Age and ageing最新文献

{"title":"A decade of increasing complexity in patients sustaining a hip fracture in England, Wales and Northern Ireland: a national cohort study using the National Hip Fracture Database dataset.","authors":"Richard James Holleyman, Thomas Baldock, Andre Charlett, Paul Baker, Celia L Gregson, Andrew Judge, David John Deehan","doi":"10.1093/ageing/afag228","DOIUrl":"10.1093/ageing/afag228","url":null,"abstract":"<p><strong>Background: </strong>Hip fractures (HF) are a major cause of morbidity and mortality and account for substantial health and social care costs. We report the incidence and characteristics of older patients (≥60 years) presenting with hip fractures (HFs) in England, Wales and Northern Ireland.</p><p><strong>Methods: </strong>We conducted a national cohort study of HF events recorded in the National Hip Fracture Database (NHFD) between May 2011 and September 2023. HF incidence was derived using sex and age-banded mid-year population estimates from the Office for National Statistics to calculate at-risk population incidence for the whole cohort and by sex and age strata.</p><p><strong>Results: </strong>735 436 HF events were included (71% female, mean age 82.9 years). Annual NHFD HF numbers increased across the study period from 55 832 to 63 341 (13.5%). However, overall incidence declined from 422.8 to 412.8 per 100 000 population. Divergence was observed between sexes, with falling incidence in females but rising in males. HF patients are presenting with greater systemic disease burden, with the proportion graded American Society of Anaesthesiologists ≥3 increasing in both females (66.4% to 80.4%) and males (73.4% to 84.3%).</p><p><strong>Conclusion: </strong>Despite modest declines in overall incidence in women, absolute HF numbers continue to rise. The divergent sex-specific trends and substantial increase in patient comorbidity represent important shifts in HF epidemiology with implications for service capacity, risk stratification and secondary prevention strategies. This mandates urgent realignment of care resources to minimise the impact on patient mortality and economic health burden.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711020","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":"Determinants and mitigation strategies of vaccine hesitancy toward routine immunisations recommended for older adults: a systematic review.","authors":"Siwen Huang, Mengyue Zhang, Chi Ruan, Yudan Song, Xiaosong Hu, Na Liu, Jiakai Ye, Dingwan Chen, Yuhang Zhang, Jingtao Zhou, Qingyu Li, Linjie Wang, Xinyu Shi, Wenzhou Yu, Sitong Luo","doi":"10.1093/ageing/afag233","DOIUrl":"10.1093/ageing/afag233","url":null,"abstract":"<p><strong>Background: </strong>Vaccine hesitancy among older adults has increasingly raised public concern and warrants global actions in the post-COVID-19 era. This systematic review aimed to synthesise determinants of vaccine hesitancy and related mitigation strategies toward routine vaccinations recommended for older adults (influenza, pneumococcal and shingles vaccines), which is important for promoting healthy ageing and fighting against infectious diseases during both pandemic and non-pandemic periods.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic literature search was conducted between November 2024 and June 2025 across Web of Science, PubMed and MEDLINE. The data were analysed by narrative synthesis guided by two theoretical frameworks.</p><p><strong>Results: </strong>A total of 72 studies were included. Most of them were conducted in developed countries, with a surge since the COVID-19 pandemic. Determinants of vaccine hesitancy were summarised from 49 studies into 3 levels, 8 themes and 24 sub-themes: individual level (sociodemographics, personal perceptions, previous experiences), group and social level (interpersonal influence, community influence, media/cultural influence) and practical issues level (willingness to pay, convenience of access). The intervention strategies were categorised from 23 studies into five types, including dialogue-based intervention, reminder/recall-based intervention, incentive-based intervention, passive intervention and multi-component intervention. Notably, this review identified a lack of conceptual clarity in distinguishing vaccine hesitancy from actual vaccination behaviours and a shortage of comprehensive interventions tailored to older adults.</p><p><strong>Conclusion: </strong>Vaccine hesitancy toward routine immunisations among older adults is driven by multilayer determinants, underscoring the need for comprehensive, theory-informed and tailored interventions that address the diverse determinants.