriptive and logistic regression analyses.</p><p><strong>Results: </strong>Here we show that 80.96% (740/914) of GRTs from CALWH (median age 13, interquartile range 7-15 years) across 114 facilities demonstrate HIVDR. Of the 740 individuals with HIVDR, 609 (82.30%) had non-nucleoside reverse transcriptase inhibitor (NNRTI) mutations, and among them, 32 (5.25%) were on NNRTI treatment. Additionally, 525 (70.95%) had nucleoside reverse transcriptase inhibitor (NRTI) mutations, and 181 (24.46%) had major protease inhibitor (PI) mutations. One in every 6 GRTs with HIVDR (129/740; 17.43%) have triple-class NRTI, NNRTI and PI mutations. When analysed by age, ~9 in every 10 GRTs from CALWH aged 0-9 years (237/257, 92.22%) have HIVDR, compared to 76.56% (503/657) aged 10-17 years (OR = 3.63, 95% CI: 2.22-5.93, p < 0.001). GIS-interpolation maps show potential-low-level resistance to tenofovir, low-to-intermediate-level resistance to abacavir (high-level in northern localities) and intermediate-to-high-level resistance to lamivudine, nevirapine and efavirenz.</p><p><strong>Conclusions: </strong>Routine GRTs demonstrate high HIVDR prevalence among younger children, while ART susceptibility maps show overall uniformity with variations in certain regions, such as northern KwaZulu-Natal localities. GIS-linked real-time monitoring of HIVDR is crucial to assess the impact of the revised HIV-1 treatment guidelines for CALWH in South Africa.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying cortical lesions in multiple sclerosis MRI datasets using multi-contrast post-processing and deep learning.","authors":"Michael G Dwyer, Niels Bergsland, Alexander Bartnik, Dejan Jakimovski, Samantha Noteboom, Menno M Schoonheim, Martijn D Steenwijk, Jinglan Pei, David Clayton, Robert Zivadinov","doi":"10.1038/s43856-026-01683-7","DOIUrl":"10.1038/s43856-026-01683-7","url":null,"abstract":"<p><strong>Background: </strong>Multiple sclerosis (MS) is a chronic neurological disease affecting both white and gray matter of the central nervous system. Despite the well-established involvement of cortical lesions in MS, feasibility limitations in their visualization on typical magnetic resonance imaging (MRI) protocols prevent their evaluation in nearly all clinical trials. Recently, several post-processing methods, including synthetic contrasts and artificial intelligence (AI)-based approaches, have shown potential for enhancing cortical lesion detection on conventional MRI data. These methods have the potential to reanalyze existing clinical-trial data to answer key mechanistic questions about both MS development and about treatment effects.</p><p><strong>Methods: </strong>We sought to evaluate the feasibility of combining and extending existing methods into a unified framework for analysis using the data from the large, multicenter, phase 3 ORATORIO trial (full n = 732, age=44.6 ± 8.0; development subset n = 80, age=46.6 ± 7.1). We specifically evaluated three of the most promising of them - fluid-attenuated inversion recovery squared (FLAIR²), T1/T2 ratio, and artificial intelligence-derived double inversion recovery (AI-DIR) - and introduced a new combined contrast called multi-modal cortical lesion enhanced (MMCLE). We also harnessed transformer-based semantic segmentation to improve automated detection and delineation of these lesions.</p><p><strong>Results: </strong>At baseline, we detected 14.8 + /-20.72 lesions per participant, with 86.0% true positive rate and 8.4% false positive rate across subjects for blinded MMCLE, using simultaneous review of all contrasts as the reference. High reproducibility was observed across field strengths and acquisition types (ICC 88.8-92.5%).</p><p><strong>Conclusions: </strong>We confirmed that cortical lesions can be clearly visualized and quantified with these methods. Using deep learning, we also confirmed that the simultaneous use of multiple contrasts improves quantification.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342072/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407091","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 roles of neuroticism, genetic susceptibility, and amygdala structure in chronic musculoskeletal pain onset and recovery.","authors":"Mattia Cannistra, Yu Liu, Valeria Sacca, Sierra Hodges, Lynn Pham, Pierangelo Veltri, Phil Hyoun Lee, Jian Kong","doi":"10.1038/s43856-026-01754-9","DOIUrl":"https://doi.org/10.1038/s43856-026-01754-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic musculoskeletal pain (CMP) represents a significant global health burden, yet the neurobiological mechanisms underlying its development remain poorly understood. This study investigates the complex interplay between neuroticism, genetic risk, and amygdala morphology in CMP onset, recovery, and pain characteristics using UK Biobank data.