Age and ageing最新文献

{"title":"Plant-based dietary patterns and frailty in older adults: a multicohort longitudinal study with within-between decomposition and network analysis","authors":"","doi":"10.1093/ageing/afag304","DOIUrl":"https://doi.org/10.1093/ageing/afag304","url":null,"abstract":"<span class=\"paragraphSection\"><div class=\"boxTitle\">Objective</div>Plant-based dietary patterns may influence healthy ageing, but their longitudinal and multidimensional associations with frailty remain unclear. We examined these associations across three primary ageing cohorts and explored links between dietary components and frailty domains.<div class=\"boxTitle\">Methods</div>The primary sample included 8628 older adults from Chinese Longitudinal Healthy Longevity Survey (CLHLS), Health and Retirement Study (HRS) and English Longitudinal Study of Ageing (ELSA). Overall, healthful and unhealthful plant-based diet indices (PDIs, hPDIs and uPDIs) were derived from cohort-specific food-group data. A supplementary analysis of 10 821 SHARE participants used a two-component plant–animal contrast. Frailty was assessed using a multidomain deficit-accumulation index. Generalised linear mixed models examined diet–frailty associations, and Mundlak decomposition separated between-person differences from within-person changes where repeated diet data were available. Spline and network analyses examined non-linearity and component-level associations.<div class=\"boxTitle\">Results</div>Higher PDI was associated with lower frailty risk across all three primary cohorts (ORs = 0.71–0.80), whereas higher uPDI was associated with higher risk (ORs = 1.24–1.41). hPDI was inversely associated only in ELSA and was null in CLHLS and HRS. In CLHLS, between-person dietary differences showed stronger associations than within-person changes. Spline analysis provided limited evidence of non-linearity. Network analyses highlighted nuts, vegetables and plant oils as showing predominantly inverse associations with several frailty domains. SHARE analysis showed an inverse between-person association, no within-person association, with the plant-based component also showing predominantly inverse links with frailty domains.<div class=\"boxTitle\">Conclusion</div>Higher overall plant-based diet scores were associated with lower frailty risk, whereas unhealthful plant-based diets were associated with higher risk, underscoring the importance of diet quality.</span>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"3 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149226484","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":"Scottish priorities for dementia and brain health research—results of a national research priority setting exercise","authors":"Fenna Maria Alexandra Lunter, Winnie Henry, David Ross, Jacqui Kerr, Emma Law, Stephen Makin, Alison Mckean, Tom C Russ, Lucy Stirland, Susan Deborah Shenkin, Jennifer Kirsty Burton, Terence J Quinn","doi":"10.1093/ageing/afag261","DOIUrl":"https://doi.org/10.1093/ageing/afag261","url":null,"abstract":"Background Dementia is a global challenge, but benefits from local, context-specific evidence. With finite resource, and numerous potential research directions, formal priority setting can help develop equitable and relevant research agendas. We used this approach to establish dementia and brain health research priority questions for Scotland. Methods A steering board of professionals and experts through lived experience guided the process, following established research prioritisation frameworks. Research questions were collected through surveys and refined to create an interim list. This was further rationalised through Delphi-style ranking involving cross-disciplinary, cross-sectoral interest-holders. After reaching consensus, each research question was assessed for potential impact. Results Between April and July 2025, 706 participants submitted 2677 questions. These were consolidated into an interim list of 142 questions. Two ranking rounds (n = 242, n = 252) reduced the list to 20 questions (10 brain health, 10 dementia). Interest-holders included people living with cognitive impairment (n = 48, 6·8%), current or previous caregivers (n = 217, 30·7%), public contributors (n = 261, 37·0%), and professionals (n = 134, 19·0%). Risk reduction was a leading brain health priority, while early diagnosis was a top dementia priority. Research around brain resilience and improving dementia care pathways was selected as having greatest potential impact. Conclusion We established Scotland-specific research priorities for brain health and dementia, which we advocate to researchers, funders and decision-makers. Our national research prioritisation exercise received engagement from diverse interest-holders, ensuring a range of voices will inform future research.