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719960","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":"Deprescribing antihypertensive drugs in patients aged over 80 years: an evidence-based way forward.","authors":"Denis O'Mahony","doi":"10.1093/ageing/afag249","DOIUrl":"https://doi.org/10.1093/ageing/afag249","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786964","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":"Preservation of functional capacity and lower-limb mechanical power during acute hospitalisation: effects of a low-cost multicomponent exercise programme in older adults-a randomised controlled trial.","authors":"Marcelo Bandeira-Guimarães, Eduarda Blanco-Rambo, Mikel Izquierdo, Nadyne Rubin, Antenor Barbosa Calandrini, Philipe de Souto Barreto, Renato G B de Mello, Martim Bottaro, Emilio H Moriguchi, Caroline Pietta-Dias, Mikel L Sáez de Asteasu, Eduardo Lusa Cadore","doi":"10.1093/ageing/afag301","DOIUrl":"https://doi.org/10.1093/ageing/afag301","url":null,"abstract":"<p><strong>Background: </strong>Hospitalised older adults are at increased risk of hospitalisation-associated disability.</p><p><strong>Objective: </strong>to investigate the effects of an in-hospital exercise program on functional and cognitive outcomes in older adults admitted to an Acute Care for the Elderly (ACE) unit.</p><p><strong>Methods: </strong>This randomised controlled trial included acutely hospitalised older adults (≥70 years) randomised to an exercise intervention based on VIVIFRAIL program [intervention group (IG)] or usual care [control group (CG)]. Exercise intervention included resistance/power training, balance and gait exercises. Primary outcome was the Short Physical Performance Battery (SPPB). Secondary outcomes included handgrip strength, gait speed, balance, timed-up-and-go, sit-to-stand (STS) time and relative STS power, global cognitive function using Mini Mental State Examination (MMSE), executive function and depressive symptoms. Assessments were performed at ACE unit admission and discharge. Analyses followed the intention-to-treat principle using generalised estimating equations.</p><p><strong>Results: </strong>Forty-seven participants (83.1 ± 5.1 years, 33% women) were randomised into the groups and performed 4 ± 2 exercise sessions across the hospitalisation period. Significant time × group interactions were found for SPPB, STS time, maximal and mean relative STS power, balance and MMSE, favouring IG compared to CG. Between-groups mean differences at discharge were observed for SPPB [3.18 points, 95% CI (1.3, 5.1)], STS time [-11.3 s, (-20.6, -1.9)], maximal relative STS power [1.45 W/Kg, (0.3, 2.5)], mean relative STS power [0.70 W/Kg, (0.2, 1.2)] and MMSE [2.16 points, (0.6, 3.7)] favouring IG compared to CG.</p><p><strong>Conclusion: </strong>Multicomponent exercise may attenuate physical and cognitive declines during acute hospitalisation. These findings support the implementation of structured exercise programmes during hospitalisation. (Registration number: NCT06682598).</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 10","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149214847","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":"Associations between neuropsychiatric symptoms and functional decline in dementia: a systematic review.","authors":"Kevin O'Hara-Veintimilla, Jacobo Ramirez-Triana, Salomón Páez-García, Kiara Torres-Tello, Patrick Verhelst-Forero, Jennifer A Watt, Miguel Germán Borda","doi":"10.1093/ageing/afag258","DOIUrl":"10.1093/ageing/afag258","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric symptoms (NPS) occur in up to 80-90% of people with dementia and contribute substantially to clinical complexity, caregiver burden and health and social care use. However, it remains unclear which NPS domains are most consistently associated with functional decline.</p><p><strong>Objectives: </strong>To synthesise evidence on the association between NPS and functional decline in dementia, measured as activities of daily living (ADL) and instrumental activities of daily living (IADL).</p><p><strong>Methods: </strong>This systematic review was registered in PROSPERO (CRD420261280442) and reported according to PRISMA 2020. MEDLINE, PubMed, Embase and PsycINFO were searched from inception to September 2025. Observational and mixed-design studies of adults aged ≥65 years with dementia reporting validated NPS and ADL/IADL measures were included. Given heterogeneity, findings were synthesised without meta-analysis. Certainty of longitudinal evidence was assessed using GRADE.</p><p><strong>Results: </strong>Forty studies including 13 711 participants were included. Across study designs, NPS were frequently associated with poorer functional performance and greater dependence. In longitudinal studies, apathy was the most consistently associated domain overall (6/9 studies), while delusions showed fully consistent associations (5/5). Hallucinations were also consistently associated (3/3) and showed some of the strongest reported associations with subsequent decline. Other NPS domains and overall NPS burden were also associated with worsening ADL/IADL, although consistency varied across domains and dementia subtypes. Certainty of evidence was generally low to very low.</p><p><strong>Conclusions: </strong>NPS, particularly apathy and psychotic symptoms, are associated with functional decline in dementia and may help identify patients at risk of emerging dependency beyond cognitive impairment alone.