Age and ageing最新文献

{"title":"Effects of digital technology-based serious games interventions for older adults with mild cognitive impairment: a meta-analysis of randomised controlled trials.","authors":"Yan Gao, Naiquan Liu","doi":"10.1093/ageing/afaf080","DOIUrl":"https://doi.org/10.1093/ageing/afaf080","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of digital technology-based serious games (DTBSGs) interventions in older adults with mild cognitive impairment (MCI).</p><p><strong>Methods: </strong>A librarian-designed search of eight databases was conducted to identify randomised controlled trials published in English or Chinese up to 10 August 2024. The primary and secondary outcomes were compared between the intervention and control groups. A fixed- or random-effects meta-analysis model was used to determine the mean difference, based on the results of the heterogeneity test. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.</p><p><strong>Results: </strong>A meta-analysis of 28 trials, including 1698 participants, showed greater improvements in favour of interventions using DTBSGs compared to the control group in global cognitive function, executive function, attention function, depression, and activities of daily living (ADL). However, there was no significant improvement in memory function, anxiety, apathy or quality of life (QOL) compared to the control group. Subgroup analysis showed that computer games, exergames and iPad tablet games were superior to immersive virtual reality (VR) games in terms of global cognitive and executive function. VR games were superior to computer games in terms of attention and ADL. The GRADE evidence quality assessment results showed that global cognitive function and ADL were of moderate quality; executive function, attention, depression and anxiety were of low quality; and memory, apathy and QOL were of very low quality.</p><p><strong>Conclusion: </strong>Patients with MCI benefited from DTBSGs. With the rapid development of information and communication technology, DTBSGs have great potential and may be used as adjuncts or substitutes in MCI rehabilitation.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794356","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":"Predicting cardiovascular morbidity and mortality with SCORE2 (OP) and Framingham risk estimates in combination with indicators of biological ageing.","authors":"Anna Tirkkonen, Jonathan K L Mak, Johan G Eriksson, Pauliina Halonen, Juulia Jylhävä, Sara Hägg, Linda Enroth, Jani Raitanen, Iiris Hovatta, Tuija Jääskeläinen, Seppo Koskinen, Markus J Haapanen, Mikaela B von Bonsdorff, Laura Kananen","doi":"10.1093/ageing/afaf075","DOIUrl":"10.1093/ageing/afaf075","url":null,"abstract":"<p><strong>Background and objective: </strong>Previous research assessing whether biological ageing (BA) indicators can enhance the risk assessment of cardiovascular disease (CVD) outcomes beyond established CVD risk indicators, such as Framingham Risk Score (FRS) and Systematic Coronary Risk Evaluation (SCORE2)/SCORE2-Older Persons (OP), is scarce. We explored whether BA indicators, namely the Rockwood Frailty Index (FI) and leukocyte telomere length (TL), improve predictive accuracy of CVD outcomes beyond the traditional CVD risk indicators in general population of middle-aged and older CVD-free individuals.</p><p><strong>Methods: </strong>Data included 14 118 individuals from three population-based cohorts: TwinGene, Health 2000 (H2000), and the Helsinki Birth Cohort Study, grouped by baseline age (<70, 70+). The outcomes were incident CVD and CVD mortality with 10-year follow-up. Risk estimations were assessed using Cox regression and predictive accuracies with Harrell's C-index.</p><p><strong>Results: </strong>Across the three study cohorts and age groups: (i) a higher FI, but not TL, was associated with a higher occurrence of incident CVD (P < .05), (ii) also when considering simultaneously the baseline CVD risk according to FRS or SCORE2/SCORE2-OP (P < .05) (iii) adding FI to the FRS or SCORE2/SCORE2-OP model improved the predictive accuracy of incident CVD. Similar findings were seen for CVD mortality, but less consistently across the cohorts.</p><p><strong>Conclusions: </strong>We show robust evidence that a higher FI value at baseline is associated with an increased risk of incident CVD in middle-aged and older CVD-free individuals, also when simultaneously considering the risk according to the FRS or SCORE2/SCORE2-OP. The FI improved the predictive accuracy of CVD outcomes beyond the traditional CVD risk indicators and demonstrated satisfactory predictive accuracy even when used independently.