Age and ageing最新文献

{"title":"Creating dementia-friendly travel: enhancing accessibility and inclusion.","authors":"Sara Solis-Lopez, Dafne Estefania Durón-Reyes, Raquel Gutiérrez-Zuñiga, Joaquin Migeot, Brian Lawlor, Roman Romero-Ortuno","doi":"10.1093/ageing/afaf016","DOIUrl":"https://doi.org/10.1093/ageing/afaf016","url":null,"abstract":"<p><p>The growing participation of older adults in travel is reshaping this industry and highlighting the need for inclusive travel experiences, particularly for people living with dementia (PLwD). While travel provides substantial physical, psychological, cognitive and social benefits that promote active and healthy ageing, it also presents significant challenges. Although physical disabilities are generally proactively addressed, more \"hidden\" cognitive difficulties often remain unrecognised and unaddressed. These include navigating complex environments, making timely decisions and relying on working memory-tasks that are further challenged by dynamic settings such as airports, train stations and bus terminals. Although efforts to create dementia-friendly travel experiences are underway, their implementation across travel infrastructure remains inconsistent. There is still much to be done to ensure this activity is accessible and inclusive for this population, and there is a need to advocate for a comprehensive, person-centred approach to dementia-friendly travel environments, emphasising the integration of tailored assessments, innovative technologies and coordinated global policies.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078357","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":"Editor\"s view-Safety first: optimising treatment modalities.","authors":"Nathalie van der Velde","doi":"10.1093/ageing/afaf032","DOIUrl":"https://doi.org/10.1093/ageing/afaf032","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466736","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":"Correction to: Evaluation of claims-based frailty measurements in older patients with cancer: a retrospective cohort study.","authors":"","doi":"10.1093/ageing/afaf044","DOIUrl":"https://doi.org/10.1093/ageing/afaf044","url":null,"abstract":"","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412778","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":"Effects of osteoporosis treatment and multicomponent integrated care on intrinsic capacity and happiness among rural community-dwelling older adults: the Healthy Longevity and Ageing in Place (HOPE) randomised controlled trial.","authors":"Ya-Hui Chang, Chih-Chien Hung, Yen-Yi Chiang, Chiu-Ying Chen, Ling-Chiao Liao, Matthew Huei-Ming Ma, Juey-Jen Hwang, Chih-Cheng Hsu, Chung-Yi Li, Shau-Huai Fu, Chen-Yu Wang","doi":"10.1093/ageing/afaf017","DOIUrl":"10.1093/ageing/afaf017","url":null,"abstract":"<p><strong>Background: </strong>Monitoring and improving intrinsic capacity (IC) and well-being are essential for older adults to maintain functional abilities. However, evidence of effective interventions to improve IC and happiness is scarce. This study examined the effects of multicomponent interventions in the Healthy Longevity and Ageing in Place (HOPE) randomised controlled trial on IC and happiness among rural community-dwelling older adults.</p><p><strong>Methods: </strong>This cluster randomised trial was conducted in rural communities in Taiwan (NCT05104034). Participants aged ≥50 were enrolled from September 2021 to April 2022 and randomly assigned by community level to one of three groups: multicomponent integrated care (MIC), osteoporosis care (OC) and usual care (UC). MIC included osteoporosis, sarcopenia and polypharmacy care, along with exercise and nutritional support. OC was a resource-conservative, focusing on osteoporosis screening and treatment alone. IC and happiness were measured at baseline and 12 months after follow-up. IC was assessed across cognition, locomotion, vitality, sensory and psychological domains per World Health Organization Integrated Care for Older People (ICOPE) guidelines. Happiness was measured using the 10-item Chinese Happiness Inventory. Generalised estimating equations were used to estimate the effect of the intervention.</p><p><strong>Results: </strong>567 residents were recruited from 30 congregate meal service centres. Mean IC score increased across all the groups, though the happiness score decreased. Compared to UC, the MIC group exhibited a significantly greater improvement in IC scores (adjusted estimate = 0.30, standard error (SE) = 0.11, P = .01), whereas OC did not show significant effects. Smaller reductions in happiness scores were observed in both the MIC (adjusted estimate = 1.46, SE = 0.48, P = .003) and OC groups (adjusted estimate = 0.95, SE = 0.48, P = .05).</p><p><strong>Conclusion: </strong>MIC, including osteoporosis and pharmaceutical care, along with exercise and nutritional support, is an effective strategy to enhance IC and happiness compared to osteoporosis treatment alone and UC. This underscores the importance of comprehensive strategies for promoting healthy ageing in rural communities.