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"8 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149221336","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":"Correction to: Prescribing cascades potentially associated with harms before and after transition to long-term care facilities.","authors":"","doi":"10.1093/ageing/afag308","DOIUrl":"10.1093/ageing/afag308","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 10","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149190609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, characteristics and risk factors for chronic lower-limb oedema in the older population living in the community or in an aged-care home: a systematic review","authors":"Maree O’connor, Suzanne Kuys, Michael Steele, Peter Franks, Helen Badge","doi":"10.1093/ageing/afag277","DOIUrl":"https://doi.org/10.1093/ageing/afag277","url":null,"abstract":"Introduction Chronic lower-limb oedema co-occurs with multimorbidity, functional limitations and increased risk of wounds and cellulitis. Findings vary across settings and methodologies. Objectives To synthesise the prevalence, characteristics and risk factors for chronic lower-limb oedema in older adults living in the community or aged-care homes. Methods A systematic review was conducted according to PRISMA 2020 guidelines. MEDLINE, EMBASE, Scopus, Web of Science and Cochrane were searched to 25 March 2026. Eligible studies included adults aged ≥60 years in community or aged-care settings and reported prevalence, characteristics or risk factors for chronic lower-limb oedema. Two reviewers independently screened studies, extracted data and assessed methodological quality. Results Sixteen studies met inclusion criteria; 14 were conducted in community settings and two in aged-care homes. Community population-based studies estimated prevalence between 22.7% and 26.4%. Aged-care home prevalence ranged from 10.0% to 27.5% but discretionary exclusion of residents may bias estimates. Chronic lower-limb oedema commonly co-occurred with diabetes, heart disease, obesity (reported at high prevalence across studies), cellulitis and wounds. Evidence for independent risk factors was limited. Substantial heterogeneity reflected differences in study populations, sampling strategies and assessment methods limiting generalisability of findings. Methodological quality varied, particularly in population description and outcome measurement. Conclusion Chronic lower-limb oedema appears common ranging from 22.7% to 26.4% prevalence in community settings and up to 27.5% in aged-care homes. Despite potential clinical and economic burden, the evidence base, particularly within aged-care homes, remains limited. Screening may be warranted in these high-risk groups.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019771","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":"Gut microbiome modulation can improve cognitive function in older adults: a systematic review and meta-analysis.","authors":"Benjamin Birns, Sabiha Murshed, Mary Ni Lochlainn","doi":"10.1093/ageing/afag287","DOIUrl":"10.1093/ageing/afag287","url":null,"abstract":"<p><strong>Background: </strong>Age-related cognitive decline and dementia exert increasing pressure on healthcare systems. Gut microbiome modulation may offer a novel approach to improving cognitive health.</p><p><strong>Objective: </strong>To establish the effect of gut microbiome modulation on cognitive function in older adults.</p><p><strong>Methods: </strong>A systematic search was conducted of PubMed, Cochrane Library, Medline and Embase (OVID) to identify randomised controlled trials (RCTs) and observational studies assessing cognitive outcomes in adults aged ≥60. Interventions aimed at modifying the gut microbiome (prebiotics, probiotics, synbiotics) were included. Studies involving faecal transplants or comparing modifiers to one another instead of to placebo were excluded. Changes in cognitive function were measured by neuropsychological assessments and standardised cognitive tests (e.g. MMSE, MoCA).</p><p><strong>Results: </strong>Fourteen studies met inclusion criteria (13 RCTs, 1 interventional study), consisting of 10 probiotic, 2 prebiotic and 2 synbiotic trials. Participants included both healthy older adults and those with cognitive impairment. Nine studies reported statistically significant improvements in at least one cognitive domain, particularly global cognition, memory, attention and executive function. Meta-analysis of a sub-group resulted in a statistically significant (MD = 1.28; 95% CI = 0.15-2.40; P < 0.05) improvement in global cognition scores after supplementation.</p><p><strong>Conclusions: </strong>Gut microbiome modulation through probiotic, prebiotic and synbiotic supplementation can improve cognition in older adults. Whilst heterogeneity and paucity of high-quality literature exists, the overall evidence is positive. Gut microbiome modulation therefore holds huge promise as a viable strategy to support cognitive health in older people, particularly considering the interventions are mostly already commercially available and low-risk.