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11966606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771047","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":"Natural history of lower urinary tract symptoms and voiding parameters in ageing men with 5-year follow-up-the concord health and ageing in men project (CHAMP).","authors":"Giovanni Losco, Lewis Chan, Rachel Esler, Vasi Naganathan, Fiona Blyth","doi":"10.1093/ageing/afaf078","DOIUrl":"10.1093/ageing/afaf078","url":null,"abstract":"<p><strong>Background: </strong>Natural history of voiding parameters with age is poorly understood. We aim to understand both subjective and objective lower urinary tract parameters in older men over 5 years.</p><p><strong>Methods: </strong>The Concord Health and Ageing in Men Project is a prospective cohort study of older men, involving 1705 men aged 70 years and over living in Sydney, Australia. Men were assessed at 0, 2 and 5 years. Demographic information, medical history, International Prostate Symptom Score (IPSS), flow rate and post-void volume were collected at three timepoints.</p><p><strong>Results: </strong>A total of 1705 men aged 70-97 years participated. At 2 and 5 year follow-up, 1367 and 940 men presented for assessment. Mean IPSS was 7.35 at baseline, 6.96 at 2 years (P = .9) and 7.18 at 5 years (P = .30). Mean flow rate at baseline was 15.0 ml/s, 14.6 ml/s at 2 years (P = .001) and 15.3 ml/s at 5 years (P = .42). Adjusting for age at baseline, the change in flow over 5 years was not significant (P = .93). Mean post-void residual was 72.4 ml at baseline, 84.0 ml at 2 years (P = .003) and 93.2 ml at 5 years (P = .001). Men with residual volume >200 ml at baseline had no significant change in residual over 5 years (P = .51).</p><p><strong>Conclusions: </strong>Urinary symptoms and voiding parameters remain stable over 5 years. Men with elevated post-void volume did not deteriorate significantly. Conservative management of lower urinary tract symptoms appears a reasonable strategy in older men.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794365","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":"Fall prevention lessons from Australian Coroner’s Court cases about older adults: harnessing the prophylactic power of medico-legal findings","authors":"Jennifer Sarah Schulz-Moore, Paulo Henrique Silva Pelicioni","doi":"10.1093/ageing/afaf055","DOIUrl":"https://doi.org/10.1093/ageing/afaf055","url":null,"abstract":"Despite our existing knowledge about fall prevention, older adults are still falling, and some die from those falls. Much of this knowledge comes from work done with live patients. Coroners (who investigate sudden and unexpected deaths) offer fresh insights into preventive lessons for minimising falls in older adults. Coroners have a legal public health function to reduce preventable deaths. Their court investigations draw from documents, such as witness statements, police records, healthcare records and expert witness statements. The lessons gleaned from the rich coronial data could be incorporated into updated versions of the World Fall Guidelines. Despite the preventive power of coronial data, it is an under-researched and under-used source of prophylactic insights for fall prevention. Numerous preventive lessons have emerged from our ongoing study of Australian coroners’ cases about fatal falls in older adults living in residential care. Specifically, these prophylactic learnings involve equipment, legal and policy changes and systems-level adaptations. While recognising the robustness of the World Falls Guideline, the coronial examples studied were not described in the working group specific to them and could add value to preventing falls in aged-care facilities. The global interest in the ageing population calls for serious consideration of additional ways to glean fall prevention insights. It is time to recognise and harness the preventive power of coronial data to benefit older adults and our communities.