Lancet Healthy Longevity最新文献

{"title":"Impact of hip fracture on survival, disability, pain, and health-related quality of life in Zimbabwe: a prospective cohort study","authors":"Mohamad I Nasser PhD ,&nbsp;Anya Burton PhD ,&nbsp;Hannah Wilson PhD ,&nbsp;Tadios Manyanga MSc ,&nbsp;Tafadzwa Madanhire PhD ,&nbsp;Prudance Mushayavanhu FCS Orthopaedics ,&nbsp;Munyaradzi Ndekwere FCS Orthopaedics ,&nbsp;Joseph Chipanga ,&nbsp;Samuel Hawley PhD ,&nbsp;Simon Matthew Graham PhD ,&nbsp;James Masters PhD ,&nbsp;Kate A Ward PhD ,&nbsp;Matthew L Costa PhD ,&nbsp;Rashida A Ferrand PhD ,&nbsp;Celia L Gregson FRCP","doi":"10.1016/j.lanhl.2025.100766","DOIUrl":"10.1016/j.lanhl.2025.100766","url":null,"abstract":"<div><h3>Background</h3><div>The population in Africa is ageing, and fragility fractures increasing. We assessed 1-year health outcomes following hip fracture in older adults in Zimbabwe.</div></div><div><h3>Methods</h3><div>In this prospective cohort study, a cohort of adults aged 40 years or older with hip fracture, presenting to hospitals in Harare (two public and five private hospitals) between Oct 15, 2021, and Oct 14, 2022, were followed up for 12 months. The primary outcome was survival, analysed with Kaplan–Meier curves at different timepoints (30 days, 120 days, 6–8 months, and 12 months after case identification), overall and stratified by age (&lt;70 years <em>vs</em> ≥70 years), delay to presentation (no delay [≤2 weeks] <em>vs</em> delay [&gt;2 weeks]), and facility type and operative management. We also quantified health-related quality of life (HRQoL), measured with 5-level EQ-5D (EQ-5D-5L), hip pain, self-reported from 0 (none) to 5 (all the time) and measured as interference with walking and sleep (1 [no interference] to 10 [complete interference]), as per the Brief Pain Inventory, and disability, measured with the WHO Disability Assessment Schedule version 2.0 (WHODAS).</div></div><div><h3>Findings</h3><div>Of 196 patients with hip fracture (96 [49%] female, 100 [51%] male; median age 74 years [IQR 62·5–83]), 162 (83%) had had a fragility fracture (low-energy trauma). In total, 173 (88%) were managed in a public hospital, of whom 96 (55%) received operative hip fixation. In contrast, all of the 23 (12%) managed in private facilities had an operation. After 12 months, 55 (29%) had died (49 [42%] of 117 patients aged ≥70 years, and six [9%] of 70 patients aged &lt;70 years). In public hospitals, 31 (42%) of 73 non-operated patients died, compared with 18 (19%) of 93 patients who were operated on. Overall, survival declined to 88% (95% CI 82–92) by 30 days and to 71% (64–77) by 12 months. The probability of survival was lower in patients aged 70 years or older than in those younger than 70 years (mortality hazard ratio for ≥70 years 6·10, 95% CI 2·61−14·22). The mean HRQoL utility score decreased from 0·81 (95% CI 0·80–0·83) pre-fracture to 0·29 (0·25–0·34) at 30 days post fracture. Minimal recovery was seen after 120 days (0·34, 0·29–0·39). By 12 months, 97 (97%) of 100 patients alive and able to provide data still reported pain from their hip injury. Post-fracture disability was almost universal, with only two (2%) of 100 patients being disability-free (WHODAS=0) by 12 months.</div></div><div><h3>Interpretation</h3><div>Following hip fracture, survival and quality of life decreased substantially in the study population. These findings reveal the need for the implementation of guidelines to standardise care and improve operative capacity to manage the predicted rise in fractures in this region.</div></div><div><h3>Funding</h3><div>Wellcome Trust.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100766"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287362","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":"Cognitive decline before and after mid-to-late-life smoking cessation: a longitudinal analysis of prospective cohort studies from 12 countries","authors":"Mikaela Bloomberg PhD ,&nbsp;Prof Jamie Brown PhD ,&nbsp;Giorgio Di Gessa PhD ,&nbsp;Feifei Bu PhD ,&nbsp;Prof Andrew Steptoe DSc","doi":"10.1016/j.lanhl.2025.100753","DOIUrl":"10.1016/j.lanhl.2025.100753","url":null,"abstract":"<div><h3>Background</h3><div>Whether short-term improvements in cognitive performance observed following smoking cessation are transient or if longer-term cognitive trajectories are also improved is unclear, particularly when adults are middle-aged or older at smoking cessation. We examined whether long-term cognitive trajectories improved following mid-to-late-life smoking cessation.</div></div><div><h3>Methods</h3><div>In this longitudinal study, we used data from three nationally representative cohort studies from 12 countries including 18 years of cognitive data (2002–20). Participants who quit smoking during follow-up were matched with an equal number of continuing smokers according to key demographic, socioeconomic, and cognitive criteria. We used piecewise linear mixed models to examine memory and fluency decline before and after smoking cessation and during a comparable time period in continuing smokers.</div></div><div><h3>Findings</h3><div>We included data from 9436 participants who smoked (4718 [50·0%] smokers who quit matched with 4718 [50·0%] continuing smokers, aged 40–89 years, with 4886 [51·8%] women and 4550 [48·2%] men). In the six years before smoking cessation, matched smokers who quit and continuing smokers had similar rates of memory and fluency decline (difference in memory decline [smokers who quit–continuing smokers] –0·03 SDs [95% CI –0·06 to 0·01], p=0·16; difference in fluency decline –0·01 [–0·04 to 0·03], p=0·76). In the six years following smoking cessation, smokers who quit had memory and fluency scores that declined more slowly than continuing smokers (difference in memory decline 0·05 SDs [0·00–0·10], p=0·036; difference in fluency decline 0·05 SDs [0·01–0·10], p=0·030). Coefficients for interaction with age at smoking cessation suggested results did not differ by age at smoking cessation (p&gt;0·05 for all).