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The effect of frailty in pleural disease 虚弱对胸膜疾病的影响。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-01 DOI: 10.1016/j.lanhl.2024.07.002
Barbara H Rosario , Imran Mohamed Noor
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引用次数: 0
The effect of frailty on mortality and hospital admission in patients with benign pleural disease in Wales: a cohort study 虚弱对威尔士良性胸膜疾病患者死亡率和入院率的影响:一项队列研究。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-01 DOI: 10.1016/S2666-7568(24)00114-4
Roxanna Short PhD , Prof Ben Carter PhD , Alessia Verduri PhD , Eleanor Barton MBBS , Prof Nick Maskell PhD , Jonathan Hewitt MBBS

Background

Pleural disease is common, representing 5% of the acute medical workload, and its incidence is rising, partly due to the ageing population. Frailty is an important feature and little is known about disease progression in patients with frailty and pleural disease. We aimed to examine the effect of frailty on mortality and other relevant outcomes in patients diagnosed with pleural disease.

Methods

In this cohort study in Wales, the national Secure Anonymised Information Linkage databank was used to identify a cohort of individuals diagnosed with non-malignant pleural disease between Jan 1, 2005, and March 1, 2023, who were not known to have left Wales. Frailty was assessed at diagnosis of pleural disease using an electronic Frailty Index. The primary outcome was time from diagnosis to all-cause mortality for all patients. Data were analysed using multilevel mixed-effects Cox proportional hazards regression adjusting for the prespecified covariates of age, sex, Welsh Index of Multiple Deprivation quintile, smoking status, comorbidity, and subtype of pleural disease.

Findings

54 566 individuals were included in the final sample (median age 66 years [IQR 47–77]; 26 477 [48·5%] were female and 28 089 [51·5%] were male). By the end of the study period, 25 698 (47·1%) participants had died, with a median follow-up of 1·0 years (IQR 0·2–3·6). There was an association between frailty and all-cause mortality, which increased as frailty worsened. Compared with fit individuals, there was increasing mortality for those with mild frailty (adjusted hazard ratio 1·11 [95% CI 1·08–1·15]; p<0·0001), moderate frailty (1·25 [1·20–1·31]; p<0·0001), and severe frailty (1·36 [1·28–1·44]; p<0·0001).

Interpretation

Independent of age and comorbidities, frailty status at diagnosis of pleural disease appeared to be useful as a prognostic indicator. Patients with moderate or severe frailty had a rapid decline in health. Future patients should be assessed for frailty at the time of diagnosis of pleural disease and might benefit from optimised care and advance care planning.

Funding

Cardiff University’s Wellcome Trust iTPA funding award.

背景:胸膜疾病很常见,占急诊工作量的 5%,其发病率正在上升,部分原因是人口老龄化。虚弱是其重要特征之一,但人们对虚弱和胸膜疾病患者的疾病进展知之甚少。我们旨在研究虚弱对确诊胸膜疾病患者的死亡率和其他相关结果的影响:在威尔士进行的这项队列研究中,我们使用了国家安全匿名信息链接数据库,以确定在 2005 年 1 月 1 日至 2023 年 3 月 1 日期间被诊断患有非恶性胸膜疾病且未知是否已离开威尔士的患者队列。在诊断胸膜疾病时使用电子虚弱指数对虚弱程度进行评估。主要结果是所有患者从诊断到全因死亡的时间。数据采用多层次混合效应考克斯比例危害回归进行分析,并对年龄、性别、威尔士多重贫困指数五分位数、吸烟状况、合并症和胸膜疾病亚型等预设协变量进行调整:54 566 人被纳入最终样本(中位数年龄为 66 岁 [IQR 47-77];26 477 [48-5%] 为女性,28 089 [51-5%] 为男性)。研究结束时,25 698 名参与者(47-1%)已经死亡,随访时间中位数为 1-0 年(IQR 0-2-3-6)。体弱与全因死亡率之间存在关联,体弱程度越严重,全因死亡率越高。与体格健壮者相比,轻度虚弱者的死亡率有所上升(调整后的危险比为 1-11 [95% CI 1-08-1-15]; p解释:与年龄和合并症无关,胸膜疾病诊断时的虚弱状态似乎是一个有用的预后指标。中度或重度虚弱患者的健康状况会迅速下降。未来的患者应在诊断胸膜疾病时进行虚弱评估,并从优化护理和预先护理规划中获益:卡迪夫大学威康信托基金iTPA资助。
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引用次数: 0
Ageing with grace and graft 优雅而嫁接地老去。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-01 DOI: 10.1016/S2666-7568(24)00111-9
Chloe Attree , Kristina Kokorelias , Samir Sinha , Mamatha Bhat
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引用次数: 0
Highlights of the 2024 Annual Scientific Meeting of the American Geriatrics Society 美国老年医学会 2024 年科学年会要点。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-01 DOI: 10.1016/S2666-7568(24)00113-2
Sophie Raeder
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引用次数: 0
Correction to Lancet Healthy Longev 2024; 5: e170–71 Lancet Healthy Longev 2024; 5: e170-71 更正。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-01 DOI: 10.1016/S2666-7568(24)00063-1
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引用次数: 0
Intrinsic capacity assessment works—let's move on actions 内在能力评估有效--让我们行动起来。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-01 DOI: 10.1016/S2666-7568(24)00110-7
