Age and ageing最新文献

{"title":"Features of successful medication review and deprescribing interventions for fall prevention in residential aged care facilities: an intervention component analysis of an updated systematic review.","authors":"Jenni Suen, Sujita Narayan, Lotta J Seppala, Nathalie van der Velde, Catherine Sherrington, Katy Sutcliffe, Ian D Cameron, Dylan Kneale, Suzanne Marie Dyer","doi":"10.1093/ageing/afaf230","DOIUrl":"https://doi.org/10.1093/ageing/afaf230","url":null,"abstract":"<p><strong>Background: </strong>Medication review and deprescribing are common fall prevention strategies, as falls risk increasing drugs and polypharmacy are potentially modifiable falls risk factors. We sought to understand why some trials in residential aged care facilities (RACFs) testing medication review/deprescribing reduced falls whilst others did not. We used intervention component analysis (ICA) to develop a theory of the key feature(s) from the trialists' perspective.</p><p><strong>Methods: </strong>Randomised controlled trials (RCTs) evaluating medication review/deprescribing as a single falls prevention intervention in RACFs, were identified via a Cochrane review and additional database searches to 1 April 2025. ICA was conducted with inductive thematic analysis of the Discussion sections of trial publications. Alignment between themes/subthemes and trial outcomes were examined.</p><p><strong>Results: </strong>Thirteen trials from six countries were included. Trialists perceived that medication review/deprescribing interventions should include a tool (i.e. algorithm/list of medications) to facilitate decisions between clinicians on the appropriateness of resident's prescriptions, with at least one prescriber from the residents' usual care team involved in decisions and implementation of medication changes, reviewing medications together at least 6 monthly. These features were present in 100% (3/3) successful trials and 20% (2/10) unsuccessful trials.</p><p><strong>Conclusions: </strong>ICA indicated using a tool as a guide amongst clinicians, at least six monthly and including at least one prescriber from the usual care team, could be an important combination of features to improve intervention success. This approach which aligns with recent World Falls Guidelines should be tested in future RCTs of medication optimisation for people living in RACFs.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939479","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":"A geriatric care competence assessment tool for selecting family health duty bearers from family caregivers: reliability and validity test.","authors":"Liu Lingna, Li Meiman, Ning Yanhua, Liv Xiongxiong, Kong Weijuan, Guo Yahong, Shi Jing, Li Xinjin, Yang Cailing","doi":"10.1093/ageing/afaf232","DOIUrl":"10.1093/ageing/afaf232","url":null,"abstract":"<p><strong>Objectives: </strong>This research aims to construct a geriatric care competence assessment tool to select family health duty bearers from family caregivers for older adults and to test its reliability and validity.</p><p><strong>Methods: </strong>According to the model of Caregiver Skill Building/Effectiveness and the Knowledge-Attitude/Belief-Practice Model, we constructed a geriatric care competence assessment tool through literature review, semi-structural interviews and the Delphi method, and investigated to test the reliability and validity of this assessment tool.</p><p><strong>Results: </strong>The final version of the geriatric care competence assessment tool consists of 33 items in six dimensions: caregiving knowledge, caregiving attitudes, caregiving behaviours, caregiver role adaptation, assessment and utilisation of family resources and assessment and utilisation of social resources. The overall content validity index was 0.816, and the content validity index for each item ranged from 0.83 to 1.00. Exploring factor analysis extracted six common factors, and the cumulative variance contribution rate was 68.399%. The confirmatory factor analysis showed that the six dimensions of the tool fit very well, and the convergent validity was very satisfactory. The Cronbach's α coefficient of the tool was 0.930.</p><p><strong>Conclusions: </strong>This assessment tool, which has good reliability and validity, can be used to select family health duty bearers for older adults.