Lancet Healthy Longevity最新文献

{"title":"Oropharyngeal dysphagia: a narrative review towards an integrated neurogeriatric perspective","authors":"Bendix Labeit MD ,&nbsp;Sriramya Lapa PhD ,&nbsp;Gero Lueg MD ,&nbsp;Rebecca Joebges MD ,&nbsp;Jule Hofacker MSc ,&nbsp;Paul Muhle MD ,&nbsp;Prof Sonja Suntrup-Krueger MD ,&nbsp;Cornelius J Werner MD ,&nbsp;Stefanie Schreiber MD ,&nbsp;Prof Rainer Wirth MD ,&nbsp;Tobias Warnecke MD ,&nbsp;Rainer Dziewas MD ,&nbsp;Prof Sven G Meuth MD","doi":"10.1016/j.lanhl.2025.100794","DOIUrl":"10.1016/j.lanhl.2025.100794","url":null,"abstract":"<div><div>Oropharyngeal dysphagia, prevalent in neurogeriatric populations, increases the risks of malnutrition, pneumonia, and mortality. Oropharyngeal dysphagia manifests as a multi-aetiological syndrome with diverse phenotypes. We advocate for a neurogeriatric perspective that integrates specific neurological insights with geriatric care principles to improve dysphagia management. This approach highlights the diagnostic value of disease-specific neurological dysphagia manifestations and recognises the condition as a potential target for neurological therapies, as shown by the benefits that acetylcholinesterase inhibitors in myasthenia gravis and dopaminergic agents in Parkinson's disease have against the syndrome. Age-related factors such as presbyphagia, which includes reduced pharyngeal sensation, sarcopenia, and decreased neuroplasticity, further contribute to the pathophysiology of oropharyngeal dysphagia. Cross-disease treatment strategies encompass oral hygiene, nutritional support, dietary modifications, individualised interventions to improve swallowing physiology, and emerging neurostimulation techniques that are currently under investigation. Current research aims to refine assessment protocols tailored to these interventions, identify outcome predictors to contextualise dysphagia findings, and evaluate the potential of neurostimulation or pharmacological agents, with the aim to improve quality of life and reduce mortality.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 12","pages":"Article 100794"},"PeriodicalIF":14.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potentially modifiable risk factors for dementia in Norway (HUNT4 70+): a retrospective cohort study","authors":"Prof Merete Ellingjord-Dale PhD ,&nbsp;Prof Bjørn Heine Strand PhD ,&nbsp;Prof Vegard Skirbekk PhD ,&nbsp;Prof Bernt Bratsberg PhD ,&nbsp;Prof Teferi Mekonnen PhD ,&nbsp;Prof Ekaterina Zotcheva PhD ,&nbsp;Prof Geir Selbæk MD ,&nbsp;Prof Yaakov Stern PhD ,&nbsp;Prof Asta Kristine Håberg MD ,&nbsp;Prof Bo Engdahl PhD","doi":"10.1016/j.lanhl.2025.100802","DOIUrl":"10.1016/j.lanhl.2025.100802","url":null,"abstract":"<div><h3>Background</h3><div>The 2024 <em>Lancet</em> Commission report on dementia identified 14 modifiable dementia risk factors. The Norwegian HUNT study uniquely includes data collection of all 14 risk factors in the same individuals throughout adulthood, as well as a study-specific dementia diagnosis. We aimed to evaluate the potential for dementia prevention associated with these 14 risk factors, along with three additional sociodemographic risk factors in this retrospective cohort.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included data on participants with study-specific diagnosis from the HUNT4 70+ study (2017–19) and was linked with national administrative registries (1960–2018) and earlier HUNT surveys (1984–2008) with data on dementia risk factors at ages 35–92 years. Inverse probability weighting was applied to account for non-response. Logistic regression estimated dementia risk associated with exposure to less education in early adult life (age &lt;45 years), hearing loss, high LDL cholesterol, depression, traumatic brain injury, physical inactivity, diabetes, smoking, hypertension, obesity, excessive alcohol use in midlife (age 45–65 years), and social isolation, air pollution, and vision loss in late life (age &gt;65 years). Midlife occupational physical activity and marital and employment status were added to the <em>Lancet</em> model. The potential for dementia prevention was assessed using population attributable fraction (PAF).