Pub Date : 2025-10-01DOI: 10.1016/j.lanhl.2025.100776
Natalia Dowgiałło-Gornowicz
{"title":"Metabolic and bariatric surgery in septuagenarians","authors":"Natalia Dowgiałło-Gornowicz","doi":"10.1016/j.lanhl.2025.100776","DOIUrl":"10.1016/j.lanhl.2025.100776","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 10","pages":"Article 100776"},"PeriodicalIF":14.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422959","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}
Pub Date : 2025-10-01DOI: 10.1016/j.lanhl.2025.100791
Anna Hung , Yoon Hie Kim , Juliessa M Pavon
{"title":"Testing complex interventions for polypharmacy in real-world conditions","authors":"Anna Hung , Yoon Hie Kim , Juliessa M Pavon","doi":"10.1016/j.lanhl.2025.100791","DOIUrl":"10.1016/j.lanhl.2025.100791","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 10","pages":"Article 100791"},"PeriodicalIF":14.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145446062","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}
Pub Date : 2025-10-01DOI: 10.1016/j.lanhl.2025.100782
Shahmir H Ali
{"title":"Care beyond caregivers: a wider spectrum of social support for older adults","authors":"Shahmir H Ali","doi":"10.1016/j.lanhl.2025.100782","DOIUrl":"10.1016/j.lanhl.2025.100782","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 10","pages":"Article 100782"},"PeriodicalIF":14.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145348939","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}
Pub Date : 2025-10-01DOI: 10.1016/j.lanhl.2025.100772
Patricia M Ortega PhD , Elena Brachimi MBBS , Ahmed R Ahmed PhD , Prof Sanjay Purkayastha MD , Christos Tsironis MD , Krishna Moorthy MD , Sherif Hakky PhD , Jonathan Cousins MBBS , Harvinder Chahal PhD , Saira Hameed PhD , Prof Tricia Tan PhD , Samantha Scholtz PhD , Karen O'Donnell BSc , Louisa Brolly BSc , Ciara Price BSc , Anna Sackey MSc , Candace Bovill-Taylor BSc , Joanne Boyle BSc , Rhian Houghton BSc , Jonathan Sullivan MSc , Chioma Izzi-Engbeaya PhD
Background
The prevalence of obesity is rising alongside population ageing, yet the long-term benefits of metabolic and bariatric surgery (MBS) in older adults is unclear. We aimed to evaluate the impact of MBS on survival in individuals aged 69 years and older with obesity.
Methods
We conducted a retrospective cohort study of patients aged 69 years and older managed in a UK tertiary bariatric centre between Jan 1, 2015, and Dec 31, 2024. Patients were eligible for inclusion if they had complete clinical data. Patients who underwent MBS were compared with matched controls who did not undergo MBS. Mahalanobis distance matching was performed (1:1) using age, BMI, American Society of Anesthesiologists grade, type 2 diabetes, and cardiovascular disease. Data were retrieved from electronic health records. The primary outcome was all-cause mortality after matching. Cox regression was used to assess survival.
Findings
Of the 186 patients, 44 (24%) underwent MBS. The median age was 71 years (IQR 70–74), 114 (61%) of 186 patients were women, 72 (39%) were men, median BMI was 41 kg/m2 (IQR 37–45), and median follow-up was 39 months (IQR 22–70). After matching, 44 MBS patients were compared with 34 control participants. Matched Kaplan–Meier analysis showed superior survival among MBS patients compared with control patients (log-rank p=0·010). MBS was associated with a 68% reduction in all-cause mortality on univariate analysis (hazard ratio 0·32 [95% CI 0·11–0·92]; p=0·036) and a 75% reduction in all-cause mortality on multivariate analysis (0·25 [0·08–0·77]; p=0·015). In MBS patients, the postoperative 30-day morbidity rate was 9%: Dindo-Clavien grade III-IV complications occurred in three (7%) of 44 patients, and one person (2%) died.
Interpretation
In a specialist setting, MBS was independently associated with improved survival in individuals aged 69 years and older, with acceptable perioperative risk. Chronological age alone should not preclude consideration for MBS. These findings support further evaluation of surgical options in well selected older adults with obesity.