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"19 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653455","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":"Predictive factors of gait recovery after hip fracture: a scoping review","authors":"Cristina González de Villaumbrosia, Raquel Barba, Cristina Ojeda-Thies, Eulalia Grifol-Clar, Noelia Álvarez-Diaz, Teresa Álvarez-Espejo, Jose Manuel Cancio-Trujillo, Jesús Mora-Fernández, Teresa Pareja-Sierra, Raquel Barrera-Crispín, Alicia Calle-Egusquiza, Aina Capdevila-Reniu, Cristina Carrasco-Paniagua, Mª Carmen Cervera Díaz, Patricia Condorhuamán-Alvarado, Laura Cotano-Abad, Leonor Cuadra-Llopart, Verónica García-Cárdenas, Sofía González-Chávez, Luisa Alejandra Hernández-Sánchez, Beatriz Herrero-Pinilla, Jose López-Castro, Nuria Montero-Fernández, Angélica Muñoz-Pascual, Marta Muñoz-Vélez, Raquel Ortés-Gómez, Andrea Sáenz-Tejada, Javier Sanz-Reig, Sonia Torras-Cortada, Miriam Ramos Cortés, Pilar Sáez-López","doi":"10.1093/ageing/afaf057","DOIUrl":"https://doi.org/10.1093/ageing/afaf057","url":null,"abstract":"Objective This scoping review aimed to identify predictive factors influencing gait recovery post-hip fracture surgery among adults aged 65 and older. Design A systematic search of MEDLINE, Embase and CINAHL databases was conducted, focusing on studies assessing predictive factors of gait recovery within one month to one-year post-surgery. Two independent reviewers carried out study selection, quality assessment and data extraction using the Quality in Prognosis Studies Tool to gauge evidence levels. Results About 10,627 articles were initially identified. After duplicates were removed, 7665 were screened based on title and abstract, then 796 based on full text; 138 articles were finally included. The review identified a total of 77 predictive factors. However, just under half (34) of these were supported by studies with a low risk of bias. Higher-level evidence-supported factors were age, pre-fracture independence in daily activities, cognitive impairment, delirium, orthogeriatric multidisciplinary co-management, specific surgical interventions, allowing weight-bearing, comorbidities, nutritional status, rehabilitation treatments and polypharmacy. Conclusion The identified factors influencing gait recovery include both non-modifiable factors [such as younger age, pre-fracture independence in activities of daily living, absence of cognitive impairment, fewer comorbidities and lower anaesthetic risk] and modifiable factors, including rehabilitation treatments, organisational factors, absence of delirium, orthogeriatric co-management, surgical factors such as implant type and unrestricted weight-bearing, better nutritional status and strength, and reduced polypharmacy. We believe the latter should be prioritised in managing patients with hip fractures to achieve optimal recovery.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"20 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653454","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":"Routine benign paroxysmal positional vertigo (BPPV) physiotherapy management: a feasibility study","authors":"Erin Dale Bicknell, Laura Ferguson, Alisha da Silva, Tiffany Theoharidis, Khyati Gohil, Jennifer Langford, Melissa Clarke, Anne McGann, Wendy Bower","doi":"10.1093/ageing/afaf039","DOIUrl":"https://doi.org/10.1093/ageing/afaf039","url":null,"abstract":"Background Benign paroxysmal positional vertigo (BPPV) is common in older adults with a falls history. The feasibility of routine physiotherapy management in subacute inpatients is not known. Objective Examine the feasibility of implementing routine BPPV physiotherapy management in older subacute inpatients and ascertain the proportion BPPV positive. Methods Subacute inpatients aged ≥50 years sustaining a fall within six months were assessed for BPPV. Feasibility was defined as &amp;gt;75% of eligible patients able to be assessed for BPPV. Implementation was also evaluated through surveys completed by study physiotherapists. Demographic, falls, medical history, frailty, functional mobility information and modified dizziness handicap inventory (DHI) versions were also collected. Results Overall, 67% of 447 eligible patients underwent BPPV assessment; 301 completed ≥ one BPPV assessment, 146 could not be assessed, most commonly due to physical limitation, cognition precluding assessment, declining assessment or discharged prior. Physiotherapists perceived BPPV management to be acceptable (88%), appropriate (90%) and feasible (76%) however constrained by patient-factors, time required and environmental barriers. BPPV was found in 6% of those assessed, with 35% reporting current dizziness or unsteadiness. Modified DHI scores were significantly higher in those BPPV positive (5-item P ≤ .001; 8-item P = .001). Conclusion BPPV management was not feasible in this population predominantly due to physical limitations and cognitive impairment. Physiotherapists perceive BPPV management as important but difficult amongst these patient-factors and competing clinical priorities. Subjective symptoms may not indicate BPPV risk, however, the 5-item DHI may identify need for individual assessment.