Age and ageing最新文献

{"title":"Seasonal influenza vaccination rate and vaccine effectiveness among older adults in mainland China: a systematic review and meta-analysis.","authors":"Rui Ma, Yuling Du, Wenduo Jing, Hao Ma, Kerui Wang, Aonan Liu, Siran Chen, Mengqi Zhou, Yinuo Zhou, Shaohui Su, Li Zhang, Yanfang Yang","doi":"10.1093/ageing/afaf252","DOIUrl":"10.1093/ageing/afaf252","url":null,"abstract":"<p><strong>Introduction: </strong>Both vaccine coverage and its effectiveness determine the influence of seasonal influenza vaccination on influenza control within a population. We conducted a systematic review and meta-analysis to estimate the influenza vaccination rate (IVR) and vaccine effectiveness (VE) among older adults in mainland China.</p><p><strong>Methods: </strong>We searched five databases for the last 12 years, selecting studies that included people aged 60 years or older in mainland China. Random or fixed effects models were used to generate summary IVR and VE. The heterogeneity was assessed by subgroup analyses and meta-regression. Potential biases of the included studies were examined using the Agency for Healthcare Research and Quality Inventory and the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>For IVR, we included 65 studies, involving 149 458 672 participants. The overall pooled IVR was found to be 17% (95% CI: 14%-21%), with lower IVRs observed in areas lacking free vaccination policies (7%, 95% CI: 5%-9%) and among individuals with chronic diseases (13%, 95% CI: 8%-19%). To assess VE against laboratory-confirmed influenza, we included 14 studies, involving 13 950 participants. The overall pooled VE was 33% (95% CI: 10%-51%), with a higher VE estimate observed for influenza A(H1N1) pdm09 (51%, 95% CI: 13%-73%) and when the vaccine matched the circulating virus strain (37%, 95% CI: 9%-56%).</p><p><strong>Conclusions: </strong>IVRs among older adults in the included areas are low, especially among those lacking access to free policies and those with chronic diseases. Furthermore, the current vaccine provides low protection. It is crucial to increase influenza vaccination uptake and develop more effective vaccines for older adults.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084730","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":"Does mental illness history affect primary care chronic disease management in older adults? A population-based propensity score-matched study.","authors":"Rebecca H Correia, Sandra Peterson, Rita K McCracken, Ridhwana Kaoser, Andrew Putman, François Gallant, Eric Poarch, Allie Peckham, David Rudoler, M Ruth Lavergne","doi":"10.1093/ageing/afaf246","DOIUrl":"10.1093/ageing/afaf246","url":null,"abstract":"<p><strong>Background: </strong>Older adults living with physical chronic conditions and comorbid mental illness have more complex care needs, and may experience side effects of treatment for mental illness that can exacerbate physical conditions. There is a need to examine variation in health service use and chronic disease management in the context of treatment for mental illness.</p><p><strong>Objective: </strong>We compared evidence-informed management of diabetes, heart failure and chronic obstructive pulmonary disease (COPD) amongst older adults based on history of mental illness treatment.</p><p><strong>Design/setting: </strong>We conducted a population-based propensity score-matched study in British Columbia, Canada, using health administrative data from 1 April 2020 to 31 March 2023.</p><p><strong>Subjects: </strong>Older adults (aged ≥65) registered for provincial health insurance and diagnosed with diabetes, heart failure and/or COPD.</p><p><strong>Methods: </strong>Within each chronic disease subgroup, propensity scores (matching for age, sex, rurality and neighbourhood income quintile) paired individuals 1:1 based on mental illness history. Differences in health service utilisation and chronic disease management outcomes were assessed from P-values.</p><p><strong>Results: </strong>Older adults with mental illness history had more primary care contacts, virtual visits and contacts with their usual primary care provider and specialists. However, they also had fewer labs/testing and a lower likelihood of being dispensed drugs for their chronic condition than those without mental illness history.</p><p><strong>Conclusion: </strong>Despite more frequent contact with primary care, older adults with mental illness may face barriers to receiving comparable chronic disease management. These findings underscore the need for more integrated, multidisciplinary care models that address both mental and physical health needs.