Fei-Yuan Hsiao , Liang-Kung Chen
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引用次数: 0
Association of intrinsic capacity with functional decline and mortality in older adults: a systematic review and meta-analysis of longitudinal studies 内在能力与老年人功能衰退和死亡率的关系:纵向研究的系统回顾和荟萃分析。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-01 DOI: 10.1016/S2666-7568(24)00092-8
Juan Luis Sánchez-Sánchez PhD , Wan-Hsuan Lu PhD , Daniel Gallardo-Gómez MSc , Borja del Pozo Cruz PhD , Philipe de Souto Barreto PhD , Alejandro Lucia MD , Pedro L Valenzuela PhD
<div><h3>Background</h3><p>Together with environmental factors, intrinsic capacity (the composite of all the physical and mental capacities of an individual) has been proposed as a marker of healthy ageing. However, whether intrinsic capacity predicts major clinical outcomes is unclear. We aimed to explore the association of intrinsic capacity with functional decline and mortality in older adults.</p></div><div><h3>Methods</h3><p>In this systematic review and meta-analysis, we conducted a systematic search in MEDLINE (via PubMed), Scopus, and Web of Science from database inception to Feb 14, 2024, of observational longitudinal studies conducted in older adults (age ≥60 years) assessing the association of intrinsic capacity with impairment in basic activities of daily living (BADL) or instrumental activities of daily living (IADL) or risk of mortality. Estimates were extracted by two reviewers (JLS-S and W-HL) and were pooled using three-level meta-analytic models. The quality of each study was independently assessed by two authors (JLS-S and PLV) using the Newcastle–Ottawa Scale for longitudinal studies. Heterogeneity was evaluated using the <em>I</em><sup>2</sup> indicator at two levels: within-study (level 2) and between-study (level 3) variation. For associations between intrinsic capacity and IADL and BADL, we transformed data (standardised β coefficients and odds ratios [ORs]) into Pearson product moment correlation coefficients (<em>r</em>) using Pearson and Digby formulas to allow comparability across studies. For associations between intrinsic capacity and risk of mortality, hazard ratios (HRs) with 95% CIs were extracted from survival analyses. This study is registered with PROSPERO, CRD42023460482.</p></div><div><h3>Findings</h3><p>We included 37 studies (206 693 participants; average age range 65·3–85·9 years) in the systematic review, of which 31 were included in the meta-analysis on the association between intrinsic capacity and outcomes; three studies (2935 participants) were included in the meta-analysis on the association between intrinsic capacity trajectories and longitudinal changes in BADL or IADL. Intrinsic capacity was inversely associated with longitudinal impairments in BADL (Pearson's <em>r</em> –0·12 [95% CI –0·19 to –0·04]) and IADL (–0·24 [–0·35 to –0·13]), as well as with mortality risk (hazard ratio 0·57 [95% CI 0·51 to 0·63]). An association was also found between intrinsic capacity trajectories and impairment in IADL (but not in BADL), with maintained or improved intrinsic capacity over time associated with a lower impairment in IADL (odds ratio 0·37 [95% CI 0·19 to 0·71]). There was no evidence of publication bias (Egger's test p>0·05) and there was low between-study heterogeneity (<em>I</em><sup>2</sup>=18·4%), though within-study (<em>I</em><sup>2</sup>=63·2%) heterogeneity was substantial.</p></div><div><h3>Interpretation</h3><p>Intrinsic capacity is inversely associated with functional decline and mortality
背景:内在能力(个人所有体能和智能的综合)与环境因素一起被认为是健康老龄化的标志。然而,内在能力是否能预测主要临床结果尚不清楚。我们旨在探索内在能力与老年人功能衰退和死亡率之间的关系:在这项系统性综述和荟萃分析中,我们在 MEDLINE(通过 PubMed)、Scopus 和 Web of Science 中进行了系统性检索,检索时间从数据库建立之初至 2024 年 2 月 14 日,检索对象为老年人(年龄≥60 岁),检索内容为评估内在能力与基本日常生活活动(BADL)或工具性日常生活活动(IADL)损伤或死亡风险之间关系的观察性纵向研究。估算值由两位评审员(JLS-S 和 W-HL)提取,并使用三级荟萃分析模型进行汇总。每项研究的质量由两位作者(JLS-S 和 PLV)使用纽卡斯尔-渥太华纵向研究量表进行独立评估。异质性采用两个级别的 I2 指标进行评估:研究内变异(第 2 级)和研究间变异(第 3 级)。对于内在能力与 IADL 和 BADL 之间的关系,我们使用 Pearson 和 Digby 公式将数据(标准化 β 系数和几率比 [ORs])转换为皮尔逊积矩相关系数 (r),以实现不同研究之间的可比性。对于内在能力与死亡风险之间的关系,则从生存分析中提取了带有 95% CI 的危险比 (HR)。本研究已在 PROSPERO 注册,编号为 CRD42023460482:我们在系统综述中纳入了 37 项研究(206 693 名参与者;平均年龄范围为 65-3-85-9 岁),其中 31 项纳入了内在能力与结果之间关系的荟萃分析;3 项研究(2935 名参与者)纳入了内在能力轨迹与 BADL 或 IADL 纵向变化之间关系的荟萃分析。内在能力与 BADL(Pearson's r -0-12 [95% CI -0-19 to -0-04])和 IADL(-0-24 [-0-35 to -0-13])的纵向损伤以及死亡风险(危险比 0-57 [95% CI 0-51 to 0-63])成反比。研究还发现了内在能力轨迹与 IADL(而非 BADL)损伤之间的关系,随着时间的推移,内在能力的保持或提高与 IADL 损伤的降低有关(几率比 0-37 [95% CI 0-19 至 0-71])。没有证据表明存在发表偏倚(Egger 检验 p>0-05),研究间异质性较低(I2=18-4%),但研究内异质性很大(I2=63-2%):解释:内在能力与老年人的功能衰退和死亡风险成反比。这些研究结果可以支持将内在能力作为健康老龄化的标志,不过还需要进一步研究,以完善这一概念在不同环境和人群中的结构和可操作性:无:摘要的西班牙文和法文译文见 "补充材料 "部分。
