Age and ageing最新文献

{"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}

{"title":"Hospital admissions due to adverse drug reactions and adverse drug events in older adults: a systematic review","authors":"Nicole Cosgrave, Juliane Frydenlund, Francis Beirne, Stuart Lee, Iman Faez, Caitriona Cahir, David Williams","doi":"10.1093/ageing/afaf231","DOIUrl":"https://doi.org/10.1093/ageing/afaf231","url":null,"abstract":"Background Adverse drug reactions (ADRs) and adverse drug events (ADEs) are consistently reported to cause up to 30% of hospital admissions in older adults, resulting in significant morbidity, mortality and an added health economic burden. This systematic review aimed to establish the frequency of ADRs and ADEs as a cause of hospitalisation in older adults. Methods Standard databases and citations were searched from 2015 to 2025. Studies specifically assessing ADR and ADE prevalence and risk factors in older adults were included. The review was registered in PROSPERO (CRD42024613426) and quality was assessed using the Joanna Briggs Institute criteria with bias determined via ROBINS-E. Results Nine studies underwent full evaluation. The reported prevalence of ADRs ranged from 3.3% to 23.1% and ADEs ranged from 11.75% to 18% as causes of hospitalisation. The median age of those included, in the respective studies, was between 77 and 86 years. Falls (19.4%–20.9%), delirium (7.3%–12.9%) and bleeding (8%–30.2%) were the most frequently encountered ADR/ADEs causing hospitalisation. Anti-thrombotics (11.5%–30.2%) diuretics (14.7%–30.2%) and renin-angiotensin-aldosterone system (RAAS) inhibitors (7.5%–8.9%) accounted for the highest proportion of ADR/ADE causative agents. Conclusion This review has limitations stemming from the heterogeneity of the included studies and the exclusion of the grey literature. However, ADRs and ADEs remain a significant cause of hospital admissions in older patients. The possible preventability of these and their possible hospital admission avoidance highlights the critical need for further research into ADR/ADE risk prediction methods in addition to co-morbidity and medication optimisation for older adults.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"22 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899399","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":"Initiation of anti-osteoporosis medication following hip fracture in older adults: a systematic review and thematic synthesis of qualitative studies from patient and healthcare professional perspectives","authors":"Sabine de Jong-Holthuijsen, Willeke M Ravensbergen, Wilco P Achterberg, Natasha M Appelman-Dijkstra, Jacobijn Gussekloo, Rosalinde K E Poortvliet","doi":"10.1093/ageing/afaf237","DOIUrl":"https://doi.org/10.1093/ageing/afaf237","url":null,"abstract":"Background Pharmacological osteoporosis treatment is recommended for secondary fracture prevention in older patients following a hip fracture. However, not all eligible patients receive anti-osteoporosis medication (AOMs). Understanding the decision-making process regarding treatment initiation at patient level may help explain low prescription rates and offer novel solutions beyond organisational initiatives. Objective This systematic review aimed to synthesise data from qualitative studies on the initiation of AOMs after a hip fracture in old age, to (i) explore the experiences and preferences of patients and healthcare professionals in the decision-making process, and (ii) clarify if this explains low prescription rates. Methods A systematic search in seven medical databases identified qualitative publications on the initiation of AOMs in older hip fracture patients. Thematic synthesis was applied, with the CASP checklist and GRADE-CERQual approach enhancing review’s rigour. Results Twenty studies were included, revealing two main themes with eight subthemes. The ‘addressing’ step illustrates that addressing osteoporosis treatment is not self-evident and depends on specialty-specific responsibilities, knowledge and capability, commitment to identifying eligible patients, and the perceived importance and feasibility of treatment. The ‘discussing’ step highlights the need for patient education, patient perceptiveness, making sense, a patient-centred approach, and patient choice, indicating that discussing treatment is not a clear-cut path. Conclusions AOM initiation after hip fracture in old age is shaped by a two-step decision-making process of (i) addressing treatment and (ii) discussing treatment—which may partly explain low prescription rates. Beyond organisational strategies, promoting education and awareness may strengthen professional initiative and patient engagement.