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Editor’s view—adaptive approaches
Nathalie van der Velde
doi : 10.1093/ageing/afae260
Volume 53, Issue 11, November 2024, afae260
Older adults increasingly live with multiple long term conditions (MLTC), yet guidelines for managing multimorbidity are relatively new, emerging only in the past decade. The challenge lies in adapting healthcare systems to address the complexities of frailty and MLTC, particularly amid constrained funding. In their New Horizons paper, N. Aujla et al. [1] propose using systems engineering to enhance health and social care delivery for older individuals. They highlight its focus on integrating people, systems, design, and risk management, setting it apart from traditional improvement methods.
Unveiling mild behavioural impairment in Parkinson’s disease: insights from a systematic review
Bin Hu
doi : 10.1093/ageing/afae253
Volume 53, Issue 11, November 2024, afae253
Community GeriatricsDementia and Related Disorders
New horizons in hospital-associated deconditioning: a global condition of body and mind
Carly Welch, Yaohua Chen, Peter Hartley, Corina Naughton, Nicolas Martinez-Velilla, Dan Stein, Roman Romero-Ortuno
doi : 10.1093/ageing/afae241
Volume 53, Issue 11, November 2024, afae241,
Hospital-associated deconditioning is a broad term, which refers non-specifically to declines in any function of the body secondary to hospitalisation. Older people, particularly those living with frailty, are known to be at greatest risk. It has historically been most commonly used as a term to describe declines in muscle mass and function (i.e. acute sarcopenia). However, declines in physical function do not occur in isolation, and it is recognised that cognitive deconditioning (defined by delayed mental processing as part of a spectrum with fulminant delirium at one end) is commonly encountered by patients in hospital. Whilst the term ‘deconditioning’ is descriptive, it perhaps leads to under-emphasis on the inherent organ dysfunction that is associated, and also implies some ease of reversibility. Whilst deconditioning may be reversible with early intervention strategies, the long-term effects can be devastating. In this article, we summarise the most recent research on this topic including new promising interventions and describe our recommendations for implementation of tools such as the Frailty Care Bundle.
Physical activity and sedentary behaviour interventions for people living with both frailty and multiple long-term conditions and their informal carers: a scoping review and stakeholder consultation
Hannah M L Young, Joseph Henson, Paddy C Dempsey, Scott A Willis, Roseanne E Billany, Ffion Curtis, Laura Gray, Sharlene Greenwood, Louisa Y Herring, Patrick Highton
doi : 10.1093/ageing/afae255
Volume 53, Issue 11, November 2024, afae255,
This scoping review mapped evidence on physical activity (including structured exercise) and sedentary behaviour interventions (interventions to reduce sedentary behaviour) in people living with both frailty and multiple long-term conditions (MLTCs) and their informal carers
Mild behavioural impairment in Parkinson’s disease: a systematic review
Ruan-Ching Yu, Lung Chan, Szu-Yi Chou, Li-Fong Lin, Chaur-Jong Hu, Chien-Tai Hong
doi : 10.1093/ageing/afae247
Volume 53, Issue 11, November 2024, afae247
Behavioural symptoms are common manifestations of Parkinson’s disease (PD). Early behavioural symptoms characterise mild behavioural impairment (MBI). The prevalence and intensity of MBI in people with PD (PwP) have been studied across various cohorts. However, methodological differences have obscured our understanding of MBI in these individuals. This systematic review examines and synthesises findings from relevant studies, enhancing understanding of the symptoms and implications of MBI in PD. Nine studies from five separate research institutions were identified. The conceptualisation of MBI varied considerably, affecting the reported prevalence rates of MBI in individuals with early-stage PD. Among PwP, MBI was associated higher education and impaired cognition. Affective dysregulation and impulse control disorders were primary contributors to MBI; abnormal perception was least contributor. This systematic review underscores the specific characteristics and incidence of MBI in early-stage PD. Mood and impulse control disorders are primary concerns associated with MBI. Future longitudinal studies are required to clarify the progression of these symptoms and evaluate MBI’s potential as an indicator for PD-related dementia or increased dependency
A scoping review of the measurement and analysis of frailty in randomised controlled trials
Yanhe Sun, Miles D Witham, Andy Clegg, Rod S Taylor, Grace Dibben, David McAllister, Peter Hanlon
doi : 10.1093/ageing/afae258
Volume 53, Issue 11, November 2024, afae258,
Frailty is of increasing interest in trials, either as a target of intervention, as an outcome or as a potential treatment modifier. However, frailty measurement is often highly variable. This scoping review assessed how frailty is quantified in randomised controlled trials (RCTs), in what context and for what purposes
Systematic review of guideline recommendations for older and frail adults with type 2 diabetes mellitus
Jennifer Bolt, Valeria Carvalho, Kristine Lin, Sung Ju Lee, Colleen Inglis
doi : 10.1093/ageing/afae259
Volume 53, Issue 11, November 2024, afae259
The application of clinical practice guidelines (CPGs) across the spectrum of individuals living with diabetes can be challenging, particularly in older adults, where factors such as frailty and multimorbidity exacerbate the complexity of management
Adverse events caused by cannabinoids in middle aged and older adults for all indications: a meta-analysis of incidence rate difference
Latha Velayudhan, Sara Pisani, Marta Dugonjic, Katie McGoohan, Sagnik Bhattacharyya
doi : 10.1093/ageing/afae261
Volume 53, Issue 11, November 2024, afae261,
To quantify the incidence rate difference (IRD) of AEs in middle aged and older adults of age??50 years receiving CBMs and also examine associations with weekly doses.