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"90 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641088","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 low bone mineral density and dementia in older women: insights from the Longevity Improvement and Fair Evidence Study","authors":"Kengo Kawaguchi, Megumi Maeda, Fumiko Murata, Yasuharu Nakashima, Haruhisa Fukuda","doi":"10.1093/ageing/afaf058","DOIUrl":"https://doi.org/10.1093/ageing/afaf058","url":null,"abstract":"Background Both osteoporosis and dementia have emerged as important public health challenges in Japan’s aging population. This study aimed to investigate the impact of low bone mineral density (BMD) on the subsequent risk of dementia in older Japanese women aged ≥65 years, given the overlapping demographics of individuals affected by these two conditions. Methods This cohort study was conducted using osteoporosis screening data and insurance claims data from a municipality. We identified 8618 women (median age: 73 years) who underwent osteoporosis screening between April 2019 and March 2021. Participants with a BMD &amp;lt;80% of the young adult mean were assigned to a low-BMD group (n = 2297), whereas those with a BMD ≥80% were assigned to a control group (n = 6321). The study outcomes were new-onset all-cause dementia and Alzheimer’s disease (AD). To estimate the risk of low BMD on these outcomes, we constructed Cox proportional hazards models that adjusted for covariates (age, care needs, year of cohort entry, comorbidities and medications) using inverse probability of treatment weighting. Results The low-BMD group had a significantly higher risk of developing both all-cause dementia (adjusted hazard ratio: 1.58, 95% confidence interval: 1.20–2.08) and AD (1.61, 1.11–2.36) than the control group over approximately 30 months of follow-up. Conclusion These findings suggest that low BMD is associated with medium-term onset of dementia. Osteoporosis screenings could be useful not only for the secondary prevention of osteoporosis, but also for the primary prevention of dementia.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"69 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653459","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":"Developing an integrated care conceptual framework for older adults with multimorbidity within china’s integrated delivery system","authors":"Jingjie Wu, Jing Shao, Dandan Chen, Erxu Xue, Yujia Fu, Hui Zhang, Qinhong Xu, Chunbo Liu, Zhihong Ye","doi":"10.1093/ageing/afaf060","DOIUrl":"https://doi.org/10.1093/ageing/afaf060","url":null,"abstract":"Background The definition of China’s integrated delivery system remains abstract since it was proposed in 2021, lacking detailed clarification on essential concepts such as specific contents and main providers of services for older adults with multimorbidity. Aim To develop an integrated care conceptual framework for older adults with multimorbidity within China’s integrated delivery system. Methods A scoping review, semi-structured interviews and a modified e-Delphi study were used to explore specific contents of integrated care for older adults with multimorbidity. A social network analysis was conducted to identify healthcare providers with the greatest potential to play a central role in the integrated care for older adults with multimorbidity. Finally, an integrated care conceptual framework was established based on specific contents and main providers. Results The center of the framework represents the people-centered and need-oriented connotation of China’s integrated delivery system. The first circle reflects three significant characteristics of the integrated delivery system, namely care comprehensiveness, care coordination, and care continuity. The second circle includes main providers of integrated care, which are expected to play a central role in professional collaboration and information diffusion. The outermost circle consists of specific contents of integrated care, including clinical practice, human workforce, organisational collaboration, information technology, regulations and policies. Conclusion The framework derived from this study is expected to promote the understanding and implementation of integrated care for older adults with multimorbidity within the Chinese context. The service content of integrated care related to clinical practice also offers valuable references for other countries.