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144870912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best practice assessment and management of benign paroxysmal positional vertigo in older adults.","authors":"Hilary Cox, James Frith","doi":"10.1093/ageing/afaf225","DOIUrl":"10.1093/ageing/afaf225","url":null,"abstract":"<p><p>Benign paroxysmal positional vertigo (BPPV) is a common and disabling condition, with prevalence increasing with advancing age. It typically causes positional dizziness but is also common in those with balance abnormalities and falls without the typical dizziness. It is an underdiagnosed problem, which can lead to reduced quality of life, depression and increased falls risk. Whilst the diagnosis and treatment of the commonest form of BPPV (posterior canal) is straightforward in robust and younger populations, this is frequently not the case in people with multiple long-term conditions or frailty. Barriers to diagnosis and treatment of BPPV in each of the three canals can be overcome with simple practical measures, which are presented here. Given the lack of good quality evidence in this area, this best practise article presents evidence, where it exists, alongside expert clinical experience.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862013","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":"Feedback-based perturbation balance training during stationary cycling improves reactive and proactive balance among older adults: a single-blinded randomised controlled trial.","authors":"Shani Batcir, Koby Livne, Rotem Lev Lehman, Yuliya Berdichevsky, Sarel Maoz, Lilach Wolf Shkedy, Rafi Adar, Elena Rabaev, Yaacov G Bachner, Guy Shani, Omri Lubovsky, Amir Shapiro, Neil B Alexander, Itshak Melzer","doi":"10.1093/ageing/afaf215","DOIUrl":"10.1093/ageing/afaf215","url":null,"abstract":"<p><strong>Background: </strong>Perturbation balance training (PBT) is an effective regime that reduces fall rates by triggering and improving balance recovery skills. Controlling trunk movements consistently reflects effective reactive stepping, as it enhances proximal stability, providing a stable base for limb movements.</p><p><strong>Objective: </strong>To demonstrate the effect of PBT during seated hands-free stationery cycling on objective balance parameters of reactive and proactive balance control in standing.</p><p><strong>Design: </strong>Two-arm parallel-group, single-blinded randomised controlled trial with concealed allocation, blinded assessors and data analysers, with intention-to-treat analyses.</p><p><strong>Participants: </strong>Fifty-six community-dwelling older adults, 70+ years of age (mean ± standard deviation: 76.43 ± 4.76 years, 39.3% of men and 60.7% of women), walking independently without assistive devices.</p><p><strong>Interventions: </strong>The two groups performed twenty sessions of seated stationary cycling, 20 minutes each, over 12 weeks, while performing concurrent cognitive tasks: (i) cycling hands free, received perturbations with real-time implicit sensorimotor feedback (PBT during hands-free stationary cycling, n = 29); (ii) standard cycling training (SCT, n = 27) cycled using hands without perturbations.</p><p><strong>Outcome measures: </strong>The primary outcome measures were the reactive balance measures in standing, e.g. single-step threshold, multiple-step threshold and the probability of stepping. Secondary outcomes were voluntary stepping Test and 6-Minute Walk Test (6MWT). Measures were taken at baseline and immediately postinterventions.</p><p><strong>Results: </strong>The group-by-time interactions indicate that PBT during hands-free stationary cycling improved balance reactive responses i.e. increased single- and multiple-step thresholds in mediolateral perturbations (P = .001, effect size [ES] = 0.88, and P = .001, ES = 0.64, respectively) and multiple-step threshold in anteroposterior perturbations (P = .022, ES = 0.34) and decreased the probability of stepping compared to standard cycling training. PBT during hands-free stationary cycling also resulted in faster voluntary step reaction (P = .011, ES = -0.84) and foot contact times (P = .037, ES = -0.56). Both groups significantly improved their 6MWT results.</p><p><strong>Conclusion: </strong>Feedback-based PBT during hands-free stationary cycling has the potential to improve reactive and proactive balance measures in standing.</p><p><strong>Registration: </strong>clinicaltrials.gov, NCT03636672, https://clinicaltrials.gov/study/NCT03636672.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833743","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":"What are we teaching UK medical students about ageing and geriatric medicine? Results of the third British Geriatrics Society national curriculum and teaching survey.","authors":"Alice Watson, Grace Margaret Evelyn Pearson, Rebecca Winter, Adrian Blundell, Tahir Masud, Adam Lee Gordon, Emily Jane Henderson","doi":"10.1093/ageing/afaf216","DOIUrl":"10.1093/ageing/afaf216","url":null,"abstract":"<p><strong>Introduction: </strong>The ageing population means all newly qualified doctors will need knowledge, skills and attitudes to care for older people with complex health conditions. An essential component of preparing the medical workforce to care for older people is including teaching on ageing and geriatric medicine in undergraduate medical curricula. We present results of the British Geriatrics Society national curriculum survey 2021-22, highlighting progress in undergraduate teaching in geriatric medicine.