Aging Clinical and Experimental Research最新文献

Background

The gut microbiota is closely related to aging, but the genetic relationship between gut microbiota and aging has not been well investigated. The aim of the study was to explore the association of microbiota with epigenetic age acceleration (EAA) using the Mendelian randomization.

Method

The independent genetic instruments of gut microbiota were obtained from MiBioGen consortium and the Dutch Microbiome Project. EAA data were derived from genome-wide association study. To assess the causal relationship between gut microbiota and EAA, we applied four different methods of Mendelian Randomization (MR) analysis: the inverse variance weighted method (IVW), the MR-Egger regression, the weighted median analysis (WMA), and the weighted mode. Furthermore, sensitivity analyses were conducted to evaluate heterogeneity and horizontal pleiotropy.

Results

We identified potential causal associations between 12 bacterial taxa and EAA (P_IVW and P_WMA < 0.05). Among them, species Holdemania_unclassified (OR: 1.31, 95% CI: 1.13–1.52, P = 0.0004) retained a strong positive association with GrimAge acceleration. Family Acidaminococcaceae (OR: 0.64, 95% CI: 0.44–0.93, P = 0.019) and family Clostridiaceae1 (OR: 0.69, 95% CI: 0.49–0.97 P = 0.031) were negative association with GrimAge acceleration. Reverse MR analyses indicated that EAA was associated with 6 bacterial taxa in IVW and WMA. Among them, a strong inverse association was found between Phenoage acceleration and genus Turicibacter (OR: 0.928, 95%CI: 0.888–0.971, P_IVW and P_WMA < 0.001).

Conclusion

Our study implicates the potential causal effects of specific microbiota on EAA, potentially providing novel insights into the prevention aging through specific gut microbiota.

Background

The COVID-19 pandemic impacted worldwide. The Basque Country was one of the regions in Spain most affected by the virus.

Methods

In this retrospective study, we took advantage of the Basque Health Service electronic health records data lake of over 20,000 deceased individuals, including 5000 positives for COVID-19, between 2020 and 2022 in Gipuzkoa (Basque Country, Spain).

Results

Comparison between COVID-19-positive and negative individuals’ showed that the prevalence of infections was higher inside nursing homes and COVID-19 promoted a significant rise in hospitalizations, emergency entrances, and ICU admissions. No differences were observed between genders in terms of infections or survival but were detected in health resources and vaccination showed a strong protective effect against the disease.

Conclusions

Our results provided a complete characterization of the impact of COVID-19 on the Basque population, which expands the knowledge of the pandemic on older individuals and the health system. Our study also highlights the benefit of the use of Electronic Health Records in studying human diseases.

Background

Elevated blood pressure is a major risk factor for severe medical conditions. Adherence to antihypertensive medication, especially in free-dose combinations, poses a significant challenge. This study aims to develop a novel method for assessing co-exposure to free-dose antihypertensive medications using secondary data sources.

Methods

A register-based cohort study was conducted on individuals aged 65 years or older in Denmark who initiated antihypertensive therapy from 1996 to 2016 and followed for 730 days from the index date. A new method was developed to assess co-exposure to antihypertensive medications through redeemed prescriptions, treatment episodes, and overlapping medication events. The method's accuracy was evaluated using a random sample of 400 individuals.

Results

A total of 1,021,819 individuals were included in the study, with a mean age of 68.8 years, and 53.7% were women. The method achieved 100% accuracy in identifying co-exposure periods. During the early stage of the follow-up (0–180 days), 54.1% of individuals were co-exposed to at least two antihypertensive medications, while 37.5% were co-exposed during the late stage of the follow-up period (181–730 days). The most frequent antihypertensive combinations included bendroflumethiazide and potassium with either amlodipine or enalapril in the early (13.2% and 12.5% of patients, respectively) and late stages (16.9% and 15.0% of patients, respectively).

Conclusions

The newly developed method effectively assesses co-exposure to antihypertensive medications, overcoming previous limitations. The findings reveal common co-exposure combinations and evolving trends in antihypertensive medication use among older individuals, reflecting changes in clinical practice and guidelines over two decades.

Background

Handgrip strength (HGS) weakness and asymmetry are both abnormal conditions of upper-limb muscle strength. The association between HGS weakness and physical performance is controversial, and the link between HGS asymmetry and physical performance remains unclear.

Aims

This study aimed to investigate the associations of HGS weakness and asymmetry separately and concurrently with low physical performance among Chinese older people.