</div></div><div><h3>Findings</h3><div>Between Sept 1, 2017, and Feb 28, 2019, 19 403 individuals were invited to participate and 9745 participants (1525 with dementia, 8220 without dementia) were included. 4445 (45·6%) of 9745 participants were male and 5300 (54·4%) were female. The total PAF for the 14 <em>Lancet</em> risk factors was 50·9% (95% CI 37·7–61·4). Including family-related and work-related risk factors increased the PAF to 54·9% (42·3–64·7; p&lt;0·0001). When these factors were added for women, the total PAF increased from 48·0% (95% CI 29·4–61·7) to 52·2% (34·2–65·3; p=0·0090), whereas no significant change was observed in men (56·2% [95% CI 35·5–70·2] to 56·7 [95% CI 36·1–70·6]; p=0·71).</div></div><div><h3>Interpretation</h3><div>Addressing all 14 <em>Lancet</em> risk factors could prevent over half of all dementia cases. Adding factors related to marital and occupational status offers additional preventive potential, particularly among women.</div></div><div><h3>Funding</h3><div>The National Institutes of Health and NRC-ATWORK.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 12","pages":"Article 100802"},"PeriodicalIF":14.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporality might matter in people with atrial fibrillation and heart failure","authors":"Nicholas R Jones ,&nbsp;Margaret Smith ,&nbsp;Yaling Yang ,&nbsp;F D Richard Hobbs ,&nbsp;Clare J Taylor","doi":"10.1016/j.lanhl.2025.100806","DOIUrl":"10.1016/j.lanhl.2025.100806","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 12","pages":"Article 100806"},"PeriodicalIF":14.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the issue of ultra-processed foods","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2025.100810","DOIUrl":"10.1016/j.lanhl.2025.100810","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 12","pages":"Article 100810"},"PeriodicalIF":14.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145744949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of pain with intrinsic capacity and the moderating role of inflammation in France: a cross-sectional analysis of the INSPIRE-T project","authors":"Federico Bellelli MD ,&nbsp;Jeremy Raffin PhD ,&nbsp;Prof Matteo Cesari MD PhD ,&nbsp;Sophie Guyonnet PhD ,&nbsp;David Furman PhD ,&nbsp;Prof Yves Rolland MD PhD ,&nbsp;Prof Bruno Vellas MD PhD ,&nbsp;Prof Philipe de Souto Barreto PhD ,&nbsp;IHU HealthAge INSPIRE Platform Group,&nbsp;IHU HealthAge Open Science group","doi":"10.1016/j.lanhl.2025.100798","DOIUrl":"10.1016/j.lanhl.2025.100798","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Although pain singularly impacts most critical domains of health status, its relationship with intrinsic capacity has been poorly investigated. Inflammation is central to pain biology, and longitudinal evidence indicates that pain can amplify inflammatory activity over time. This study evaluated the cross-sectional association of pain with intrinsic capacity and its domains in a cohort of community-dwelling people across the lifespan, as well as the moderating role of the inflammatory ageing (iAge) clock in this association. The secondary objective was to explore whether the pain–intrinsic capacity associations varied as a function of age and sex.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The analyses included 971 participants from the INSPIRE-T cohort. INSPIRE-T is an ongoing 10-year observational study in Toulouse, France, that recruited individuals aged 20 years and older who were not affected by severe illness that could compromise life expectancy within 5 years (or within 1 year for individuals who were already disabled and at old age). Pain was assessed based on self-reported presence over the previous 8 days, using a numeric scale (0–4, where higher is worse). A composite intrinsic capacity score (calculated as the arithmetic mean of the scores across the five domains) and