Lancet Healthy Longevity最新文献

{"title":"Correction to Lancet Healthy Longev 2024; 5: 552–562","authors":"","doi":"10.1016/j.lanhl.2024.08.002","DOIUrl":"10.1016/j.lanhl.2024.08.002","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100633"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001594/pdfft?md5=6cdd1adeb80a30dcff492e13d446b578&pid=1-s2.0-S2666756824001594-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074063","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}

{"title":"Combating dementia: the imperative for population-level interventions","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2024.07.014","DOIUrl":"10.1016/j.lanhl.2024.07.014","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100631"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001491/pdfft?md5=9b42b7b1b87a4a7b4fa256586232d670&pid=1-s2.0-S2666756824001491-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989094","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}

{"title":"Association between surgical admissions, cognition, and neurodegeneration in older people: a population-based study from the UK Biobank","authors":"Jennifer Taylor PhD ,&nbsp;Kristy P Robledo PhD ,&nbsp;Vicente Medel PhD ,&nbsp;Prof Gillian Heller PhD ,&nbsp;Thomas Payne MD ,&nbsp;Jordan Wehrman PhD ,&nbsp;Cameron Casey PhD ,&nbsp;Phillip F Yang MBBS MS ,&nbsp;Bryan M Krause PhD ,&nbsp;Richard Lennertz MD PhD ,&nbsp;Prof Sharon Naismith DPsych ,&nbsp;Prof Armando Teixeira-Pinto PhD ,&nbsp;Prof Robert D Sanders MBBS PhD","doi":"10.1016/j.lanhl.2024.07.006","DOIUrl":"10.1016/j.lanhl.2024.07.006","url":null,"abstract":"<div><h3>Background</h3><p>Previous studies have shown that major surgical and medical hospital admissions are associated with cognitive decline in older people (aged 40–69 years at recruitment), which is concerning for patients and caregivers. We aimed to validate these findings in a large cohort and investigate associations with neurodegeneration using MRI.</p></div><div><h3>Methods</h3><p>For this population-based study, we analysed data from the UK Biobank collected from March 13, 2006, to July 16, 2023, linked to the National Health Service Hospital Episode Statistics database, excluding participants with dementia diagnoses. We constructed fully adjusted models that included age, time, sex, <em>Lancet</em> Commission dementia risk factors, stroke, and hospital admissions with a participant random effect. Primary outcomes were hippocampal volume and white matter hyperintensities, both of which are established markers of neurodegeneration, and exploratory analyses investigated the cortical thickness of Desikan–Killiany–Tourville atlas regions. The main cognitive outcomes were reaction time, fluid intelligence, and prospective and numeric memory. Surgeries were calculated cumulatively starting from 8 years before the baseline evaluation.</p></div><div><h3>Findings</h3><p>Of 502 412 participants in the UK Biobank study, 492 802 participants were eligible for inclusion in this study, of whom 46 706 underwent MRI. Small adverse associations with cognition were found per surgery: reaction time increased by 0·273 ms, fluid intelligence score decreased by 0·057 correct responses, prospective memory (scored as correct at first attempt) decreased (odds ratio 0·96 [95% CI 0·95 to 0·97]), and numeric memory maximum correct matches decreased by 0·025 in fully adjusted models. Surgeries were associated with smaller hippocampal volume (β=−5·76 mm³ [−7·89 to −3·64]) and greater white matter hyperintensities volume (β=100·02 mm³ [66·17 to 133·87]) in fully adjusted models. Surgeries were also associated with neurodegeneration of the insula and superior temporal cortex.</p></div><div><h3>Interpretation</h3><p>This population-based study corroborates that surgeries are generally safe but cumulatively are associated with cognitive decline and neurodegeneration. Perioperative brain health should be prioritised for older and vulnerable patients, particularly those who have multiple surgical procedures.</p></div><div><h3>Funding</h3><p>The Australian and New Zealand College of Anaesthetists (ANZCA) Foundation and the University of Sydney.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100623"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001399/pdfft?md5=bd3cfbe08dfee9f5b21f45c2462307a5&pid=1-s2.0-S2666756824001399-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156176","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}

