Age and ageing最新文献

{"title":"Digital biomarkers for real-life, home-based monitoring of frailty: a systematic review and meta-analysis","authors":"Jundan Huang, Shuhan Zhou, Qi Xie, Jia Yu, Yinan Zhao, Hui Feng","doi":"10.1093/ageing/afaf108","DOIUrl":"https://doi.org/10.1093/ageing/afaf108","url":null,"abstract":"Background Frailty, characterised by decreased physiological function and increased vulnerability to stressors, was associated with an increase in numerous adverse outcomes. Although the number of digital biomarkers for detecting frailty in older adults is increasing, there remains a lack of evidence regarding their effectiveness for early detection and follow-up in real-world, home-based settings. Methods Five databases were searched from inception until 1 August 2024. Standardised forms were utilised for data extraction. The Quality Assessment of Diagnostic Accuracy Studies was used to assess the risk of bias and applicability of included studies. A meta-analysis was conducted to assess the overall sensitivity and specificity for frailty detection. Results The systematic review included 16 studies, identifying digital biomarkers relevant for frailty detection, including gait, activity, sleep, heart rate, hand movements and room transition. Meta-analysis further revealed pooled sensitivity of 0.78 [95% confidence interval (CI): 0.70–0.86] and specificity of 0.79 (95% CI: 0.72–0.86) to classify robust and pre-frailty/frailty participants. The overall risk of bias indicated that all the included studies were characterised as having a high or unclear risk of bias. Conclusion This study offers a thorough characterisation of digital biomarkers for detecting frailty, underscoring their potential for early prediction in home settings. These findings are instrumental in bridging the gap between evidence and practice, enabling more proactive and personalised healthcare monitoring. Further longitudinal studies involving larger sample sizes are necessary to validate the effectiveness of these digital biomarkers as diagnostic tools or prognostic indicators.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"61 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143849740","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":"From biology of ageing to geroscience: where will knowledge take us?","authors":"Aurélie Mailliez, Chantal Fradin, Éric Boulanger","doi":"10.1093/ageing/afaf098","DOIUrl":"https://doi.org/10.1093/ageing/afaf098","url":null,"abstract":"Healthy life expectancy is a major challenge in many countries and one of the World Health Organisation’s main concerns for the current decade. With different animal models, from invertebrates to mammals, research into the biology of ageing has identified various biological and physiological processes that alter the quality of ageing. Twelve characteristics of ageing have been defined, and the aim of a growing number of studies is to find how to slow down or halt their onset. Unfortunately, the direct transposition of animal models to humans is too often disappointing, and the race to bring anti-ageing products to market is a source of misleading promises. The development of geroscience will enable the identification and validation, with more relevant clinical evidence, of pro-ageing targets to develop anti-ageing therapies and aim for healthy ageing.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"5 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143851068","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":"Quadriceps muscle thickness as measured by point-of-care ultrasound is associated with hospital length of stay among hospitalised older patients","authors":"Uyanga Ganbat, Altan-Ochir Byambaa, Portia Tang, Boris Feldman, Shane Arishenkoff, Graydon Meneilly, Kenneth Madden","doi":"10.1093/ageing/afaf103","DOIUrl":"https://doi.org/10.1093/ageing/afaf103","url":null,"abstract":"Background Predicting hospital length of stay (LOS) can potentially improve healthcare resource allocation. Recent studies suggest that point-of-care ultrasound (POCUS), specifically measurements of muscle thickness (MT), may be valuable in assessing patient outcomes, including LOS. This study investigates the hypothesis that quadriceps MT and echo intensity (EI) can predict patient outcomes, particularly LOS. Methods Quadriceps MT and EI were measured using POCUS in patients admitted to a hospital’s acute medical unit. Predictor variables