</p><p><strong>Methods: </strong>All 35 UK General Medical Council-registered medical schools at the time of data collection were invited to participate in an online survey on the content, methodology, timing and duration of teaching in ageing and geriatric medicine.</p><p><strong>Results: </strong>Thirty out of the thirty-five (83%) UK medical schools responded, all of which provided some teaching in geriatric medicine. Most teaching occurred in the fourth year of study (n = 21). The majority (n = 15) reported a discrete module for geriatric medicine lasting 4-8 weeks, an increase on previous surveys. Three schools reported geriatric medicine exposure lasting >12 weeks, of which two were integrated clerkships. We observed a reduction in interprofessional education but identified several examples combining simulated teaching with other healthcare professions (n = 7). Every school (n = 30) incorporated small-group or case-based learning.</p><p><strong>Conclusion: </strong>There is increased exposure to geriatric medicine compared to previous surveys in 2008 and 2013. Generally, programmes reported a move towards clinically framed small-group and case-based learning, employing a wider variety of assessment methods than previously. We also identified key gaps in teaching provision for targeted improvement and ongoing research.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833747","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":"Association of lipid-lowering therapy with dementia and cognitive outcomes: a systematic review and meta-analysis.","authors":"Catriona Reddin, Aidan Stankard, Kei Yen Chan, Finn Krewer, Conor Judge, Michelle Canavan, Daniel H J Davis, Martin O'Donnell","doi":"10.1093/ageing/afaf219","DOIUrl":"10.1093/ageing/afaf219","url":null,"abstract":"<p><strong>Background and objectives: </strong>Lipid-lowering agents are effective in reducing cardiovascular risk, but their effect on cognitive impairment and dementia is uncertain. The aim of this meta-analysis was to determine whether lipid-lowering therapy, compared to control, was associated with a reduction in risk of dementia or cognitive impairment.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of randomised controlled trials comparing lipid-lowering therapy to control that reported dementia or change in cognitive scores, adhering to the Cochrane Collaboration Guidelines. A random effects meta-analysis was used to estimate a pooled treatment-effect. The primary outcome measure was incident cognitive impairment or dementia.</p><p><strong>Results: </strong>Twenty randomised controlled trials were eligible for inclusion, 15 trials (n = 139 169 participants) reported dementia or cognitive impairment on follow-up (primary outcome) and nine trials (n = 32 370) reported on change in cognitive score. The mean (SD) age of trial participants was 65.4 (5.06) years in the intervention arm and 65.4 (5.03) in the control arm. Lipid-lowering therapy compared with control was not associated with a significant reduction in dementia or cognitive impairment (1.33% vs 1.36% over a mean trial follow-up of 34.5 months; Odds Ratio, 0.96; 95% CI, 0.74-1.26). Heterogeneity was moderate (I2 = 37.6%). There was no significant association amongst drug classes (Statin; OR 0.90; 95% CI, 0.67-1.21, PCSK9 inhibitor: OR 1.77; 95% CI, 0.46-6.83, Other: OR 0.85; 0.61-1.17).</p><p><strong>Discussion: </strong>In this meta-analysis of over 100 000 participants, lipid-lowering therapy was not significantly associated with a lower risk of incident cognitive impairment or dementia. This meta-analysis provides evidence to support the safety of lipid-lowering therapy on cognitive health, however, does not provide evidence of risk reduction of incident cognitive impairment or dementia.