{"title":"The associations of socioeconomic status, social activities, and loneliness with depressive symptoms in adults aged 50 years and older across 24 countries: findings from five prospective cohort studies","authors":"Yaping Wang MD ,&nbsp;Prof Min Liu PhD ,&nbsp;Prof Fude Yang MD ,&nbsp;Prof Hongguang Chen MD ,&nbsp;Prof Yaogang Wang PhD ,&nbsp;Prof Jue Liu PhD","doi":"10.1016/j.lanhl.2024.07.001","DOIUrl":"10.1016/j.lanhl.2024.07.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Depression is the leading cause of mortality among mental health disorders. Evidence about the associations of socioeconomic status, social activities, and loneliness with depression is scarce. We aimed to identify whether social activities and loneliness mediate the association between socioeconomic status and depression, and the extent of interactive or joint relationships between social activities, loneliness, and socioeconomic status on depression.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this population-based, cross-national cohort study we used data from five nationally representative surveys across 24 countries between Feb 15, 2008, and Feb 27, 2019: the Health and Retirement Study (HRS); the English Longitudinal Study of Ageing (ELSA); the Survey of Health, Ageing and Retirement in Europe (SHARE); the China Health and Retirement Longitudinal Study (CHARLS); and the Mexican Health and Ageing Study (MHAS). We included participants who were aged 50 years and older with reported information on socioeconomic status, social activities, and loneliness at baseline, and who had been assessed at least twice. We excluded participants with depressive symptoms at baseline; those with missing data on depressive symptoms and covariates; and those lost to follow-up. We defined socioeconomic status as high and low using latent class analysis based on family income, education, and employment status. Depression was assessed using the Center for Epidemiological Studies Depression Scale (CES-D) or EURO-D. We applied Cox proportional hazard models to estimate the association of socioeconomic status with depression. We used random-effects models to obtain pooled results. Joint and interactive effects of socioeconomic status, social activities, and loneliness on depression were explored, and the mediating roles of social activities and loneliness in the association between socioeconomic status and depression were explored using causal mediation analysis.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;A total of 69 160 participants were included in our study and, during a median follow-up of 5 years, a total of 20 237 participants developed depression with a pooled incidence of 7·2 (95% CI 4·4–10·0) per 100 person-years. Compared with participants with high socioeconomic status, those with low socioeconomic status had a higher risk of depression (pooled hazard ratio [HR] 1·34; 95% CI 1·23–1·44). The proportion of the associations between socioeconomic status and depression mediated by social activities and loneliness were 6·12% (1·14–28·45) and 5·54% (0·71–27·62), respectively. We only observed a significant multiplicative interaction of socioeconomic status and loneliness with depression (pooled HR 0·84; 0·79–0·90). Compared with participants with high socioeconomic status and who were socially active and not lonely, those with low socioeconomic status and who were socially inactive and lonely had a higher risk of depression (pooled HR 2·45; 2·08–2·82).","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 9","pages":"Article 100618"},"PeriodicalIF":13.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266675682400134X/pdfft?md5=412aa34e9dea043387eb9d7c218215ac&pid=1-s2.0-S266675682400134X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142112843","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}

{"title":"Global barriers to hip-fracture care","authors":"Naoko Onizuka ,&nbsp;Carmen Quatman","doi":"10.1016/S2666-7568(24)00088-6","DOIUrl":"10.1016/S2666-7568(24)00088-6","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 8","pages":"Pages e510-e511"},"PeriodicalIF":13.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000886/pdfft?md5=3a9ca6fcefafd061076cf9811ce4cf88&pid=1-s2.0-S2666756824000886-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724610","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}