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13619334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standing strong and tall-improving mobility and balance in older Aboriginal people through the Ironbark program.","authors":"Rebecca Ivers, Kathleen Clapham, Courtney Ryder, Rona Macniven, Anne-Marie Hill, Holger Moeller, Bronte Haynes, Margaret Gidgup, Leanne McCarthy, Tamara Mackean, Kim Delbaere, Anne Tiedemann, Catherine Sherrington, Julieann Coombes, Ironbark Investigators Group","doi":"10.1093/ageing/afag264","DOIUrl":"10.1093/ageing/afag264","url":null,"abstract":"<p><strong>Background: </strong>Prevention of falls aids healthy ageing, but there are few Aboriginal-led and designed programs.</p><p><strong>Objectives: </strong>This study aimed to evaluate the effect of Ironbark, an Aboriginal co-designed fall prevention program, on functional mobility, a key indicator of falls.</p><p><strong>Methods: </strong>This controlled pre-post study was conducted in organisations delivering services to Aboriginal people aged 45 years and older in New South Wales and Western Australia. A co-designed fall prevention program incorporating exercises and yarning circles targeting fall risk factors ('Ironbark Standing Strong and Tall') was compared to a social program ('Ironbark Healthy Community'). Data were collected at baseline and after 12 months of follow-up.</p><p><strong>Results: </strong>The 'Ironbark Standing Strong and Tall' program was delivered at 16 sites and the 'Healthy Community' program at three. Due to lower recruitment than anticipated, combined analysis was not possible. There were significant improvements in the 'Ironbark Standing Strong and Tall' participants for the primary outcome of functional mobility (Short Performance Physical Battery; a change of 0.8 points, 95% CI: 0.4-1.1), reductions in stepping times, improvements in leg stance and increased incidental and planned exercise. There were no significant changes in falls, health-related quality of life (HRQoL) or psychological distress. Participants in the 'Healthy Community' sites had no change in functional mobility but saw declines in HRQoL, physical activity and stepping time.</p><p><strong>Conclusions: </strong>A co-designed and delivered program for older Aboriginal people, implemented in community settings aligned with stated priorities of Aboriginal older people, improved functional mobility.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148899895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CCL2 and CXCL2 are markers of delirium vulnerability in community dwelling older people.","authors":"Hannah Moorey, Hannah F Botfield, Maria Krogseth, Geir Selbaek, Daisy Wilson, Torgeir Bruun Wyller, Thomas Andrew Jackson","doi":"10.1093/ageing/afag290","DOIUrl":"https://doi.org/10.1093/ageing/afag290","url":null,"abstract":"<p><strong>Background: </strong>Delirium is common and age, frailty and dementia are risk-factors. The pathophysiology is complex and poorly understood, but age-related immune system changes may be key. This study aimed to measure markers of immune cell migration, accelerated immune ageing and blood-brain barrier permeability in community-dwelling, older people comparing those who developed ≥1 episode of delirium over 2 years with those that did not.</p><p><strong>Methods: </strong>Baseline samples were collected from CASCADE participants who were followed up for 2 years. Delirium screening was performed weekly; positive screens or hospital admission triggered a delirium assessment. Serum was isolated, stored and analysed using a multiplex panel comparing levels between participants with and without delirium episodes.</p><p><strong>Results: </strong>About 98 participants were included. Median age was 88 (IQR: 81.8-92.0), with 90.8% classified as frail. Forty-three participants (43.9%) experienced ≥1 delirium episodes. CCL2 (MCP-1) and CXCL2 (MIP-2α), measured in a stable state at baseline, were significantly higher in the delirium group compared to the no delirium group (13.38 (11.21-17.93) vs. 10.83 (9.03-14.64) P = .004) and (17.23 (11.80-24.22) vs. 13.49 (10.19-17.98) P = .031), respectively. When stratified by dementia status, the associations of CCL2 with delirium were maintained in both groups, but CXCL2 was only significantly higher in delirium in the subgroup without dementia.</p><p><strong>Discussion: </strong>CCL2 and CXCL2 are chemokines involved in immune cell recruitment and markers of accelerated immune ageing. Future work should elucidate the role of immune cell recruitment and brain infiltration in delirium, to identify treatment targets. Furthermore, work should explore whether targeting immune ageing can reduce delirium risk.