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"9 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899443","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":"Identifying predictors of medication-related harm in older populations: a latent class analysis approach","authors":"Ross Brannigan, Juliane Frydenlund, David J Williams, Frank Moriarty, Emma Wallace, Ciara Kirke, Kathleen E Bennett, Caitriona Cahir","doi":"10.1093/ageing/afaf227","DOIUrl":"https://doi.org/10.1093/ageing/afaf227","url":null,"abstract":"Background The aim of this study was to apply latent class analysis to identify underlying groupings of predictors, including drug classes and clinical predictors, co-occurring in older people at higher risk of medication-related harm. Method The Adverse Drug reactions in an Ageing PopulaTion cohort was used (N = 798 patients aged ≥65 years admitted acutely to hospital). Seven drug classes; antithrombotic agents, diuretics, renin-angiotensin-aldosterone system, calcium channel blockers, beta-blocking agents, psychoanaleptics, non-steroidal anti-inflammatory drugs, and comorbidity, frailty and significant polypharmacy (10+ different drug classes) were included as potential predictors of medication-related harm. Medication-related harm outcomes included adverse drug reactions (ADR)-related hospital admissions, health-related quality of life, functional impairment and emergency department visits. Determination of the best number of latent classes was based on standard comparison of fit statistics. Univariate and multivariable logistic, linear and Poisson regression models were used to examine the associations between the latent groups and the medication-related harm outcomes. Results A five class model was determined to fit best; (i) high-risk prescribing and polypharmacy group (N = 245); (ii) low-risk group (n = 138); (iii) high-risk prescribing only group (N = 332); (iv) antihypertensive group (N = 18); and (v) psychoanaleptics and polypharmacy group (N = 65). Patients in both the high-risk prescribing and polypharmacy group (a.OR = 2.59, 95%CI = 1.51–4.44) and the high-risk prescribing only group (a.OR = 2.85, 95%CI = 1.57–5.20) were more likely to have an ADR-related hospital admission, with the high-risk prescribing and polypharmacy group also having statistically significant higher functional impairment (β = 1.21, 95% CI = 0.09, 2.33) compared to those in the low-risk group. Conclusion Identifying distinct subgroups of older people based on their medications may lead to more targeted and tailored interventions to reduce potential medication-related harm.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"8 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899610","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":"Re-evaluating sleep difficulty as a risk factor for dementia in the UK Biobank cohort: addressing survival bias using a semi-competing risks approach","authors":"Tao Sun, Xinyu Jiang, Xiaojun Wang","doi":"10.1093/ageing/afaf235","DOIUrl":"https://doi.org/10.1093/ageing/afaf235","url":null,"abstract":"Introduction Sleep difficulty, a prevalent sleep disturbance in ageing populations, has shown paradoxical associations with dementia risk in prior epidemiological studies. Emerging evidence suggests that survival bias—where premature mortality in individuals with sleep difficulty obscures dementia risk—may explain these inconsistencies. Methods We analysed data from 457,367 UK Biobank participants aged 40–69 years who were enrolled at baseline between 2006 and 2010 and followed until 2022. Sleep difficulty was assessed via self-reported questionnaires, and dementia was obtained from electronic health records. To address survival bias, we employed a semi-competing risks framework that jointly models dementia incidence and mortality, contrasting results with conventional Cox proportional hazard models. Results Semi-competing risk analyses suggested that usual sleep difficulty modestly increased risks of vascular dementia (fully adjusted HR 1.14, 95% CI 1.02–1.28) and slightly increased all-cause dementia (HR 1.03, 95% CI 0.98–1.08) in the total sample. The association is particularly strong in younger adults (below 55 years old) and low APOE risk (APOE ε4 non-carriers) when adjusted for age, sex and education. Conversely, Cox models suggested a protective association between usual sleep difficulty and all-cause dementia in the total sample, aligning with prior UK Biobank studies. This discrepancy highlights how survival bias distorts risk estimates. Discussion Our findings resolve conflicting evidence by demonstrating sleep difficulty’s direct dementia risk when accounting for competing mortality. The semi-competing risks approach provides a robust framework for ageing research, when survival bias is present. Clinically, these results underscore sleep difficulty management as a modifiable dementia prevention target in mid-to-late life.