{"title":"Metabolic and bariatric surgery in adults aged 69 years and older in England: a matched survival retrospective cohort study","authors":"Patricia M Ortega PhD , Elena Brachimi MBBS , Ahmed R Ahmed PhD , Prof Sanjay Purkayastha MD , Christos Tsironis MD , Krishna Moorthy MD , Sherif Hakky PhD , Jonathan Cousins MBBS , Harvinder Chahal PhD , Saira Hameed PhD , Prof Tricia Tan PhD , Samantha Scholtz PhD , Karen O'Donnell BSc , Louisa Brolly BSc , Ciara Price BSc , Anna Sackey MSc , Candace Bovill-Taylor BSc , Joanne Boyle BSc , Rhian Houghton BSc , Jonathan Sullivan MSc , Chioma Izzi-Engbeaya PhD","doi":"10.1016/j.lanhl.2025.100772","DOIUrl":"10.1016/j.lanhl.2025.100772","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of obesity is rising alongside population ageing, yet the long-term benefits of metabolic and bariatric surgery (MBS) in older adults is unclear. We aimed to evaluate the impact of MBS on survival in individuals aged 69 years and older with obesity.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study of patients aged 69 years and older managed in a UK tertiary bariatric centre between Jan 1, 2015, and Dec 31, 2024. Patients were eligible for inclusion if they had complete clinical data. Patients who underwent MBS were compared with matched controls who did not undergo MBS. Mahalanobis distance matching was performed (1:1) using age, BMI, American Society of Anesthesiologists grade, type 2 diabetes, and cardiovascular disease. Data were retrieved from electronic health records. The primary outcome was all-cause mortality after matching. Cox regression was used to assess survival.</div></div><div><h3>Findings</h3><div>Of the 186 patients, 44 (24%) underwent MBS. The median age was 71 years (IQR 70–74), 114 (61%) of 186 patients were women, 72 (39%) were men, median BMI was 41 kg/m<sup>2</sup> (IQR 37–45), and median follow-up was 39 months (IQR 22–70). After matching, 44 MBS patients were compared with 34 control participants. Matched Kaplan–Meier analysis showed superior survival among MBS patients compared with control patients (log-rank p=0·010). MBS was associated with a 68% reduction in all-cause mortality on univariate analysis (hazard ratio 0·32 [95% CI 0·11–0·92]; p=0·036) and a 75% reduction in all-cause mortality on multivariate analysis (0·25 [0·08–0·77]; p=0·015). In MBS patients, the postoperative 30-day morbidity rate was 9%: Dindo-Clavien grade III-IV complications occurred in three (7%) of 44 patients, and one person (2%) died.</div></div><div><h3>Interpretation</h3><div>In a specialist setting, MBS was independently associated with improved survival in individuals aged 69 years and older, with acceptable perioperative risk. Chronological age alone should not preclude consideration for MBS. These findings support further evaluation of surgical options in well selected older adults with obesity.</div></div><div><h3>Funding</h3><div>National Institute for Health and Care Research.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 10","pages":"Article 100772"},"PeriodicalIF":14.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145422947","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}
Pub Date : 2025-09-01DOI: 10.1016/j.lanhl.2025.100757
Ruby Yu PhD , Derek Lai MSc , Grace Leung MSc , Lok-yan Tam BNurs , Clara Cheng MASSM , Sara Kong BSc , Cecilia Tong MSc , Matthew Yu BSc , Prof Jean Woo MD
<div><h3>Background</h3><div>Declines in intrinsic capacity have been associated with increased risks of frailty, disability, and hospitalisation. We estimated population attributable fractions (PAFs) for these outcomes with respect to intrinsic capacity-related conditions and traditional modifiable risk factors in different age groups.</div></div><div><h3>Methods</h3><div>We analysed data from a territory-wide, multicentre, community-based, prospective cohort study (2023–24) in Hong Kong. Among 22 237 Chinese adults aged 60 years and older with follow-up data, we calculated age-specific PAFs for incident frailty, instrumental activities of daily living (IADL) disability, and hospitalisation associated with 13 modifiable risk factors. These risk factors included intrinsic capacity conditions, cardiometabolic conditions, and socioeconomic and lifestyle factors, and combinations of these.