Pub Date : 2025-01-01DOI: 10.1016/j.lanhl.2024.100672
Prof Sunyoung Kim MD , Soeun Kim MSc , Prof Selin Woo PhD , Jiyeon Oh MD , Yejun Son MSc , Prof Louis Jacob MD , Prof Pinar Soysal MD , Prof Jungha Park MD , Prof Liang-Kung Chen MD , Dong Keon Yon MD
<div><h3>Background</h3><div>Deaths related to falls are a substantial public health problem worldwide, and insight into trends and differences in global fall-related deaths can be valuable for identifying prevention strategies and developing effective policies. Thus, we aimed to estimate global fall-related mortality rate trends and forecast future fall-related deaths.</div></div><div><h3>Methods</h3><div>In this global time-series analysis and modelling study, we investigated temporal trends in fall-related mortality rates from 1990 to 2021 using the WHO Mortality Database, following the GATHER guidelines, and forecasted trends until 2040 across 59 high-income and upper-middle-income countries. We focused on identifying specific patterns of variation in mortality rates across different age groups, sexes, and income levels based on World Bank country classification. We analysed temporal trends and patterns using a locally weighted scatter plot smoother curve presented by age-standardised mortality rates (ASMRs), and future projections were calculated based on Bayesian age–period–cohort analysis. We performed a decomposition analysis to identify variations in fall-related deaths by examining factors such as population growth, ageing, and epidemiological changes.</div></div><div><h3>Findings</h3><div>Fall-related mortality rates per 100 000 people declined from 23·21 (95% CI 21·30 to 25·12) in 1990 to 11·01 (9·94 to 12·08) in 2009, increasing to 12·50 (10·36 to 14·64) by 2021. Throughout the period from 1990 to 2021, fall-related mortality rates were consistently higher among men, individuals in high-income countries, and older adults. The results represent a clear pattern in fall-related mortality rates according to sex, income level, and age group. ASMRs exhibited varying patterns, with an initial decrease of 43·83% (from 11·54 [95% CI 9·33 to 13·76] in 1990 to 6·48 [95% CI 5·28 to 7·68] in 2005) in upper-middle-income countries with a subsequent rise of 49·69% to 9·70 (9·33 to 13·76) in 2021, with a 17·81% increase among women (from 9·04 in 2009 to 10·65 in 2021), and with a 1434·8% increase in individuals aged 85 years and older (from 5·00 [−4·94 to 14·94] in 1992 to 76·74 [62·10 to 91·39] in 2021). Furthermore, ASMRs showed a positive correlation with Socio-demographic Index (β=42·29 [10·26 to 74·32]; p<0·011), the Environmental Performance Index (β=0·19 [0·05 to 0·33]; p=0·0090), and the reverse Gini coefficient (β=22·58 [0·45 to 44·72]; p=0·046). Projections indicate that the fall-related mortality rate is expected to rise from 14·80 (95% credible intervals, 14·04 to 15·59) per 100 000 people in 2021 to 19·48 (7·02 to 98·84) by 2040. The increase in fall-related deaths from 1990 to 2040 can be attributed to the growth in population, because the absolute number of fall-related deaths has risen despite a declining rate.</div></div><div><h3>Interpretation</h3><div>Temporal trend in fall-related deaths declined from 1990 to 2009, followed by
{"title":"Temporal trends and patterns in mortality from falls across 59 high-income and upper-middle-income countries, 1990–2021, with projections up to 2040: a global time-series analysis and modelling study","authors":"Prof Sunyoung Kim MD , Soeun Kim MSc , Prof Selin Woo PhD , Jiyeon Oh MD , Yejun Son MSc , Prof Louis Jacob MD , Prof Pinar Soysal MD , Prof Jungha Park MD , Prof Liang-Kung Chen MD , Dong Keon Yon MD","doi":"10.1016/j.lanhl.2024.100672","DOIUrl":"10.1016/j.lanhl.2024.100672","url":null,"abstract":"<div><h3>Background</h3><div>Deaths related to falls are a substantial public health problem worldwide, and insight into trends and differences in global fall-related deaths can be valuable for identifying prevention strategies and developing effective policies. Thus, we aimed to estimate global fall-related mortality rate trends and forecast future fall-related deaths.