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188199","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":"Housing adaptations and older adults' health trajectories by level of initial health: evidence from the English Longitudinal Study of Ageing.","authors":"Jiawei Wu, Emily M Grundy","doi":"10.1093/ageing/afaf023","DOIUrl":"10.1093/ageing/afaf023","url":null,"abstract":"<p><strong>Background: </strong>In many ageing societies, the housing stock is poorly designed to meet the needs of older people with health limitations. Housing adaptations may enable older people to retain functional ability in the home, improve well-being and reduce the risks of falls. There is mixed evidence on whether adaptations are most beneficial for those who have limitations or whether they have a greater impact if implemented before people experience substantial disability. This study aimed to identify socio-demographic factors associated with obtaining housing adaptations and whether and how the impact of adaptations on changes in mental and physical health varied by initial level of health measured using objective indicators.</p><p><strong>Methods: </strong>We used data from the English Longitudinal Study of Ageing to analyse socio-demographic factors associated with acquiring housing adaptations using logistic regression. We then estimated mixed-effects models to assess how a measure of baseline physical health, derived from observer-measured indicators of physical function, modified the association between acquiring housing adaptations and health and disability outcomes for two cohorts each followed up for three waves.</p><p><strong>Results: </strong>Having more activities of daily living (ADL) limitations was positively associated with acquiring housing adaptations, but we found no evidence for socio-demographic variations. Acquiring housing adaptations was associated with slower development of instrumental ADL/ADL disability among older people with initially good latent physical health. Sensitivity analysis suggested that housing adaptations mitigated the predicted probability of falls for those with severe mobility impairments.</p><p><strong>Conclusions: </strong>Housing adaptations may slow down development of disability in older people with initially good health.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432025","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 co-designed conceptual model for implementing falls prevention programmes for community-dwelling older adults in Singapore: a systems thinking approach.","authors":"Vanessa Jean Wen Koh, David Bruce Matchar, Abhijit Visaria, Wei Xuan Lai, Jing Wen Goh, Joann Poh, Mimaika Luluina Ginting, Vanda Wen Teng Ho, Hozaidah Hosain, Noor Hafizah Binte Ismail, Christopher Lien, Doris Yanshan Lim, Reshma Aziz Merchant, Shawn Leng Hsien Soh, Angelique Wei-Ming Chan","doi":"10.1093/ageing/afaf021","DOIUrl":"10.1093/ageing/afaf021","url":null,"abstract":"<p><strong>Introduction: </strong>Implementing falls prevention programmes in the community presents numerous challenges. We sought to understand the dynamics between the determinants influencing implementation to develop a common conceptual model describing the complexities of implementing falls prevention programmes in Singapore.</p><p><strong>Methods: </strong>A full-day group model building workshop with a series of structured activities was organised with 31 multidisciplinary stakeholders. Stakeholders who attended include healthcare professionals of different specialities (i.e. geriatrics, rehabilitation medicine, physiotherapy, nursing), community-based voluntary welfare organisations, researchers and policymakers.</p><p><strong>Results: </strong>A causal loop diagram was developed to illustrate the determinants influencing implementation of community-based fall prevention programmes. It revealed factors driving key implementation and service outcomes in supply and demand of such programmes. Determinants of these outcomes were synthesised into four themes: (i) structural factors affecting the management and resource allocation for community-based falls prevention programmes, (ii) participation in programmes affected by older adults' willingness and ability to participate, (iii) perceived value as a composite of costs and benefits, and (iv) social support and exercise self-efficacy motivating long-term adherence. Furthermore, in our analysis of feedback relationships, two organisational behaviours were identified: unsustainable growth due to resource constraints (Limits to Growth) and tensions between executing symptomatic or fundamental solutions (Eroding Goals). Stakeholders also explored strategies for effective implementation.</p><p><strong>Conclusions: </strong>A conceptual model describing the dynamics of implementing community-based fall prevention programmes was developed. This informed the formulation of a National Falls Prevention Framework, a priority action step for the effective implementation of these programmes in Singapore.