</div></div><div><h3>Findings</h3><div>Between March 21, 2023, and Dec 31, 2024, 47 776 participants were recruited to the study. 41 226 (86·3%) had complete baseline data for all intrinsic capacity conditions, cardiometabolic conditions, socioeconomic and lifestyle factors, demographic covariates, and outcome variables and were therefore included in our study sample. 22 237 (53·9%) of 41 226 participants completed follow-up assessments at least 6 months after baseline with a mean follow-up of 360·4 days (SD 71·6, median 348·0, IQR 307·0–399·0), 1398 (7·1%) of 19 777 participants had incident frailty, 1152 (6·0%) of 19 171 participants had incident IADL disability, and 2068 (11·1%) of 18 622 participants were hospitalised. Limited mobility was the leading risk factor associated across all outcomes (PAFs 9·8–25·3%). Depressive symptoms were a strong risk factor associated with frailty (PAF 19·1%). Age-stratified analyses revealed that limited mobility had the highest PAFs in adults aged 80 years and older, whereas depressive symptoms showed peak PAFs in those aged 60–69 years in most cases. Hypertension contributed to all outcomes (PAFs 8·4–19·6%) only in adults younger than 80 years. In adults aged 60–69 years physical activity was the predominant risk factor associated with frailty (PAF 21·9%) and disability (PAF 22·3%). The attributable risk of lower education with frailty increased with age, reaching its peak in adults aged 80 years and older (PAF 20·2%). Regarding the joint effects of the risk factors, intrinsic capacity decline was the factor associated with the highest overall attributable risk for all outcomes, exceeding the impact of cardiometabolic diseases and socioeconomic and lifestyle risk.</div></div><div><h3>Interpretation</h3><div>Our findings provide insights into age-specific risk factors for frailty, disability, and hospitalisation in older people, underlining the importance of targeted prevention strategies across age groups. Our findings further support a shift towards prioritising intrinsic capacity to better support healthy ageing at the popu
{"title":"Age-specific population attributable fractions for frailty, functional disability, and hospitalisation in Chinese older people: an ICOPE-based prospective cohort study","authors":"Ruby Yu PhD , Derek Lai MSc , Grace Leung MSc , Lok-yan Tam BNurs , Clara Cheng MASSM , Sara Kong BSc , Cecilia Tong MSc , Matthew Yu BSc , Prof Jean Woo MD","doi":"10.1016/j.lanhl.2025.100757","DOIUrl":"10.1016/j.lanhl.2025.100757","url":null,"abstract":"<div><h3>Background</h3><div>Declines in intrinsic capacity have been associated with increased risks of frailty, disability, and hospitalisation. We estimated population attributable fractions (PAFs) for these outcomes with respect to intrinsic capacity-related conditions and traditional modifiable risk factors in different age groups.</div></div><div><h3>Methods</h3><div>We analysed data from a territory-wide, multicentre, community-based, prospective cohort study (2023–24) in Hong Kong. Among 22 237 Chinese adults aged 60 years and older with follow-up data, we calculated age-specific PAFs for incident frailty, instrumental activities of daily living (IADL) disability, and hospitalisation associated with 13 modifiable risk factors. These risk factors included intrinsic capacity conditions, cardiometabolic conditions, and socioeconomic and lifestyle factors, and combinations of these.</div></div><div><h3>Findings</h3><div>Between March 21, 2023, and Dec 31, 2024, 47 776 participants were recruited to the study. 41 226 (86·3%) had complete baseline data for all intrinsic capacity conditions, cardiometabolic conditions, socioeconomic and lifestyle factors, demographic covariates, and outcome variables and were therefore included in our study sample. 