{"title":"The economic burden of cancer, coronary heart disease, dementia, and stroke in England in 2018, with projection to 2050: an evaluation of two cohort studies","authors":"Filipa Landeiro DPhil ,&nbsp;Callum Harris MA BMBCH ,&nbsp;David Groves MSc ,&nbsp;Samuel O’Neill MBBS ,&nbsp;Kuljinder Singh Jandu MBChB ,&nbsp;Eliana M C Tacconi DPhil ,&nbsp;Samantha Field MSc ,&nbsp;Nileema Patel MSc ,&nbsp;Anya Göpfert MSc ,&nbsp;Hannes Hagson MSc ,&nbsp;José Leal DPhil ,&nbsp;Ramón Luengo-Fernández DPhil","doi":"10.1016/S2666-7568(24)00108-9","DOIUrl":"10.1016/S2666-7568(24)00108-9","url":null,"abstract":"<div><h3>Background</h3><p>Cancer, coronary heart disease, dementia, and stroke are major contributors to morbidity and mortality in England. We aimed to assess the economic burden (including health-care, social care, and informal care costs, as well as productivity losses) of these four conditions in England in 2018, and forecast this cost to 2050 using population projections.</p></div><div><h3>Methods</h3><p>We used individual patient-level data from the Clinical Practice Research Datalink (CPRD) Aurum, which contains primary care electronic health records of patients from 738 general practices in England, to calculate health-care and residential and nursing home resource use, and data from the English Longitudinal Study on Ageing (ELSA) to calculate informal and formal care costs. From CPRD Aurum, we included patients registered on Jan 1, 2018, in a CPRD general practice with Hospital Episode Statistics (HES)-linked records, omitting all children younger than 1 year. From ELSA, we included data collected from wave 9 (2018–19). Aggregate English resource use data on morbidity, mortality, and health-care, social care, and informal care were obtained and apportioned, using multivariable regression analyses, to cancer, coronary heart disease, dementia, and stroke.</p></div><div><h3>Findings</h3><p>We included 4 161 558 patients from CPRD Aurum with HES-linked data (mean age 41 years [SD 23], with 2 079 679 [50·0%] men and 2 081 879 [50·0%] women) and 8736 patients in ELSA (68 years [11], with 4882 [55·9 %] men and 3854 [44·1%] women). In 2018, the total cost was £18·9 billion (95% CI 18·4–19·4) for cancer, £12·7 billion (12·3–13·0) for coronary heart disease, £11·7 billion (9·6–12·7) for dementia, and £8·6 billion (8·2–9·0) for stroke. Using 2050 English population projections, we estimated that costs would rise by 40% (39–41) for cancer, 54% (53–55) for coronary heart disease, 100% (97–102) for dementia, and 85% (84–86) for stroke, for a total of £26·5 billion (25·7–27·3), £19·6 billion (18·9–20·2), £23·5 billion (19·3–25·3), and £16·0 billion (15·3–16·6), respectively.</p></div><div><h3>Interpretation</h3><p>This study provides contemporary estimates of the wide-ranging impact of the most important chronic conditions on all aspects of the economy in England. The data will help to inform evidence-based polices to reduce the impact of chronic disease, promoting care access, better health outcomes, and economic sustainability.</p></div><div><h3>Funding</h3><p>Alzheimer's Research UK.</p></div>","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 8","pages":"Pages e514-e523"},"PeriodicalIF":13.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001089/pdfft?md5=e457d0f2af96e04d97c9bfe514b3cebd&pid=1-s2.0-S2666756824001089-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789346","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}

{"title":"Deprescribing for older adults with hypertension at high risk for adverse events: not so fast","authors":"Nicholas M Pajewski ,&nbsp;Mark A Supiano","doi":"10.1016/j.lanhl.2024.07.003","DOIUrl":"10.1016/j.lanhl.2024.07.003","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 8","pages":"Pages e512-e513"},"PeriodicalIF":13.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001363/pdfft?md5=72266904b1289ce694ba26d8e7b27e71&pid=1-s2.0-S2666756824001363-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879614","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}