{"title":"Association of intrinsic capacity with functional decline and mortality in older adults: a systematic review and meta-analysis of longitudinal studies","authors":"Juan Luis Sánchez-Sánchez PhD ,&nbsp;Wan-Hsuan Lu PhD ,&nbsp;Daniel Gallardo-Gómez MSc ,&nbsp;Borja del Pozo Cruz PhD ,&nbsp;Philipe de Souto Barreto PhD ,&nbsp;Alejandro Lucia MD ,&nbsp;Pedro L Valenzuela PhD","doi":"10.1016/S2666-7568(24)00092-8","DOIUrl":"10.1016/S2666-7568(24)00092-8","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Together with environmental factors, intrinsic capacity (the composite of all the physical and mental capacities of an individual) has been proposed as a marker of healthy ageing. However, whether intrinsic capacity predicts major clinical outcomes is unclear. We aimed to explore the association of intrinsic capacity with functional decline and mortality in older adults.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this systematic review and meta-analysis, we conducted a systematic search in MEDLINE (via PubMed), Scopus, and Web of Science from database inception to Feb 14, 2024, of observational longitudinal studies conducted in older adults (age ≥60 years) assessing the association of intrinsic capacity with impairment in basic activities of daily living (BADL) or instrumental activities of daily living (IADL) or risk of mortality. Estimates were extracted by two reviewers (JLS-S and W-HL) and were pooled using three-level meta-analytic models. The quality of each study was independently assessed by two authors (JLS-S and PLV) using the Newcastle–Ottawa Scale for longitudinal studies. Heterogeneity was evaluated using the &lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt; indicator at two levels: within-study (level 2) and between-study (level 3) variation. For associations between intrinsic capacity and IADL and BADL, we transformed data (standardised β coefficients and odds ratios [ORs]) into Pearson product moment correlation coefficients (&lt;em&gt;r&lt;/em&gt;) using Pearson and Digby formulas to allow comparability across studies. For associations between intrinsic capacity and risk of mortality, hazard ratios (HRs) with 95% CIs were extracted from survival analyses. This study is registered with PROSPERO, CRD42023460482.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;We included 37 studies (206 693 participants; average age range 65·3–85·9 years) in the systematic review, of which 31 were included in the meta-analysis on the association between intrinsic capacity and outcomes; three studies (2935 participants) were included in the meta-analysis on the association between intrinsic capacity trajectories and longitudinal changes in BADL or IADL. Intrinsic capacity was inversely associated with longitudinal impairments in BADL (Pearson's &lt;em&gt;r&lt;/em&gt; –0·12 [95% CI –0·19 to –0·04]) and IADL (–0·24 [–0·35 to –0·13]), as well as with mortality risk (hazard ratio 0·57 [95% CI 0·51 to 0·63]). An association was also found between intrinsic capacity trajectories and impairment in IADL (but not in BADL), with maintained or improved intrinsic capacity over time associated with a lower impairment in IADL (odds ratio 0·37 [95% CI 0·19 to 0·71]). There was no evidence of publication bias (Egger's test p&gt;0·05) and there was low between-study heterogeneity (&lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=18·4%), though within-study (&lt;em&gt;I&lt;/em&gt;&lt;sup&gt;2&lt;/sup&gt;=63·2%) heterogeneity was substantial.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;p&gt;Intrinsic capacity is inversely associated with functional decline and mortality","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 7","pages":"Pages e480-e492"},"PeriodicalIF":13.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000928/pdfft?md5=b688ecb698cd1d4ebbeecbdf43357fce&pid=1-s2.0-S2666756824000928-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471218","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}
引用次数: 0
