Age and ageing最新文献

{"title":"Bleeding risk scores in atrial fibrillation-how should they influence decision-making for anticoagulants?","authors":"Anneka Mitchell, Anita McGrogan","doi":"10.1093/ageing/afaf158","DOIUrl":"https://doi.org/10.1093/ageing/afaf158","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265048","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":"Using scores from the 4AT delirium detection tool as an indicator of possible dementia: a study of 75 221 older adult hospital admissions.","authors":"Rose S Penfold, Emily Bowman, Emma R L C Vardy, Elizabeth L Sampson, Atul Anand, Bruce Guthrie, Alasdair M J MacLullich","doi":"10.1093/ageing/afaf144","DOIUrl":"10.1093/ageing/afaf144","url":null,"abstract":"<p><strong>Introduction: </strong>Overall dementia diagnosis rates are substantially below true rates. Hospital admissions of older people involve cognitive and functional assessments relevant to dementia diagnosis. These assessments could be harnessed to contribute to identifying patients for further assessment. Yet relationships of inpatient cognitive tests with known dementia are unclear. The 4AT (www.the4AT.com) assesses for delirium (Scores 4-12) and also cognitive impairment via embedded cognitive tests (Scores 1-3). We investigated relationships between 4AT scores and clinical dementia diagnoses.</p><p><strong>Methods: </strong>We included participants aged ≥65 years admitted as a medical emergency to three hospitals from 4 January 2016 to 4 January 2020, who had the 4AT performed on admission. Clinical dementia diagnosis was ascertained from linked primary care, hospital discharge and community prescribing data.</p><p><strong>Results: </strong>Of 75 221 admissions, 62 188 (82.7%; 33 625 unique patients; mean age 80.2 years; 55.8% female) had a 4AT on admission. Of these, 9948 (16.0%) had a recorded clinical dementia diagnosis at the time of admission, with a further 1197 (1.9%) receiving a new diagnosis at discharge. Of admissions with dementia, 9669/11 145 (86.8%) had a 4AT score ≥1 on admission, compared to 14 994/51 043 (29.4%) without dementia.4AT ≥1 had a sensitivity of 0.87 (95% CI 0.86-0.87) and a specificity of 0.71 (0.70-0.71) in relation to clinical dementia diagnosis. 4AT ≥4 showed sensitivity of 0.50 (0.50-0.51) and a specificity of 0.88 (0.88-0.88).</p><p><strong>Conclusions: </strong>4AT scores were associated with clinically diagnosed dementia. These results suggest that routinely collected 4AT scores could be leveraged in conjunction with other clinical indicators to identify patients with possible undiagnosed dementia who could undergo further inpatient diagnostic assessment and/or post-discharge specialist follow-up.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301016","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":"Correction to: Risk of adverse outcomes associated with mirtazapine compared to sertraline use among older people living in long-term care facilities.","authors":"","doi":"10.1093/ageing/afaf178","DOIUrl":"10.1093/ageing/afaf178","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281989","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":"Correction to: Does concern about falling predict future falls in older adults? A systematic review and meta-analysis.","authors":"","doi":"10.1093/ageing/afaf183","DOIUrl":"10.1093/ageing/afaf183","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144324178","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":"End-of-life dementia care: a qualitative study of the experiences and perceptions of minority ethnic and economically disadvantaged groups.","authors":"Louise Tomkow, Marie Poole, Efioanwan Damisa, Barbara Hanratty, Faith Tissa, Malcolm Ngouala, Josie Dixon, Maria Karagiannidou, Margaret Ogden, Felicity Dewhurst","doi":"10.1093/ageing/afaf168","DOIUrl":"10.1093/ageing/afaf168","url":null,"abstract":"<p><strong>Background: </strong>Dementia is a leading cause of morbidity and mortality amongst ageing populations. However, palliative care is often poor or non-existent. People from minority ethnic and economically disadvantaged communities are especially likely to miss out. Research exploring how inclusive end-of-life (EOL) care should be provided for people living with dementia (PLWD) is limited and commonly fails to include sufficient representation of people from minority ethnic groups and those living in poverty.</p><p><strong>Aims: </strong>Our aim was to understand the experiences and perceptions of EOL dementia care amongst underserved groups and investigate how ethnicity and socioeconomic status influence experiences and perceptions of EOL dementia care.</p><p><strong>Methods: </strong>Ten workshops were held with a total of 29 Experts-by-Experience (EbE). All had professional and/or personal experience of care for people from disadvantaged groups living with dementia in England. The groups explored (i) current evidence gaps, (ii) barriers and facilitators to EOL care for PLWD across different ethnic and socioeconomic groups and (iii) recommendations for care and future research. The discussions were recorded, transcribed and the qualitative data analysed thematically.</p><p><strong>Results: </strong>Data point to cultural, socioeconomic and systemic barriers to accessing quality EOL care for PLWD. EbE described how there is fear and stigma of talking about dementia and EOL care, and a mistrust of health and care services. Financial concerns were pervasive throughout the data and were described by EbE as significant drivers of inequalities in access to quality care.</p><p><strong>Conclusion: </strong>EbE from minority ethnic and socioeconomically disadvantaged groups report poor experiences of EOL dementia care. Our data suggests there is a need to improve multiple aspects of care, including access and coordination. Future research should work with underserved communities to co-produce culturally sensitive interventions to address inequalities in dementia EOL care.