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456589","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":"The trajectories of depression and multimorbidity affect the patterns of cognitive decline: a prospective cohort study.","authors":"Kai Cui, Ronghui Zhao, Ning Ding, Xiaonuo Xu, Weiqi Gu, Jing He, Xiaoyan Ge","doi":"10.1093/ageing/afaf036","DOIUrl":"https://doi.org/10.1093/ageing/afaf036","url":null,"abstract":"<p><strong>Background: </strong>The course of decline of global cognitive function is heterogeneous, with patterns varying among individuals. The influence of depression, functional limitations and multimorbidity on patterns of decline of global cognitive function among community-dwelling older adults remains unknown. This study examines the relationship between these health conditions and the course of decline of global cognitive function.</p><p><strong>Methods: </strong>A prospective cohort of 4032 participants aged ≥60 years at baseline was constructed using the Health and Retirement Study (2006-20), through surveys every 2 years. Information on depression, functional limitations and multimorbidity was collected from 2006 to 2012. Data on cognitive function were collected between 2012 and 2020. Latent class trajectory models were used to identify the latent trajectories. Multinomial logistic regression models were employed to analyse the association between the latent trajectories and cognitive function.</p><p><strong>Results: </strong>Different trajectories were identified for depression (low-stable, decline-rise and rise-decline), activities of daily living (ADLs; low-stable, decline-rise and rise-decline), instrumental activities of daily living (IADLs; low-stable and rise), and multimorbidity (stable and rise). Three trajectories of cognitive decline were identified: high stable, modest and later steep. The trajectories of depression (for decline-rise: OR: 1.47, 95% CI: 1.11-1.95; for rise-decline: OR: 1.72, 95% CI: 1.24-2.38) and multimorbidity (OR: 1.63, 95% CI: 1.08-2.46) increased the risk of cognitive decline.</p><p><strong>Conclusion: </strong>The trajectories of depression and multimorbidity affect cognitive decline patterns. Longitudinal surveillance of health conditions can be used to identify different patterns of cognitive decline and predict faster cognitive decline.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143456592","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":"Supporting older people with cognitive impairment during and after hospital stays with intersectoral care management (intersec-CM)-results of a randomised clinical trial.","authors":"Melanie Boekholt, Angela Nikelski, Fanny Schumacher-Schoenert, Friederike Kracht, Horst Christian Vollmar, Wolfgang Hoffmann, Stefan Henner Kreisel, Jochen René Thyrian","doi":"10.1093/ageing/afaf011","DOIUrl":"10.1093/ageing/afaf011","url":null,"abstract":"<p><strong>Background: </strong>The transition from hospital to primary care is a risk factor for negative health outcomes in people with cognitive impairment.</p><p><strong>Objective: </strong>To test the effectiveness of intersectoral care management during the transition from hospital to primary care on repeated admission to hospital, functionality and institutionalisation in people with cognitive impairment.</p><p><strong>Design: </strong>Longitudinal multisite randomised controlled trial with two arms (care as usual and intersectoral care management) and two follow-ups 3 and 12 months after discharge.</p><p><strong>Setting: </strong>Three hospitals in two different primary care regions in Germany.</p><p><strong>Subjects: </strong>n = 401 people with cognitive impairment: community-dwelling, age 70+. Randomised into control (n = 192) or intervention (n = 209).</p><p><strong>Methods: </strong>Primary outcomes for the study after 3 months: admission to hospital, physical and instrumental functionality. Primary outcome after 12 months: institutionalisation, physical and instrumental functionality. Secondary outcomes: health-related quality of life, depressive symptoms, cognitive status and frailty. Statistical analyses include descriptive analyses as well as univariate and multivariate regression models for all outcomes.</p><p><strong>Results: </strong>There was no statistically significant effect of the intervention on hospital admission and activities of daily living after 3 months, as well as on institutionalisation and activities of daily living after 12 months. There were significantly fewer participants in the intervention group readmitted to the hospital 12 months after discharge.Analyses show a significant effect on health-related quality of life 3 months and 12 months after discharge. Depressive symptoms were significantly less likely in the intervention group 3 months after discharge. No effects on cognition or frailty.</p><p><strong>Conclusion: </strong>Intersectoral care management supports people with cognitive impairment during discharge and transition. Even though we were not able to show an impact of the intervention on the chosen primary outcomes everyday functionality and institutionalisation, the effects on health-related quality of life, hospital admission rate and mental health are solid indicators for an improved individual situation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, NCT03359408; https://clinicaltrials.gov/ct2/show/NCT03359408.