Frailty progression in adults aged 40 years and older in rural Burkina Faso: a longitudinal, population-based study 布基纳法索农村地区 40 岁及以上成年人的衰弱进展:一项以人口为基础的纵向研究。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-01 DOI: 10.1016/S2666-7568(24)00096-5
Dina Goodman-Palmer PhD , Prof Carolyn Greig PhD , Sandra Agyapong-Badu PhD , Prof Miles D Witham PhD , Collin F Payne PhD , Mamadou Bountogo MD , Boubacar Coulibaly PhD , Pascal Geldsetzer ScD , Guy Harling ScD , Maxime Inghels PhD , Jennifer Manne-Goehler ScD , Lucienne Ouermi MD , Ali Sie PhD , Prof Justine I Davies MD
<div><h3>Background</h3><p>Little is known about ageing and frailty progression in low-income settings. We aimed to describe frailty changes over time in individuals living in rural Burkina Faso and to assess which sociodemographic, disability, and multimorbidity factors are associated with frailty progression and mortality.</p></div><div><h3>Methods</h3><p>This longitudinal, population-based study was conducted at the Nouna Health and Demographic Surveillance Systems (HDSS) site in northwestern Burkina Faso. Eligible participants were aged 40 years or older and had been primarily resident in a household within the HDSS area for at least the past 6 months before the baseline survey and were selected from the 2015 HDSS household census using a stratified random sample of adults living in unique households within the area. Participants were interviewed in their homes in 2018 (baseline), 2021 (follow-up), or both. We derived the Fried frailty score for each participant at each timepoint using data on grip strength, gait speed, self-reported weight loss, self-reported exhaustion, and physical activity, and described changes in frailty status (no frailty, pre-frailty, or frailty) between 2018 and 2021. We used multivariate regression models to assess factors (ie, sex, age, marital status, educational attainment, wealth quintile, WHO Disability Assessment Schedule (WHODAS) score, and multimorbidity) associated with frailty progression (either worsening frailty status or dying, compared with frailty status remaining the same or improving) and with mortality, and developed sequential models: unadjusted, adjusting for sociodemographic factors (sex, age, marital status, educational attainment, and wealth quintile), and adjusting for sociodemographic factors, disability, and multimorbidity.</p></div><div><h3>Findings</h3><p>Between May 25 and July 19, 2018, and between July 1 and Aug 22, 2021, 5952 individuals were invited to participate: 1709 (28·7%) did not consent, 1054 (17·8%) participated in 2018 only and were lost to follow-up, 1214 (20·4%) participated in 2021 only, and 1975 (33·2%) were included in both years or died between years. Of 1967 participants followed up with complete demographic data, 190 (9·7%) were frail or unable to complete the frailty assessment in 2018, compared with 77 (3·9%) in 2021. Between 2018 and 2021, frailty status improved in 567 (28·8%) participants and worsened in 327 (16·6%), and 101 (5·1%) participants died. The relative risk of frailty status worsening or of dying (compared with frailty impRoving or no change) increased with age and WHODAS score, whereas female sex appeared protective. After controlling for all sociodemographic factors, multimorbidity, and WHODAS score, odds of mortality were 1·07 (odds ratio 2·07, 95% CI 1·05–4·09) times higher among pre-frail individuals and 1·1 (2·21, 0·90–5·41) times higher among frail individuals than among non-frail individuals.</p></div><div><h3>Interpretation</h3><p>Frailty sta
背景:人们对低收入环境中的老龄化和虚弱进展知之甚少。我们的目的是描述生活在布基纳法索农村地区的个体随着时间推移而发生的虚弱变化,并评估哪些社会人口、残疾和多病因素与虚弱进展和死亡率相关:这项以人口为基础的纵向研究在布基纳法索西北部的努纳健康与人口监测系统(HDSS)站点进行。符合条件的参与者年龄在 40 岁或 40 岁以上,在基线调查之前的至少 6 个月内主要居住在 HDSS 地区的一个家庭中,并通过分层随机抽样从 2015 年 HDSS 家庭普查中选出居住在该地区独特家庭中的成年人。参与者于 2018 年(基线)、2021 年(随访)或这两年在家中接受访谈。我们利用握力、步态速度、自我报告的体重减轻情况、自我报告的疲惫程度和体力活动等数据,得出了每位参与者在每个时间点的弗里德虚弱评分,并描述了 2018 年至 2021 年间虚弱状态(无虚弱、虚弱前期或虚弱)的变化。我们使用多变量回归模型来评估与虚弱进展(虚弱状态恶化或死亡,与虚弱状态保持不变或改善相比)和死亡率相关的因素(即性别、年龄、婚姻状况、教育程度、财富五分位数、世卫组织残疾评估表(WHODAS)评分和多病症),并建立了序列模型:未调整、调整社会人口因素(性别、年龄、婚姻状况、教育程度和财富五分位数)、调整社会人口因素、残疾和多病情况。研究结果在 2018 年 5 月 25 日至 7 月 19 日以及 2021 年 7 月 1 日至 8 月 22 日期间,共有 5952 人受邀参加:1709人(28-7%)未同意参加,1054人(17-8%)仅参加了2018年的随访并失去了随访机会,1214人(20-4%)仅参加了2021年的随访,1975人(33-2%)在两年间都参加了随访或在两年间死亡。在有完整人口统计学数据的 1967 名随访参与者中,2018 年有 190 人(9-7%)体弱或无法完成体弱评估,而 2021 年有 77 人(3-9%)。在 2018 年至 2021 年期间,567 名参与者(28-8%)的虚弱状况有所改善,327 名参与者(16-6%)的虚弱状况有所恶化,101 名参与者(5-1%)死亡。虚弱状态恶化或死亡(与虚弱状态无变化或无变化相比)的相对风险随年龄和WHODAS评分的增加而增加,而女性似乎具有保护作用。在控制了所有社会人口学因素、多病症和 WHODAS 评分后,虚弱前患者的死亡几率是非虚弱患者的 1-07 倍(几率比 2-07,95% CI 1-05-4-09),虚弱患者的死亡几率是非虚弱患者的 1-1 倍(2-21,0-90-5-41):在这一低收入环境中,虚弱状态是高度动态的,而且似乎是可以改变的。鉴于低收入或中等收入国家的老年人数量迅速增加,了解这些环境中的虚弱行为对于制定政策和卫生系统以确保维持老龄人口的健康和福祉具有重要意义。未来的工作应侧重于设计适合具体情况的干预措施,以改善虚弱状况:亚历山大-冯-洪堡基金会、伯明翰大学全球创新研究所和威康信托基金会。