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"1 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144901849","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":"A post-market, cluster randomised controlled trial of the effect of the TENA SmartCare Change Indicator on continence care efficiency and skin health in nursing homes","authors":"Adrian Wagg, Fredrik Agholme, Hardy Schwiegel, Nicole Huige, Daniela Hayder-Beichel","doi":"10.1093/ageing/afaf236","DOIUrl":"https://doi.org/10.1093/ageing/afaf236","url":null,"abstract":"Background Urinary Incontinence (UI) is highly prevalent in older residents of nursing homes. For many, management consists of using appropriate products (pads) maintained by a check and change regimen; this is often poorly managed. Digital health technology devices, like urine saturation sensors, may aid ensure timely change of pads. This study examined the efficacy and safety of the use of the TENA SmartCare Change Indicator (Change Indicator) device for nursing home residents with UI. Methods Cluster randomised controlled trial of device use in older nursing home residents with UI, compared to usual care. Co-primary outcomes were a compound care efficiency score and change in skin health. Secondary resident and caregiver outcomes were also compared. Results Fourteen sites were recruited, nine of which operated routine check and change regimens. Included units comprised 108 residents, 53 in the intervention group and 49 in the usual care group and 83 caregivers (31 usual care, 52 intervention). The median age of residents was 87 (range 59–101) years; 21.5% were male. Care efficiency was improved by 30 min/day in the intervention group and 16 min/day in the usual care group (P &amp;gt; .05). There was no change in skin health. There were statistically significant improvements in sleep quality and a total of 24 hour absorbency of pads used, favouring device use. One device related harm was reported. Discussion This comparative trial of a device designed to improve the delivery of continence care to older residents of nursing homes resulted in reductions in time spent in continence care by 30 min/day, or a 31% reduction. Given that the study failed to demonstrate its primary outcome, it is difficult to assess the clinical relevance of device use. The reduction in pad use and in number of sleep interruptions are valuable outcomes. A longer-term implementation and efficacy study is warranted.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"15 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899491","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":"Longitudinal trajectories of polypharmacy in older people, and their association with the risk of mortality: a joint latent class model analysis of real-world data from the UK and the Netherlands","authors":"Leena Elhussein, Ross D Williams, Wai Yi Man, Edward Burn, Antonella Delmestri, Victoria Y Strauss, Daniel Prieto-Alhambra","doi":"10.1093/ageing/afaf233","DOIUrl":"https://doi.org/10.1093/ageing/afaf233","url":null,"abstract":"Objective Polypharmacy is the use of multiple drugs. Many definitions have been established for polypharmacy, often cross-sectionally, despite it naturally changing over time. In this study, we aimed to identify clusters of older people with distinct polypharmacy trajectories over time and associated mortality risks. We then characterised the identified clusters and assessed their generalisability in two external databases. Methods Data were extracted from three primary care databases: the UK Clinical Practice Research Datalink (CPRD) GOLD, CPRD Aurum and the Dutch Integrated Primary Care Information (IPCI). People aged ≥65 on 1 January 2015 were included. Polypharmacy, defined as the cumulative number of prescribed ingredients, was calculated at baseline and at the end of each subsequent follow-up year (2015–19). We applied joint latent class modelling, which divides the population into clusters with different trajectories and associated mortality risks. The model was trained in GOLD and validated in Aurum and IPCI. Results Four clusters were identified and characterised based on polypharmacy baseline and rate of progression: low-steady, intermediate-slow/increasing, intermediate-fast/increasing and high-decreasing. The high-decreasing cluster had the highest average baseline polypharmacy (intercept = 23.4) and prevalence of non-cancer chronic comorbidities, whilst the intermediate-fast/increasing had the steepest polypharmacy rate of progression per year (slope = 6.4), highest baseline and cumulative incidence of cancer, and worst survival outcome. Good validation was found in Aurum and IPCI. Conclusion High baseline levels and increasing levels of polypharmacy were associated with an increased mortality risk in older people. The clusters identified in this study were externally validated in two European databases, confirming their robustness and generalisability.