{"title":"Time from injury to hip-fracture surgery in low-income and middle-income regions: a secondary analysis of data from the International Orthopaedic Multicentre Study in Fracture Care (INORMUS)","authors":"Elizabeth Armstrong MPH ,&nbsp;Kris Rogers PhD ,&nbsp;Chuan Silvia Li MSc ,&nbsp;Jagnoor Jagnoor PhD ,&nbsp;Paul Moroz MD ,&nbsp;Gerald Chukwuemeka Oguzie MD ,&nbsp;Samuel Hailu MD ,&nbsp;Prof Theodore Miclau III MD ,&nbsp;Fernando de la Huerta MD ,&nbsp;Jose de Jesus Martinez-Ruiz MD ,&nbsp;Fernando Bidolegui MD ,&nbsp;Prof Junlin Zhou MD ,&nbsp;Prof Xinlong Ma MD ,&nbsp;Prof Bo Wu MD ,&nbsp;Parag Sancheti PhD ,&nbsp;La Ngoc Quang MD ,&nbsp;Vali Baigi PhD ,&nbsp;Mashyaneh Haddadi MD ,&nbsp;Maoyi Tian PhD ,&nbsp;Sheila Sprague PhD ,&nbsp;Igor A. Escalante Elguezabal","doi":"10.1016/S2666-7568(24)00062-X","DOIUrl":"10.1016/S2666-7568(24)00062-X","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Globally, fall-related injuries are a substantial problem, and 80% of fatal falls occur in low-income and middle-income countries. We aimed to measure time from injury to hip-fracture surgery in people aged 50 years or older living in low-income and middle-income regions, as well as to measure the proportion of patients with surgical stabilisation of their hip fracture within 72 h of admission to hospital and to identify risk factors associated with surgical delay.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;For this secondary analysis, we analysed data collected from Africa, Latin America, China, India, and Asia (excluding China and India) for the International Orthopaedic Multicentre Study in Fracture Care (INORMUS) between March 29, 2014, and June 15, 2022. Patients from INORMUS were included in this analysis if they were aged 50 years or older and had an isolated, primary hip fracture sustained from a ground-level fall. Staff at participating hospitals identified patients with musculoskeletal injury and referred them for assessment of eligibility. We report time from injury to surgery as three distinct time periods: time from injury to hospital admission, time from admission to surgery, and a total time from injury to surgery. Date and time of injury were self-reported by patients at the time of study recruitment. If time to hospital admission after injury exceeded 24 h, patients reported the primary reason for delayed admission. Reasons for surgery, no surgery, and surgical delay were reported by the treating team. For patients undergoing surgery, multivariable regression analyses were used to identify risk factors for surgical delay.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;4486 adults aged 50 years or older with an isolated, primary hip fracture were enrolled in INORMUS from 55 hospitals in 24 countries. Countries were grouped into five regions: Africa (418 [9·3%] of 4486), Latin America (558 [12·4%]), China (1680 [37·4%]), India (1059 [23·6%]) and Asia (excluding China and India; 771 [17·2%]). Of 4486 patients, 3805 (84·8%) received surgery. The rate of surgery was similar in all regions except in Africa, where only 193 (46·3%) of 418 patients had surgery. Overall, 2791 (62·2%) of 4486 patients were admitted to hospital within 24 h of injury. However, 1019 (22·7%) of 4486 patients had delayed hospital admission of 72 h or more from injury. The two most common reasons for delayed admission of more than 24 h were transfer from another hospital (522 [36·2%] of 1441) and delayed care-seeking because patients thought the injury would heal on its own (480 [33·3%]). Once admitted to hospital, 1451 (38·1%) of 3805 patients who received surgery did so within 72 h (median 4·0 days [IQR 1·7–6·0]). Regional variation was seen in the proportion of patients receiving surgery within 72 h of hospital admission (92 [17·9%] of 514 in Latin America, 53 [27·5%] of 193 in Africa, 454 [30·9%] of 1471 in China, 318 [44·4%] of 716 in Asia [excluding Chi","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 8","pages":"Pages e552-e562"},"PeriodicalIF":13.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266675682400062X/pdfft?md5=5dc7aa47625fc75db61bf34ba5fbbad1&pid=1-s2.0-S266675682400062X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724611","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}

