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Editor’s view—ageing in place
Roy L Soiza
doi : 10.1093/ageing/afae206
Volume 53, Issue 9, September 2024, afae206
Some older people are forced to move away from their usual place of residence against their preference and sometimes even against their wishes. Indeed, just 4 months ago, we published a paper that showed avoiding this scenario was the top priority for older patients when they seek medical attention [1]. ‘Ageing in place’ refers to the ability to remain at home throughout late life. A systematic review of social inequalities around ageing in place across multiple countries makes some fascinating counter-intuitive findings, as well as confirming the importance of some influencing factors that will not surprise anyone [2]. Those with better socioeconomic circumstances were more likely to age in place, but the relationship to financial resources was not straight-forward and linear, possibly because the poorest may not be able to afford long term in some countries. Interestingly, those with higher educational attainment were significantly less likely to age in place, while those living in rural areas were more likely to do so. This shows the complex interplay of individual and societal factors that shape decisions around ageing in place
Uncertainty and advance care planning in older adults living with frailty. A collection and commentary on the theme of advance care planning
Pippa Collins, Sarah Hopkins, Helen Milbourn, Simon N Etkind
doi : 10.1093/ageing/afae146
Volume 53, Issue 9, September 2024, afae146
Older people often live with multiple serious illnesses and frailty with a reduced biological reserve [1]. People living with frailty face an inherently uncertain future with the unpredictable dying trajectory of frailty being widely recognised [2]. Uncertainty can also result from healthcare systems, from fragmented care due to multiple illnesses, or patchy communication between services. It can leave patients, carers and health professionals distressed and overwhelmed
Amyotrophic lateral sclerosis as a disease model of sarcopenia
Domenico Azzolino, Rachele Piras, Aida Zulueta, Tiziano Lucchi, Christian Lunetta
doi : 10.1093/ageing/afae209
Volume 53, Issue 9, September 2024, afae209
Sarcopenia, the progressive decline of muscle mass and function, has traditionally been viewed as an age-related process leading to a broad range of adverse outcomes. However, it has been widely reported that sarcopenia can occur earlier in life in association with various conditions (i.e. disease-related sarcopenia), including neuromuscular disorders. As early as 2010, the European Working Group on Sarcopenia in Older People included neurodegenerative diseases characterised by motor neuron loss among the mechanisms underlying sarcopenia. Despite some differences in pathogenetic mechanisms, both amyotrophic lateral sclerosis (ALS) and age-related sarcopenia share common characteristics, such as the loss of motor units and muscle fibre atrophy, oxidative stress, mitochondrial dysfunction and inflammation. The histology of older muscle shows fibre size heterogeneity, fibre grouping and a loss of satellite cells, similar to what is observed in ALS patients. Regrettably, the sarcopenic process in ALS patients has been largely overlooked, and literature on the condition in this patient group is very scarce. Some instruments used for the assessment of sarcopenia in older people could also be applied to ALS patients. At this time, there is no approved specific pharmacological treatment to reverse damage to motor neurons or cure ALS, just as there is none for sarcopenia. However, some agents targeting the muscle, like myostatin and mammalian target of rapamycin inhibitors, are under investigation both in the sarcopenia and ALS context. The development of new therapeutic agents targeting the skeletal muscle may indeed be beneficial to both ALS patients and older people with sarcopenia
Why the UK is vaccinating its older adult population against RSV—what geriatricians should know
Johnny Naylor, Antonia Ho, Roy L Soiza
doi : 10.1093/ageing/afae202
Volume 53, Issue 9, September 2024, afae202
The UK is launching a new free vaccination programme against respiratory syncytial virus (RSV) in adults aged 75 or over. This follows the development of safe and effective vaccines against RSV and the growing realisation of the burden of RSV-related disease in older adults—estimated at circa 8000 deaths and 175 000 GP episodes every year in the UK. It is likely that the full burden of RSV-related illness is under-appreciated and under-reported due to a lack of testing and awareness of its dangers in older adults. Healthcare professionals working with older people should be aware of the evidence base and be in a position to advise patients on the risks and benefits of vaccination and nonvaccination. We briefly review the evidence for the safety and effectiveness of the two licensed vaccines against RSV with a special focus on what geriatricians and others working with frailer, older people need to know