{"title":"Frailty progression in adults aged 40 years and older in rural Burkina Faso: a longitudinal, population-based study","authors":"Dina Goodman-Palmer PhD ,&nbsp;Prof Carolyn Greig PhD ,&nbsp;Sandra Agyapong-Badu PhD ,&nbsp;Prof Miles D Witham PhD ,&nbsp;Collin F Payne PhD ,&nbsp;Mamadou Bountogo MD ,&nbsp;Boubacar Coulibaly PhD ,&nbsp;Pascal Geldsetzer ScD ,&nbsp;Guy Harling ScD ,&nbsp;Maxime Inghels PhD ,&nbsp;Jennifer Manne-Goehler ScD ,&nbsp;Lucienne Ouermi MD ,&nbsp;Ali Sie PhD ,&nbsp;Prof Justine I Davies MD","doi":"10.1016/S2666-7568(24)00096-5","DOIUrl":"10.1016/S2666-7568(24)00096-5","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Little is known about ageing and frailty progression in low-income settings. We aimed to describe frailty changes over time in individuals living in rural Burkina Faso and to assess which sociodemographic, disability, and multimorbidity factors are associated with frailty progression and mortality.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;This longitudinal, population-based study was conducted at the Nouna Health and Demographic Surveillance Systems (HDSS) site in northwestern Burkina Faso. Eligible participants were aged 40 years or older and had been primarily resident in a household within the HDSS area for at least the past 6 months before the baseline survey and were selected from the 2015 HDSS household census using a stratified random sample of adults living in unique households within the area. Participants were interviewed in their homes in 2018 (baseline), 2021 (follow-up), or both. We derived the Fried frailty score for each participant at each timepoint using data on grip strength, gait speed, self-reported weight loss, self-reported exhaustion, and physical activity, and described changes in frailty status (no frailty, pre-frailty, or frailty) between 2018 and 2021. We used multivariate regression models to assess factors (ie, sex, age, marital status, educational attainment, wealth quintile, WHO Disability Assessment Schedule (WHODAS) score, and multimorbidity) associated with frailty progression (either worsening frailty status or dying, compared with frailty status remaining the same or improving) and with mortality, and developed sequential models: unadjusted, adjusting for sociodemographic factors (sex, age, marital status, educational attainment, and wealth quintile), and adjusting for sociodemographic factors, disability, and multimorbidity.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;Between May 25 and July 19, 2018, and between July 1 and Aug 22, 2021, 5952 individuals were invited to participate: 1709 (28·7%) did not consent, 1054 (17·8%) participated in 2018 only and were lost to follow-up, 1214 (20·4%) participated in 2021 only, and 1975 (33·2%) were included in both years or died between years. Of 1967 participants followed up with complete demographic data, 190 (9·7%) were frail or unable to complete the frailty assessment in 2018, compared with 77 (3·9%) in 2021. Between 2018 and 2021, frailty status improved in 567 (28·8%) participants and worsened in 327 (16·6%), and 101 (5·1%) participants died. The relative risk of frailty status worsening or of dying (compared with frailty impRoving or no change) increased with age and WHODAS score, whereas female sex appeared protective. After controlling for all sociodemographic factors, multimorbidity, and WHODAS score, odds of mortality were 1·07 (odds ratio 2·07, 95% CI 1·05–4·09) times higher among pre-frail individuals and 1·1 (2·21, 0·90–5·41) times higher among frail individuals than among non-frail individuals.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;p&gt;Frailty sta","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 7","pages":"Pages e493-e502"},"PeriodicalIF":13.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000965/pdfft?md5=47de85b8a01f69fad948af73b6c0f100&pid=1-s2.0-S2666756824000965-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471219","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}
引用次数: 0