Methods

The study used two waves of data from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015. HGS weakness and asymmetry were defined according to the maximal HGS and the HGS ratio, respectively. Participants were classified into 4 groups according to HGS status: normal, asymmetry only, weakness only, and concurrent weakness and asymmetry. The logistic regression model was used to investigate the cross-sectional association between low physical performance and each of maximal HGS, HGS ratio, and HGS status, as well as the prospective association between baseline HGS status and new-onset physical performance decline after two years.

Results

Participants with HGS asymmetry only, weakness only, and two abnormalities showed a higher prevalence of low physical performance when asymmetry defined as an HGS ratio exceeding 1.20 and 1.30 (all, p < 0.001), with the greatest odds in those with two abnormalities (20% threshold: OR 3.83; 30% threshold: OR 5.41). The longitudinal analysis found that HGS weakness can predict the new-onset low physical performance over a two-year period, with concurrent HGS asymmetry further increased the future risk of physical performance decline.

Conclusions

Both HGS weakness and asymmetry were associated with a higher prevalence of low physical performance, in an additive way. This study will help screen older people with low physical performance more efficiently, and identify those at higher risk of developing new-onset physical performance decline within two years.

Background

Both long and short sleep durations may lead to cognitive decline in the elderly individuals, though the underlying mechanisms remain unclear.

Aims

To explore the mediating mechanism of activities of daily living and depression on different sleep durations and cognitive function in older Chinese older adults.

Methods

This retrospective study used data from 5,899 older adults who completed the 2018 China Health and Retirement Longitudinal Surveys. We used the PROCESS macro in SPSS to determine the chain mediating effect of ADL and depression on the relationship between different sleep durations and cognitive functions.

Results

(1) There were significant correlations among sleep duration, ability to perform ADL, depression, and cognitive function. (2) For sleep durations ≤ 7 h/night or > 7 h/night, ADL and depression play a chain mediating role in the relationship between sleep duration and cognitive function.

Conclusions

Shorter or longer sleep durations were associated with cognitive decline by weakening ADL and worsening depression, which suggests that medical personnel should take action to correct abnormal sleep duration in older adults. Timely treatment of ADL impairment and depression may help prevent cognitive decline.

Background

Sarcopenic obesity is a condition where loss of muscle mass occurs alongside fat gain, and it is considered a risk factor for mortality. However, the use of various definitions for this condition has led to conflicting results.

Aim

To investigate whether the coexistence of low muscle mass and abdominal obesity, defined using two simple measures employed in clinical practice, is a risk factor for mortality in individuals aged 50 or older.

Methods

A longitudinal study with a 14-year follow-up was conducted involving 5,440 participants of the English Longitudinal Study of Ageing. Abdominal obesity and low muscle mass were respectively defined based on high waist circumference and low skeletal muscle mass index (SMMI) determined by an equation. The sample was divided into four groups: non-low muscle mass/non-abdominal obesity (NLMM/NAO), non-low muscle mass/abdominal obesity (NLMM/AO), low muscle mass/non-abdominal obesity (LMM/NAO), and low muscle mass/abdominal obesity (LMM/AO). Cox regression models were used to estimate the mortality risk as a function of muscle mass and abdominal obesity status.

Results

LMM/AO increased the risk of death by 83% (HR:1.83; 95%CI: 1.35–2.66) compared to those in the NLMM/NAO group. AO alone was not associated with a greater risk of mortality (HR:1.09; 95%CI: 0.93–1.27), whereas LMM alone increased the risk by 40% (HR:1.40; 95%CI:1.18–1.66).

Conclusions

Identifying LMM/AO in individuals aged 50 or older can be crucial for predicting the risk of mortality. Simple and easily applicable measures can serve as a proxy for sarcopenic obesity and aid in implementing the necessary interventions.

The interest in the Mediterranean diet has grown considerably due to its potential health benefits on the prevention of diverse age-related chronic diseases and its association with longevity. This dietary pattern, considered among the healthiest in the world, is not simply a combination of healthy foods but goes further in its historical and cultural roots. Mediterranean diet is not intrinsically tied to any specific religion or spiritual system, but its cultural and geographical context has influenced the dietary practices of its inhabitants, encompassing the history of Western civilization and of the three Monotheistic religions Christianity, Judaism, and Islam. These religions may have some impact on dietary choices due to religious customs and practices. In 2010 the Mediterranean diet was inscribed on the UNESCO’s Representative List of Intangible Cultural Heritage of Humanity, highlighting it as a social and cultural expression of the different food cultures of the Mediterranean region and indicating that the importance of this dietary and lifestyle pattern lies not only in its specific foods and nutrients, but in the way in which its characteristic foods are produced, cooked, and eaten. In this narrative review we will discuss the possible connections between the main religions originated in the Mediterranean basin and their influence on the composition of the Mediterranean diet, and the links between spirituality/religion and this dietary pattern. This traditional model can represent a form of conscious healthy eating and lifestyle in contrast to the unhealthy Western lifestyle and ultra-processed food consumption widespread throughout the world.