intrinsic capacity domains (locomotion, cognition, vitality, psychology, and sensory capacity, including visual and hearing capacities) were assessed. Estimates from the regression models should be interpreted inversely (eg, a positive regression coefficient indicates a negative association), except for the vitality domain. Multiple linear regressions analyses were conducted to examine the association of pain with intrinsic capacity and its domains, as well as the interaction with iAge (pain × iAge), age (pain × age) and sex (pain × sex). The INSPIRE Platform is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT04224038&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;Enrolment began on Oct 16, 2019, and the majority of participants were recruited by December, 2021. A total of 1014 individuals were recruited in the INSPIRE-T cohort; of those, 971 individuals (median age 64 years [IQR 48–77], range 20–102 years; 366 [38%] male and 605 female [62%] individuals) with complete pain data and intrinsic capacity evaluation data were included in the analysis. Both moderate pain (β 0·264, SE 0·076, p=0·0006) and intense pain (0·479, 0·105, p&lt;0·0001) were negatively associated with intrinsic capacity values. Pain at all intensities, mild (0·512, 0·163, p=0·0017), moderate (1·111, 0·191, p&lt;0·0001), or intense (1·532, 0·263, p&lt;0·0001), was significantly associated with lower scores in the psychological domain. Intense pain was associated with reduced scores in all intrinsic capacity domains (locomotor: 0·857, 0·219, p&lt;0·0001; vitality: –4·159, 1·742, p=0·017; cognitive:","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 12","pages":"Article 100798"},"PeriodicalIF":14.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145709592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety outcomes of trazodone versus antipsychotics for delirium after hospital admission in adults aged 65 years and older: a nationwide cohort study using a target trial emulation framework","authors":"Chun-Ting Yang PhD ,&nbsp;James M Wilkins MD DPhil ,&nbsp;Kevin T Pritchard PhD ,&nbsp;Qiaoxi Chen PhD ,&nbsp;Xiaojuan Liu PhD ,&nbsp;Dae Hyun Kim MD ScD ,&nbsp;Kueiyu Joshua Lin MD ScD","doi":"10.1016/j.lanhl.2025.100804","DOIUrl":"10.1016/j.lanhl.2025.100804","url":null,"abstract":"<div><h3>Background</h3><div>Trazodone has emerged as a potentially safer alternative to atypical antipsychotic medications for managing delirium-related symptoms in older adults after hospital admission. This study aimed to compare safety outcomes in older adults who were prescribed trazodone versus atypical antipsychotic medication after hospital discharge.</div></div><div><h3>Methods</h3><div>This population-based cohort study was done using US Medicare data from Jan 1, 2013, to Dec 31, 2022, and Optum de-identified Clinformatics Data Mart Database data from Jan 1, 2013, to Aug 31, 2025, with a target trial emulation framework. Patients aged at least 65 years without psychiatric disorders who were prescribed a new trazodone or atypical antipsychotic medication (quetiapine, risperidone, or olanzapine) prescription within 30 days of hospital discharge with a claims-based delirium diagnosis were included. We applied propensity score overlap weighting to adjust for 162 covariates. The primary outcome was all-cause rehospitalisation. Secondary outcomes included rehospitalisation for delirium, falls (including fall-related emergency department visits), pneumonia, urinary tract infections, stroke, and all-cause mortality. Treatment-outcome associations were estimated using the Fine–Gray model for non-fatal outcomes (presented as subdistribution hazard ratio [SDHR]) and the Cox model for all-cause mortality (presented as hazard ratio [HR]). Estimates from the two databases were pooled using inverse-variance weighting.