</p><p><strong>Methods: </strong>We conducted longitudinal analyses on (1) 9382 pain-free individuals followed for CMP development and (2) 3460 CMP patients tracked for recovery outcomes. Neuroticism was quantified via a validated 12-item questionnaire assessing psychological distress. To assess chronic pain trajectories, we examined polygenic risk scores (PRS) for CMP and neuroticism, along with amygdala grey matter volumes, as predictors. Multivariate logistic and linear regression models were employed, followed by mediation analyses to elucidate underlying relationships between variables. Analyses were restricted to individuals of European ancestry.</p><p><strong>Results: </strong>We found that higher neuroticism scores, neuroticism PRS, and CMP PRS were significantly associated with increased risk of CMP onset and reduced likelihood of recovery across cohorts (all P_corrected < 0.05). Both neuroticism scores and PRS were positively correlated with pain intensity, whereas CMP PRS were not. Additionally, amygdala grey matter volumes were significantly associated with neuroticism in the CMP onset cohort but not in the recovery group. Neuroticism mediated the relationship between CMP PRS and subsequent CMP onset with a small effect size, while no mediation was observed for CMP recovery.</p><p><strong>Conclusions: </strong>This study demonstrated significant associations between neuroticism, genetic factors, and amygdala morphology in CMP trajectories, highlighting a potential neurobiological mechanism linking psychological vulnerability to chronic pain. These results underscore the importance of integrating psychological assessment and targeted interventions into comprehensive pain management strategies.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OncoMimic peptide-based immunotherapy EO2401 induces shared T cell clusters in patients with adrenal cancer.","authors":"Christoph Schultheiß, Brenda Besemer, Edith Willscher, Lisa Paschold, Tifanny Mersceman, Alice Talpin, Clara Serger, Alfred Zippelius, Alfredo Berruti, Salvatore Grisanti, Catharina Willemien Menke-van der Houven van Oordt, Eric Baudin, Laura-Sophie Landwehr, Jaume Capdevila, Vivek Subbiah, Dan Granberg, Kirsten Gedske Daugaard, Alexandra Triebig, Thibault Gauduchon, Christine Do Cao, Marie-Eve Garcia, Joao Magalhaes, Laurent Chêne, Mascha Binder","doi":"10.1038/s43856-026-01755-8","DOIUrl":"https://doi.org/10.1038/s43856-026-01755-8","url":null,"abstract":"<p><strong>Background: </strong>Patients with advanced malignant adrenal tumors face poor prognoses with limited treatment options. Emerging data suggest that these rare tumors exhibit immunogenicity, potentially benefiting from intensified immunotherapy.</p><p><strong>Methods: </strong>The SPENCER trial (NCT04187404) evaluates EO2401, an off-the-shelf in vivo peptide immunotherapy containing three synthetic HLA-A*02 restricted-peptides called OncoMimic and derived from human gut commensals that exhibit molecular mimicry to tumor-associated antigens (BIRC5, FOXM1, IL13RA2) combined with nivolumab in patients with locally advanced or metastatic adrenocortical carcinoma (ACC) or malignant pheochromocytoma/ paraganglioma (PPGL). We performed T cell receptor (TCR) repertoire sequencing to profile the TCR architecture in ACC and characterize vaccination imprints.</p><p><strong>Results: </strong>Here we show that ACC patients are characterized by a restricted peripheral T cell richness. EO2401 does not expand highly shared TCR clones across patients but diversifies pre-existing T cell clusters. These clusters are not converging on known neoantigen-specific TCRs but exhibit generation probabilities characteristic of public clones some of which being shared across patients.</p><p><strong>Conclusions: </strong>These findings suggest that EO2401-based peptide immunotherapy combined with checkpoint inhibition can broaden and activate public, pre-existing T cell clusters, potentially enhancing tumor-specific immune responses.