Obesity and risk of diseases associated with hallmarks of cellular ageing: a multicohort study 肥胖与细胞老化标志相关疾病的风险:一项多队列研究。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-01 DOI: 10.1016/S2666-7568(24)00087-4
Prof Mika Kivimäki FMedSci , Philipp Frank PhD , Jaana Pentti MSc , Xiaolin Xu PhD , Prof Jussi Vahtera MD , Jenni Ervasti PhD , Solja T Nyberg PhD , Joni V Lindbohm MD , Prof Markus Jokela PhD , Prof Linda Partridge FMedSci
<div><h3>Background</h3><p>Ageing hallmarks, characterising features of cellular ageing, have a role in the pathophysiology of many age-related diseases. We examined whether obesity is associated with an increased risk of developing such hallmark-related diseases.</p></div><div><h3>Methods</h3><p>In this multicohort study, we included people aged 38–72 years with data on weight, height, and waist circumference measured during a clinical examination at baseline between March 13, 2006, and Oct 1, 2010, from the UK Biobank with follow-up until Nov 12, 2021. To test reproducibility of the findings (replication analysis), we used data from people aged 40 years or older included in the Finnish Public Sector study and the Finnish Health and Social Support study who responded to the study surveys, had data on BMI, and were successfully linked to electronic health records from national registers up to Dec 31, 2016. Obesity and clinical characteristics were assessed at baseline. Via linkage to national health records, participants were followed up for 83 diseases related to nine ageing hallmarks (genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication). Outcomes were the first instance of hallmark-related disease, in addition to co-occurrence of three or more hallmark-related diseases and mortality.</p></div><div><h3>Findings</h3><p>496 530 adults (mean age 57·0 years [SD 8·1]) from the UK Biobank were included in the primary analysis, and 83 249 (mean age 48·2 years [6·4]) adults from the Finnish cohorts were included in the replication analysis. Median follow-up was 12·7 years (IQR 12·0–13·4) in the UK Biobank and 14·0 years (8·0–15·0) in the Finnish cohorts. After adjusting for demographic characteristics, lifestyle factors, and depression, UK Biobank participants with obesity (BMI ≥30·0 kg/m<sup>2</sup>) had a 1·40 (95% CI 1·38–1·41) times higher hazard ratio for the first hallmark-related disease than those with a healthy weight (BMI 18·5–24·9 kg/m<sup>2</sup>). The corresponding hazard ratios for three co-occurring diseases were 2·92 (95% CI 2·64–3·22) for deregulated nutrient sensing, 2·73 (2·46–3·02) for telomere attrition, 2·33 (2·10–2·60) for epigenetic alterations, 2·30 (2·14–2·48) for mitochondrial dysfunction, 2·23 (2·04–2·45) for stem cell exhaustion, 2·02 (1·89–2·16) for altered intercellular communication, 2·01 (1·89–2·15) for cellular senescence, 1·83 (1·67–2·00) for loss of proteostasis, and 1·39 (1·27–1·52) for genomic instability. These findings were replicated in the Finnish cohorts. In both studies, the associations between other risk factors (low education, unhealthy dietary factors [available only in the UK Biobank], smoking, high alcohol consumption, physical inactivity, and depression) and hallmark-related diseases were weaker than those with obesity. 45–60% of t
背景:衰老标志是细胞衰老的特征,在许多与年龄有关的疾病的病理生理学中发挥作用。我们研究了肥胖是否与罹患此类标志性疾病的风险增加有关:在这项多队列研究中,我们纳入了年龄在 38-72 岁之间、在 2006 年 3 月 13 日至 2010 年 10 月 1 日期间接受临床检查时测量了体重、身高和腰围数据的人群,这些数据来自英国生物库,随访至 2021 年 11 月 12 日。为了检验研究结果的可重复性(复制分析),我们使用了芬兰公共部门研究和芬兰健康与社会支持研究中40岁或40岁以上人群的数据,这些人群对研究调查做出了回应,拥有体重指数数据,并与截至2016年12月31日的国家登记册电子健康记录成功链接。肥胖和临床特征在基线时进行了评估。通过与国家健康记录的链接,对参与者的 83 种疾病进行了随访,这些疾病与九种老化标志(基因组不稳定、端粒损耗、表观遗传学改变、蛋白稳态丧失、营养传感失调、线粒体功能障碍、细胞衰老、干细胞衰竭和细胞间通信改变)有关。结果是首次出现与标志性疾病相关的疾病,以及同时出现三种或三种以上与标志性疾病相关的疾病和死亡率:主要分析包括英国生物库中的 496 530 名成人(平均年龄 57-0 岁 [SD 8-1]),复制分析包括芬兰队列中的 83 249 名成人(平均年龄 48-2 岁 [6-4])。英国生物库的随访中位数为12-7年(IQR为12-0-13-4),芬兰队列的随访中位数为14-0年(8-0-15-0)。在对人口统计学特征、生活方式因素和抑郁进行调整后,英国生物库参与者中肥胖者(体重指数≥30-0 kg/m2)首次罹患标志性疾病的危险比是体重健康者(体重指数18-5-24-9 kg/m2)的1-40(95% CI 1-38-1-41)倍。三种并发疾病的相应危险比分别为:营养传感失调 2-92 (95% CI 2-64-3-22);端粒损耗 2-73 (2-46-3-02);表观遗传改变 2-33 (2-10-2-60);线粒体功能障碍 2-30 (2-14-2-48)、2-23(2-04-2-45)为干细胞衰竭,2-02(1-89-2-16)为细胞间交流改变,2-01(1-89-2-15)为细胞衰老,1-83(1-67-2-00)为蛋白稳态丧失,1-39(1-27-1-52)为基因组不稳定。这些结果在芬兰队列中得到了重复。在这两项研究中,其他风险因素(教育程度低、不健康饮食因素[仅在英国生物库中提供]、吸烟、高酒精消耗量、缺乏运动和抑郁)与标志性相关疾病之间的关联弱于与肥胖相关的关联。肥胖症患者45%-60%的超额死亡率可归因于标志性疾病:释义:肥胖可能在与细胞老化相关的疾病发展中扮演重要角色。解决老化机制问题可能有助于减轻肥胖症流行造成的疾病和死亡负担:惠康信托基金会、英国医学研究委员会、美国国家老龄化研究所、芬兰科学院和芬兰心血管研究基金会:摘要的德语和芬兰语译文见补充材料部分。