Sexuality is a fundamental part of human existence and it encompasses thoughts, desires, behaviors, relationships, as well as neuropsychological and physiological components. However, sexuality in older adults is under-researched from the neuropsychological and psychophysiological perspectives and is often neglected by healthcare providers in the clinical practice. This article aims to explore the state of the art on the neuropsychology and psychophysiology of older adults’ sexuality, proposing future research directions and emphasizing its significance. By summarizing current knowledge on the sexuality of younger individuals, it was possible to lay the groundwork for formulating research questions about older adults’ sexuality. The implications proposed in this article will potentially impact both the scientific and also the clinical field. In fact, gaining insights on the neuropsychological and psychophysiological aspects of sexuality in healthy older adults can also shed light into those with neurocognitive disorders.

Purpose

The relationship between dysmagnesemia and all-cause mortality probability in individuals with acute kidney injury (AKI) have not been investigated. In this study, we evaluated the correlation of varying magnesium levels with mortality in older adults undergoing AKI.

Patients and methods

Older adults receiving treatment at the Chinese PLA General Hospital between 2007 and 2018 were retrospectively recruited. All-cause mortality was evaluated at four preset magnesium concentrations: <0.8, 0.8–0.9, 0.9–1.0, and ≥ 1.0 mmol/L. Using multivariable-adjusted Cox assessment, the all-cause mortality risk was approximated by setting the reference magnesium concentration at 0.8–0.9 mmol/L.

Results

Totally 744 participants were enrolled, whose median age was 88 years, with most of them being male (94.2%). Among them, 184 patients were assigned into the < 0.8 mmol/L group, 156 into the 0.8–0.9 mmol/L group, 206 into the 0.9–1.0 mmol/L group, and 198 into the ≥ 1.0 mmol/L group. After 28 days, the mortality rates in the four strata were 26.6, 17.9, 17.5, and 37.4%, respectively. The corresponding mortalities after 90 days were 42.4, 23.7, 26.7, and 45.5%, respectively. Compared with patients who had magnesium levels of 0.8–0.9 mmol/L, those with magnesium levels < 0.8 mmol/L (P = 0.048), and ≥ 1.0 mmol/L (P < 0.001) exhibited higher 28-day mortalities. Significant correlations also showed that patients with magnesium levels < 0.8 mmol/L (P = 0.017) and ≥ 1.0 mmol/L (P < 0.001) were significantly related to the increased 90-day mortality.

Conclusion

Magnesium levels outside the interval of 0.8–1.0 mmol/L were related to the higher risks of 28- and 90-day mortalities among older adults with AKI.

Aims

We examined whether admission risk increases at a certain threshold of number of systems medicated or whether any increase confers greater admission risk in either sex in a community-dwelling cohort of older persons in Hertfordshire. This study uses a longitudinal retrospective study design.

Methods

Data from 2997 men and women (aged 59–73 at baseline) were analyzed. Participants were followed up from baseline (1998–2004) until December 2018 using Hospital Episode Statistics and mortality data, reporting clinical outcomes using ICD-10 coding. Number of systems medicated in relation to mortality (all-cause, cancer-related, cardiovascular-related) and admission (any, neurological, cardiovascular, and respiratory) were examined using Cox regression.

Results

Apart from cancer-related mortality among women, more systems medicated predicted increased risk of all events among both sexes (p ≤ 0.001). For ‘any’, cardiovascular and respiratory admissions, there were increases in risk for each category of number of systems medicated. For example, compared to men with no systems medicated, those with 1, 2 and > 2 systems medicated had hazard ratios (95% CI) for cardiovascular admissions of 1.82 (1.57,2.12), 2.39 (2.00,2.84) and 3.45 (2.84,4.20) respectively; estimates among women were 1.74 (1.44,2.11), 2.35 (1.92,2.88) and 3.40 (2.79,4.13).

Conclusions

Increases in numbers of systems medicated conferred greater risk of admission in both sexes. Interventions aimed at reducing the burden of chronic disease in mid-late adulthood are required.