</div></div><div><h3>Methods</h3><div>In this global time-series analysis and modelling study, we investigated temporal trends in fall-related mortality rates from 1990 to 2021 using the WHO Mortality Database, following the GATHER guidelines, and forecasted trends until 2040 across 59 high-income and upper-middle-income countries. We focused on identifying specific patterns of variation in mortality rates across different age groups, sexes, and income levels based on World Bank country classification. We analysed temporal trends and patterns using a locally weighted scatter plot smoother curve presented by age-standardised mortality rates (ASMRs), and future projections were calculated based on Bayesian age–period–cohort analysis. We performed a decomposition analysis to identify variations in fall-related deaths by examining factors such as population growth, ageing, and epidemiological changes.</div></div><div><h3>Findings</h3><div>Fall-related mortality rates per 100 000 people declined from 23·21 (95% CI 21·30 to 25·12) in 1990 to 11·01 (9·94 to 12·08) in 2009, increasing to 12·50 (10·36 to 14·64) by 2021. Throughout the period from 1990 to 2021, fall-related mortality rates were consistently higher among men, individuals in high-income countries, and older adults. The results represent a clear pattern in fall-related mortality rates according to sex, income level, and age group. ASMRs exhibited varying patterns, with an initial decrease of 43·83% (from 11·54 [95% CI 9·33 to 13·76] in 1990 to 6·48 [95% CI 5·28 to 7·68] in 2005) in upper-middle-income countries with a subsequent rise of 49·69% to 9·70 (9·33 to 13·76) in 2021, with a 17·81% increase among women (from 9·04 in 2009 to 10·65 in 2021), and with a 1434·8% increase in individuals aged 85 years and older (from 5·00 [−4·94 to 14·94] in 1992 to 76·74 [62·10 to 91·39] in 2021). Furthermore, ASMRs showed a positive correlation with Socio-demographic Index (β=42·29 [10·26 to 74·32]; p<0·011), the Environmental Performance Index (β=0·19 [0·05 to 0·33]; p=0·0090), and the reverse Gini coefficient (β=22·58 [0·45 to 44·72]; p=0·046). Projections indicate that the fall-related mortality rate is expected to rise from 14·80 (95% credible intervals, 14·04 to 15·59) per 100 000 people in 2021 to 19·48 (7·02 to 98·84) by 2040. The increase in fall-related deaths from 1990 to 2040 can be attributed to the growth in population, because the absolute number of fall-related deaths has risen despite a declining rate.</div></div><div><h3>Interpretation</h3><div>Temporal trend in fall-related deaths declined from 1990 to 2009, followed by","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100672"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.lanhl.2024.100663
Elburg van Boetzelaer MPH , Lekha Rathod MBBS , Patrick Keating PhD , Umberto Pellecchia PhD , Sunita Sharma PhD , Jason Nickerson PhD , Judith van de Kamp PhD , Prof Oscar H Franco PhD , James Smith MBBS , Favila Escobio MD , Joyce L Browne PhD
Health needs of older people in humanitarian settings are poorly documented, negatively affecting the appropriateness of health services they receive. This Review identified the major health needs of older people across humanitarian contexts, including non-communicable diseases and mental health conditions (eg, psychological distress and depression). Barriers to health care of older people included inaccessibility of health-care services; shortage of appropriate health care; insufficient availability of medications and medical equipment; poor geriatric expertise of health-care staff, health policy makers, and health authorities; and age discrimination by health-care personnel. Individual factors included low mobility, poor health literacy, dependence on others for access to care, and self-directed ageism. The participation of older people in shaping health-care services was highlighted as a facilitator of age-inclusive care. Several understudied areas related to the health needs of older people in humanitarian emergencies in low-income and middle-income countries were exposed. We urge governments, academic institutions, humanitarian organisations, and other health-care providers to focus their response and research efforts on the health needs of older people in conflict settings; the health needs of older people in humanitarian emergencies in understudied regions; and on neglected issues such as communicable diseases, cancer, neurocognitive disorders, sexual and reproductive health, genitourinary conditions, and nutrition. The participation of older people in the design, implementation, and evaluation of health-care services is essential to ensure accessibility, appropriateness, and acceptability of care.