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain aging in Type II GM1 gangliosidosis.","authors":"Connor J Lewis, Selby I Chipman, Precilla D'Souza, Jean M Johnston, Muhammad H Yousef, William A Gahl, Cynthia J Tifft, Maria T Acosta","doi":"10.1038/s43856-026-01745-w","DOIUrl":"10.1038/s43856-026-01745-w","url":null,"abstract":"<p><strong>Background: </strong>GM1 gangliosidosis is an inherited, progressive, and fatal neurodegenerative lysosomal storage disorder with no approved treatment. In this study, we present the first use of MRI-based predicted brain age in GM1 gangliosidosis aimed at assessing the neuronal degeneration in this cohort.</p><p><strong>Methods: </strong>We calculated a predicted brain age and Brain Structures Age Gap Estimation (BSAGE) for 81 MRI scans from 41 Type II (26 juvenile and 15 late-infantile) GM1 gangliosidosis patients and 897 MRI scans from 556 neurotypical controls (NC) utilizing BrainStructuresAges, a machine learning MRI analysis pipeline.</p><p><strong>Results: </strong>NC shows whole-brain aging at a rate of 0.83 per chronological year compared with 1.57 in juvenile GM1 patients and 12.25 in late-infantile GM1 patients. Accelerated and distinct brain aging is observed throughout midbrain structures, including the thalamus and caudate nucleus, hindbrain structures, including the cerebellum and brainstem, and the ventricles in juvenile and late-infantile GM1 patients compared to NC, reflecting neurodegeneration from disease progression. Cross-sectional evaluations of BSAGE for the whole brain show an average BSAGE = 35.50 years in the late-infantile cohort, 21.19 years in the juvenile cohort, and 0.03 years in NC. Predicted brain age and BSAGE both correlate with cross-sectional and longitudinal clinical outcome assessments.</p><p><strong>Conclusions: </strong>Predicted brain age accurately reflects the neurodegenerative clinical trajectories of the Type II GM1 disease subtypes. Correlations with clinical outcome assessments indicate evaluations of predicted brain aging may be an important candidate neuroimaging outcome measure for clinical trials in GM1 gangliosidosis.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rostral lesion shift and tract-specific degeneration drive functional heterogeneity in degenerative cervical myelopathy.","authors":"Fauziyya Muhammad, Dario Pfyffer, Nicholas Dobson, Todd Parrish, Serena S Hu, John Ratliff, Nathaniel D Stetson, Yasin Dhaher, Andrew C Smith, Kenneth A Weber, Zachary A Smith","doi":"10.1038/s43856-026-01764-7","DOIUrl":"10.1038/s43856-026-01764-7","url":null,"abstract":"<p><strong>Background: </strong>Degenerative cervical myelopathy (DCM) is the leading cause of spinal cord impairment worldwide, yet conventional magnetic resonance imaging metrics of canal stenosis fail to explain the remarkable heterogeneity in patient outcomes.</p><p><strong>Methods: </strong>We applied automated deep-learning segmentation to map the topography of intramedullary lesions in 73 patients and determine their tract-specific functional impact. Functional measures included the modified Japanese Orthopaedic Association score, comprising upper- and lower-body motor dysfunction, sensory function, and sphincter function domains; the Nine-Hole Peg Test for dexterity; and the Standing Balance Test.</p><p><strong>Results: </strong>Here we show presence of T2-hyperintense lesions in 45% of the cohort, defining a biologically distinct phenotype associated with greater neurological disability. Spatially, lesion density peaked at C4, rostral to the site of maximal compression (C5), implicating venous congestion and ascending degeneration as key pathophysiological drivers. Multivariate modeling revealed that balance impairment represents a systems-level failure, predicted independently by combined damage to the dorsal columns (P = 0.032) and lateral reticulospinal tract (P = 0.011). In contrast, dexterity deficits were not attributable to any single tract, suggesting reliance on global cord integrity. Importantly, we found that unlike in traumatic spinal cord injury, residual tissue bridges (spared tissue) did not universally predict function; they conferred protective benefit for balance (P = 0.044) only when reticulospinal tract integrity was accounted for.</p><p><strong>Conclusions: </strong>These findings establish tract-specific lesion profiling as a mechanistic biomarker, shifting the clinical framework from measuring global compression to characterizing biological vulnerability.