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129850","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":"Vascular ageing and cognitive function: blood pressure mediation in the association between arterial stiffness and cognitive decline in Chinese adults.","authors":"Jie Jin, Chen Bao, Caimu Wang, Wukun Ge, Qinfeng Gu","doi":"10.1093/ageing/afaf274","DOIUrl":"10.1093/ageing/afaf274","url":null,"abstract":"<p><strong>Background: </strong>Arterial stiffness has emerged as a potential risk factor for cognitive decline, yet underlying mechanisms remain incompletely understood. We investigated the longitudinal association between arterial stiffness and cognitive function in Chinese adults, examining blood pressure components as potential mediators.</p><p><strong>Methods: </strong>Data from 3485 participants (aged 45-90) in the China Health and Retirement Longitudinal Study (2011-2018) were analysed. Arterial stiffness was assessed using estimated pulse wave velocity (ePWV). Multivariate regression models examined associations between baseline ePWV and cognitive outcomes. Mediation analyses quantified blood pressure mediation effects.</p><p><strong>Results: </strong>Baseline cognitive scores demonstrated significant inverse relationships across ePWV tertiles: 13.67 ± 2.62, 13.40 ± 2.68 and 12.93 ± 2.79 (P < 0.001), persisting at 7-year follow-up. Each unit increase in ePWV was associated with cognitive decline in fully adjusted models (β = -0.14, 95% CI: -0.23 to -0.05, P = 0.003). Whilst unadjusted analysis suggested blood pressure mediation (systolic: 63.4%, diastolic: 47.0%), these effects became non-significant after demographic adjustment. Restricted cubic spline analysis revealed optimal ePWV thresholds below 8.0 m/s, with U-shaped blood pressure interactions showing maximum cognitive vulnerability at intermediate ranges (systolic: 110-140 mmHg, diastolic: 70-90 mmHg).</p><p><strong>Conclusion: </strong>ePWV independently predicts long-term cognitive decline in Chinese adults through mechanisms beyond blood pressure elevation alone. The U-shaped interactions between ePWV and blood pressure reveal maximum cognitive vulnerability at intermediate blood pressure ranges (110-140/70-90 mmHg), suggesting that cognitive risk assessment should integrate ePWV measures alongside blood pressure control, with optimal targets potentially individualised based on arterial compliance status.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172349","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":"Improving access to physical healthcare for older people in mental health settings: the ImPreSs-care qualitative study.","authors":"Lucy Beishon, Bethan Hickey, Bhavisha Desai, Damodar Chari, Firoza Davies, Rachel Evley, Hari Subramaniam, Elizabeta Mukaetova-Ladinska, Gregory Maniatopoulos, Tomas J Welsh, Elizabeth L Sampson, Nilesh Sanganee, Peter Neville, Cheryl Clegg, Anthony Donovan, Tom Dening, Anto P Rajkumar, Thompson Robinson, Carolyn Tarrant","doi":"10.1093/ageing/afaf261","DOIUrl":"10.1093/ageing/afaf261","url":null,"abstract":"<p><strong>Background: </strong>Older people with serious mental ill health have high levels of physical comorbidity. Despite this, mental health services receive limited physical health support from primary or secondary care. This study investigated the facilitators and barriers to delivering physical healthcare for older people in mental health settings.</p><p><strong>Methods: </strong>In total, 54 semi-structured interviews (REC:22/IEC08/0022) were conducted with different stakeholders [staff (n = 28), patients (n = 7), carers (n = 19)] across two mental health hospitals. Interviews explored the facilitators and barriers to delivering physical healthcare for older people (>65 years) receiving secondary mental healthcare (dementia and psychiatric disorders). Data were analysed thematically, underpinned by a framework of integrated care for individuals living with multimorbidity.</p><p><strong>Results: </strong>A 'multidisciplinary approach' was valued, particularly to identify patients for targeted physical health support. There was felt to be a loss of physical health 'training and skills' over time, particularly amongst nursing and medical staff. Admissions to the acute hospital were potentially avoidable through improved 'support and availability of physical health expertise', to provide more proactive than reactive care. Alongside improved training and support, managing advanced care planning, end of life care and polypharmacy were perceived to facilitate improved physical healthcare in mental health settings.</p><p><strong>Conclusions: </strong>Lack of senior physical health leadership (e.g. geriatrician or general practitioner) and loss of skills and confidence in managing physical health in mental health settings have led to a low threshold for admissions to the acute hospital. In particular, services should support advanced care planning and end of life care from physical causes in mental health settings.