{"title":"Health needs of older people and age-inclusive health care in humanitarian emergencies in low-income and middle-income countries: a systematic review","authors":"Elburg van Boetzelaer MPH , Lekha Rathod MBBS , Patrick Keating PhD , Umberto Pellecchia PhD , Sunita Sharma PhD , Jason Nickerson PhD , Judith van de Kamp PhD , Prof Oscar H Franco PhD , James Smith MBBS , Favila Escobio MD , Joyce L Browne PhD","doi":"10.1016/j.lanhl.2024.100663","DOIUrl":"10.1016/j.lanhl.2024.100663","url":null,"abstract":"<div><div>Health needs of older people in humanitarian settings are poorly documented, negatively affecting the appropriateness of health services they receive. This Review identified the major health needs of older people across humanitarian contexts, including non-communicable diseases and mental health conditions (eg, psychological distress and depression). Barriers to health care of older people included inaccessibility of health-care services; shortage of appropriate health care; insufficient availability of medications and medical equipment; poor geriatric expertise of health-care staff, health policy makers, and health authorities; and age discrimination by health-care personnel. Individual factors included low mobility, poor health literacy, dependence on others for access to care, and self-directed ageism. The participation of older people in shaping health-care services was highlighted as a facilitator of age-inclusive care. Several understudied areas related to the health needs of older people in humanitarian emergencies in low-income and middle-income countries were exposed. We urge governments, academic institutions, humanitarian organisations, and other health-care providers to focus their response and research efforts on the health needs of older people in conflict settings; the health needs of older people in humanitarian emergencies in understudied regions; and on neglected issues such as communicable diseases, cancer, neurocognitive disorders, sexual and reproductive health, genitourinary conditions, and nutrition. The participation of older people in the design, implementation, and evaluation of health-care services is essential to ensure accessibility, appropriateness, and acceptability of care.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 1","pages":"Article 100663"},"PeriodicalIF":13.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.lanhl.2024.100660
Eliza C Miller MD , Patrick Conley MS , Mohammad Alirezaei MD , Katrin Wolfova , Mitzi M Gonzales PhD , Zaldy S Tan MD , Sarah E Tom PhD , Lynn M Yee MD , Prof Adam M Brickman PhD , Natalie A Bello MD
<div><h3>Background</h3><div>Individuals with adverse pregnancy outcomes have an increased risk of cerebrovascular disease, but the association between adverse pregnancy outcomes and cognitive impairment and dementia is less well established. We aimed to synthesise, combine, and assess the growing body of data examining the associations between adverse pregnancy outcomes and mild cognitive impairment and dementia in parous women.</div></div><div><h3>Methods</h3><div>In this systematic review and meta-analysis, we searched PubMed (MEDLINE), Web of Science, and Embase from database inception up to July 18, 2024, with no language restrictions, for observational studies or clinical trials that reported mild cognitive impairment or dementia as outcomes and included female individuals or women who had an adverse pregnancy outcome, including hypertensive disorders of pregnancy, gestational diabetes, stillbirth, fetal growth restriction, preterm birth, or placental abruption. We excluded studies of men, nulliparous women, women with pre-pregnancy conditions associated with impaired cognition, and studies examining cognitive impairment within 6 months of pregnancy. Database searches were supplemented by manual review of the reference lists of included studies. If studies met eligibility criteria but did not have sufficient data for meta-analysis (ie, did not report a summary statistic or a hazard ratio [HR] for outcome estimation), they were included in the systematic review and excluded from the meta-analysis. After removing duplicates, two investigators independently screened titles and abstracts using Covidence software, with potentially eligible studies undergoing full-text review by the same reviewers, with further review by a third reviewer and disagreements resolved by discussion and group consensus. Study quality was assessed and summary statistics extracted by two reviewers independently. The primary outcomes of our study were mild cognitive impairment, all-cause dementia, Alzheimer’s disease, and vascular dementia. Heterogeneity was measured using the Q test and <em>I</em><sup>2</sup> statistic, and we used random-effects models with inverse-variance weighting to assess the association between adverse pregnancy outcome and primary outcomes with sufficient meta-analysable data via pooled adjusted HRs and 95% CIs. The study protocol was registered with PROSPERO, CRD42023453511.</div></div><div><h3>Findings</h3><div>Of 11 251 publications identified, 15 studies (including 7 347 202 participants) met inclusion criteria for the systematic review, and 11 studies (6 263 431 participants) had sufficient data for meta-analysis. A history of any adverse pregnancy outcome was associated with higher risk of all-cause dementia (adjusted HR 1·32 [95% CI 1·17–1·49]; <em>I</em><sup>2</sup>= 80%), Alzheimer’s disease (1·26 [1·04–1·53]; <em>I</em><sup>2</sup>=63%), and vascular dementia (1·94 [1·70–2·21]; <em>I</em><sup>2</sup>=0%). A history of any hypertensive