</div></div><div><h3>Findings</h3><div>11 678 trazodone and 29 590 atypical antipsychotic medication users were included. Compared with antipsychotic medications, trazodone was associated with lower risks of rehospitalisation (SDHR 0·95 [95% CI 0·91–0·98]), rehospitalisation for delirium (SDHR 0·80 [0·75–0·86]), urinary tract infection (SDHR 0·84 [0·72–0·99]), and all-cause mortality (HR 0·84 [0·79–0·90]); no significant difference was observed for falls (SDHR 0·93 [0·85–1·02]), pneumonia (SDHR 0·96 [0·79–1·16]), and stroke (SDHR 0·92 [0·77–1·11]). The reduced risk of rehospitalisation with trazodone was consistent when compared with risperidone (SDHR 0·89 [0·84–0·95]), and olanzapine (SDHR 0·88 [0·82–0·94]) but no difference was seen with quetiapine (SDHR 0·97 [0·93–1·01]).</div></div><div><h3>Interpretation</h3><div>These results revealed reduced risks of rehospitalisation and all-cause mortality associated with trazodone versus atypical antipsychotic medications. Trazodone is a potentially safer alternative to antipsychotic medications in the management of delirium-related symptoms after hospital discharge.</div></div><div><h3>Funding</h3><div>National Institute on Aging.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 12","pages":"Article 100804"},"PeriodicalIF":14.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145834945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of learning APOE genotype on cognitively unimpaired adults: a pre-screening cohort study of the Alzheimer’s Prevention Initiative Generation Study 1","authors":"Jessica B Langbaum PhD ,&nbsp;Prof Angela R Bradbury MD ,&nbsp;Prof Brian L Egleston PhD ,&nbsp;Elisabeth McCarty Wood MS LCSG ,&nbsp;Carolyn M Langlois MS ,&nbsp;Emily A Largent JD PhD RN ,&nbsp;Kristin Harkins MPH ,&nbsp;Claire M Erickson PhD MPA ,&nbsp;Shana D Stites PsyD ,&nbsp;Emma Oyen BS ,&nbsp;Marie-Emmanuelle Riviere PhD ,&nbsp;Fonda Liu PharmD ,&nbsp;Ana Graf MD ,&nbsp;Scott Y H Kim MD PhD ,&nbsp;Prof Joshua D Grill PhD ,&nbsp;Prof Eric M Reiman MD ,&nbsp;Prof Pierre N Tariot MD ,&nbsp;Prof J Scott Roberts PhD ,&nbsp;Jason Karlawish MD","doi":"10.1016/j.lanhl.2025.100778","DOIUrl":"10.1016/j.lanhl.2025.100778","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The apolipoprotein E (&lt;em&gt;APOE&lt;/em&gt;) gene is the best established genetic risk factor for Alzheimer’s disease in later life, with the ε4 allele conferring higher risk. &lt;em&gt;APOE&lt;/em&gt; disclosure is becoming increasingly common in the clinical care of people with Alzheimer’s disease and in cognitively unimpaired adults. In this study, we aimed to describe changes in measures of genetic disease knowledge and psychiatric symptoms following &lt;em&gt;APOE&lt;/em&gt; disclosure to cognitively unimpaired adults.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Data were collected as part of the screening phase of the global, multicentre, Alzheimer’s Prevention Initiative Generation Study 1 (&lt;span&gt;&lt;span&gt;NCT02565511&lt;/span&gt;&lt;svg&gt;&lt;path&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;). Eligible individuals were cognitively unimpaired (Mini-Mental State Exam total score ≥24), aged 60–75 years, and psychologically pre-screened for readiness (by measures of depressive symptoms and anxiety) to receive their &lt;em&gt;APOE&lt;/em&gt; genotype from a health-care provider. Participants were assessed before disclosure, and 2–7 days, 6 weeks, 6 months, and 12 months after disclosure. Multivariable linear and ordinal logistic regressions were used to compare changes in genetic disease knowledge, anxiety, depression, and distress by &lt;em&gt;APOE4&lt;/em&gt; genotype status, adjusting for key covariates, with a focus on 2–7 days after disclosure. Multiple imputation by chained equations methods was used to account for missing outcome data.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;The trial took place between Nov 30, 2015, and Sept 23, 2019. In total, 9496 participants (including 790 &lt;em&gt;APOE4&lt;/em&gt; homozygotes, 4869 heterozygotes, and 3837 non-carriers) learned their &lt;em&gt;APOE&lt;/em&gt; genotype from a health-care provider as part of Generation Study 1 screening. 