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129823","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":"Brain-computer-interface-based intervention increases brain functional segregation in cognitively normal older adults.","authors":"Xing Qian, Kwun Kei Ng, Si Ning Yeo, Yng Miin Loke, Yin Bun Cheung, Lei Feng, Mei Sian Chong, Tze Pin Ng, K Ranga Rama Krishnan, Cuntai Guan, Tih-Shih Lee, Juan Helen Zhou","doi":"10.1093/ageing/afaf250","DOIUrl":"10.1093/ageing/afaf250","url":null,"abstract":"<p><p>Brain-computer interface (BCI)-based cognitive training systems have shown promise in enhancing cognitive performance in cognitively normal older adults. However, the brain network changes underlying these behavioural improvements remain poorly understood. To address this gap, we investigated topological alterations in intrinsic brain functional networks following BCI-based training and their behavioural relevance in cognitively normal older adults using resting-state functional magnetic resonance imaging and graph theoretical analysis. Compared to a non-intervention waitlist (WL) group, the intervention (INT) group did not show significant behavioural improvements. However, they exhibited positive changes in brain network organisation. Specifically, the INT group demonstrated a reduced nodal participation coefficient, indicating enhanced strength of a node's connections within its community, primarily within control and subcortical networks, as well as increased system segregation after training. Additionally, the modular organisation of the brain functional network in the INT group became more segregated and more aligned with a young adult-based partition template (quantified using the adjusted Rand index) compared to the WL group. Importantly, decreased participation coefficients, particularly in subcortical regions, were associated with language improvement, while increases in the adjusted Rand index were linked to enhancements in everyday memory function. These findings suggest that BCI-based cognitive training may contribute to maintaining brain network organisation in cognitively normal ageing by enhancing functional network segregation, potentially supporting cognitive performance. This study provides insights into the neural mechanisms underlying the effectiveness of BCI-based cognitive training for cognitively normal ageing.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084754","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 of latent tuberculosis infection in older adults: a systematic review and meta-analysis.","authors":"Yuxiao Ling, Min Wang, Songhua Chen, Qian Wu, Yu Zhang, Kui Liu, Ke Yang, Luyu Wang, Wei Wang, Bin Chen, Jianmin Jiang","doi":"10.1093/ageing/afaf268","DOIUrl":"10.1093/ageing/afaf268","url":null,"abstract":"<p><strong>Background: </strong>The burden of tuberculosis (TB) is increasingly borne by older adults. Several studies have investigated the prevalence of latent tuberculosis infection (LTBI) in special populations. However, the global estimates of the prevalence of LTBI in older adults are unclear. This study aimed to assess the prevalence of LTBI amongst older adults.</p><p><strong>Methods: </strong>We conducted a systematic search of PubMed, Web of Science, Scopus and Embase databases. A systematic review and meta-analysis of relevant research articles published between 1 January 2000 and 28 February 2025 was performed. The I2 and Cochran's Q statistical tests were used to assess heterogeneity. Funnel plots and Egger's test were used to examine publication bias. Meta-regression and subgroup analyses were performed to assess the sources of heterogeneity.</p><p><strong>Results: </strong>A total of 20 studies were finally included in this study after screening the articles. The overall pooled prevalence of LTBI in older adults was 31.1% [95% confidence intervals (CIs): 22.8%-39.3%]. Subgroup meta-analyses revealed significant differences in the prevalence of LTBI between countries when categorised by WHO regions and WHO TB incidence intervals. Besides, the prevalence of LTBI was 30.9% (95% CI: 23.9%-37.9%) and 33.4% (95% CI: 25.9%-40.8%) based on studies that utilized interferon-gamma release assay and tuberculin skin test, respectively.</p><p><strong>Conclusions: </strong>The prevalence of LTBI is relatively high amongst older adults, emphasising the high burden of undetected infection in this population. Future research integrating cost-effectiveness analyses and intervention studies is needed to further explore the feasibility of population-based screening and prevention strategies to promote TB prevention and control.