{"title":"Associations between adverse pregnancy outcomes and cognitive impairment and dementia: a systematic review and meta-analysis","authors":"Eliza C Miller MD , Patrick Conley MS , Mohammad Alirezaei MD , Katrin Wolfova , Mitzi M Gonzales PhD , Zaldy S Tan MD , Sarah E Tom PhD , Lynn M Yee MD , Prof Adam M Brickman PhD , Natalie A Bello MD","doi":"10.1016/j.lanhl.2024.100660","DOIUrl":"10.1016/j.lanhl.2024.100660","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with adverse pregnancy outcomes have an increased risk of cerebrovascular disease, but the association between adverse pregnancy outcomes and cognitive impairment and dementia is less well established. We aimed to synthesise, combine, and assess the growing body of data examining the associations between adverse pregnancy outcomes and mild cognitive impairment and dementia in parous women.</div></div><div><h3>Methods</h3><div>In this systematic review and meta-analysis, we searched PubMed (MEDLINE), Web of Science, and Embase from database inception up to July 18, 2024, with no language restrictions, for observational studies or clinical trials that reported mild cognitive impairment or dementia as outcomes and included female individuals or women who had an adverse pregnancy outcome, including hypertensive disorders of pregnancy, gestational diabetes, stillbirth, fetal growth restriction, preterm birth, or placental abruption. We excluded studies of men, nulliparous women, women with pre-pregnancy conditions associated with impaired cognition, and studies examining cognitive impairment within 6 months of pregnancy. Database searches were supplemented by manual review of the reference lists of included studies. If studies met eligibility criteria but did not have sufficient data for meta-analysis (ie, did not report a summary statistic or a hazard ratio [HR] for outcome estimation), they were included in the systematic review and excluded from the meta-analysis. After removing duplicates, two investigators independently screened titles and abstracts using Covidence software, with potentially eligible studies undergoing full-text review by the same reviewers, with further review by a third reviewer and disagreements resolved by discussion and group consensus. Study quality was assessed and summary statistics extracted by two reviewers independently. The primary outcomes of our study were mild cognitive impairment, all-cause dementia, Alzheimer’s disease, and vascular dementia. Heterogeneity was measured using the Q test and <em>I</em><sup>2</sup> statistic, and we used random-effects models with inverse-variance weighting to assess the association between adverse pregnancy outcome and primary outcomes with sufficient meta-analysable data via pooled adjusted HRs and 95% CIs. The study protocol was registered with PROSPERO, CRD42023453511.</div></div><div><h3>Findings</h3><div>Of 11 251 publications identified, 15 studies (including 7 347 202 participants) met inclusion criteria for the systematic review, and 11 studies (6 263 431 participants) had sufficient data for meta-analysis. A history of any adverse pregnancy outcome was associated with higher risk of all-cause dementia (adjusted HR 1·32 [95% CI 1·17–1·49]; <em>I</em><sup>2</sup>= 80%), Alzheimer’s disease (1·26 [1·04–1·53]; <em>I</em><sup>2</sup>=63%), and vascular dementia (1·94 [1·70–2·21]; <em>I</em><sup>2</sup>=0%). A history of any hypertensive ","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 12","pages":"Article 100660"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11726346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.lanhl.2024.100648
Tone Rubak MD , Simon Mark Dahl Baunwall PhD , Merete Gregersen PhD , Sara Ellegaard Paaske MD , Malene Asferg MD , Ishay Barat PhD , Joanna Secher-Johnsen MD , Mikael Groth Riis MD , Jeppe Bakkestrøm Rosenbæk PhD , Troels Kjærskov Hansen PhD , Marianne Ørum PhD , Prof Claire J Steves MD , Hanne Veilbæk RN , Prof Christian Lodberg Hvas PhD , Prof Else Marie Skjøde Damsgaard DMSc
Background
Clostridioides difficile infection causes diarrhoea and colitis. Older patients with C difficile infection are often frail and have comorbidities, leading to high mortality rates. The frailty burden in older people might restrict access to treatments, such as C difficile infection-specific antibiotics and faecal microbiota transplantation. We aimed to investigate the clinical effects of early comprehensive geriatric assessment (CGA) and frailty evaluation, including home visits and assessment for faecal microbiota transplantation, in older patients with C difficile infection.
