Lancet Healthy Longevity最新文献

{"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}

{"title":"Ageing in South-East Asia","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2025.100807","DOIUrl":"10.1016/j.lanhl.2025.100807","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100807"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145655158","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":"A pragmatic application with clear personal impact","authors":"Carolyn E Schwartz","doi":"10.1016/j.lanhl.2025.100795","DOIUrl":"10.1016/j.lanhl.2025.100795","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100795"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640782","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":"Bridging the age gap: improving representation of older adults in clinical trials for type 2 diabetes and chronic kidney disease","authors":"Changyuan Yang MD ,&nbsp;Hanneke Joosten MD PhD ,&nbsp;Lynne Chepulis PhD ,&nbsp;Fabiana Rossi Varallo PhD ,&nbsp;Peter van Dijk MD PhD ,&nbsp;Deidra C Crews MD ,&nbsp;Priya Vart PhD","doi":"10.1016/j.lanhl.2025.100796","DOIUrl":"10.1016/j.lanhl.2025.100796","url":null,"abstract":"<div><div>Chronic kidney disease (CKD) is common among older adults, with more than a third of individuals older than 65 years having moderate to severe CKD globally. Management of CKD in older adults is often complex because of multiple comorbidities, polypharmacy, and frailty. However, older adults remain under-represented in clinical trials for both type 2 diabetes (T2D), which is the leading risk factor for CKD, and CKD itself. Recent analyses show consistent low representation of older adults in T2D trials. Similarly, participants of dialysis trials tend to be younger, healthier, and have a lower mortality rate than individuals in the real-world dialysis population, and even greater age disparities are reported in trials for non-dialysis-dependent CKD. This under-representation limits the evidence base for treating older adults and often compels clinicians to extrapolate findings from younger populations or rely on observational data. Consequently, both undertreatment and overtreatment of T2D and CKD might occur. Excluding older adults from trial participation leads to society bearing the costs of avoidable harms from preventable adverse events, inappropriate medication use, and missed opportunities to improve functional outcomes in an ageing population. Addressing this age gap in trial population and target treatment population is crucial to ensure evidence-based, equitable care for older adults. In this Personal View, we explore the barriers of under-representation of older adults and propose strategies to enhance their inclusion in future trials for T2D and CKD.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100796"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606714","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":"Understanding changes in complex care needs over time: key research insights into multimorbidity trajectories","authors":"Amaia Calderón-Larrañaga PhD ,&nbsp;Elisa Fabbri MD ,&nbsp;Ana Isabel González MD ,&nbsp;Prof Rafael Perera-Salazar PhD ,&nbsp;Nina Grede PhD ,&nbsp;Prof Bruce Guthrie MD ,&nbsp;Prof José M Valderas MD ,&nbsp;Caterina Gregorio PhD ,&nbsp;Prof Christiane Muth MD ,&nbsp;Davide L Vetrano MD ,&nbsp;Prof Gabriele Meyer PhD ,&nbsp;Luigi Ferrucci MD ,&nbsp;Jeanet W Blom MD ,&nbsp;Kerstin Bernartz MSc ,&nbsp;Lara Schürmann MSc ,&nbsp;Maria Hanf MSc ,&nbsp;Prof Martin Scherer MD ,&nbsp;Prof Michael A Steinman MD ,&nbsp;Prof Mieke Rijken PhD ,&nbsp;Prof Sharon Straus MD ,&nbsp;Marjan van den Akker PhD","doi":"10.1016/j.lanhl.2025.100790","DOIUrl":"10.1016/j.lanhl.2025.100790","url":null,"abstract":"<div><div>Multimorbidity, the coexistence of multiple chronic diseases or conditions, poses a major challenge for health-care systems worldwide. Traditional research has largely relied on cross-sectional studies, offering limited insight into multimorbidity evolution over time. This Personal View advocates for a paradigm shift towards longitudinal approaches that capture multimorbidity trajectories. Tracking the sequence, pace, and severity of disease accumulation can enhance our understanding of underlying mechanisms, inform early interventions, and improve patient care. Drawing on expert discussions from an international workshop held in Bielefeld, Germany, in May, 2024, we outline key themes and findings to guide future research on the dynamic processes underlying multimorbidity trajectories. Specifically, we summarise previous work, examine the challenges and opportunities of existing data resources, and highlight priority areas for further investigation. Advancing this field will require the standardisation of longitudinal multimorbidity phenotypes, integration of health and social care processes, and testing the usefulness of trajectories for patient-relevant outcomes and risk stratification. Progress will also depend on methodological innovation, patient and public involvement, harmonisation of diverse data sources, and close interdisciplinary collaboration. Ultimately, a trajectory-based framework for multimorbidity research can enable more personalised, efficient, and equitable health-care strategies, improving outcomes in ageing populations.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100790"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145640755","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":"Hidden risks: long-term mortality after invasive pneumococcal disease","authors":"Carmen Ardanuy ,&nbsp;Jordi Càmara","doi":"10.1016/j.lanhl.2025.100785","DOIUrl":"10.1016/j.lanhl.2025.100785","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100785"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145597806","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":"Pain and suicide in ageing societies: closing a structural blind spot","authors":"Nilson N Mendes Neto ,&nbsp;Jessika M Mendes ,&nbsp;Thiago Duarte ,&nbsp;Brendon Stubbs","doi":"10.1016/j.lanhl.2025.100787","DOIUrl":"10.1016/j.lanhl.2025.100787","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 11","pages":"Article 100787"},"PeriodicalIF":14.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524418","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 WHO Integrated Care for Older People programme: a key strategy for addressing ageing in sub-Saharan Africa","authors":"Maturin Tabue-Teguo ,&nbsp;Marie-Josiane Ntsama-Essomba ,&nbsp;Moustapha Drame ,&nbsp;Mamadou Coume ,&nbsp;Nadine Simo","doi":"10.1016/j.lanhl.2025.100784","DOIUrl":"10.1016/j.lanhl.2025.100784","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 10","pages":"Article 100784"},"PeriodicalIF":14.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145472203","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}