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of retinal vessel calibre, white matter hyperintensities and cognitive decline in community-dwelling older adults.","authors":"Catherine Robb, Amy Brodtmann, Robyn L Woods, Ruth E Trevaks, Stephanie A Ward, Meng Law, Suzanne G Orchard, Anne M Murray, Rory Wolfe, Joanne Ryan, Nigel P Stocks, Noni Rupasinghe, Raj C Shah, Christopher M Reid, Walter P Abhayaratna, Gary F Egan, Mohamed Salah Khlif, Trevor T J Chong, Liubov Robman, John J McNeil","doi":"10.1093/ageing/afaf243","DOIUrl":"10.1093/ageing/afaf243","url":null,"abstract":"<p><strong>Background: </strong>Retinal vessel calibres (RVCs) are non-invasive markers of microvascular health and may serve as accessible indicators of cerebral small vessel disease (CSVD) and future cognitive impairment. This study examines whether RVCs are associated with cognitive decline, and how these associations compare with those observed for white matter hyperintensities (WMH), a known marker of CSVD.</p><p><strong>Methods: </strong>Data were analysed from community-dwelling participants aged 70+ in the ASPREE trial and sub-studies, free of dementia and cardiovascular disease at baseline. RVCs were measured from fundus photography and WMH volumes from 3 T magnetic resonance imaging. Covariate-adjusted linear mixed-effects models assessed cognitive trajectories relative to baseline RVCs and WMH volumes. Cross-sectional associations between baseline RVCs and WMHs were examined via linear regression.</p><p><strong>Results: </strong>This study included 3540 participants with RVC data and 489 with WMH data (median [IQR] age: 73.2 [71.4-76.3] and 72.5 [71.2-75.4] years; female: 52.9% and 47.6%) over a median follow-up of 7.4 [IQR 5.5-8.5] and 3.8 [IQR 2.9-5.3] years, respectively. Baseline RVCs were not significantly associated with cognitive trajectories nor with baseline WMHs. Larger baseline WMH volumes were associated with greater global (Modified Mini-Mental State Examination) decline (mean 0.40 points/year; 95% CI 0.57, 0.22) and declines in delayed memory (HVLT-r) (-0.13 [-0.22, -0.04]), psychomotor function (Symbol Digit Modalities Test) (-0.29 [-0.52, -0.07]) and to a lesser extent, executive function (Controlled Oral Word Association Test) (-0.09 [95% CI -0.22, 0.03]).</p><p><strong>Conclusion: </strong>In contrast to WMH volumes, RVCs were not associated with cognitive decline. Exploring longitudinal changes in a broader range of retinal and brain biomarkers may provide deeper insights into the relationship between ocular and cerebral biomarkers in CSVD and clinical outcomes.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084709","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":"Autonomic function parameters are associated to incident limitations in advanced activities of daily living after 2 years follow-up in adults aged 80 and over.","authors":"Jordy Saren, Veerle Knoop, Axelle Costenoble, Sofie Vermeiren, Roberta Vella Azzopardi, Siddhartha Lieten, Ellen Gorus, Patricia De Vriendt, Aziz Debain, Ivan Bautmans","doi":"10.1093/ageing/afaf259","DOIUrl":"https://doi.org/10.1093/ageing/afaf259","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic orthostatic hypotension and blood pressure variability (BPV) may be considered as additional clinical parameters to evaluate preventive interventions. This is particularly relevant if these parameters predict difficulties in performing activities of daily living (ADL).</p><p><strong>Aim: </strong>To explore the predictive value of autonomic function parameters (AFPs) for incident limitations in ADL mediated by changes in locomotor function in relatively robust older adults over 2 years.</p><p><strong>Methods: </strong>This prospective longitudinal study included 267 participants (aged 83 ± 3 years) from the BUTTERFLY study. Data were collected at baseline and after 6, 12 and 24 months. Both direct and indirect associations of autonomic function with the onset of limitations in ADL after 2 years follow-up, mediated by changes in locomotor function, were assessed using PROCESS macro mediating logistic regression analysis.</p><p><strong>Results: </strong>High systolic supine-to-stand BPV was associated with increased limitations in advanced ADL (aADL) [unstandardised beta (B) = 0.160, P < .001] after a 2-year follow-up. Increased visit-to-visit systolic BPV indirectly predicted incident limitations of aADL, mediated by changes in gait speed during year 1 (B = 0.018, 95% CI: 0.001-0.054). No direct or indirect association between autonomic function and basic or instrumental ADL was observed.</p><p><strong>Conclusion: </strong>Our prospective study demonstrated that various AFPs predict incident limitations in aADL among adults aged 80+ after a 2-year follow-up period. These results are important because aADL represent a complex level of ADL that often deteriorates first. Therefore, monitoring BPV in clinical settings becomes crucial because it potentially affects long-term independence.