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Are adverse socioeconomic conditions in childhood associated with intrinsic capacity in older age? A cross-sectional study from the Lausanne cohort Lc65+

Por: Plys · E. · Fustinoni · S. · Avendano · M. · Belloni · G. · Blanco · J. M. · Seematter-Bagnoud · L. · Henchoz · Y.
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

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.

Mixed-methods process evaluation of ctDNA use to guide decision-making in patients with advanced solid cancers: study protocol for a substudy of the LIQPLAT trial

Por: Schwenke · J. M. · Schmitt · A. M. · McLennan · S. · Janiaud · P. · Läubli · H. · Binder · M. · Alborelli · I. · Matter · M. S. · Hinke · J. · Widmer · C. C. · Hemkens · L. G. · Kasenda · B. · Briel · M.
Introduction

There is an urgent need to better understand how information from circulating tumour DNA (ctDNA) can be integrated into routine care for patients with advanced solid cancer.

Methods and analysis

The implementation of liquid biopsies in routine care of patients with advanced solid cancer trial (LIQPLAT) is a single-centre, single-arm trial investigating the implementation of ctDNA in the routine care of patients with advanced solid cancer. We present a mixed-methods process evaluation embedded in the LIQPLAT trial, following Medical Research Council guidance and the Reach, Effectiveness, Adoption, Implementation, Maintenance framework. We show a logic model, which details the causal chain and related assumptions from recruiting patients into the trial to the goal of improving quality of life and survival. Data collection is longitudinal and includes: semistructured interviews with healthcare professionals (pathologists, biologists, oncologists; planned n=20) and patients (planned n=15) to identify implementation barriers and facilitators; recordings of molecular tumour board meetings to analyse clinical decision-making; the 23-item Normalisation MeAsure Development survey for healthcare professionals (planned n=20) at four time points. Quantitative data from hospital records will be used to assess implementation outcomes like patient acceptance rates and ctDNA workflow success. Qualitative data will undergo thematic and content analysis, and quantitative data will be analysed using a Bayesian framework.

Ethics and dissemination

The LIQPLAT trial was approved by the regional ethics committee of Northwestern and Central Switzerland (BASEC 2024-00358). The qualitative aspects of the process evaluation were exempted from ethics review according to the Swiss Human Research Act. We follow guidelines for data security, confidentiality and information governance. Results will be submitted for publication in peer-reviewed journals and discussed at conferences.

Trial registration number

NCT06367751, SNCTP000005844.

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