Methods
In this randomised, quality improvement trial with a pragmatic design, patients from the Central Denmark Region aged 70 years or older with a positive PCR test for C difficile toxin were randomly assigned (1:1) to CGA or standard care, both with equal access to faecal microbiota transplantation. Patients and investigators were unmasked to treatment. The primary outcome was 90-day mortality, and was compared in the study groups according to the intention-to-treat principle. The study is registered with ClinicalTrials.gov, NCT05447533.
Findings
Between Sept 1, 2022, and May 3, 2023, we randomly assigned 217 patients to CGA (n=109) or standard care (n=108). The median patient age was 78 years (IQR 74–84). 116 (53%) of 217 patients were female and 101 (47%) were male. 16 (15%; 95% CI 9–23) of 109 patients in the CGA group and 22 (20%; 14–29) of 108 patients in the standard-care group died within 90 days (odds ratio 0·66, 95% CI 0·32–1·38. No serious adverse events or deaths related to patient assessment or faecal microbiota transplantation were recorded in either group. Deaths directly attributable to C difficile infection were lower in the CGA group (seven [44%] of 16 deaths vs 18 [82%] of 22 deaths in the standard-care group; p=0·020).
Interpretation
Older patients who received CGA had a 90-day mortality rate similar to that of patients who received standard care, but with fewer deaths directly attributable to C difficile infection.
Funding
Innovation Fund Denmark, Novo Nordisk Foundation, and Helsefonden.
背景：艰难梭菌感染会导致腹泻和结肠炎：艰难梭菌感染会导致腹泻和结肠炎。感染艰难梭菌的老年患者通常体弱多病，死亡率很高。老年人的虚弱负担可能会限制艰难梭菌感染特异性抗生素和粪便微生物群移植等治疗方法的使用。我们旨在研究早期老年综合评估（CGA）和虚弱评估（包括家访和粪便微生物群移植评估）对艰难梭菌感染老年患者的临床效果：在这项采用实用设计的随机质量改进试验中，丹麦中部地区 70 岁或以上、艰难梭菌毒素 PCR 检测呈阳性的患者被随机分配（1:1）接受 CGA 或标准护理，两者均可接受粪便微生物群移植。患者和研究人员在接受治疗时均未蒙面。主要结果是90天死亡率，根据意向治疗原则对研究组进行比较。该研究已在ClinicalTrials.gov注册，编号为NCT05447533.研究结果：2022年9月1日至2023年5月3日期间，我们将217名患者随机分配至CGA（109人）或标准护理（108人）。患者年龄中位数为 78 岁（IQR 74-84）。217 名患者中有 116 名（53%）女性，101 名（47%）男性。CGA组109名患者中有16人（15%；95% CI 9-23）在90天内死亡，标准护理组108名患者中有22人（20%；14-29）在90天内死亡（几率比0-66，95% CI 0-32-1-38）。两组患者均未发生与患者评估或粪便微生物群移植相关的严重不良事件或死亡。CGA组直接因艰难梭菌感染导致的死亡人数较少（16例死亡中的7例[44%]与标准护理组22例死亡中的18例[82%]；P=0-020）：接受CGA治疗的老年患者的90天死亡率与接受标准治疗的患者相似，但因艰难梭菌感染直接导致的死亡人数较少：资金来源：丹麦创新基金、诺和诺德基金会和Helsefonden。
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Pub Date : 2024-12-01DOI: 10.1016/j.lanhl.2024.100658
Antonia J Clarke MBBS , Maja Christensen MBBS , Anna H Balabanski PhD , Angela Dos Santos (Gumbaynggirr Kwiamble) PhD , Prof Peter A Barber (Ngāti Porou, Whakatōhea) PhD , Prof Alex Brown (Yuin) PhD , Matire Harwood (Ngāpuhi) PhD , Christina Storm Mienna (Sámi) PhD , Donald K Warne (Oglala Lakota) MD , Marwan Ahmed PhD , Judith M Katzenellenbogen PhD , Adrienne Withall (Dharawal Yuin) PhD , Kylie Radford PhD , Prof Amy G Brodtmann PhD
Dementia is a health priority for Indigenous peoples. Here, we reviewed studies on the prevalence of dementia or cognitive impairment among Indigenous populations from countries with a very high Human Development Index (≥0·8). Quality was assessed using the Joanna Briggs Institute risk-of-bias tool and CONSolIDated critERia for strengthening the reporting of health research involving Indigenous peoples (CONSIDER), with oversight provided by an Indigenous Advisory Board. After screening, 23 studies were included in the Review. Relative to the respective non-Indigenous populations, greater age-standardised prevalence ratios were observed in the Australian Aboriginal and Torres Strait Islander (2·5–5·2), Aotearoa-New Zealand Māori (1·2–2·0), and Singaporean Malay (1·3–1·7) populations, and greater crude prevalence ratios were observed in the Canadian First Nation (1·3), Singaporean Malay (2·3), Malaysian Melanau (1·7–4·0), American Indian and Alaska Native (1·0–3·2), and Chamorro of Guam (1·2–2·0) populations. The prevalence ratios were greater across younger age groups, predominantly comprising those younger than 70 years. 