Yves Henchoz

Background and Objectives: The COVID-19 pandemic and related confinement measures have exacerbated health inequalities and posed unique challenges to cognitive aging. This study examined longitudinal changes in cognitive performance and associated factors before and after the COVID-19 pandemic, using data from the Swiss Lc65+ aging study. Methods: Analyses included participants with complete data across 3 assessment waves (2016-2024): 412 participants from Cohort 1 (born 1934-1938), 702 from Cohort 2 (born 1939-1943), and 826 from Cohort 3 (born 1944-1948), with women representing 58%-63% of each cohort. Cognitive performance was measured using the Mini-Mental State Examination (MMSE). Generalized estimating equations were used to evaluate changes in cognition and associations with socioeconomic, psychological, behavioral, and nutritional indicators. Results: Significant declines in MMSE scores were observed over time in Cohorts 1 and 2 (p < .001), with a smaller but significant reduction in Cohort 3. The prevalence of global cognitive efficiency deficits increased notably in Cohort 1 (16.5%-30.6%) and to a lesser extent in Cohort 2, while remaining stable in Cohort 3. Financial assistance for health insurance was associated with cognitive outcomes in several models, although the direction of this association varied across cohorts. Increases in anxiety and apathy were also observed, particularly following the COVID-19 confinement period. Discussion and Implications: Findings indicate that the COVID-19 pandemic and confinement period coincided with accelerated cognitive decline and heightened socioeconomic vulnerability among older adults, particularly in the oldest cohort. Results highlight the need for multidimensional public health strategies.

Objectives: This study aimed to estimate the proportion of individuals potentially eligible for lung cancer screening in Lausanne, canton of Vaud, Switzerland, and its associations with key sociodemographic and health-related covariates. Methods: We analyzed self-reported, cross-sectional data from three sources: Lausanne cohort 65+ (2014; n = 1,678; ages 65–70), CoLaus|PsyCoLaus (2014–2017; n = 3,839; ages 50–79), and the Swiss Health Survey (2022, representative of Vaud, ages 50–79). Eligibility was defined by the 2021 United States Preventive Services Task Force criteria. Screening eligibility prevalence was estimated separately in each dataset, and eligible and non-eligible participants were compared using bivariate hypothesis tests. Results: Eligibility was 18.2% in the Lc65+ cohort, 16.0% in CoLaus, and 14.4% in the Swiss Health Survey. Among eligible individuals, the prevalence of current smoking was 58.7% in Lc65+, 60.1% in the Swiss Health Survey, and 64.9% in CoLaus. Eligible participants tended to have a higher burden of comorbidities and social vulnerabilities, including cardiovascular disease, metabolic syndrome, depression, and lower education or income; statistically significant differences varied by dataset. Conclusion: In this Swiss population, about one in six adults met lung cancer screening criteria. Findings highlight the need for combining early detection with tobacco cessation, health promotion, and equitable access to care.

Objectives: This study aimed to assess the associations between childhood adverse socioeconomic conditions and intrinsic capacity in older adults using an integrative approach to ageing. Design: A cross-sectional study. Setting: We used data from the Lausanne Cohort 65+, a population-based longitudinal study that has been conducted in Lausanne, Switzerland, since 2004. Participants: Lausanne citizens aged 67–71 years old. Outcomes: Intrinsic capacity was assessed in 2015 using validated self-reported measures and performance tests. Partial Least Squares Structural Equation Modelling was used in a formative approach to calculate the global score of intrinsic capacity and the scores of its domains. Adverse socioeconomic conditions in childhood were retrospectively assessed in 2014 using self-reported measures of financial strain, dietary restrictions and child labour. Results: The study sample included 1328 individuals. Multivariable regressions revealed that the global score of intrinsic capacity was lower in individuals who reported financial strain (B=−0.15, p=0.029) and dietary restrictions (B=−0.314, p=0.004) in childhood. They further showed an association between financial strain and lower locomotor and sensory capacities (B=−0.173, p=0.011 and B=−0.153, p=0.027, respectively), and between child labour and a lower score on cognition (B=−0.342, p<0.001). Conclusions: Our results emphasise the critical role of early life conditions in healthy ageing. They highlight the importance of financial support for families and access to nutrition.

Lower socioeconomic status (SES) is linked to earlier nursing home admission, but it is unclear if this remains true after accounting for health needs. This study examines SES-related inequalities in nursing home admission, controlling for health needs in an area of Switzerland with universal home-based care for older adults. Data were from the Lausanne Cohort 65+ study, including 3650 participants. SES was measured by education level, occupational class, and receiving means-tested benefits (a proxy for low income). Health needs were assessed with a set of physical and mental health variables. Cox proportional hazard models are controlled for demographics and health needs. Over 6 years, 115 (3.2%) participants were admitted to a nursing home. Lower education and receiving means-tested benefits were linked to earlier nursing home admission. However, after adjusting for all SES variables and health needs, associations between socioeconomic inequalities and nursing home admission did not remain significant. Lower SES is initially associated with earlier nursing home admission, but this is substantially explained by functional and cognitive impairment. The study suggests that access to long-term care in Switzerland is horizontally equitable but emphasizes the importance of preventing functional and cognitive decline in lower SES groups.