The discontinuation of implantable cardioverter defibrillator shock therapies towards the end of life: consensus guideline from the British Heart Rhythm Society
Honey Thomas, Amy Dutton, Miriam J Johnson, Heather Herbert, Jane Wallace, Paul Foley
doi : 10.1093/ageing/afae246
Volume 53, Issue 11, November 2024, afae246,
Implantable cardioverter defibrillators (ICDs) are implanted in increasing numbers of patients with the aim of treating ventricular arrhythmias in high-risk patients and reducing their risk of dying. Individuals are also living longer with these devices. As a result, a greater number of patients with an ICD will deteriorate either with worsening cardiac failure, another non-cardiac condition or general frailty and will have a limited prognosis. Frequently, they will be cared for by non-cardiac teams who may be less familiar with ICDs. Therefore, to ensure the person receives high-quality end-of-life care, they should have the opportunity to consider and discuss the option to deactivate the shock function of their ICD. If the ICD shock therapy is not discontinued, there is an increased risk that, as a person reaches the last days of life, the ICD may deliver multiple, painful shocks that are distressing. There is also a risk that the device may delay the person’s natural death, which the person would not have chosen if they had been given the opportunity to discuss discontinuation. The British Heart Rhythm Society has developed a practical guideline to support all healthcare professionals who are caring for patients who have an ICD. This includes descriptions of different device types, ethical and legal aspects, timing and nature of ICD discussions and practical advice regarding how the devices may be deactivated. It aims to promote awareness and timely discussion between professionals and patients and to encourage best practice.
The Italian guideline on diagnosis and treatment of dementia and mild cognitive impairment
Elisa Fabrizi, Antonio Ancidoni, Nicoletta Locuratolo, Paola Piscopo, Francesco Della Gatta, Simone Salemme, Sara Maria Pani, Domitilla Marconi, Luca Vignatelli, Luciano Sagliocca
doi : 10.1093/ageing/afae250
Volume 53, Issue 11, November 2024, afae250,
Approximately 2 million people in Italy are currently living with dementia or mild cognitive impairment (MCI), and 4 million are involved as family members or caregivers. Considering the significant impact of dementia, the Italian Ministry of Health entrusted the Italian National Institute of Health (Istituto Superiore di Sanità) with the development of a guideline within the Italian National Guideline System (Sistema Nazionale Linee Guida, SNLG) on the diagnosis and treatment of dementia and MCI. The main objective was to provide evidence-based recommendations aimed at reducing the variability and ensuring the appropriateness of clinical practices throughout the whole care process from identification and diagnosis to the end of life for people with dementia (PwD) or MCI and their families/caregivers
The effect of multidomain lifestyle intervention on health care service use and costs - secondary analyses from the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER): a randomised controlled trial
Maria Sääskilahti, Jenni Kulmala, Markku Nurhonen, Jenni Lehtisalo, Markku Peltonen, Francesca Mangialasche, Tiina Laatikainen, Timo Strandberg, Riitta Antikainen
doi : 10.1093/ageing/afae249
Volume 53, Issue 11, November 2024, afae249,
This study investigated the effect of a two-year FINGER multidomain intervention on health care service use during the 8-year follow-up. The costs of service use were also evaluated.
Association of night shift work and biological ageing: the mediating role of body mass index
Wenqi Shen, Lingli Cai, Jiang Li, Ying Sun, Bin Wang, Ningjian Wang, Yingli Lu
doi : 10.1093/ageing/afae242
Volume 53, Issue 11, November 2024, afae242
We aimed to examine whether current and lifetime night shift work is associated with accelerated biological ageing and the potential role of body mass index (BMI) in mediating the association.