included age, sex, MT, EI and the Charlson Comorbidity Index (CCI). The outcome variable was hospital LOS. Results One hundred twenty participants were included (average age 76 ± 7, with 64 women and 56 men). The mean LOS was 27 ± 31 days, and the mean MT was 20 ± 6 mm. Sex-based differences in MT were statistically significant (P = .032). Patients with prolonged LOS over 30 days had lower MT (mean 17 mm vs. 21 mm, P < .0001). One unit increase in MT was significantly associated with ~1.5 fewer days of hospital LOS, and one CCI score increase was associated with almost three more days of hospital LOS. Having low MT significantly increased the odds of staying in the hospital longer than 30 days by more than three times in all models. Conclusion Muscle thickness is a strong predictor of hospital LOS, highlighting the potential of POCUS for assessing patient outcomes.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"114 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837022","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":"Measuring meaning-based well-being in individuals with dementia: the creation and validation of the well-being in dementia inventory","authors":"Zehra B Turel, Allan Perry, Alexander Balicki, Elizabeta Mukaetova-Ladinska, Estefania Vargas Triguero, Anna Lesniak, John Maltby","doi":"10.1093/ageing/afaf092","DOIUrl":"https://doi.org/10.1093/ageing/afaf092","url":null,"abstract":"Despite growing attention to well-being in dementia, few studies have defined meaning-based (eudaimonic) well-being in this population, mainly due to challenges posed by cognitive decline and self-report limitations. We developed and validated a novel tool for measuring meaning-based well-being in individuals with dementia, particularly those receiving residential or home care. The study included two samples: carers of 174 care home residents and carers of 420 community-dwelling individuals for whom respondents reported dementia. The Well-being in Dementia Inventory (WiDI) assesses six core dimensions: Self-Sufficiency, Functional Mastery, Goal-Based Mastery, Purposeful Engagement, Positive Interactions and Constructive Self-Perspective. Confirmatory Factor Analysis established the WiDI’s six-factor structure, underscoring its multidimensional nature and equivalence across community-dwelling individuals, regardless of gender, age group (younger-old/mid-older-old), or care context (family or professional). The scale exhibited high internal and inter-rater reliability, though very low scores in the care home sample inflated these statistics. Concurrent validity was confirmed through strong correlations with adapted indices of meaning-based well-being (e.g. the Scales of Psychological Well-being and the Mental Health Continuum Short Form, commonly used in non-dementia samples), indicating the WiDI’s conceptual consistency. These findings clarify how meaning-based well-being can be assessed in individuals with dementia and introduce the WiDI as a reliable and valid tool for assessing well-being, suggesting broad applicability across care settings. These results have important implications for practice and policy, advocating a meaning-based approach to well-being assessments that ensures holistic, personalised care by focusing on key indicators of life quality.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"90 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841359","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":"Risk-factors and multimorbidity in oral anticoagulant-related intracerebral haemorrhage: a comparison of patients in pivotal trials and real life","authors":"Josefine Grundtvig, David Gaist, Louisa Christensen, Christian Ovesen, Inger Havsteen, Helle K Iversen, Thomas Christensen, Alexander Lilja-Cyron, Christina Kruuse, Karen Ægidius, Sverre Rosenbaum, Per Meden, Jacob Marstrand, Thorsten Steiner, Hanne Christensen","doi":"10.1093/ageing/afaf091","DOIUrl":"https://doi.org/10.1093/ageing/afaf091","url":null,"abstract":"Background We hypothesised that morbidity burden was higher in real-life patients with oral anticoagulant-related intracerebral haemorrhage (OAC-ICH) than direct oral anticoagulant (DOAC) trial-life patients (pivotal trial participants) and explored if pre-stroke morbidity was comparable (i) in real-life patients on DOAC or vitamin K antagonist (VKA) with ICH, and (ii) in trial-life patients versus real-life patients with OAC-ICH. Methods The COOL-ICH