{"title":"Leadership – can you be too old?","authors":"The Lancet Healthy Longevity","doi":"10.1016/j.lanhl.2024.07.007","DOIUrl":"10.1016/j.lanhl.2024.07.007","url":null,"abstract":"","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 8","pages":"Page 503"},"PeriodicalIF":13.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001405/pdfft?md5=8bf7c352484263f11e89e1ddb6b6446a&pid=1-s2.0-S2666756824001405-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856677","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}

{"title":"Effect of antihypertensive deprescribing on hospitalisation and mortality: long-term follow-up of the OPTiMISE randomised controlled trial","authors":"James P Sheppard PhD ,&nbsp;Eleanor Temple MSc ,&nbsp;Ariel Wang PhD ,&nbsp;Anne Smith ,&nbsp;Stephanie Pollock DPhil ,&nbsp;Prof Gary A Ford FMedSci ,&nbsp;Prof F D Richard Hobbs FMedSci ,&nbsp;Nicola Kenealy BSc ,&nbsp;Prof Paul Little FMedSci ,&nbsp;Mark Lown MRCGP ,&nbsp;Prof Simon de Lusignan MD ,&nbsp;Prof Jonathan Mant MD ,&nbsp;David McCartney MRCGP ,&nbsp;Prof Rupert A Payne FBPhS ,&nbsp;Marney Williams BEd ,&nbsp;Prof Ly-Mee Yu DPhil ,&nbsp;Prof Richard J McManus PhD ,&nbsp;OPTiMISE Investigators","doi":"10.1016/S2666-7568(24)00131-4","DOIUrl":"10.1016/S2666-7568(24)00131-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Deprescribing of antihypertensive medications is recommended for some older patients with low blood pressure and frailty. The OPTiMISE trial showed that this deprescribing can be achieved with no differences in blood pressure control at 3 months compared with usual care. We aimed to examine effects of deprescribing on longer-term hospitalisation and mortality.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This randomised controlled trial enrolled participants from 69 general practices across central and southern England. Participants aged 80 years or older, with systolic blood pressure less than 150 mm Hg and who were receiving two or more antihypertensive medications, were randomly assigned (1:1) to antihypertensive medication reduction (removal of one antihypertensive) or usual care. General practitioners and participants were aware of the treatment allocation following randomisation but individuals responsible for analysing the data were masked to the treatment allocation throughout the study. Participants were followed up via their primary and secondary care electronic health records at least 3 years after randomisation. The primary outcome was time to all-cause hospitalisation or mortality. Intention-to-treat analyses were done using Cox regression modelling. A per-protocol analysis of the primary outcome was also done, excluding participants from the intervention group who did not reduce treatment or who had medication reinstated during the initial trial 12-week follow-up period. This study is registered with the European Union Drug Regulating Authorities Clinical Trials Database (EudraCT2016-004236-38) and the ISRCTN Registry (ISRCTN97503221).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;Between March 20, 2017, and Sept 30, 2018, a total of 569 participants were randomly assigned. Of these, 564 (99%; intervention=280; control=284) were followed up for a median of 4·0 years (IQR 3·7–4·3). Participants had a mean age of 84·8 years (SD 3·4) at baseline and 273 (48%) were women. Medication reduction was sustained in 109 participants at follow-up (51% of the 213 participants alive in the intervention group). Participants in the intervention group had a larger reduction in antihypertensives than the control group (adjusted mean difference –0·35 drugs [95% CI –0·52 to –0·18]). Overall, 202 (72%) participants in the intervention group and 218 (77%) participants in the control group experienced hospitalisation or mortality during follow-up (adjusted hazard ratio [aHR] 0·93 [95% CI 0·76 to 1·12]). There was some evidence that the proportion of participants experiencing the primary outcome in the per-protocol population was lower in the intervention group (aHR 0·80 [0·64 to 1·00]).&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;p&gt;Half of participants sustained medication reduction with no evidence of an increase in all-cause hospitalisation or mortality. These findings suggest that an antihypertensive deprescribing intervention might be safe for people age","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 8","pages":"Pages e563-e573"},"PeriodicalIF":13.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824001314/pdfft?md5=4ff5939879eacaa149462e5d9052625b&pid=1-s2.0-S2666756824001314-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879615","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}