22 237 (53·9%) of 41 226 participants completed follow-up assessments at least 6 months after baseline with a mean follow-up of 360·4 days (SD 71·6, median 348·0, IQR 307·0–399·0), 1398 (7·1%) of 19 777 participants had incident frailty, 1152 (6·0%) of 19 171 participants had incident IADL disability, and 2068 (11·1%) of 18 622 participants were hospitalised. Limited mobility was the leading risk factor associated across all outcomes (PAFs 9·8–25·3%). Depressive symptoms were a strong risk factor associated with frailty (PAF 19·1%). Age-stratified analyses revealed that limited mobility had the highest PAFs in adults aged 80 years and older, whereas depressive symptoms showed peak PAFs in those aged 60–69 years in most cases. Hypertension contributed to all outcomes (PAFs 8·4–19·6%) only in adults younger than 80 years. In adults aged 60–69 years physical activity was the predominant risk factor associated with frailty (PAF 21·9%) and disability (PAF 22·3%). The attributable risk of lower education with frailty increased with age, reaching its peak in adults aged 80 years and older (PAF 20·2%). Regarding the joint effects of the risk factors, intrinsic capacity decline was the factor associated with the highest overall attributable risk for all outcomes, exceeding the impact of cardiometabolic diseases and socioeconomic and lifestyle risk.</div></div><div><h3>Interpretation</h3><div>Our findings provide insights into age-specific risk factors for frailty, disability, and hospitalisation in older people, underlining the importance of targeted prevention strategies across age groups. Our findings further support a shift towards prioritising intrinsic capacity to better support healthy ageing at the popu","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100757"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008445","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}
Pub Date : 2025-09-01DOI: 10.1016/j.lanhl.2025.100764
Raj C Shah MD , Prof Joanne Ryan PhD , Katherine L Webb MA , Prof Rory Wolfe PhD , Prof Andrew Chan MD , Trevor T-J Chong MBBS , Prof Michael E Ernst PharmD , Prof Sara E Espinoza MD , Olivia Flynn BMed , Song Yuin Lee MBBS , John McNeil MBBS , Prof Mark R Nelson MBBS , Suzanne G Orchard PhD , Prof Christopher M Reid PhD , Kerry Sheets MD , Prof Nigel P Stocks MBBS , Prof Nilakshi S Weerasinghe MBBS , Michelle E Wilson PhD , Robyn L Woods PhD , Prof Anne M Murray MD
Background
In the Aspirin in Reducing Events in the Elderly (ASPREE) clinical trial, low-dose aspirin was not associated with survival free of dementia and persistent physical disability (a measure of a healthy lifespan); however, there was a small increased risk of death. Given the long pre-clinical phase of many ageing conditions, we aimed to examine the legacy effect (post-trial) and the longer-term effect of aspirin versus placebo through extended follow-up in the ASPREE-XT observational study.
Methods
Between March 10, 2010, and Dec 24, 2014, 19 114 community-dwelling people in Australia and the USA, aged predominantly 70 years and older, were randomly assigned to low-dose aspirin or placebo for a median of 4·7 years as part of the ASPREE trial. Post-trial observational follow-up continued for a median of 4·3 years (IQR 4·1–4·6). All components of the primary endpoint (ie, incident dementia, persistent physical disability, and death) were adjudicated by masked expert panels. Analyses used Cox proportional hazards models with intention-to-treat.
Findings
15 633 participants (8836 [56·5%] were women, 6797 [43·5%] were men; 981 [6·3%] were not White) were eligible for and agreed to observational follow-up. There was no effect of randomisation to aspirin (34·37 events per 1000 person-years) versus placebo (33·68 per 1000 person-years) on the primary endpoint (hazard ratio [HR] 1·02; 95% CI 0·94–1·11; p=0·63) in the ASPREE-XT period. Similarly, over the period of both ASPREE and ASPREE-XT, no long-term effect of aspirin versus placebo was observed on the composite outcome of death, dementia, or persistent physical disability over almost a decade of follow-up (HR 1·01; 95% CI 0·95–1·08; p=0·65), including no long-term effect on deaths (1·06; 0·99–1·14; p=0·10). No effect of aspirin on incident major haemorrhagic events as compared with placebo was found in ASPREE-XT; however, aspirin was associated with an increased hazard for incident major haemorrhagic events across both ASPREE and ASPREE-XT (1·24; 1·10–1·39).
Interpretation
Low-dose aspirin does not appear to be effective in promoting a healthy lifespan in initially healthy, community-dwelling older people.
Funding
National Institute on Aging and the National Cancer Institute (USA).