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"114 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144899400","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 world falls guidelines: how is implementation progressing globally?","authors":"Lotta J Seppala, Stephen R Lord, Tahir Masud, Manuel Montero-Odasso, Jesper Ryg, Maw Pin Tan, Nathalie van der Velde","doi":"10.1093/ageing/afaf214","DOIUrl":"https://doi.org/10.1093/ageing/afaf214","url":null,"abstract":"The World guidelines for falls prevention and management for older adults (WFG), from 2022, represent a global initiative to address the rising incidence of falls and related injury. WFG provides evidence-based recommendations across various settings, including community, hospital, and care home environments. A recent report highlighted a large variation in the implementation progress of the WFG across Europe. However, to date, a comprehensive global overview of the WFG implementation status has not been undertaken. To address this gap, we reached out to experts who took part in WFG to inquire about the implementation status of WFG in their countries. The responses from experts from 18 countries (one from Africa, six from Asia, one from Europe, three from North America, one from Oceania and six from South America) revealed that efforts to implement the WFG are underway in many of them, with differing degrees of progress varying from advanced integration into guidelines/policies to no/minimal actions. While the global implementation status of WFG is encouraging, significant barriers remain, including limited resources, competing health priorities, and cultural differences in care models. Adapting the WFG to diverse healthcare systems and integrating falls prevention into national policies and health priorities is essential to enable effective implementation. Furthermore, strengthening global collaboration, sharing best practices, prioritisation of the most effective and feasible falls prevention components in low resource settings, and advocating for falls prevention as a public health priority will help accelerate progress across the world for the benefit of older patients at risk of falling.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"114 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825826","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":"Educated peers’ experiences and perceptions of the group-based FallFitness exercise programme for older adults","authors":"Maria Liljeroos, Karin Strömqvist Bååthe, Michail Tonkonogi, Marina Arkkukangas","doi":"10.1093/ageing/afaf218","DOIUrl":"https://doi.org/10.1093/ageing/afaf218","url":null,"abstract":"Introduction Despite evidence supporting the effectiveness of exercise-based fall prevention interventions, implementing these programmes in practice remains challenging. Peer-led exercise programmes have demonstrated effectiveness in delivering fall prevention education to older adults. Therefore, this study aimed to explore older adults’ experiences of being trained and serving as peer leaders in a group-based fall prevention exercise programme, focusing on the skills and qualities required for leadership. Additionally, the study sought to identify facilitators and barriers influencing training and the programme’s long-term implementation. Materials and methods Participants were recruited from a randomised controlled trial. Two focus group interviews were conducted with 13 participants from the exercise arm of the randomised controlled trial (nine females and four males). Data were analysed using inductive qualitative content analysis. Results Five main categories and nine subcategories emerged, capturing key aspects of the study aim. The categories were: (a) education to prepare fall fitness peer-led trainers; (b) peer-led trainer characteristics and roles during training sessions; (c) physical training environment; (d) psychosocial environment; and (e) prerequisites for the long-term sustainability of the FallFitness programme. Conclusions The ‘train-the-trainer’ approach for peer-led fall prevention interventions was found to be effective, highlighting the value of integrating theoretical and practical components in training. Participant feedback will inform future improvements to the FallFitness programme, ensuring its continued implementation and effectiveness.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"20 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144825480","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}