14 studies presented a moderate risk of bias and few studies reported Indigenous involvement. Despite improved management of risk factors, a greater prevalence of dementia persists in Indigenous populations, overall and at younger ages than in non-Indigenous populations. Future epidemiological work involving Indigenous populations should uphold and prioritise Indigenous perspectives.
{"title":"Prevalence of dementia among Indigenous populations of countries with a very high Human Development Index: a systematic review","authors":"Antonia J Clarke MBBS , Maja Christensen MBBS , Anna H Balabanski PhD , Angela Dos Santos (Gumbaynggirr Kwiamble) PhD , Prof Peter A Barber (Ngāti Porou, Whakatōhea) PhD , Prof Alex Brown (Yuin) PhD , Matire Harwood (Ngāpuhi) PhD , Christina Storm Mienna (Sámi) PhD , Donald K Warne (Oglala Lakota) MD , Marwan Ahmed PhD , Judith M Katzenellenbogen PhD , Adrienne Withall (Dharawal Yuin) PhD , Kylie Radford PhD , Prof Amy G Brodtmann PhD","doi":"10.1016/j.lanhl.2024.100658","DOIUrl":"10.1016/j.lanhl.2024.100658","url":null,"abstract":"<div><div>Dementia is a health priority for Indigenous peoples. Here, we reviewed studies on the prevalence of dementia or cognitive impairment among Indigenous populations from countries with a very high Human Development Index (≥0·8). Quality was assessed using the Joanna Briggs Institute risk-of-bias tool and CONSolIDated critERia for strengthening the reporting of health research involving Indigenous peoples (CONSIDER), with oversight provided by an Indigenous Advisory Board. After screening, 23 studies were included in the Review. Relative to the respective non-Indigenous populations, greater age-standardised prevalence ratios were observed in the Australian Aboriginal and Torres Strait Islander (2·5–5·2), Aotearoa-New Zealand Māori (1·2–2·0), and Singaporean Malay (1·3–1·7) populations, and greater crude prevalence ratios were observed in the Canadian First Nation (1·3), Singaporean Malay (2·3), Malaysian Melanau (1·7–4·0), American Indian and Alaska Native (1·0–3·2), and Chamorro of Guam (1·2–2·0) populations. The prevalence ratios were greater across younger age groups, predominantly comprising those younger than 70 years. 14 studies presented a moderate risk of bias and few studies reported Indigenous involvement. Despite improved management of risk factors, a greater prevalence of dementia persists in Indigenous populations, overall and at younger ages than in non-Indigenous populations. Future epidemiological work involving Indigenous populations should uphold and prioritise Indigenous perspectives.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 12","pages":"Article 100658"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.lanhl.2024.100665
Francesca R Farina PhD , Katie Bridgeman MPH , Sarah Gregory PhD , Lucía Crivelli PhD , Isabelle F Foote PhD , Otto-Emil I Jutila MSc , Ludmila Kucikova MScR , Luciano I Mariano PhD , Kim-Huong Nguyen PhD , Tony Thayanandan MSc , Funmi Akindejoye MPH , Joe Butler PhD , Ismael L Calandri MD , Giedrė Čepukaitytė DPhil , Scott T Chiesa PhD , Walter D Dawson DPhil , Kay Deckers PhD , Vanessa De la Cruz-Góngora PhD , Maria-Eleni Dounavi PhD , Ishtar Govia PhD , Laura Booi PhD