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148838565","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 ageing studies in sub-Saharan Africa-using observational data to support the shift towards integrated care for older people.","authors":"Catherine Louise Dotchin, Marie-Josiane Ntsama Essomba, Rachel Cooper","doi":"10.1093/ageing/afag250","DOIUrl":"https://doi.org/10.1093/ageing/afag250","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787097","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":"Community-based health and social care demand associated with frailty in people aged 50 and over in England 2025-40: routine data analyses and simulation modelling.","authors":"Bronagh Walsh, Carole Fogg, Tracey England, Sally Brailsford, Martin J Vernon, Peter Griffiths, Lee-Ann Fenge, Gulam Muktadir, Evgeny Galimov, Abigail Barkham, Lyndsey Williams","doi":"10.1093/ageing/afag256","DOIUrl":"10.1093/ageing/afag256","url":null,"abstract":"<p><strong>Background: </strong>In ageing populations, frailty prevalence and associated demand for health and social care services are expected to increase. Whilst there is good evidence about the demand for primary and secondary care services, the estimated demand for community-based health and social care associated with frailty is not known.</p><p><strong>Aim: </strong>To estimate future demand for community-based health services and publicly funded social care for those aged ≥50 with frailty, in England.</p><p><strong>Methods: </strong>Analysis of cohort data from North-West London provided rates of mental health, community health and publicly funded social care contacts among the population aged 50 and over, by age and electronic frailty index (eFI) categories. Using System Dynamics (SD) simulation modelling, mean service use and population estimates informed projections of national demand over 16 years (2025-40).</p><p><strong>Results: </strong>Over the simulation period, mental health, community health and publicly funded social care use are projected to increase by 16%, 30% and 30% respectively. Against baseline, lowering frailty incidence could reduce mental health, community health and local authority social care contacts by 1.4, 10 and 400 000 m respectively, between 2025 and 2040. Slowing frailty progression could reduce mental health, community health and social care contacts, compared with baseline, by 2.8, 45.3 and 2 m respectively over the same period.</p><p><strong>Conclusions: </strong>Demand for community-based health and social care services will increase substantially as the population ages and becomes more frail. Reduced frailty incidence and progression could slow demand growth, but demand will continue to grow due to large numbers already living with mild to moderate frailty.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148786990","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":"Effects of a fall prevention program on falls among rural older adults with cardiovascular disease in China: a secondary analysis of the FAMILY cluster randomised trial.","authors":"Ning Tang, Junyi Peng, Zijian Xu, Tingzhuo Liu, Boya Nan, Shichun Yan, Zhifang Li, Qian Li, Ruilin Meng, Yangchun Li, Tianyou Hao, Lan Zhang, Dandan Peng, Minghui Yang, Yao Yao, Jing Zhang, Wei Tian, Rebecca Ivers, Yongchen Wang, Pengpeng Ye, Maoyi Tian","doi":"10.1093/ageing/afag237","DOIUrl":"10.1093/ageing/afag237","url":null,"abstract":"<p><strong>Background: </strong>Older adults with cardiovascular disease (CVD) have a high risk of falls, yet evidence for scalable fall-prevention programs in this population is limited.</p><p><strong>Methods: </strong>This secondary analysis of the Fall Prevention for Rural Community-Dwelling Elderly open-label cluster randomised trial included rural Chinese adults aged 60 years or older with self-reported physician-diagnosed hypertension or heart disease at baseline from 128 villages. Villages were randomised 1:1 to a 12-month village doctor-led intervention comprising balance and functional exercise and health education, or to usual care. The primary outcome was reporting at least one fall over 12 months. Secondary outcomes included falls rate, fall-related injury, functional mobility and health-related quality of life.</p><p><strong>Results: </strong>Participants were recruited between 19 September 2023 and 15 November 2023. Compared with usual care, the intervention reduced the proportion reporting at least one fall [31.6% vs 42.7%; OR, 0.60; 95% confidence interval (CI), 0.43 to 0.84], falls rate (0.9 vs 1.6 per person-year; RR, 0.62; 95% CI, 0.43 to 0.89) and fall-related injury (15.9% vs 24.9%; OR, 0.57; 95% CI, 0.42 to 0.78). The intervention also improved chair stand performance, balance performance and health-related quality of life score, but not Timed Up and Go. Benefits were generally consistent across subgroups, with a greater effect in men.