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13625644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What can we learn from cannabinoid trials?","authors":"Kaisu H Pitkälä, Hanna-Maria Roitto","doi":"10.1093/ageing/afag294","DOIUrl":"https://doi.org/10.1093/ageing/afag294","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149079529","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":"Pharmacological stratification of fall-risk-increasing drugs for prevention of fall-related injuries in older adults: a population-based cohort study.","authors":"Miriam Schechner, Marietta Rottenkolber, Patrick Oehler, Bruce Guthrie, Eva Grill, Sabine Hoffmann, Johannes Piller, Andreas Bender, Tobias Dreischulte","doi":"10.1093/ageing/afag280","DOIUrl":"10.1093/ageing/afag280","url":null,"abstract":"<p><strong>Background: </strong>Falls are a major cause of morbidity among older adults. While deprescribing fall-risk-increasing drugs (FRIDs) is recommended for secondary prevention, their high prevalence limits efficient targeting in primary prevention. Stratification by pharmacological FRID subclasses or drugs with fall-risk-increasing adverse reactions (FRIAR-drugs) may improve identification of high-risk patients, yet its added value in routine care is uncertain.</p><p><strong>Objective: </strong>To compare pharmacological FRID classifications with a FRIAR-based framework for predicting fall-related hospitalisations and to identify drug subgroups that differentiate fall-risk among exposed older adults in a primary prevention context.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study including 120 867 adults aged ≥65 years prescribed at least one FRID or FRIAR-drug at baseline. Fall-related hospitalisations in 2019 were identified using International Classification of Diseases, 10th Revision (ICD-10) codes. Multivariate logistic regression evaluated pharmacological FRID (sub)groups and FRIAR-drug classifications, adjusted for established general predictors. Model performance was assessed using internal validation and sensitivity analyses.</p><p><strong>Results: </strong>During follow-up, 2788 individuals (2.3%) experienced a fall-related hospitalisation. Pharmacological subgroups associated with higher risk included serotonin reuptake inhibitors, older antiepileptics and drugs with moderate anticholinergic properties. In contrast, the FRIAR-drug framework added little prognostic information beyond established FRID classifications. The final model demonstrated moderate discrimination (Area under the curve (AUC) 0.73) with stable predictive performance on internal validation.</p><p><strong>Conclusion: </strong>Pharmacological stratification of FRIDs allows clinically useful differentiation of fall-risk among exposed older adults, whereas FRIAR-based classification adds limited prognostic value. These findings support more selective prioritisation of medication review in primary-preventive fall strategies, although external validation and evaluation of decision-relevant risk stratification are required.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 9","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149011792","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":"Assisted dying practices for individuals living with frailty: prevalence and eligibility.","authors":"Tommaso Squeri, Christina Luk, Simon N Etkind, Annabel Price, Alex Ruck Keene, Sarah A Hopkins","doi":"10.1093/ageing/afag275","DOIUrl":"10.1093/ageing/afag275","url":null,"abstract":"<p><strong>Background: </strong>Despite the high prevalence of frailty among individuals nearing the end of life, there is uncertainty around assisted dying practices (encompassing physician-assisted suicide and voluntary euthanasia) in this population.</p><p><strong>Aim: </strong>We aimed to (i) describe the prevalence of frailty among individuals accessing assisted dying (AD), and to describe whether frailty was the main condition or a comorbidity and (ii) where prevalence data are not available, determine whether individuals are likely to be eligible for AD on the basis of their frailty.</p><p><strong>Methods: </strong>We reviewed publicly available statistics on AD usage and the relevant legal provision from jurisdictions where AD is regulated.</p><p><strong>Results: </strong>Only Canada and the Netherlands report the prevalence of frailty among individuals accessing AD. In Canada, 9.07% of deaths by AD in 2023 were associated with frailty (either as a main condition or as a comorbidity). In the Netherlands, 3.85% of deaths by AD involved multiple geriatric syndromes in 2023.We identified 11 jurisdictions in which it would be unlikely for frailty to be an eligible condition to access AD, 6 jurisdictions where severe frailty meets or would be likely to meet eligibility criteria to access AD and 14 jurisdictions where it is unclear.</p><p><strong>Conclusion: </strong>There is a lack of detailed reporting and ongoing ambiguity about eligibility of frailty in AD across many jurisdictions. These findings support the need for improved data reporting and clarity in regulation to provide more certainty to people living with frailty and their healthcare providers.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13565127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}