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Previous studies find kidney stone formers (KSF) are at greater risk of developing cardiovascular disease (CVD). The underlying mechanisms are poorly understood, and many clinicians are unaware of this connection. We will: 1 Provide an up-to-date review of epidemiological data. 2 Clearly define CVD outcomes to understand conditions associated with kidney stone formation (KSF). 3 Review hypothesised biological pathways to further understand the relationship. Our systematic review is registered with PROSPERO (ID CRD42021251477). We searched epidemiological and biological data. The epidemiological search generated 669 papers, narrowed down to 15. There were 4,259,869 participants (230,720 KSFs). KSF was associated with 25% higher risk of coronary artery disease (CAD) (95% confidence interval (CI): 15, 35%), 17% higher risk of stroke/transient ischemic attacks (TIA) (CI:10, 25%) and 39% higher risk of arterial disease (AD) (CI: 17 65%). Significant heterogeneity was found. Female-identifying KSFs had a higher risk of stroke (ratio = 1.10) and CAD (1.20). The biological search generated 125 papers, narrowed down to 14. Potential underlying mechanisms were extracted and discussed, including intimal/medial vascular calcification, oxidative stress via osteopontin (OPN), cholesterol-induced pathology, and endothelial dysfunction. There is a significant association between KSF and CVD, supporting the consideration of KSF as a systemic, calcium-mediated disease. Clinicians will benefit from being aware of this connection. [Display omitted] • Largest systematic review on the topic of cardiovascular disease and kidney stones. • Increased risk of coronary artery disease, stroke, and peripheral arterial disease. • Relationship was stronger for female-identifying kidney stone formers. • First time epidemiological and biological review have been combined in this field. • Strengthened a poorly understood, clinically relevant relationship. [ABSTRACT FROM AUTHOR]

Accumulating evidence supports some health benefits of nutrients in fish, but evidence from comprehensive investigation of fish consumption and the risk of dementia is limited. We performed a systematic review and meta-analysis of prospective cohort studies to investigate this association. Papers relevant to our study published by 2021 were searched using PubMed, Embase, Cochrane library, and Web of Science databases. Pooled relative risks (RRs) of the association between fish consumption and dementia risk were calculated using a random-effects model. Seven prospective cohort studies with a total of 30,638 subjects were included in the meta-analysis. Overall, people with high fish consumption had a significantly lower risk of dementia compared to those with low fish consumption. In addition, the dose-response meta-analysis also supported the inverse association. The inverse association tended to be stronger in studies conducted in Asia. The findings of the meta-analysis of prospective cohort studies provide quantitative evidence for an inverse association between fish consumption and the risk of dementia. Further research on consumption of specific types of fish with respect to the risk of dementia are needed to provide more informative recommendations to the public. [ABSTRACT FROM AUTHOR]

Frailty is a common condition in older people. The epidemiological data available, however, are mainly based on the physical frailty phenotype. An extensive literature has suggested that frailty should be identified using a multidimensional approach. Based on these recommendations, we estimated the prevalence of frailty and pre-frailty in the older population, using the multidimensional prognostic index (MPI), a common tool for defining multidimensional frailty. We searched several databases until 10th May 2021 for studies reporting the prevalence of frailty according to MPI values. MPI was categorized, where possible, in < 0.33 (robustness), 0.33–0.66 (pre-frailty) and > 0.66 (frailty) or using a RECursive Partition and AMalgamation approach. A meta-analysis of the prevalence, with the correspondent 95% confidence intervals (CIs) of pre-frailty and frailty was performed stratified by setting (population-based, ambulatory, nursing home, and hospital). Among 177 papers initially screened, we included 57 studies for a total of 56,407 older people. The mean age was 78.6 years, with a slight prevalence of women (58%). The overall prevalence of multidimensional frailty (MPI-3) was 26.8% (95%CI: 22.1–31.5), being higher in nursing home setting (51.5%) and lower in population-based studies (13.3%). The prevalence of pre-frailty (MPI-2) was 36.4% (95%CI: 33.1–39.7), being higher in hospital setting (39.3%) and lower in nursing home (20%). In conclusion, frailty and pre-frailty, according to a multidimensional definition, are common in older people affecting, respectively, one person over four and one over three. Our work further strengths the importance of screening frailty in older people using a multidimensional approach. • The multidimensional approach to identify frailty is increasing in importance. • In our meta-analysis, using the MPI, we found that overall prevalence of multidimensional frailty (MPI-3) was 26.8%. • The prevalence of frailty was higher in nursing home setting, lower in community. • The prevalence of pre-frailty was 36.4%, being higher in hospital. [ABSTRACT FROM AUTHOR]