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136303","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":"Global prevalence of anorexia and appetite loss among older adults: a systematic review and meta-analysis.","authors":"Wenjie Li, Yuanyuan Ni, Hongxiu Chen, Meihong Shi, Wanlin Zhu, Shuang Li, Yan Zheng, Yuan Yuan, Qian Zhang, Xueqin Xia","doi":"10.1093/ageing/afaf249","DOIUrl":"10.1093/ageing/afaf249","url":null,"abstract":"<p><strong>Background: </strong>Anorexia/appetite loss is common among older adults and may arise from underlying diseases, adverse drug effects or the physiological ageing process. This study aims to estimate the prevalence of anorexia/appetite loss in older adults with associated factors.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>A comprehensive literature search of five electronic databases was conducted on 10 November 2024. Studies were eligible if they reported the prevalence of anorexia/appetite loss in older adults using the Simplified Nutritional Appetite Questionnaire. A random-effects model was applied to calculate the overall prevalence of anorexia/appetite loss. Predefined subgroup analyses were conducted to estimate the prevalence of anorexia/appetite loss among older adults with varying characteristics.</p><p><strong>Results: </strong>Sixty-two studies from 24 countries (n = 80 176 participants) were included. The pooled prevalence of anorexia/appetite loss was 29% (95% CI: 26%-34%). The pooled prevalence of anorexia/appetite loss varied geographically, ranging from 22% (95% CI: 17%-27%) in South America to 55% (95% CI: 51%-59%) in Africa. By setting, anorexia/appetite loss prevalence was 25% (95% CI: 21%-30%; n = 56 172) in communities, 38% (95% CI: 28%-50%; n = 471) in nursing homes and 42% (95% CI: 32%-52%; n = 2498) in hospitals. Subgroup analyses showed that female sex, lower educational level, eating alone, oral problems and depression were associated with higher rates of anorexia/appetite loss.</p><p><strong>Conclusions: </strong>The high prevalence of anorexia/appetite loss warrants attention. Further studies should explore a broader array of sociodemographic and biopsychosocial factors to enhance understanding of anorexia/appetite loss and guide targeted interventions.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 9","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084768","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":"Blood pressure and all-cause mortality in dementia: a nationwide cohort study","authors":"Jung Eun Yoo, Kyungdo Han, Jin-Hyung Jung, Kye-Yeung Park, Chung-Woo Lee, Dong Wook Shin, Ga Eun Nam","doi":"10.1093/ageing/afaf239","DOIUrl":"https://doi.org/10.1093/ageing/afaf239","url":null,"abstract":"Background Comorbidities are crucial in managing hypertension, but studies on individuals with dementia are lack. This study investigated the association between blood pressure (BP) and all-cause mortality in dementia. Methods We analysed 146 832 individuals newly diagnosed with dementia (2008–2016) who underwent national health screening within 4 years after their dementia diagnosis. Dementia was defined using prescriptions for anti-dementia medications and relevant ICD-10 codes. Participants were categorised by systolic BP (SBP) and diastolic BP (DBP). All-cause mortality was assessed using multivariable Cox proportional hazards regression. Results The cohort’s mean age was 75.1 years, with 35.5% men. Over a mean follow-up of 3.7 years, there were 52,118 deaths (35.5%). A reverse J-shaped association was observed between SBP and mortality, with nadir at SBP 138 mmHg on cubic spline curve (P for trend &amp;lt;.001). Compared to SBP 120–129 mmHg, mortality increased for SBP &amp;lt;100 mmHg [adjusted hazard ratio (aHR) 1.17, 95% confidence interval (CI) 1.11–1.24] and SBP ≥160 mmHg (aHR 1.08, 95% CI 1.04–1.13). Mortality increased linearly with higher DBP (P for trend .001), with DBP ≥90 mmHg associated with higher risk (aHR 1.10, 95% CI 1.05–1.16 for DBP ≥100 mmHg) relative to DBP 70–79 mmHg. These associations were maintained in dementia subtypes and after stratification, with a greater strength observed for older people and antihypertensive drugs use. Conclusions Individuals with dementia were revealed to have a reverse J-shaped association between SBP and all-cause mortality. The risk significantly increased with higher DBP, starting from ≥90 mmHg.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"15 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906124","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}