cohort included 401 acute, consecutive patients with OAC-ICH (272 VKA-ICH, 129 DOAC-ICH) from the Capital Region of Denmark. Risk-factors and morbidity in trial-life patients were retrieved from publications. Results Risk-factors, CHADS2 and Charlson Comorbidity Index were comparable in DOAC vs VKA users in real-life. Pre-stroke modified Rankin Scale (mRS) was higher in DOAC users than in VKA users (median mRS 1 vs 0, P = 0.002). More DOAC users were women (53% vs 39%, P = 0.009). Compared to trial-life patients, age and proportion of women were higher in real-life patients. CHADS2-scores were comparable. Conclusion In conclusion, burden of risk-factors and comorbidities were similar in real-life patients with DOAC-ICH and VKA-ICH, as well as in real-life patients compared to trial-life patients. However, real-life patients especially those on DOAC, were older and more frequently women than trial-life patients. It is reassuring that burden of comorbidity was similar in real-life and trial-life patients. Nevertheless, this report underlines the importance of recruiting adequate numbers of older people and women to cardio-vascular trials to ensure sufficient safety data to advice prescriptions in these very prevalent sub-groups of patients.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837023","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":"Small vessel disease contributions to acute delirium: a pilot feasibility MRI study","authors":"Una Clancy, Yajun Cheng, Charlotte Jardine, Fergus Doubal, Alasdair M J MacLullich, Joanna M Wardlaw","doi":"10.1093/ageing/afaf099","DOIUrl":"https://doi.org/10.1093/ageing/afaf099","url":null,"abstract":"Background and aims Delirium carries an eight-fold risk of future dementia. Small vessel disease (SVD), best seen on magnetic resonance imaging (MRI), increases delirium risk, yet delirium is understudied in MRI research. We aimed to determine MRI feasibility, tolerability, image usability and prevalence of SVD lesions in delirium. Methods This case–control feasibility study performed MRI (3D T1/T2-weighted), fluid-attenuated inversion recovery, susceptibility-weighted and diffusion-weighted imaging (DWI) on 20 medical inpatients >65 years: 10 with delirium ≥3 weeks and 10 without delirium, matched for vascular risk, Clinical Frailty Scale (CFS) and cognition. We excluded acute stroke, agitation necessitating sedation, mobility assistance of >2 and MRI contraindications. We measured scan duration, tolerability, image usability, acute infarcts and SVD features. Six months later, we recorded CFS and cognitive diagnoses. Results Mean age was 83.5 years (delirium 78.7 vs non-delirium 88.4); 13/20 were female; 17/20 had premorbid cognitive decline/impairment or dementia. Acquisition took mean 26.8 min. MRI was well tolerated in 16/20 (7/10 in delirium arm; 9/10 in non-delirium arm). Also, 4/20 had early scan termination, but 20/20 had clinically interpretable images. We detected DWI-hyperintense lesions in 3/10 (30%) with delirium (2/10 small subcortical and 1/10 cortical) and in 3/10 (30%) without delirium (2/10 small subcortical; 1/10 cortical). Mean white matter hyperintensity Fazekas score was 6 in delirium versus 4.5 without. Conclusions MRI is feasible, usable and tolerable in delirium, and we detected DWI-hyperintense lesions in one-third of all study participants, regardless of delirium status. This study indicates acute vascular contributions, including SVD, to both delirium- and non-delirium–related presentations, supporting the need for larger studies.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"14 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143837021","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":"Tinnitus, noise exposure and the risk of dementia: a prospective cohort study based on UK biobank","authors":"Qilu Zhang, Mengyao Shi, Jing Zhang, Xiaoxiao Wang, Yi Chen, Xiangyan Yin, Yonghong Zhang","doi":"10.1093/ageing/afaf097","DOIUrl":"https://doi.org/10.1093/ageing/afaf097","url":null,"abstract":"Background The burden of dementia is increasing dramatically with the population aging. Tinnitus and chronic noise exposure are associated with neuropsychiatric diseases and cognitive decline, but relationships between tinnitus and noise exposure and incident dementia remain unclear. Methods 160 032 participants from the UK Biobank were included. Information on tinnitus, tinnitus severity, noise exposure (loud