New horizons in prediction modelling using machine learning in older people’s healthcare research
Daniel Stahl
doi : 10.1093/ageing/afae201
Volume 53, Issue 9, September 2024, afae201,
Machine learning (ML) and prediction modelling have become increasingly influential in healthcare, providing critical insights and supporting clinical decisions, particularly in the age of big data. This paper serves as an introductory guide for health researchers and readers interested in prediction modelling and explores how these technologies support clinical decisions, particularly with big data, and covers all aspects of the development, assessment and reporting of a model using ML. The paper starts with the importance of prediction modelling for precision medicine. It outlines different types of prediction and machine learning approaches, including supervised, unsupervised and semi-supervised learning, and provides an overview of popular algorithms for various outcomes and settings. It also introduces key theoretical ML concepts. The importance of data quality, preprocessing and unbiased model performance evaluation is highlighted. Concepts of apparent, internal and external validation will be introduced along with metrics for discrimination and calibration for different types of outcomes. Additionally, the paper addresses model interpretation, fairness and implementation in clinical practice. Finally, the paper provides recommendations for reporting and identifies common pitfalls in prediction modelling and machine learning. The aim of the paper is to help readers understand and critically evaluate research papers that present ML models and to serve as a first guide for developing, assessing and implementing their own
Medication management information priorities of people living with dementia and their carers: a scoping review
Alexander J Clough, Danijela Gnjidic, Amanda J Cross, Natali Jokanovic, Karen Watson, Jacqueline Wesson, Stephanie Beshara, Justin Cheng, Mouna J Sawan
doi : 10.1093/ageing/afae200
Volume 53, Issue 9, September 2024, afae200,
To identify the priorities for information on medication management expressed by people living with dementia and their carers
Hip fracture has profound psychosocial impacts: a systematic review of qualitative studies
Nicholas F Taylor, Made U Rimayanti, Casey L Peiris, David A Snowdon, Katherine E Harding, Adam I Semciw, Paul D O’Halloran, Elizabeth Wintle, Scott Williams, Nora Shields
doi : 10.1093/ageing/afae194
Volume 53, Issue 9, September 2024, afae194
This systematic review aimed to synthesise qualitative evidence about the psychosocial impact of hip fracture on the people who sustain these injuries
Hospital-initiated palliative care interventions for adults with frailty: findings from a systematic review and narrative synthesis
Phoebe Sharratt, Antony Zacharias, Amara Callistus Nwosu, Amy Gadoud
doi : 10.1093/ageing/afae190
Volume 53, Issue 9, September 2024, afae190,
Synthesise the evidence regarding hospital palliative care (HPC) for patients with frailty. Narratively analyse the evidence regarding methods used to identify palliative care needs; types of palliative care interventions studied; and whether HPC improves outcomes
Association between dizziness and future falls and fall-related injuries in older adults: a systematic review and meta-analysis
Yuxiao Li, Rebecca M Smith, Susan L Whitney, Barry M Seemungal, Toby J Ellmers
doi : 10.1093/ageing/afae177
Volume 53, Issue 9, September 2024, afae177
Dizziness is common in older adults, especially in those attending falls services. Yet, the extent to which dizziness is associated with future falls has not been reviewed. This systematic review and meta-analysis assessed the association between dizziness and future falls and related injuries in older adult
Alcohol consumption and frailty risk: a dose–response meta-analysis of cohort studies
Sepideh Soltani, Ahmad Jayedi, Seyedmojtaba Ghoreishy, Mahdieh Mousavirad, Samira Movahed, Maedeh Jabbari, Farzaneh Asoudeh
doi : 10.1093/ageing/afae199
Volume 53, Issue 9, September 2024, afae199
While previous studies suggest that light-to-moderate alcohol consumption may reduce the frailty risk, the dose–response relationship is still under question. To address the knowledge gap, we conducted a systematic review and dose–response meta-analysis of cohort studies to examine the association of alcohol consumption with the risk of both prefrailty and frailty in adults
Effect of intranasal insulin on perioperative cognitive function in older adults: a randomized, placebo-controlled, double-blind clinical trial
Miao Sun, Xianghan Ruan, Zhikang Zhou, Yuting Huo, Min Liu, Siyuan Liu, Jiangbei Cao, Yan-hong Liu, Xiaoying Zhang, Yu-long Ma
doi : 10.1093/ageing/afae188
Volume 53, Issue 9, September 2024, afae188,
Postoperative cognitive impairment are common neural complications in older surgical patients and exacerbate the burden of medical care on families and society.