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipidomic profiling reveals a distinct lipidomic signature of early gestational diabetes.","authors":"Saeede Saadati, Rasoul Godini, Eveline Jona, Christopher K Barlow, Adriana Ch Neven, Christopher J Nolan, David Simmons, Helena Teede, Aya Mousa","doi":"10.1038/s43856-026-01765-6","DOIUrl":"https://doi.org/10.1038/s43856-026-01765-6","url":null,"abstract":"<p><strong>Background: </strong>Gestational diabetes mellitus (GDM) diagnosed early in pregnancy (before 20 weeks' gestation) is associated with increased metabolic risk, yet its molecular profile remains poorly defined. While disrupted lipid metabolism is an important feature of GDM, no previous study has characterized the lipidomic profile of women with early GDM (eGDM).</p><p><strong>Methods: </strong>We performed untargeted liquid chromatography mass spectrometry on maternal plasma samples from a cohort of 180 women at risk of GDM, enrolled in the Treatment of Booking GDM (TOBOGM) multicenter randomized controlled trial. Oral glucose tolerance tests (OGTT) were conducted before 20 weeks' gestation to diagnose eGDM using World Health Organization (2013) criteria. Lipidomic data were analyzed using multivariable linear regression, unsupervised clustering, weighted gene co-expression network analysis (WGCNA), and logistic regression-based risk modeling.</p><p><strong>Results: </strong>In 89 eGDM and 91 non-GDM controls, we quantify 543 lipid species across 18 lipid classes. We identify a distinct lipidomic signature of eGDM, comprising elevated concentrations of glycerolipids (diacylglycerols), fatty acids, and ethanolamine-containing glycerophospholipids (phosphatidylethanolamine and lysophosphatidylethanolamine), alongside lower concentrations of choline-containing glycerophospholipids (lysophosphatidylcholine and ether-linked phosphatidylcholine) and glycosphingolipids (hexosylceramides). Fatty acid and diacylglycerol species are the strongest and most consistent lipid predictors of eGDM and glycemic indices, independent of clinical risk factors. Lipid ontology-based enrichment analysis reveals perturbations in pathways related to lipid storage, membrane remodeling, and signaling.</p><p><strong>Conclusion: </strong>To our knowledge, this is the first study to characterize the lipidomic profile of women with eGDM. We identify a distinct lipidomic signature associated with eGDM, offering molecular insights into pathophysiology and highlighting candidate lipid biomarkers for future investigation and validation in this context.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bayesian multistate modelling of prefrailty and frailty using microsimulation with weight management interventions for prevention in Asian settings.","authors":"Xinyu Zhang, Shihui Jin, Haolong Song, Johnathan Hong-Hui Yeo, Borame Lee Dickens","doi":"10.1038/s43856-026-01756-7","DOIUrl":"https://doi.org/10.1038/s43856-026-01756-7","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of pre-frailty and frailty is increasing in Asia, resulting in substantial morbidity and mortality in older populations. Modelling frameworks are required to estimate the prevalence of frailty and potential impacts of ongoing population-level nutritional interventions.</p><p><strong>Methods: </strong>Using a microsimulation sociodemographic model of 3,353,032 individuals from 2011 to 2050, and published estimates from the Singapore Longitudinal Ageing Study 2 of 3270 participants, we developed a Bayesian multistate model of robust, pre-frail, and frail stages with estimated transition probabilities by age, ethnicity, gender, and body mass index category. We then explored four scenarios where weight management interventions are applied that modify the annual distribution of underweight, normal weight, overweight, obese I and obese II individuals.</p><p><strong>Results: </strong>Here we show that, between 2011 and 2050, the projected overall prevalence of pre-frailty and frailty increases from 44.2% to 49.57% (95% credible interval: 47.60-51.00%), and from 3.2% to 11.97% (7.34-15.60%), respectively. Reductions range from 22,045 (18,430-23,487) to 3,599 (2554-4621) pre-frail individuals and from 62,847 (40,165-91,517) to 15,802 (13,238-17,133) frail individuals when 100% to 5% of both underweight individuals shift to normal weight and obese II individuals move to obese I, respectively. Total healthcare utilisation decreases by 7.1% (3.9-9.4%) to 0.3% (0.2-0.5%) under 100% to 5% intervention coverage.</p><p><strong>Conclusions: </strong>Frailty prevalence in Singapore is projected to substantially increase by 2050, while population-level weight management interventions could avert cases of both pre-frailty and frailty in older individuals, even at modest real-world effectiveness.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}