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254508","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":"Care home quality and 'inappropriate' emergency healthcare use-failing to engage with complexity.","authors":"Fawn Harrad-Hyde, Jennifer Kirsty Burton","doi":"10.1093/ageing/afaf030","DOIUrl":"10.1093/ageing/afaf030","url":null,"abstract":"<p><p>Care home residents are more likely to experience unplanned, emergency healthcare than those living elsewhere in the community. This can be potentially burdensome for both individual residents and healthcare systems. Academic and policy attention has focussed on quantifying this resource use, exploring potential causes and reducing unplanned emergency healthcare. Considerable attention has been placed on emergency healthcare that may be 'inappropriate' or 'avoidable'. In this commentary, we problematise such concepts. We suggest that the absence of an agreed definition can lead to wide variation in estimations which fail to acknowledge the complexity of care home residents' needs and their right to timely healthcare support. We draw attention to the impact of popular discourse in this area as potentially stigmatising to care home organisations, staff and residents. We argue that emergency healthcare use data alone is insufficient to measure and evaluate the quality of care provided by care homes. We propose a move away from over-simplistic distinctions, between emergency healthcare that is or is not 'appropriate', to develop more nuanced conceptualisations that account for the complexity involved in providing healthcare support to people living in care homes. People living in care homes have significant healthcare needs. It is necessary that models of care supporting homes are resourced to respond and support care home professionals. Rather than focusing solely on quantifying emergency healthcare use, acknowledging and embracing complexity will help to refocus our efforts and redesign our services around both individual and population needs, rather than around existing systems.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482078","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":"Plasma brain-derived neurotrophic factor concentrations are elevated in community-dwelling adults with sarcopenia.","authors":"Jedd Pratt, Evgeniia Motanova, Marco V Narici, Colin Boreham, Giuseppe De Vito","doi":"10.1093/ageing/afaf024","DOIUrl":"10.1093/ageing/afaf024","url":null,"abstract":"<p><strong>Background: </strong>The scalability of a blood-based sarcopenia assessment has generated interest in circulating markers that may enhance management strategies. Data regarding the relevance of brain derived neurotrophic factor (BDNF), a regulator of neuroplasticity, to sarcopenia in community-dwelling adults are scarce. We examined the association between plasma BDNF concentrations, sarcopenia and individual sarcopenia signatures in a well-characterised adult cohort.</p><p><strong>Methods: </strong>Participants included 246 men and women aged 50-82 years (mean age = 63.6 years; 52% female). Muscle strength and skeletal muscle index (SMI) were assessed by hand dynamometry and dual-energy X-ray absorptiometry. Plasma BDNF concentrations were determined, in duplicate, with commercially available enzyme-linked immunosorbent assays. Sarcopenia and individual signatures of sarcopenia (i.e. low grip strength or low SMI) were diagnosed according to the EWGSOP2 algorithm.</p><p><strong>Results: </strong>Plasma BDNF concentrations were 47.6% higher in participants with sarcopenia than controls (P = 0.005), and demonstrated acceptable diagnostic accuracy (areas under the curves = 0.702, 95%CI = 0.597-0.806, P = 0.002, optimal cut-off >1645 pg/ml). Plasma BDNF concentration >1645 pg/ml was associated with 2.83 greater odds for sarcopenia (95%CI = 1.13-7.11, P = 0.027), than ≤1645 pg/ml, whilst a BDNF Z-score ≥2 was associated with 5.14 higher odds for sarcopenia (95%CI = 1.16-22.82, P = 0.031), than a Z-score <1. Covariates included sex, age, body mass index, habitual physical activity, smoking status, alcohol consumption, comorbidity and educational attainment.</p><p><strong>Conclusion: </strong>Circulating BDNF concentrations are elevated in community-dwelling men and women with sarcopenia, which may reflect increased neuromuscular remodelling in these people. Our findings complement existing data, supporting the presence of an intricate relationship between neural integrity and skeletal muscle health. Future studies are needed to establish the mechanistic pathways that may underpin the associations.</p>","PeriodicalId":7682,"journal":{"name":"Age and ageing","volume":"54 2","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11831035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143432026","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}