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473789","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":"Improving the safety and experience of transitions from hospital to home: a cluster randomised controlled trial of an intervention to involve older people in their care (Your Care Needs You)","authors":"Jenni Murray, Kalpita Baird, Stephen Brealey, Laura Mandefield, Gerry Richardson, Jane O'Hara, Robbie Foy, Laura Sheard, Alison Cracknell, Alfredo Palacios, Simon Walker, Ed Breckin, Lubena Mirza, Ruth Baxter, Catherine Hewitt, Rebecca Lawton","doi":"10.1093/ageing/afaf142","DOIUrl":"https://doi.org/10.1093/ageing/afaf142","url":null,"abstract":"Background Transitions from hospital to home are risky for older people. The role of patient involvement in supporting safe transitions is unclear. Objective To assess the clinical effectiveness of an intervention to improve the safety and experience of care transitions for older people. Trial design Cluster randomised controlled trial. Participants Eleven National Health Service acute hospital trusts and 42 wards (clusters) routinely providing care for older people (aged 75 years and older) planning to transition back home. Intervention Patient involvement ward-level intervention—Your Care Needs You (YCNY). Outcomes Unplanned hospital readmission rates within 30 days of discharge (primary outcome). Secondary outcomes included readmissions at 60 and 90 days post-discharge, experience of transitions and safety events. Randomisation Ward as the unit of randomisation from varying medical specialities randomised to YCNY or care-as-usual on a 1:1 basis. Blinding Ward staff, research nurses and researchers were unblinded. Patients were unaware of treatment allocation. Statisticians were blinded to the primary outcome data until statistical analysis plan sign-off. Results Using a mixed effects logistic regression we saw no significant difference in unplanned 30-day readmission rates (OR 0.93; 95% CI, 0.78 to 1.10; P = .372) between intervention (17%) and control (19%). At all timepoints, rates were lower in the intervention group. The total number of readmissions was lower in the intervention group (all timepoints) reaching statistical significance across 90-days with 13% fewer readmissions (IRR: 0.87; 95% CI 0.76 to 0.99) than the control. At 30-days only, intervention group patients reported better experiences of transitions and significantly fewer safety events. Serious adverse events were similarly observed in both groups [YCNY: 26 (52.0%), Care-as-usual: 24 (48.0%)]. None related to treatment. Conclusions YCNY did not significantly impact on unplanned hospital readmissions at 30 days but in some secondary outcomes we did find evidence of clinical benefit.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"14 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176568","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":"Body mass index changes and trajectories from midlife to late-life: association with subjective cognitive complaints in a 30-year Women’s cohort study","authors":"Ho Kyung Sung, Fen Wu, Yelena Afanasyeva, Karen L Koenig, Tess V Clendenen, Anne Zeleniuch-Jacquotte, Yu Chen","doi":"10.1093/ageing/afaf130","DOIUrl":"https://doi.org/10.1093/ageing/afaf130","url":null,"abstract":"Background The relationship between body mass index (BMI) changes across the lifespan and cognitive health in later life remains unclear. This study evaluated the association between BMI changes from midlife to late-life and subsequent subjective cognitive complaints (SCCs) in women. Methods We analysed data from 5160 women in the New York University Women’s Health Study, a prospective cohort with over 30 years of follow-up. BMI was calculated using self-reported height and weight at baseline and follow-up. SCCs were assessed using a validated questionnaire in 2018–2020. Odds ratios (ORs) for reporting ≥2 SCCs were estimated using unconditional logistic regression. Results BMI at specific life stages was not significantly associated with SCC risk. BMI changes from midlife to late-life were associated with SCC risk. Compared to women with stable BMI (≤5% change), moderate BMI loss (5.1–10% decrease) was associated with higher odds of ≥2 SCCs (OR: 1.23, 95% CI: 1.02–1.48), large BMI gain (&amp;gt;10% increase) was associated with lower odds of ≥2 SCCs (OR: 0.81, 95% CI: 0.67–0.97). These findings were consistent across sensitivity analyses, including varying age cut-offs and excluding BMI changes occurring 5–10 years before late-life. Conclusions Our findings emphasize the importance of considering lifelong weight changes in assessing cognitive health risks. In particular, significant weight loss from midlife to late-life may serve as a potential indicator of cognitive decline in older adults. Further research is needed to elucidate the underlying mechanisms of this association and to explore effective interventions for mitigating cognitive health risks.