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Pub Date : 2025-09-01DOI: 10.1016/j.lanhl.2025.100763
Prof Mikel Izquierdo PhD , Robinsón Ramírez-Vélez PhD , Prof Maria A Fiatarone Singh MD FRACP
Integrating exercise prescriptions with medication management represents a novel approach for enhancing health and function, optimising medication effectiveness, and reducing adverse drug reactions and polypharmacy in older adults (ie, those aged ≥60 years). This Personal View highlights the need for a comprehensive assessment of lifestyle, diagnoses, geriatric syndromes, and medications with an emphasis on fully incorporating exercise treatment into geriatric care. Exercise is an alternative to less effective or unsafe medications for many conditions, including depression, anxiety, insomnia, osteoarthritis, and dementia. Exercise is an important adjunct to pharmacotherapy for many common chronic conditions such as coronary artery disease, heart failure, diabetes, osteoporosis, cancer, and chronic obstructive pulmonary disease. Adding exercise to drug management can mitigate adverse drug reactions, enhance medication compliance, and reduce the adverse effects of sedentary behaviour and ageing processes on chronic disease expression. Targeted exercise programmes have also been shown to ameliorate drug-induced side-effects, including anorexia, falls, sarcopenia, osteoporosis, and orthostatic hypotension, and to overcome constraints such as reduced aerobic fitness, balance impairment, and muscle atrophy due to some medications. Health-care professionals require additional training and support to ensure that exercise assumes a key, central role in older adults with multimorbidity and polypharmacy, as supported by the current literature. This Personal View describes practical approaches to incorporating exercise into clinical practice as a step towards an integrated geriatric care model, with the ultimate aim of increasing health span and minimising disability.
{"title":"Integrating exercise and medication management in geriatric care: a holistic strategy to enhance health outcomes and reduce polypharmacy","authors":"Prof Mikel Izquierdo PhD , Robinsón Ramírez-Vélez PhD , Prof Maria A Fiatarone Singh MD FRACP","doi":"10.1016/j.lanhl.2025.100763","DOIUrl":"10.1016/j.lanhl.2025.100763","url":null,"abstract":"<div><div>Integrating exercise prescriptions with medication management represents a novel approach for enhancing health and function, optimising medication effectiveness, and reducing adverse drug reactions and polypharmacy in older adults (ie, those aged ≥60 years). This Personal View highlights the need for a comprehensive assessment of lifestyle, diagnoses, geriatric syndromes, and medications with an emphasis on fully incorporating exercise treatment into geriatric care. Exercise is an alternative to less effective or unsafe medications for many conditions, including depression, anxiety, insomnia, osteoarthritis, and dementia. Exercise is an important adjunct to pharmacotherapy for many common chronic conditions such as coronary artery disease, heart failure, diabetes, osteoporosis, cancer, and chronic obstructive pulmonary disease. Adding exercise to drug management can mitigate adverse drug reactions, enhance medication compliance, and reduce the adverse effects of sedentary behaviour and ageing processes on chronic disease expression. Targeted exercise programmes have also been shown to ameliorate drug-induced side-effects, including anorexia, falls, sarcopenia, osteoporosis, and orthostatic hypotension, and to overcome constraints such as reduced aerobic fitness, balance impairment, and muscle atrophy due to some medications. Health-care professionals require additional training and support to ensure that exercise assumes a key, central role in older adults with multimorbidity and polypharmacy, as supported by the current literature. This Personal View describes practical approaches to incorporating exercise into clinical practice as a step towards an integrated geriatric care model, with the ultimate aim of increasing health span and minimising disability.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100763"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182213","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}
Pub Date : 2025-09-01DOI: 10.1016/j.lanhl.2025.100749
Juliana S Oliveira PhD , Prof Catherine Sherrington PhD , Prof Stephen R Lord PhD , Giane C Camara MPhil , Shannon Colley BA , Courtney A West MHC , Abby Haynes PhD , Heidi Gilchrist PhD , Wing S Kwok PhD , Louise MN Pearce PhD , Geraldine Wallbank BAppSc , Mallory Trent PhD , Prof Adrian Bauman PhD , Anne C Grunseit PhD , Prof Kaarin J Anstey PhD , Prof Anne Tiedemann PhD
Background
Exercises targeting balance and strength are proven to prevent falls. Yoga is growing in popularity and can improve balance and mobility in older adults, but its effects on falls have not been rigorously tested. In this study, we aimed to compare the effects of Iyengar yoga-based exercise and seated relaxation yoga on the rate of falls among older adults.