{"title":"Obesity and risk of diseases associated with hallmarks of cellular ageing: a multicohort study","authors":"Prof Mika Kivimäki FMedSci ,&nbsp;Philipp Frank PhD ,&nbsp;Jaana Pentti MSc ,&nbsp;Xiaolin Xu PhD ,&nbsp;Prof Jussi Vahtera MD ,&nbsp;Jenni Ervasti PhD ,&nbsp;Solja T Nyberg PhD ,&nbsp;Joni V Lindbohm MD ,&nbsp;Prof Markus Jokela PhD ,&nbsp;Prof Linda Partridge FMedSci","doi":"10.1016/S2666-7568(24)00087-4","DOIUrl":"10.1016/S2666-7568(24)00087-4","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;p&gt;Ageing hallmarks, characterising features of cellular ageing, have a role in the pathophysiology of many age-related diseases. We examined whether obesity is associated with an increased risk of developing such hallmark-related diseases.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;p&gt;In this multicohort study, we included people aged 38–72 years with data on weight, height, and waist circumference measured during a clinical examination at baseline between March 13, 2006, and Oct 1, 2010, from the UK Biobank with follow-up until Nov 12, 2021. To test reproducibility of the findings (replication analysis), we used data from people aged 40 years or older included in the Finnish Public Sector study and the Finnish Health and Social Support study who responded to the study surveys, had data on BMI, and were successfully linked to electronic health records from national registers up to Dec 31, 2016. Obesity and clinical characteristics were assessed at baseline. Via linkage to national health records, participants were followed up for 83 diseases related to nine ageing hallmarks (genomic instability, telomere attrition, epigenetic alterations, loss of proteostasis, deregulated nutrient sensing, mitochondrial dysfunction, cellular senescence, stem cell exhaustion, and altered intercellular communication). Outcomes were the first instance of hallmark-related disease, in addition to co-occurrence of three or more hallmark-related diseases and mortality.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;p&gt;496 530 adults (mean age 57·0 years [SD 8·1]) from the UK Biobank were included in the primary analysis, and 83 249 (mean age 48·2 years [6·4]) adults from the Finnish cohorts were included in the replication analysis. Median follow-up was 12·7 years (IQR 12·0–13·4) in the UK Biobank and 14·0 years (8·0–15·0) in the Finnish cohorts. After adjusting for demographic characteristics, lifestyle factors, and depression, UK Biobank participants with obesity (BMI ≥30·0 kg/m&lt;sup&gt;2&lt;/sup&gt;) had a 1·40 (95% CI 1·38–1·41) times higher hazard ratio for the first hallmark-related disease than those with a healthy weight (BMI 18·5–24·9 kg/m&lt;sup&gt;2&lt;/sup&gt;). The corresponding hazard ratios for three co-occurring diseases were 2·92 (95% CI 2·64–3·22) for deregulated nutrient sensing, 2·73 (2·46–3·02) for telomere attrition, 2·33 (2·10–2·60) for epigenetic alterations, 2·30 (2·14–2·48) for mitochondrial dysfunction, 2·23 (2·04–2·45) for stem cell exhaustion, 2·02 (1·89–2·16) for altered intercellular communication, 2·01 (1·89–2·15) for cellular senescence, 1·83 (1·67–2·00) for loss of proteostasis, and 1·39 (1·27–1·52) for genomic instability. These findings were replicated in the Finnish cohorts. In both studies, the associations between other risk factors (low education, unhealthy dietary factors [available only in the UK Biobank], smoking, high alcohol consumption, physical inactivity, and depression) and hallmark-related diseases were weaker than those with obesity. 45–60% of t","PeriodicalId":34394,"journal":{"name":"Lancet Healthy Longevity","volume":"5 7","pages":"Pages e454-e463"},"PeriodicalIF":13.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666756824000874/pdfft?md5=5dbd86ff2a160f3a1ac7676bb4fa3351&pid=1-s2.0-S2666756824000874-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471222","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}
引用次数: 0
Temporal trends in the prevalence of Parkinson's disease from 1980 to 2023: a systematic review and meta-analysis 1980年至2023年帕金森病患病率的时间趋势:系统回顾和荟萃分析。
IF 13.4 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-07-01 DOI: 10.1016/S2666-7568(24)00094-1
Jinqiao Zhu MMed , Yusha Cui MMed , Junjiao Zhang MMed , Rui Yan MMed , Dongning Su MD , Prof Dong Zhao PhD , Anxin Wang PhD , Prof Tao Feng MD