Efforts to prevent dementia can benefit from precision interventions delivered to the right population at the right time; that is, when the potential to reduce risk is the highest. Young adults (aged 18–39 years) are a neglected population in dementia research and policy making despite being highly exposed to several known modifiable risk factors. The risk and protective factors that have the biggest effect on dementia outcomes in young adulthood, and how these associations differ across regions and groups, still remain unclear. To address these uncertainties, the Next Generation Brain Health team convened a multidisciplinary expert group representing 15 nations across six continents. We identified several high-priority modifiable factors in young adulthood and devised five key recommendations for promoting brain health, ranging from individual to policy levels. Increasing research and policy focus on brain health across the life course, inclusive of younger populations, is the next crucial step in the efforts to prevent dementia at the global level.
{"title":"Next generation brain health: transforming global research and public health to promote prevention of dementia and reduce its risk in young adult populations","authors":"Francesca R Farina PhD , Katie Bridgeman MPH , Sarah Gregory PhD , Lucía Crivelli PhD , Isabelle F Foote PhD , Otto-Emil I Jutila MSc , Ludmila Kucikova MScR , Luciano I Mariano PhD , Kim-Huong Nguyen PhD , Tony Thayanandan MSc , Funmi Akindejoye MPH , Joe Butler PhD , Ismael L Calandri MD , Giedrė Čepukaitytė DPhil , Scott T Chiesa PhD , Walter D Dawson DPhil , Kay Deckers PhD , Vanessa De la Cruz-Góngora PhD , Maria-Eleni Dounavi PhD , Ishtar Govia PhD , Laura Booi PhD","doi":"10.1016/j.lanhl.2024.100665","DOIUrl":"10.1016/j.lanhl.2024.100665","url":null,"abstract":"<div><div>Efforts to prevent dementia can benefit from precision interventions delivered to the right population at the right time; that is, when the potential to reduce risk is the highest. Young adults (aged 18–39 years) are a neglected population in dementia research and policy making despite being highly exposed to several known modifiable risk factors. The risk and protective factors that have the biggest effect on dementia outcomes in young adulthood, and how these associations differ across regions and groups, still remain unclear. To address these uncertainties, the Next Generation Brain Health team convened a multidisciplinary expert group representing 15 nations across six continents. We identified several high-priority modifiable factors in young adulthood and devised five key recommendations for promoting brain health, ranging from individual to policy levels. Increasing research and policy focus on brain health across the life course, inclusive of younger populations, is the next crucial step in the efforts to prevent dementia at the global level.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 12","pages":"Article 100665"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-01DOI: 10.1016/j.lanhl.2024.100661
Anton De Spiegeleer , Bart De Spiegeleer
{"title":"Geriatricians-on-the-Move for sustainable ageing","authors":"Anton De Spiegeleer , Bart De Spiegeleer","doi":"10.1016/j.lanhl.2024.100661","DOIUrl":"10.1016/j.lanhl.2024.100661","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 12","pages":"Article 100661"},"PeriodicalIF":13.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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