Methods
This pragmatic, two-arm, parallel randomised controlled trial recruited Australian community-dwelling people aged 60 years and older who were not currently practising yoga and who lived independently. Participants were randomly assigned (1:1) to the intervention (Iyengar yoga-based exercise) or control (seated relaxation yoga) group using a computer-generated sequence. Participants and yoga instructors were unmasked, but research staff verifying falls data and assessing goal attainment were masked to group allocation. Intervention participants received 80 supervised, 1-h, twice-weekly yoga classes over 12 months, and were encouraged to undertake unsupervised practice on 2 additional days per week. Control participants attended two 1-h supervised workshops focused on seated breathing and stretching. Most classes were held online due to the COVID-19 pandemic. The primary outcome was fall rate per year. Secondary outcomes were mental wellbeing, physical activity, quality of life, balance self-confidence, physical function, sleep quality, pain, and goal attainment, all assessed in the intention-to-treat population. The study protocol was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001183178).
Findings
Between Oct 3, 2019, and Oct 28, 2021, 2182 older adults expressed their interest in participating, 810 were assessed for eligibility, 110 were excluded, and 700 were randomly assigned to either the Iyengar yoga exercise programme or the control group (seated yoga relaxation programme; 350 participants per group). The mean age of participants was 67 years (SD 5·2), and 570 (81%) were female and 130 (19%) were male. Six intervention participants reported musculoskeletal-related adverse events associated with the yoga programme, and no serious adverse events occurred. Contrary to expectations, there was a higher fall rate in the intervention group than in the control group (0·87 vs 0·64 falls per person-year; incidence rate ratio 1·33 [95% CI 1·01–1·75; p=0·044]). The intervention improved the number of hours per week of planned physical activity (mean difference 0·96 h per week [95% CI 0·43–1·49]; p<0·0001), self-reported balance confidence (mean difference 2·94 [0·60–5·28]; p=0·014), and goal attainment (mean difference 0·60 [0·26–0·94]; p=0·0006). No significant between-group differences were identified for other secondary outcomes.
Interpretation
This Iyengar yoga-based programme should not be recommended for fall prevention in its
背景:以平衡和力量为目标的锻炼已被证明可以防止跌倒。瑜伽越来越受欢迎,可以改善老年人的平衡和活动能力,但它对摔倒的影响还没有经过严格的测试。在这项研究中,我们旨在比较艾扬格瑜伽和坐姿放松瑜伽对老年人跌倒率的影响。方法:这项实用的,双臂,平行随机对照试验招募了60岁及以上的澳大利亚社区居民,他们目前没有练习瑜伽,并且独立生活。参与者按照电脑生成的顺序被随机分配到干预组(基于艾扬格瑜伽的锻炼)和对照组(坐式放松瑜伽)。参与者和瑜伽教练没有戴面具,但验证跌倒数据和评估目标实现情况的研究人员对小组分配不戴面具。干预参与者在12个月的时间里接受了80次有监督的、每周两次的1小时瑜伽课程,并被鼓励每周额外进行2天的无监督练习。对照组参与者参加了两个1小时的有监督的讲习班,重点是坐姿呼吸和伸展。受新型冠状病毒感染症(COVID-19)疫情影响,大部分课程都在网上进行。主要观察指标为每年的下降率。次要结果是心理健康、身体活动、生活质量、平衡自信、身体功能、睡眠质量、疼痛和目标实现,所有这些都是在意向治疗人群中评估的。该研究方案已在澳大利亚新西兰临床试验登记处注册(ACTRN12619001183178)。研究结果:在2019年10月3日至2021年10月28日期间,2182名老年人表达了参与的兴趣,810人被评估为合格,110人被排除,700人被随机分配到艾杨格瑜伽锻炼项目或对照组(坐式瑜伽放松项目,每组350人)。参与者的平均年龄为67岁(SD 5.2),女性570人(81%),男性130人(19%)。6名干预参与者报告了与瑜伽计划相关的肌肉骨骼相关不良事件,没有发生严重的不良事件。与预期相反,干预组的跌倒率高于对照组(0.87 vs 0.64 /人/年;发病率比1.33 [95% CI 1.01 - 1.75; p= 0.044])。干预提高了每周计划体育活动的小时数(平均差异为0.96小时/周[95% CI 0.43 -1·49]);解释:这种基于艾扬格瑜伽的计划不应以目前的形式推荐用于预防跌倒。改进的动态平衡规划和预防跌倒战略值得调查。资助:国家卫生和医学研究委员会。