<div><h3>Background</h3><p>Parkinson's disease is the second most common neurodegenerative disorder, exhibiting an upward trend in prevalence. We aimed to investigate the prevalence of Parkinson's disease, temporal trends between 1980 and 2023, and variations in prevalence by location, age, sex, survey period, sociodemographic index (SDI), human development index (HDI), and study characteristics (sample size, diagnostic criteria, and data source).</p></div><div><h3>Methods</h3><p>In this systematic review and meta-analysis we searched PubMed, Cochrane, Web of Science, Embase, Scopus, and Global Health for observational studies that reported Parkinson's disease prevalence in the general population from database inception to Nov 1, 2023. We included studies if they were original observational investigations, had participants from the general population or community-based datasets, and provided numerical data on the prevalence of Parkinson's disease either with 95% CIs or with sufficient information to calculate 95% CIs. Studies were excluded if they were conducted in a specific population, had a sample size smaller than 1000, or were review articles, case reports, protocols, meeting abstracts, letters, comments, short communications, posters, and reports. The publication characteristics (first author and publication year), study location (countries, WHO regions, SDI, and HDI), survey period, study design, diagnostic criteria, data source, participant information, and prevalence data were extracted from articles using a standard form. Two authors independently evaluated eligibility, and discrepancies were resolved through discussion with the third author. We used random effect models to pool estimates with 95% CIs. Estimated annual percentage change (EAPC) was calculated to assess the temporal trend in prevalence of Parkinson's disease. The study was registered with PROSPERO, CRD42022364417.</p></div><div><h3>Findings</h3><p>83 studies from 37 countries were eligible for analysis, with 56 studies providing all-age prevalence, 53 studies reporting age-specific prevalence, and 26 studies providing both all-age and age-specific prevalence. Global pooled prevalence of Parkinson's disease was 1·51 cases per 1000 (95% CI 1·19–1·88), which was higher in males (1·54 cases per 1000 [1·17–1·96]) than in females (1·49 cases per 1000 [1·12–1·92], p=0·030). During different survey periods, the prevalence of Parkinson's disease was 0·90 cases per 1000 (0·48–1·44; 1980–89), 1·38 cases per 1000 (1·17–1·61; 1990–99), 1·18 cases per 1000 (0·77–1·67; 2000–09), and 3·81 cases per 1000 (2·67–5·14; 2010–23). The EAPC of Parkinson's disease prevalence was significantly higher in the period of 2004–23 (EAPC 16·32% [95% CI 6·07–26·58], p=0·0040) than in the period of 1980–2003 (5·30% [0·82–9·79], p=0·022). Statistically significant disparities in prevalence were observed across six WHO regions. Prevalence increased with HDI or SDI. Considerable variations were observed in t
背景:帕金森病是第二大最常见的神经退行性疾病,发病率呈上升趋势。我们旨在调查帕金森病的患病率、1980 年至 2023 年间的时间趋势,以及不同地区、年龄、性别、调查时期、社会人口指数 (SDI)、人类发展指数 (HDI) 和研究特征(样本大小、诊断标准和数据来源)在患病率方面的差异:在本系统综述和荟萃分析中,我们检索了 PubMed、Cochrane、Web of Science、Embase、Scopus 和 Global Health 等数据库,以查找自数据库建立至 2023 年 11 月 1 日期间报告普通人群帕金森病患病率的观察性研究。如果研究是原始观察性调查,参与者来自普通人群或基于社区的数据集,并提供了帕金森病患病率的数字数据,且包含 95% CIs 或有足够的信息来计算 95% CIs,我们就将其纳入研究。如果研究是在特定人群中进行的,样本量少于 1000 个,或者是综述文章、病例报告、协议、会议摘要、信件、评论、短文、海报和报告,则排除在外。使用标准表格从文章中提取出版特征(第一作者和出版年份)、研究地点(国家、WHO 地区、SDI 和 HDI)、调查时间、研究设计、诊断标准、数据来源、参与者信息和流行率数据。由两位作者独立评估是否符合条件,不一致之处由第三位作者讨论解决。我们使用随机效应模型来汇总带有 95% CI 的估计值。我们计算了估计年度百分比变化(EAPC),以评估帕金森病患病率的时间趋势。该研究已在 PROSPERO 注册,编号为 CRD42022364417:来自 37 个国家的 83 项研究符合分析条件,其中 56 项研究提供了全年龄段的患病率,53 项研究报告了特定年龄段的患病率,26 项研究同时提供了全年龄段和特定年龄段的患病率。帕金森病的全球总患病率为1-51例/1000人(95% CI 1-19-1-88),男性患病率(1-54例/1000人 [1-17-1-96])高于女性(1-49例/1000人 [1-12-1-92],P=0-030)。在不同的调查时期,帕金森病的患病率分别为 0-90 例/1000(0-48-1-44;1980-89 年)、1-38 例/1000(1-17-1-61;1990-99 年)、1-18 例/1000(0-77-1-67;2000-09 年)和 3-81 例/1000(2-67-5-14;2010-23 年)。帕金森病发病率的 EAPC 在 2004-23 年期间(EAPC 16-32% [95% CI 6-07-26-58],p=0-0040)明显高于 1980-2003 年期间(5-30% [0-82-9-79],p=0-022)。世卫组织的六个地区在流行率方面存在明显的统计学差异。流行率随人类发展指数或社会发展指数的增加而增加。根据不同的样本量或诊断标准,帕金森病的总体患病率存在很大差异。患病率也随着年龄的增长而增加,在 60 岁以上的人群中,患病率达到 9-34 例/1000(7-26-11-67):自 20 世纪 80 年代以来,帕金森病的全球患病率一直在上升,在过去 20 年中上升更为明显。在人类发展指数(HDI)或社会发展指数(SDI)较高的国家,帕金森病的患病率较高。有必要对帕金森病进行更多高质量的流行病学研究,尤其是在SDI较低的国家:国家自然科学基金:摘要中译文见补充材料部分。
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Lancet Healthy Longevity
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