music and noisy workplace) was collected at baseline. Cox proportional hazards models were used to assess the associations of tinnitus, tinnitus severity and noise exposure with the risk of incident dementia. Logistic regression models were used to assess the associations between noise exposure and tinnitus. Results During a median follow-up of 12.8 years, 2219 incident dementias were recorded. Compared with participants without tinnitus, those with tinnitus had a 10% increased risk of dementia (hazard ratios [HR]: 1.10, 95% CI: 1.00–1.20). Among the participants with tinnitus, compared with those with the lowest tinnitus severity, those with slight and moderate or severe tinnitus had 23% (95%CI: 1.03–1.46) and 64% (95%CI: 1.35–2.00) increased risks of dementia, respectively. Furthermore, compared with participants without exposure to noise, those with exposure to noise for more than 5 years had a 12% increased risk of dementia (HR: 1.12, 95%CI: 1.00–1.26). In addition, the longer time the participants exposed to noise, the higher the odds of having tinnitus (P for linear trend <.001). Conclusions Tinnitus, tinnitus severity and long-term noise exposure were associated with incident dementia, and long-term noise exposure were related to tinnitus. Tinnitus and noise exposure are public health issues vital for dementia prevention.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"108 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143841360","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":"Adherence to a Mediterranean diet and leisure-time physical activity are associated with reduced initiation of antidepressant, anxiolytic, antipsychotic and antiseizure drug use in older adults: a cohort study","authors":"Marta H Hernandez, Eleonora Fornara, Camille Lassale, Olga Castañer-Niño, Ramón Estruch, Emilio Ros, Miguel Ángel Martínez-González, Dolores Corella, Nancy Babio, José Lapetra, Enrique Gómez-Gracia, Fernando Arós, Miquel Fiol, Lluís Serra-Majem, Antonio Riera-Mestre, Alfredo Gea, Carolina Ortega-Azorín, Andrés Díaz-López, Montserrat Fitó, Álvaro Hernáez","doi":"10.1093/ageing/afaf088","DOIUrl":"https://doi.org/10.1093/ageing/afaf088","url":null,"abstract":"Background We explored how adherence to the Mediterranean diet (MedDiet) and leisure-time physical activity (LTPA) impact psychoactive medication use in older adults. Methods We assessed the cumulative MedDiet adherence and LTPA’s impact on mental health medication initiation in older individuals at high risk of chronic disease. Associations between the cumulative average of MedDiet adherence (per one-point increase in the adherence score) and LTPA (per increase in 20 metabolic equivalents of task-minute/day [METs-min/day]) with drug initiation were assessed by multivariable Cox regressions. We explored non-linear exposure-outcome associations using smoothed cubic splines and the multiplicative interaction between MedDiet and LTPA. Results A total of 5940–6896 participants (mean age 67, 58% women) over 4.2–4.7 years, each point increase in MedDiet adherence decreased the initiation of antidepressants by 23–28% (HR 0.72, 95% CI 0.67–0.77), anxiolytics (HR 0.75, 0.70–0.81), antipsychotics (HR 0.77, 0.65–0.91), and antiseizures (HR 0.77, 0.69–0.85). Associations for anxiolytics and antiseizures were strong at low MedDiet adherence levels. Relationships between LTPA and initiation of antidepressants and anxiolytics were linear in the lowest LTPA values (0–150 METs-min/day); every 20 METs-min/day increases were associated with 20% lower risk of initiating antidepressants (HR 0.80, 0.75–0.86) and 15% less risk in anxiolytics (HR 0.85, 0.79–0.90). Association with antiseizures was linear (+20 METs-min/day: HR 0.96, 0.94–0.99), and no associations were found for antipsychotics. High MedDiet adherence (≥10) and LTPA (≥150 METs-min/day) reduced psychoactive drug initiation by 42%–59%. Combination was additive for antidepressants, antipsychotics and antiseizures and synergistic for anxiolytics. Conclusions MedDiet and LTPA adherence reduced psychoactive drugs initiation in older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"183 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824882","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":"Head-up tilt testing in older syncope patients: a systematic review","authors":"Susanne C de Ruiter, Rob J van Marum, Jaap H Ruiter, Martin E W Hemels, Joris R de Groot, René W M M