{"title":"The effect of an Iyengar yoga-based exercise programme versus a seated yoga relaxation programme on falls in people aged 60 years and older (SAGE): a pragmatic, two-arm, parallel randomised controlled trial","authors":"Juliana S Oliveira PhD , Prof Catherine Sherrington PhD , Prof Stephen R Lord PhD , Giane C Camara MPhil , Shannon Colley BA , Courtney A West MHC , Abby Haynes PhD , Heidi Gilchrist PhD , Wing S Kwok PhD , Louise MN Pearce PhD , Geraldine Wallbank BAppSc , Mallory Trent PhD , Prof Adrian Bauman PhD , Anne C Grunseit PhD , Prof Kaarin J Anstey PhD , Prof Anne Tiedemann PhD","doi":"10.1016/j.lanhl.2025.100749","DOIUrl":"10.1016/j.lanhl.2025.100749","url":null,"abstract":"<div><h3>Background</h3><div>Exercises targeting balance and strength are proven to prevent falls. Yoga is growing in popularity and can improve balance and mobility in older adults, but its effects on falls have not been rigorously tested. In this study, we aimed to compare the effects of Iyengar yoga-based exercise and seated relaxation yoga on the rate of falls among older adults.</div></div><div><h3>Methods</h3><div>This pragmatic, two-arm, parallel randomised controlled trial recruited Australian community-dwelling people aged 60 years and older who were not currently practising yoga and who lived independently. Participants were randomly assigned (1:1) to the intervention (Iyengar yoga-based exercise) or control (seated relaxation yoga) group using a computer-generated sequence. Participants and yoga instructors were unmasked, but research staff verifying falls data and assessing goal attainment were masked to group allocation. Intervention participants received 80 supervised, 1-h, twice-weekly yoga classes over 12 months, and were encouraged to undertake unsupervised practice on 2 additional days per week. Control participants attended two 1-h supervised workshops focused on seated breathing and stretching. Most classes were held online due to the COVID-19 pandemic. The primary outcome was fall rate per year. Secondary outcomes were mental wellbeing, physical activity, quality of life, balance self-confidence, physical function, sleep quality, pain, and goal attainment, all assessed in the intention-to-treat population. The study protocol was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12619001183178).</div></div><div><h3>Findings</h3><div>Between Oct 3, 2019, and Oct 28, 2021, 2182 older adults expressed their interest in participating, 810 were assessed for eligibility, 110 were excluded, and 700 were randomly assigned to either the Iyengar yoga exercise programme or the control group (seated yoga relaxation programme; 350 participants per group). The mean age of participants was 67 years (SD 5·2), and 570 (81%) were female and 130 (19%) were male. Six intervention participants reported musculoskeletal-related adverse events associated with the yoga programme, and no serious adverse events occurred. Contrary to expectations, there was a higher fall rate in the intervention group than in the control group (0·87 <em>vs</em> 0·64 falls per person-year; incidence rate ratio 1·33 [95% CI 1·01–1·75; p=0·044]). The intervention improved the number of hours per week of planned physical activity (mean difference 0·96 h per week [95% CI 0·43–1·49]; p<0·0001), self-reported balance confidence (mean difference 2·94 [0·60–5·28]; p=0·014), and goal attainment (mean difference 0·60 [0·26–0·94]; p=0·0006). No significant between-group differences were identified for other secondary outcomes.</div></div><div><h3>Interpretation</h3><div>This Iyengar yoga-based programme should not be recommended for fall prevention in its ","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100749"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179234","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}