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833736","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: 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":"","doi":"10.1093/ageing/afaf226","DOIUrl":"10.1093/ageing/afaf226","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833739","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":"No place like home-the importance of home in older adult research.","authors":"Jennifer Kirsty Burton, Simon Paul Conroy, Terence J Quinn","doi":"10.1093/ageing/afaf222","DOIUrl":"10.1093/ageing/afaf222","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 8","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144833745","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":"Six-month outcomes of layperson-delivered, telephone-based behavioural activation and mindfulness interventions on loneliness among older adults during the COVID-19 pandemic: The HEAL-HOA Dual Randomised Controlled Trial","authors":"Da Jiang, Jojo Yan Yan Kwok, Dannii Yuen-lan Yeung, Vivien Foong Yee Tang, Namkee G Choi, Rainbow Tin Hung Ho, Lisa M Warner, Kee-Lee Chou","doi":"10.1093/ageing/afaf209","DOIUrl":"https://doi.org/10.1093/ageing/afaf209","url":null,"abstract":"Background Loneliness among older adults during the COVID-19 pandemic constituted a global public health crisis. This study aimed to determine whether layperson- and telephone-delivered behavioural activation (Tele-BA) and mindfulness (Tele-MF) interventions, compared to telephone befriending/support calls (Tele-BF; attention control), could reduce loneliness among older adults who were living alone, socioeconomically deprived and digitally excluded. Methods As part of the ‘Helping Alleviate Loneliness in Hong Kong Older Adults’ dual randomised controlled trial (RCT), 1151 older adults (Mage = 76.6, SD = 7.8) were randomly assigned to Tele-BA, Tele-MF or Tele-BF. Assessments were conducted at baseline (T0), 4-week (T1), 3-month (T2) and 6-month post-intervention (T3). All interventions (eight 30-minute telephone sessions over four weeks) were delivered by 185 trained lay counsellors who were 50–70 years old and reported feeling lonely. Outcomes The primary outcome was loneliness (assessed with the UCLA Loneliness Scale [UCLA-LS] and De Jong Gierveld Loneliness Scale [DJGL]). Secondary outcomes were perceived social support, social network size, perceived stress, life satisfaction, psychological well-being, sleep quality and depressive and anxiety symptoms. The UCLA-LS scores were significantly reduced in Tele-BA at T2 and T3 and in Tele-MF at T2, compared to Tele-BF. No significant difference was observed between Tele-BA and Tele-BF from T1 through T3 in DJGL. The Tele-MF group showed significantly higher DJGL scores at T1 and T3 than the Tele-BF group. Significant positive effects of Tele-BA, compared to Tele-BF, were found in perceived social support, perceived stress, psychological well-being, depression and anxiety. Tele-MF did not significantly differ from Tele-BF on these secondary outcomes. Interpretation The trial demonstrates the effectiveness of telephone-based psychosocial interventions delivered by laypersons in reducing loneliness. It also underscores the potential for training peer lay counsellors to telephone-deliver scalable psychosocial interventions for older adults experiencing loneliness.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"138 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755839","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":"New horizons in improving research capacity in English care homes for older adults.","authors":"Elisa Ruiz-Burga,Paul Flowers,Zoe Fry,Mike Slator,Lauren Hague,Martin Green,Adam Lee Gordon,Ann-Marie Towers,Martin Knapp,Claire Surr,Laura Shallcross","doi":"10.1093/ageing/afaf211","DOIUrl":"https://doi.org/10.1093/ageing/afaf211","url":null,"abstract":"As the care home sector expands over time, the health and social care needs of both residents and staff intensify and diversify. These sector-wide changes call for significant growth in research capacity to deliver useful, pertinent and timely evidence. In this paper we highlight growing pressures in the care home sector, and the major and enduring barriers to conducting research across that sector, within homes and amongst staff, drawing primarily on our experiences conducting public health research in England. These obstacles include a lack of national infrastructure, tradition and culture, and underdeveloped systems to reimburse providers for the staff and other costs associated with research delivery. Finally, we detail short, medium and long-term actions that could enable the growth of research capacity across the sector. These include leveraging political will, remunerating and crediting research champions, and establishing a feedback loop to showcase the contribution of research in improving both quality of care and resident outcomes. Our suggested actions focus on what would be required to build research capacity in care homes in England; although these also have relevance in other countries where there is a need and wish to build research capacity in adult long-term care facilities.","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"27 1","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144766005","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}