Jansen","doi":"10.1093/ageing/afaf086","DOIUrl":"https://doi.org/10.1093/ageing/afaf086","url":null,"abstract":"Background In older syncope patients, medical histories are often less reliable due to retrograde amnesia and cognitive impairment. Therefore, additional tests may be needed to reach a diagnosis. We conducted a systematic review to evaluate positivity rates and safety of head-up tilt testing (HUTT) in these patients. Methods We searched Medline and Embase for HUTT positivity rates and diagnoses in older syncope patients (mean age ≥ 65 years) vs. younger patients. Secondary outcomes were time to syncope (TtS) and adverse events (AEs). Risk of bias was assessed with a modified version of the QUADAS-2. Results In total, 42 studies were included, with 12 378 older participants in total. Positivity rates varied widely [passive HUTT 0.0%–90.0%; isoproterenol (IPR)-HUTT 18.3%–64.0%; nitroglycerin-HUTT 30.1%–90.5%]. The majority of studies found no differences between older and younger patients. Specificity was high for all HUTT-protocols (85.5%–100%). TtS did not differ between older and younger patients, but was significantly longer in control subjects. Nitroglycerin-HUTT yielded the most diagnoses (median 64.2% vs. 23.7% for passive, P = .007, and 44.8% for IPR-HUTT, n.s.). Vasodepressive responses were more common than cardioinhibitory responses (median 54.9% vs. 9.1%) in older patients. AEs occurred in <6% of patients with passive/nitroglycerin-HUTT. Discussion/conclusion There is no consistent evidence that HUTT results differ between older and younger syncope patients. Nitroglycerin-HUTT yields the most diagnoses, whilst retaining a high specificity, and is safe to perform in older patients. Future studies should focus on the additional value of HUTT on top of the initial evaluation in these patients.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"25 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813523","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":"Nature-based interventions for older adults: a systematic review of intervention types and methods, health effects and pathways","authors":"Ki Tong, Catharine Ward Thompson, Gail Carin-Levy, Jennifer Liddle, Sarah Morton, Gillian E Mead","doi":"10.1093/ageing/afaf084","DOIUrl":"https://doi.org/10.1093/ageing/afaf084","url":null,"abstract":"Background Nature-based interventions (NBIs) may support older adults’ health and well-being, but it remains unclear which interventions are most effective, for whom and in which contexts. The existing Wilkie and Davinson framework explains the pathways between NBIs and health outcomes but underemphasises the effects of environmental qualities. Therefore, the study aims to critically examine existing NBIs and their associated health outcomes, with a focus on identifying the environmental qualities and pathways that are either facilitating or impeding. Methods The review sought 16 databases for any nature-based interventions aimed at enhancing health outcomes where participants are older adults aged ≥65. The Mixed Methods Appraisal Tool assessed risk of bias. Narrative synthesis was used for result presentation. Results Of 6143 articles retrieved, 84 studies were included. Participants were primarily community dwelling without specific conditions. Most studies were quantitative experiments. Interventions were predominantly multicomponent, with restoring psychological capacities as the most common pathway. Spiritual, behavioural and socioecological changes were identified. Some health mechanisms were specific to outdoor interventions, but indoor interventions showed comparable outcomes. Conclusions The study predominantly included community-dwelling participants without specific health conditions, potentially limiting the generalisability of findings to older adults with multimorbidity or those in alternative living environments. Multicomponent interventions challenged direct associations between pathways and outcomes. Results extend existing frameworks by identifying spiritual, behavioural and socioecological benefits. Limited detailing of environmental qualities warrants further research to associate them with specific health outcomes. Registration The protocol was registered on PROSPERO (CRD42024496114).","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"108 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143813591","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}