Slowness plays a crucial role in geriatric assessments and is closely linked to frailty. In an attempt to propose alternatives to gait speed, the Moberg picking-up test (MPUT) was proposed for measuring slowness in older adults. Concurrently, we developed the Twelve-ball test (TBT) as a novel and simplified alternative to the MPUT. This study aimed to assess and compare the intra-observer and inter-observer repeatability of the MPUT and TBT in a large sample of community dwelling older adults. This study used data from the population-based Lausanne cohort 65+. In 2020, 596 individuals, aged 81–86 years, completed two sets of MPUT or TBT measurements. Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CI) were used to examine intra-observer (two-way mixed-effects model) and inter-observer (one-way random-effects model) relative repeatability of both measurements for either the MPUT or TBT. Absolute repeatability was determined by the standard error of measurement (SEM). Bland-Altman plots were plotted for visual representation of heteroscedasticity. Subgroup analyses were conducted per gender, education, and speed. For the MPUT, intra-observer repeatability was ICC = 0.77 (95% CI 0.65 to 0.84) and SEM = 1.76, while inter-observer repeatability was ICC = 0.74 (95% CI 0.66 to 0.80) and SEM = 1.23. For the TBT, intra-observer repeatability was ICC = 0.89 (95% CI 0.80 to 0.93) and SEM = 0.91, while inter-observer repeatability was ICC = 0.84 (95% CI 0.78 to 0.89) and SEM = 0.91. In all subgroup analyses, the TBT exhibited higher intra-observer and inter-observer repeatability compared to the MPUT. The MPUT and TBT appear reliable in terms of intra- and inter-observer repeatability. However, the assessments of repeatability, considering both relative and absolute consistency, show stronger results in the TBT compared to the MPUT test. With its simplified application, the TBT proves to be a promising measure of slowness in older adults.

Objectives: This study examines how different measures of socioeconomic status (SES) across childhood and adulthood relate to frailty in older age.Methods: Data came from the Lausanne cohort 65+ (Lc65+), a population-based study of approximately 4,500 older adults followed over 20 years. SES measures included education in young adulthood, occupational class in midlife, and specific early old-age factors: perceived income, wealth, financial strain, and receipt of financial subsidies. Frailty trajectories over a 10-year period were assessed using Fried’s frailty phenotype and group-based trajectory modeling. Logistic regression models adjusted for sex, age, cohort, living situation, marital status, and number of children.Results: Lower education, occupational class, financial strain, and financial subsidies in older age were each independently associated with higher frailty risk at ages 65–70. Financial strain and financial subsidies in early old age increased odds of medium- (aOR, 1.48–1.69) and high-frailty (aOR, 2.07–2.28) trajectories.Conclusion: SES across the life course strongly correlates with frailty in early old age. Early interventions and financial protection policies in older age could help mitigate frailty risk and SES-related frailty inequalities.

A growing number of studies have underlined the relationship between socioeconomic status and health. Following that literature, we explore the causal effect of financial hardships on changes in health at older ages. Rather than traditional measures of socioeconomic variables, we study the role of financial hardships. The declarative measurement of financial hardships is particularly relevant for assessing the impact of short-term financial difficulties on health among older adults. In this study, we use data from the Lausanne cohort 65+. Participants are community-dwelling older adults representative of the population aged 65–70 years in 2004 and living in Lausanne (Switzerland) (n = 1352). We use longitudinal annual data with 11 years of follow-up (2006–16) to estimate dynamic panel models on several indicators measuring older adults’ health (self-rated health, number of medical conditions, depressive symptoms, difficulties with daily living activities). We find evidence of causal effects of financial hardships on self-rated health (coef. = 0.059, P < 0.10) and on depressive symptoms (coef.=0.060, P < 0.05). On the other hand, we find no evidence of causality running from financial hardships to the number of medical conditions and the difficulties in daily living activities. These results make a contribution to the literature where nearly all previous research on associations between financial hardship and health does not establish causal relationships. Our results support the need to integrate health policies that mitigate the potential adverse health effects of financial hardship for older adults.

The proportion of the population over the age of 65 years has doubled from 1950 to nowadays in Switzerland ¹ as everywhere else in the world, ² and will continue to increase until 2030 when the youngest Baby Boomers turn 65. This demographic shift represents a major challenge to society in general and to the health care system in particular, but it also brings potential opportunities, thanks to the growing contribution of older adults in terms of volunteering, working and consuming. The magnitude of these difficulties and opportunities mainly hinges on the extent to which individuals reach old age in a fragile or robust state of health.

Background: Low blood pressure (BP) is associated with frailty in older adults. Our aim was to explore how BP predicts transitions between frailty states. Methods: We used data from the Lausanne cohort Lc65+, a population-based cohort of older adults randomly drawn from a population registry in Switzerland, in 2004, 2009 and 2014. BP was measured using a clinically validated oscillometric automated device and frailty was defined using Fried’s phenotype, every 3 years. We used an illness-death discrete multi-state Markov model to estimate hazard ratios of forward and backward transitions between frailty states (outcome) in relation to BP categories (predictor of interest) with adjustment for sex, age and antihypertensive medication (other predictors). Results: Among 4200 participants aged 65–70 years (58% female) at baseline, 70% were non-frail, 27% pre-frail and 2.0% frail. Over an average follow-up of 5.8 years, 2422 transitions were observed, with 1575 (65%) forward and 847 (35%) backward. Compared with systolic BP (SBP) <130 mmHg, the hazard ratio (95% confidence interval) of the transition from non-frail to pre-frail was 0.86 (0.74 to 1.00) for SBP 130–150 mmHg, and 0.89 (0.74 to 1.06) for SBP ≥150 mmHg. Compared with SBP <130 mmHg, the hazard ratio of the transition from pre-frail to frail was 0.71 (0.50 to 1.01) for SBP 130–150 mmHg, and 0.90 (0.62 to 1.32) for SBP ≥150 mmHg. Diastolic BP was a weaker predictor of forward transitions. Conclusions: BP categories had no strong relationship with either forward transitions or backward transitions in frailty states. If our findings are confirmed with greater precision and assuming a causal relationship, they would suggest that there is no well-defined optimal BP level to prevent frailty among older adults.