4038 (42·5%) participants were in the 65–69-year age group, 5790 (61·0%) were female, 3706 (39·0%) were male, and 8862 (93·3%) self-identified as White. Increase in genetic disease knowledge 2–7 days after disclosure was greater in &lt;em&gt;APOE4&lt;/em&gt; homozygotes (mean 1·19 [SD 3·95]) than in heterozygotes (0·78 [3·95], p=0·042) and non-carriers (0·29 [3·96], p=0·0002). Disease-specific distress 2–7 days after disclosure increased more in homozygotes (2·25 [6·42]) than in heterozygotes (0·53 [5·08], p&lt;0·0001) and non-carriers (0·79 [4·95], p&lt;0·0001). Levels of anxiety 2–7 days after disclosure increased in homozygotes (0·17 [2·95]) but decreased in heterozygotes (–0·67 [2·68], p&lt;0·0001) and non-carriers (–0·66 [2·67], p&lt;0·0001). There were no significant changes in depressive symptoms following disclosure for any &lt;em&gt;APOE4&lt;/em&gt; group. Notably, for all &lt;em&gt;APOE4&lt;/em&gt; groups, increases in distress and anxiety were small and did not reach predefined levels of clinical concern.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;In cognitively unimpaired, psychologically pre-screened adults, &lt;em&gt;APOE&lt;/em&gt; disclosure by a trained health-care provider was generally safe an","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100778"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145649473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term survival after invasive pneumococcal disease: a matched cohort study using electronic health records in England","authors":"Anne Suffel PhD ,&nbsp;Fariyo Abdullahi MSc ,&nbsp;Eleanor Barry PhD ,&nbsp;Jemma Walker PhD ,&nbsp;Prof Nick Andrews PhD ,&nbsp;Zahin Amin-Chowdhury MSc ,&nbsp;Prof Shamez N Ladhani PhD ,&nbsp;Daniel Grint PhD ,&nbsp;Helen I McDonald PhD ,&nbsp;Prof Ian Douglas PhD ,&nbsp;Prof Kathryn E Mansfield PhD ,&nbsp;Edward P K Parker PhD","doi":"10.1016/j.lanhl.2025.100775","DOIUrl":"10.1016/j.lanhl.2025.100775","url":null,"abstract":"<div><h3>Background</h3><div>Invasive pneumococcal disease (IPD) is associated with increased long-term mortality, but it is unclear if this is explained by pre-existing comorbidities. We aimed to estimate the long-term survival following IPD in comparison with the general population, adjusting for potential confounders such as underlying comorbidities.</div></div><div><h3>Methods</h3><div>We conducted a matched cohort study comparing long-term survival (&gt;120 days after infection) in individuals with IPD and comparators without IPD. Cases were individuals aged 65 years or older with laboratory-confirmed IPD (2012–19) identified through enhanced national surveillance. Comparators matched on age, sex, and calendar date of laboratory-confirmed diagnosis were drawn from primary care electronic health records in Clinical Practice Research Datalink GOLD. We used Cox regression, stratified by matched set, to compare mortality in people with and without IPD, adjusting for relevant comorbidities, socioeconomic deprivation, and ethnicity.</div></div><div><h3>Findings</h3><div>We included 13 401 IPD cases and 67 005 comparators without IPD. There were 5038 (53·5%) female and 4380 (46·5%) male IPD cases and 19 927 (53·5%) female and 17 351 (46·5%) male comparators without IPD. After adjusting for comorbidities, socioeconomic deprivation, and ethnicity, we found increased all-cause mortality in IPD cases compared with comparators without IPD (hazard ratio 3·74 [95% CI 3·50–3·99]). The predicted median survival was 4·7 years (IQR 2·9–7·4) for IPD cases and more than 11·9 years (IQR 8·7 to &gt;11·9) for comparators without IPD. This increased mortality was consistent across subgroups defined by age, vaccination history, and comorbidity status (including diabetes, chronic respiratory disease, and chronic heart disease).</div></div><div><h3>Interpretation</h3><div>IPD was associated with increased mortality at least 5 years after infection. These findings emphasise the value of IPD prevention and the need for more research into the clinical management of people who have had IPD. Long-term mortality should be incorporated in cost-effectiveness analyses for pneumococcal vaccines.