Modifiable dementia risk associated with smaller white matter volume and altered 1/f aperiodic brain activity: cross-sectional insights from the LEISURE study
Thomas Pace, Jacob M Levenstein, Toomas E Anijärv, Alicia J Campbell, Ciara Treacy, Daniel F Hermens, Sophie C Andrews
doi : 10.1093/ageing/afae243
Volume 53, Issue 11, November 2024, afae243
The rising prevalence of dementia necessitates identifying early neurobiological markers of dementia risk. Reduced cerebral white matter volume and flattening of the slope of the electrophysiological 1/f spectral power distribution provide neurobiological markers of brain ageing alongside cognitive decline. However, their association with modifiable dementia risk remains to be understood
Clinical biomarker–based biological ageing and the risk of adverse outcomes in patients with chronic kidney disease
Hao Xiang, Yu Huang, Yuanyuan Zhang, Panpan He, Ziliang Ye, Sisi Yang, Yanjun Zhang, Xiaoqin Gan, Fan Fan Hou, Xianhui Qin
doi : 10.1093/ageing/afae245
Volume 53, Issue 11, November 2024, afae245,
Patients with chronic kidney disease (CKD) show features of premature ageing. We aimed to evaluate the association between biological ageing and adverse outcomes, including end-stage kidney disease (ESKD), cardiovascular diseases (CVD) and all-cause mortality, in patients with CKD.
Nut consumption and disability-free survival in community-dwelling older adults: a prospective cohort study
Holly Wild, Madina Nurgozhina, Danijela Gasevic, Alison M Coates, Robyn L Woods, Joanne Ryan, Lawrence Beilin, Thara Govindaraju, John J McNeil, Alice J Owen
doi : 10.1093/ageing/afae239
Volume 53, Issue 11, November 2024, afae239
The relationship between nut intake and disability-free survival (healthy lifespan) in later life is unclear. The objective was to evaluate the association between nut intake and disability-free survival in a cohort of adults aged ?70 years, and whether this varied according to overall diet quality.
Menopause age and type and dementia risk: a pooled analysis of 233 802 women
Annette J Dobson, Zhiwei XU, Louise F Wilson, Hsin-Fang Chung, Sven Sandin, Yvonne T Van der Schouw, Panayotes Demakakos, Elisabete Weiderpass, Gita D Mishra
doi : 10.1093/ageing/afae254
Volume 53, Issue 11, November 2024, afae254,
It is not clear whether the association between younger age at menopause and increased risk of dementia is modified by type of menopause. We examined the association of age at menopause or hysterectomy with dementia risk in three groups of women: those with natural menopause, premenopausal bilateral oophorectomy (surgical menopause) or premenopausal hysterectomy (without bilateral oophorectomy)
Association between metabolomics-based biomarker scores and 10-year cognitive decline in men and women. The Doetinchem Cohort Study
Annelot P Smit, Gerrie-Cor M Herber, Lieke M Kuiper, M Liset Rietman, Kirsten E J Wesenhagen, H Susan J Picavet, P Eline Slagboom, W M Monique Verschuren
doi : 10.1093/ageing/afae256
Volume 53, Issue 11, November 2024, afae256,
Metabolomic scores based on age (MetaboAge) and mortality (MetaboHealth) are considered indicators of overall health, but their association with cognition in the general population is unknown. Therefore, the association between MetaboAge/MetaboHealth and level and decline in cognition was studied, as were differences between men and women
World delirium awareness and quality survey in 2023—a worldwide point prevalence study
Heidi Lindroth, Keibun Liu, Laura Szalacha, Shelly Ashkenazy, Giuseppe Bellelli, Mark van den Boogaard, Gideon Caplan, Chi Ryang Chung, Muhammed Elhadi,
doi : 10.1093/ageing/afae248
Volume 53, Issue 11, November 2024, afae248,
To report on the global prevalence of clinically documented delirium and delirium-related clinical practices in wards caring for paediatric and adult patients in healthcare facilities
Effectiveness of bivalent mRNA booster vaccination and previous infection in older adults during Omicron period: real-world evidence
Pedro-Pablo España, Idoia Castillo-Sintes, Maria J Legarreta, Amaia Bilbao-González, Nere Larrea, Maria Gascon, Ane Uranga, Amaia Artaraz, Julia Garcia-Asensio
doi : 10.1093/ageing/afae251
Volume 53, Issue 11, November 2024, afae251,
We sought to compare the relative effectiveness of a fourth dose of vaccine using bivalent messenger ribonucleic acid (mRNA), by comparing patients who had and had not received this dose
Equality of opportunity for timely dementia diagnosis (EQUATED): a qualitative study of how people from minoritised ethnic groups experience the early symptoms of dementia and seek help
Christine Carter, Moïse Roche, Elenyd Whitfield, Jessica Budgett, Sarah Morgan-Trimmer, Sedigheh Zabihi, Yvonne Birks, Fiona Walter, Mark Wilberforce
doi : 10.1093/ageing/afae244
Volume 53, Issue 11, November 2024, afae244
People from minoritised ethnic groups are diagnosed with dementia later in the disease. We explored pathways that may determine the timing of diagnoses in a UK ethnically diverse, urban area