Visual field loss and falls requiring hospitalisation: results from the eFOVID study
Siobhan Manners, Lynn B Meuleners, Jonathon Q Ng, Joanne M Wood, Bill Morgan, Nigel Morlet
doi : 10.1093/ageing/afae191
Volume 53, Issue 9, September 2024, afae191
Examine the association between visual field loss and falls requiring hospitalisation in adults aged 50?+
Development and validation of a prognostic scoring system for 1-year mortality in older patients with hip fractures
Yusei Katsuyama, Naoyuki Horie, Kengo Yoshii, Shinichiro Nakamura, Tomoki Saito, Kenji Takahashi
doi : 10.1093/ageing/afae195
Volume 53, Issue 9, September 2024, afae195,
We developed and validated an accurate and simple prognostic scoring system for hip fractures that can be used preoperatively.
Preoperative clinical characteristics and 12-month outcomes following operative or non-operative management of asymptomatic aortic aneurysms
Phoebe Scarfield, Amy R Sharkey, Jugdeep K Dhesi, Bijan Modarai, Mark R Tyrrell, Judith S L Partridge
doi : 10.1093/ageing/afae193
Volume 53, Issue 9, September 2024, afae193
An observational cohort study conducted at a tertiary referral center for aortic surgery to describe the medical and surgical characteristics of patients assessed for abdominal aortic aneurysm repair and examine associations with 12-month outcome
The risk of geriatric syndromes in older COVID-19 survivors among the nonvaccinated population: a real world retrospective cohort study
Chien-Chou Su, Yi-Ching Yang, Yu-Huai Yu, Yu-Hsuan Tsai, Deng-Chi Yang
doi : 10.1093/ageing/afae205
Volume 53, Issue 9, September 2024, afae205,
We conducted a retrospective cohort study of patients from the US Collaborative Network in the TriNetX between January 1, 2020, and December 31, 2022. We included individuals aged older than 65 years with at least 2 health care visits who underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests during the study period. We excluded those with SARS-CoV-2 vaccination, diagnosis with neoplasm and geriatric syndromes before the index date, and death within 30 days after the index date. The index date was defined as the first date of the PCR test for SARS-CoV-2 during the study period. Hazard ratios (HRs) and 95% confidence intervals (CIs) for eight geriatric syndromes were estimated for propensity score-matched older adults with and without COVID-19. Subgroup analyses of sex and age were also performed
Trend and driving factors in burden of age-related macular degeneration in older adults aged 60–89 years: a global analysis over three decades
Qin-Yu Ni, Meng-Yao Wu, Chen-Kai Zha, Yu Wen, Lan Zhong, Jing-Jing Ding, Xue-Yan Li, Li-Ming Tao, Zheng-Xuan Jiang, Fan Cao
doi : 10.1093/ageing/afae207
Volume 53, Issue 9, September 2024, afae207,
Prevalence and years lived with disability (YLDs) were extracted. Joinpoint regression analysis was adopted to calculate average annual percentage change and to identify the year with the most significant changes. Global trends were stratified by sex, age and sociodemographic index, and regional and national trends were explored. Decomposition analysis was conducted to determine what extent the forces of population size, age structure and epidemiologic change driving alterations of AMD burden.
Shared decision-making with older people on TReatment Escalation planning for Acute deterioration in the emergency Medical Setting: a qualitative study of Clinicians’ perspectives (STREAMS-C)
Bronwen E Warner, Mary Wells, Cecilia Vindrola-Padros, Stephen J Brett
doi : 10.1093/ageing/afae204
Volume 53, Issue 9, September 2024, afae204,
This was a qualitative study following a constructivist approach. Semistructured interviews with vignettes were conducted with 26 consultant and registrar doctors working in emergency medicine, general internal medicine, intensive care medicine and palliative care medicine. Reflexive thematic analysis was performed.
Quality of life, pain and use of analgesic, anxiolytic and antidepressant medication, in people living in care homes
Jemima T Collins, Lisa Irvine, Pip Logan, Katie Robinson, Erika Sims, Adam L Gordon
doi : 10.1093/ageing/afae196
Volume 53, Issue 9, September 2024, afae196,
(i) to examine the relationship between pain, anxiety and depression and medication use in care home residents and (ii) to compare those on medications to treat pain, anxiety and depression, and those who were not, and associations with pain severity and overall QoL
Correction to: Revisiting unstable disability and the fluctuations of frailty: a measurement burst approach
doi : 10.1093/ageing/afae203
Volume 53, Issue 9, September 2024, afae203,
This is a correction to: Erwin Stolz, Anna Schultz, Hannes Mayerl, Regina Roller-Wirnsberger, Andrew Clegg, Revisiting unstable disability and the fluctuations of frailty: a measurement burst approach, Age and Ageing, Volume 53, Issue 8, August 2024, afae170