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"69 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641087","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":"Failure to improve—identifying risk factors for poor functional recovery following chronic subdural hematoma surgery","authors":"Rahul Raj, Pihla Tommiska, Teemu Luoto, Ville Leinonen, Timo Koivisto, Sami Tetri, Jussi Posti, Kimmo Lönnrot","doi":"10.1093/ageing/afaf056","DOIUrl":"https://doi.org/10.1093/ageing/afaf056","url":null,"abstract":"Background Chronic subdural hematoma (CSDH) is a common condition among older people living with frailty. Outcome after surgery is generally good, but there is a significant proportion of patients who do not benefit from surgery. This study aimed to identify predictors of failure to improve functional outcomes after CSDH surgery. Methods This is a post-hoc analysis of the nationwide FINISH trial, which enrolled 589 adult patients undergoing burr-hole drainage for symptomatic CSDH during 2020–22. Functional outcome was assessed using the modified Rankin Scale (mRS). Failure to improve was defined as unchanged or worsened mRS at 6 months compared to preoperative mRS. Multivariable logistic regression was used to identify factors associated with failure to improve. Results Of the 568 patients with available mRS data at 6 months, 20% (n = 115) showed no improvement in mRS between the preoperative and 6-month period. Factors associated with failure to improve included pre-existing dementia (OR 2.62, 95% CI 1.21–5.66), use of a walker (OR 3.19, 95% CI 1.64–6.23), smaller hematoma width (OR 0.96, 95% CI 0.93–0.99), and lesser midline shift (OR 0.91, 95% CI 0.86–0.97). Despite this, 88% of patients had stable or improved residence status, and 85% maintained or improved mobility. Conclusion A substantial proportion of surgically treated CSDH patients do not improve in functional status. Dementia was a significant predictor of poor outcomes. Future research should focus to better identify patients at risk of poor outcomes in order to avoid overtreatment and explore possible alternative treatment strategies.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"69 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143641060","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":"Best practice in the use of middle meningeal artery embolisation for chronic subdural haematoma","authors":"Frances Rickard, Mark Backhouse, Alexandra Langberg, Alex Mortimer, Adam Willliams, Anthony Cox, Crispin Wigfield, David Shipway","doi":"10.1093/ageing/afaf054","DOIUrl":"https://doi.org/10.1093/ageing/afaf054","url":null,"abstract":"Chronic subdural haematoma (cSDH) is a common neurosurgical disorder in older people and projected to become the most common cranial neurosurgical pathology by 2030. Incidence of cSDH has risen in recent years as a consequence of improved access to brain imaging, and the increased prescribing of antithrombotic medication for both primary and secondary prevention of vascular disease. Chronic SDH typically presents with an insidious onset of broad-ranging symptoms including impaired cognition, gait, balance and mobility, often with headache. It progresses to more fulminant symptoms of hemiplegia, dysphasia and eventually coma. Although the established standard of care for clearly symptomatic cSDH is burr hole trephination, Middle Meningeal Artery Embolisation (MMAE) has emerged as a minimally invasive treatment option for some patients with cSDH. This is a rapidly evolving field: recently published randomised control trials have provided an evidence-base supporting the use of MMAE not only as an adjunct to burr hole trephination, but also in patients in whom trephination is contraindicated, or in patients with mild symptomatology who are not considered appropriate for immediate burr hole trephination. This article provides practical, real-world guidance on current best practice based on our experience and the published evidence available to date. We use case studies and treatment algorithms from the UK’s highest volume MMAE centre to illustrate collaborative care pathways for patients with cSDH between neurosurgery, interventional neuroradiology and trauma geriatricians.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"25 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143653456","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}