</p><p><strong>Conclusions: </strong>A village doctor-led fall-prevention program integrated into rural primary care reduced falls and fall-related injuries and improved functional outcomes among older adults with CVD. These findings support integrating scalable nonpharmacological fall-prevention strategies into routine cardiovascular management in rural primary care.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148711148","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":"Primary care-based post diagnostic dementia care in England: modelling and scaling up evidence-based models for efficient future care.","authors":"Magdalena Walbaum, Derek King, Louise Robinson, Martin Knapp, Raphael Wittenberg","doi":"10.1093/ageing/afag232","DOIUrl":"10.1093/ageing/afag232","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of dementia is rising rapidly, placing increasing pressure on health and social care systems to deliver coordinated and equitable post-diagnostic support. In England, service fragmentation and workforce constraints limit the delivery of recommended care models. Non-clinical dementia navigator (DN) models have emerged as a potentially scalable approach to improve care coordination and access, yet evidence on their system-level impact remains limited.</p><p><strong>Methods: </strong>We estimated the population of people with diagnosed dementia in England eligible for DN support between 2025 and 2030 using NHS data and projected prevalence trends. Eligibility was adjusted for undiagnosed cases, care home residents, and expected uptake. Costs of delivering DN-led care were derived from existing UK service models and unit costs, while potential savings were based on reductions in health-care utilisation observed in the US Care Ecosystem trial. Probabilistic sensitivity analyses were conducted to assess uncertainty.</p><p><strong>Results: </strong>The number of eligible individuals receiving DN support is projected to increase from 300 000 in 2025 to 360 000 in 2030. Delivering this model would require ~940 to 1120 link workers. Annual costs are estimated at £224 million in 2025, rising to £343 million in 2030. These are offset by estimated savings of £1140 million and £1750 million, respectively. Even under conservative assumptions, DN models generate net savings.</p><p><strong>Conclusions: </strong>Scaling up DN-led care in England could support large numbers of people with dementia while generating substantial health system savings. These findings suggest that navigator-based models offer a feasible and cost-saving approach to delivering coordinated post-diagnostic dementia care at scale.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13456331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148704989","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":"Ultra-processed foods and advanced stages of sarcopenia: multinomial evidence from the Birjand longitudinal ageing study.","authors":"Akam Ramezani, Ariyan Ayati Firoozabadi, Bafrin Dabestani, Hossein Fakhrzadeh, Mitra Moodi, Azin Pakmehr, Hanieh-Sadat Ejtahed, Farshad Sharifi","doi":"10.1093/ageing/afag226","DOIUrl":"10.1093/ageing/afag226","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, the age-related loss of muscle mass and strength, contributes to frailty and disability. Ultra-processed foods (UPFs) may increase risk via metabolic and inflammatory pathways. This study examined the association between UPF intake and sarcopenia in older Iranian adults.</p><p><strong>Methods: </strong>This cross-sectional study used data from the second phase of the Birjand Longitudinal Aging Study (BLAS). Sarcopenia was defined using EWGSOP2 criteria. Dietary intake was assessed with a validated food frequency questionnaire, and UPF consumption was categorised into quartiles based on energy contribution (NOVA classification). Logistic and multinomial regression models were applied, adjusting for demographic, behavioural, nutritional and clinical factors.</p><p><strong>Results: </strong>Among 1006 participants (mean age 72.4 ± 6.5 years; 48.2% women), 29.1% had no sarcopenia, 54.4% probable sarcopenia, 8.7% confirmed sarcopenia and 7.7% severe sarcopenia. Higher UPF intake was associated with greater odds of sarcopenia in a dose-dependent manner. In fully adjusted logistic regression models, participants in the third and fourth quartiles of UPF consumption had significantly higher odds of sarcopenia compared with the lowest quartile (Q3: OR = 2.23, 95% CI: 1.17-4.23; P = .014; Q4: OR = 2.50, 95% CI: 1.32-4.74; P = .05). Multinomial analyses further demonstrated that high UPF intake was specifically associated with advanced sarcopenia stages (Q4 vs Q1: Coeff = 2.10, 95% CI: 1.05-4.18; P = .036).</p><p><strong>Conclusion: </strong>Higher UPF consumption was independently associated with both the presence and severity of sarcopenia. Reducing UPF intake may help preserve muscle health and lower disability risk in ageing populations.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"55 8","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663332","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}