</div></div><div><h3>Interpretation</h3><div>In middle-aged and older smokers with initially similar cognitive trajectories, smokers who quit subsequently had more favourable trajectories than continuing smokers regardless of age at cessation. As older adults are less likely than younger people to attempt smoking cessation, improvements in long-term cognitive trajectories might provide an additional motivation to quit.</div></div><div><h3>Funding</h3><div>National Institute on Aging, National Institute for Health and Care Research.</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 9","pages":"Article 100753"},"PeriodicalIF":14.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309379","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":"Plant-based dietary patterns and age-specific risk of multimorbidity of cancer and cardiometabolic diseases: a prospective analysis","authors":"Reynalda Córdova PhD ,&nbsp;Prof Jihye Kim PhD ,&nbsp;Alysha S Thompson PhD ,&nbsp;Hwayoung Noh PhD ,&nbsp;Sanam Shah PhD ,&nbsp;Christina C Dahm PhD ,&nbsp;Christopher F Jensen MSc ,&nbsp;Lene Mellemkjær PhD ,&nbsp;Prof Anne Tjønneland PhD ,&nbsp;Verena Katzke PhD ,&nbsp;Charlotte Le Cornet PhD ,&nbsp;Christine El-Khoury MSc ,&nbsp;Prof Matthias B Schulze DrPH ,&nbsp;Giovanna Masala MD ,&nbsp;Claudia Agnoli MSc ,&nbsp;Vittorio Simeon PhD ,&nbsp;Rosario Tumino PhD ,&nbsp;Fulvio Ricceri PhD ,&nbsp;Prof W M Monique Verschuren PhD ,&nbsp;Prof Yvonne T van der Schouw PhD ,&nbsp;Heinz Freisling PhD","doi":"10.1016/j.lanhl.2025.100742","DOIUrl":"10.1016/j.lanhl.2025.100742","url":null,"abstract":"<div><h3>Background</h3><div>It is currently unknown whether plant-based dietary patterns influence disease progression to multimorbidity after an initial non-communicable disease, and whether the associated risk of multimorbidity varies with age. This study aimed to investigate associations of plant-based diets with the risk of multimorbidity, defined as the co-occurrence of at least two chronic diseases in an individual (either cancer at any site, cardiovascular disease, or type 2 diabetes).</div></div><div><h3>Methods</h3><div>This prospective cohort study used data from EPIC and UK Biobank across six European countries, with participants aged 35–70 years at recruitment. We excluded participants from these cohorts who had cancer, cardiovascular disease, or type 2 diabetes at baseline or those with missing data on diet or health outcomes. Data on dietary habits were assessed either at baseline through a validated dietary questionnaire about habits in the previous 12 months or through several 24-h recall questionnaires during approximately a year of follow-up. Multistate modelling with Cox regression was used to estimate the risk of multimorbidity according to a healthful plant-based diet index (hPDI) and, separately, an unhealthful plant-based diet index (uPDI). Risk differences in adults younger than 60 years and those age 60 years and older were estimated.</div></div><div><h3>Findings</h3><div>407 618 participants (226 324 from EPIC and 181 294 from UK Biobank) were included in this study. During a median follow-up time of 10·9 years in EPIC and 11·4 years in UK Biobank, 6604 cancer–cardiometabolic multimorbidity events occurred in both cohorts combined. A ten-point increment of the hPDI score was associated with a lower risk of multimorbidity, with a hazard ratio (HR) of 0·89 (95% CI 0·83–0·96) in EPIC and 0·81 (0·76–0·86) in UK Biobank. This inverse association was marginally weaker in older adults than in middle-aged adults in both cohorts. In UK Biobank, a ten-point increment of the hPDI score was associated with multivariable-adjusted HRs of 0·71 (95% CI 0·65–0·79) in adults younger than 60 years and 0·86 (0·80–0·92) in those aged 60 years and older (p_interaction=0·0016). The respective HRs in EPIC were 0·86 (95% CI 0·78–0·95) and 0·92 (0·84–1·02; p_interaction=0·32). A higher adherence to an unhealthy plant-based diet was positively associated with multimorbidity risk in UK Biobank (HR per ten-point increment of uPDI 1·22, 95% CI 1·16–1·29), but this was not replicated in EPIC (1·00, 0·94–1·08).</div></div><div><h3>Interpretation</h3><div>A healthy plant-based diet might reduce the burden of multimorbidity of cancer and cardiometabolic diseases among middle-aged and older adults.</div></div><div><h3>Funding</h3><div>The Korean Government (Ministry of Science and ICT).</div></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 8","pages":"Article 100742"},"PeriodicalIF":14.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972167","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":"Screening and management of frailty among people experiencing homelessness","authors":"Salmaan Z Kamal ,&nbsp;Katherine Diaz Vickery","doi":"10.1016/j.lanhl.2025.100760","DOIUrl":"10.1016/j.lanhl.2025.100760","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 8","pages":"Article 100760"},"PeriodicalIF":14.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972252","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":"Recognising frailty throughout adulthood","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2025.100765","DOIUrl":"10.1016/j.lanhl.2025.100765","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"6 8","pages":"Article 100765"},"PeriodicalIF":14.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144972334","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}