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"23 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136782","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":"Antihypertensive drug classes and risk of incident dementia: a multinational population-based cohort study","authors":"Edmund C L Cheung, Matthew Adesuyan, Máté Szilcz, Lisa M Kalisch Ellett, Sonia Shah, Yogini H Jani, Sara Hägg, Nicole Pratt, Kui Kai Lau, Hao Luo, Eric Yuk Fai Wan, Esther Wai Yin Chan, Ian C K Wong, Jacqueline K Yuen, Kai-Hang Yiu, Robert Howard, Ruth Brauer, Celine S L Chui","doi":"10.1093/ageing/afaf121","DOIUrl":"https://doi.org/10.1093/ageing/afaf121","url":null,"abstract":"Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) are first-line antihypertensive drugs for many patients, and influencing angiotensin systems may play a role in dementia risk. This study aimed to investigate whether exposure to different antihypertensive drug classes compared with ACEI affects the risk of dementia and pathological dementia subtypes in a large multinational database study. Methods This was a multinational population-based cohort study using electronic health databases in Hong Kong, the UK, Sweden and Australia. A common protocol was used to harmonise the study design. An active comparator, a new user design, was applied to compare the risk of all-cause dementia between different antihypertensive drug classes, with secondary outcomes of Alzheimer’s disease (AD) and vascular dementia (VaD). Adjusted Cox proportional hazards models with inverse probability of treatment weighting were used to generate results in each study site and were pooled in meta-analysis. Results One million nine hundred twenty-five thousand, five hundred sixty-three individuals were included across the four databases with a median follow-up ranging from 5.6 to 8.4 years. Compared to ACEI, initiation with ARB was associated with a reduced risk of incident all-cause dementia [hazard ratio (HR): 0.92, 95% confidence interval (CI): 0.89–0.94] and VaD (HR 0.87, 95% CI 0.78–0.96) but not AD. Conclusions This is the largest multinational cohort study conducted to date investigating different classes of antihypertensive drugs and the risk of incident dementia. When initiating antihypertensives, physicians and patients should consider the reduced risk of all-cause dementia and VaD with ARB compared with ACEI in their risk–benefit assessment.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"16 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136780","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":"Normative data for age-specific skeletal muscle area based on computed tomography in Korean population","authors":"Junghwa Shin, Young-Sang Kim, Bom Taeck Kim, Chang-Won Jeong, Chaeyoung Lee, Seoung-Oh Yang","doi":"10.1093/ageing/afaf128","DOIUrl":"https://doi.org/10.1093/ageing/afaf128","url":null,"abstract":"Background Sarcopenia, a progressive loss of muscle mass and function, increases health risks in older adults, especially in rapidly ageing populations like Korea. Computed tomography (CT) imaging at the third lumbar vertebra (L3) level is a gold standard for assessing skeletal muscle area (SMA) and indices (SMIs), yet age- and sex-specific reference values are limited. This multicentre study aimed to establish these values for improved sarcopenia diagnosis. Methods We conducted a retrospective study with 2637 healthy Korean adults (1366 men, 1271 women) aged 20 and older, using abdominal CT scans from routine health check-ups at four centres. SMA and SMIs were measured at L3, and T-scores were calculated by comparing participants’ values with a healthy young reference group (ages 20–39). Sarcopenia was classified into Classes I and II using standardised cutoffs. Results An age-related SMA decline was observed in both sexes, with a more significant reduction in men. Sarcopenia prevalence was higher in men based on the SMA index, while SMA/body mass index (BMI) was more sensitive in women. Class I sarcopenia ranged from 10.1% to 21.3% in men and 10.6% to 23.6% in women, with Class II prevalence between 1.0% and 5.5% in men and 1.3% and 8.3% in women. Conclusion This study establishes CT-based reference values for SMA and SMIs, supporting early sarcopenia detection, with the SMA/BMI index proving valuable for both men and women.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"9 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113911","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":"Internet access and use for health information and its association with health outcomes in older adults in 30 countries","authors":"Hsin-Yen Yen, Hao-Yun Huang","doi":"10.1093/ageing/afaf131","DOIUrl":"https://doi.org/10.1093/ageing/afaf131","url":null,"abstract":"Background Older adults, as a vulnerable population, typically show lower engagement with eHealth technologies. Limited internet access and low use for health information may contribute to poorer health outcomes. Objectives The purposes of this study were to examine differences in socio-demographics and compare healthy lifestyles, health statuses and attitudes toward online health information among different groups of internet access and use for health information. Design This cross-sectional study utilised secondary data from the International Social Survey Programme. Methods A structured questionnaire was used for data collection from May 2023 to April 2024. Respondents were divided into three groups: 22.02% in a No-Access group (no internet access), 28.75% in a Non-User group (have access but do not use it for health information), and 49.22% in a User group (have access and use it for health information). In total, 14 008 respondents aged over 60 years from 30 countries were selected. Results Groups were significantly associated with most sociodemographic factors, with the educational level showing the strongest effect size in both access/no-access and users/non-users comparisons. Older adults in the No-Access group had lower frequencies of healthy lifestyles and worse health statuses, while those in the User group had higher frequencies of healthy lifestyles, better health statuses, and positive attitudes toward online health information. Conclusions Promoting a digitally inclusive environment is essential for enhancing internet access and use among older adults to support healthier lifestyles and improved health statuses.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"32 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113941","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}