</div></div><div><h3>Funding</h3><div>National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Vaccines and Immunisation (NIHR200929).</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100775"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significant new disability after major non-cardiac surgery in older adults aged 65 years and older in Canada: a multicentre prospective cohort study","authors":"Prof Duminda N Wijeysundera PhD ,&nbsp;Prof Shabbir M H Alibhai MD ,&nbsp;Prof Martine T E Puts PhD ,&nbsp;Keying Xu MSc ,&nbsp;Julian F Daza PhD ,&nbsp;Calvin Diep MD ,&nbsp;Karim S Ladha MD ,&nbsp;Tyler R Chesney MD ,&nbsp;Prof C David Mazer MD ,&nbsp;Alice C Wei MD ,&nbsp;Sahar Ehtesham MSc ,&nbsp;Emily Hladkowicz PhD ,&nbsp;Janneth Pazmino-Canizares MSc ,&nbsp;Stephen Choi MD ,&nbsp;Melinda Davis MBBS ,&nbsp;Prof Derek Dillane MD ,&nbsp;Emmanuelle Duceppe PhD ,&nbsp;Prof Eric Jacobsohn MBChB ,&nbsp;Gianni R Lorello MD ,&nbsp;David B MacDonald MD ,&nbsp;J Wu","doi":"10.1016/j.lanhl.2025.100789","DOIUrl":"10.1016/j.lanhl.2025.100789","url":null,"abstract":"<div><h3>Background</h3><div>Older adults aged 65 years and older considering major surgery often prioritise functional and cognitive outcomes over survival. Therefore, we conducted a prospective cohort study that aimed to characterise the incidence, effect, and predictors of new postoperative disability in older adults.</div></div><div><h3>Methods</h3><div>The Functional Improvement Trajectories After Surgery multicentre prospective cohort study enrolled older adults (ie, those aged ≥65 years) undergoing major elective non-cardiac surgery at 17 hospitals across Canada. Endovascular, joint replacement, intra-cranial, and palliative procedures were excluded. The WHO Disability Assessment Schedule was used to assess disability preoperatively and at 1, 3, 6, 9, and 12 months postoperatively. The primary outcome was 6-month significant new disability or death. The secondary outcome was this composite outcome at 12 months. Multivariable logistic regression models were used to estimate associations of baseline characteristics with outcomes.</div></div><div><h3>Findings</h3><div>Between Dec 16, 2019, and April 26, 2023, we enrolled 2007 patients (median age 72 years [IQR 68–76]; 853 [42·5%] were female), of whom 1988 (99·1%) lived at home and 868 (43·3%) lived with frailty. By 6 months after surgery, 16·5% patients had significant new disability and death, increasing to 20·7% by 1 year. Patients with new disability at 6 months had higher risks of concurrent depression (risk difference 36·7%, 95% CI 31·9–41·6) and decisional regret (9·9%, 5·1–14·7). At 12 months, the higher risks of depression (33·6%, 28·2–39·0) and decisional regret (12·9%, 7·9–17·8) persisted. Multivariable modelling identified baseline frailty, cognitive impairment, mobility aids, open surgery, smoking, and possibly unmet social supports as associated with increased risks of postoperative new disability or death.</div></div><div><h3>Interpretation</h3><div>One in six older adults in this cohort experienced new disability or death at 6 months following major surgery, increasing to one in five patients by 1 year. Preoperative assessment of frailty, cognitive status, and social supports could enhance shared decision making, care planning, and functional recovery.</div></div><div><h3>Funding</h3><div>Canadian Institutes of Health Research, PSI Foundation, Ontario Ministry of Health Innovation Fund, and the Elizabeth A and Richard J Currie, OC Chair in Translational Anesthesia Research at St Michael’s Hospital and the University of Toronto.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100789"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights of the EuGMS congress 2025","authors":"Philippa K Harris","doi":"10.1016/j.lanhl.2025.100793","DOIUrl":"10.1016/j.lanhl.2025.100793","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100793"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}