Aging Clinical and Experimental Research最新文献

The Mediterranean diet has gained significant attention for its potential health benefits on diverse pathological conditions including osteoarthritis (OA), a prevalent degenerative joint disease characterized by cartilage breakdown and inflammation. Numerous observational studies have suggested that adherence to the Mediterranean diet, may have protective effects against OA. The abundance of antioxidants and anti-inflammatory compounds and omega-3 fatty acids, among the Mediterranean diet components is believed to contribute to its beneficial effects on OA. Research investigating the association between the Mediterranean diet and OA has shown promising results. Several observational studies have reported that adherence to the Mediterranean diet is associated with a reduced risk of developing OA and with lower severity of OA symptoms. Additionally, intervention studies have demonstrated improvements in pain, function, and quality of life among OA patients following a Mediterranean diet intervention. Furthermore, emerging evidence suggests potential mechanisms underlying the protective effects of the Mediterranean diet against OA, including its ability to reduce inflammation, oxidative stress, and cartilage degradation. However, further well-designed randomized controlled trials and mechanistic studies are needed to elucidate the precise mechanisms and establish causality. In conclusion, the Mediterranean diet appears to be a promising dietary approach for the prevention and management of OA. Its rich array of nutrients and bioactive compounds may exert protective effects against OA development and progression, although more research is warranted to confirm these findings and elucidate underlying mechanisms.

Graphical abstract

Objectives

The frailty index is widely used in clinical and community settings to assess health status. This study aimed to identify the potential phenotypes of frail older adults and examine their relationship with health consequences compared with existing frailty measures.

Methods

The 11-year follow-up data from the Taiwan Longitudinal Study on Aging, covering 5,334 individuals aged ≥ 50 years, were analyzed using random-effects panel logit models. We identified three frailty phenotypes: energy-based frailty (EBF), sarcopenia-based frailty (SBF), and hybrid-based frailty (HBF). Existing frailty measures such as the Study of Osteoporotic Fractures (SOF), Fatigue, Resistance, Ambulation, Illness, and Loss of weight (FRAIL), and Fried scales were applied. We examined their correlation with health outcomes, such as falls and fractures, depression, comorbidities, hospitalization, emergency department visits, and mortality, adjusting for individual-level characteristics.

Results

Individuals with only EBF were found to be at a lower risk of falls and fractures than their counterparts with only SBF (adjusted odds ratio [AOR] = 0.13, 95% confidence interval [CI] = 0.03–0.46). Depression was less likely in the SBF group than in the EBF group (AOR = 0.02, 95% CI = 0.01–0.05). Hybrid-based frail older adults were more likely to be hospitalized (AOR = 1.84, 95% CI = 1.08–3.14) and have emergency department visits (AOR = 2.03, 95% CI = 1.15–3.58). Frailty assessed using existing measures was associated with adverse health outcomes.

Conclusion

The proposed frailty phenotype classification differs from the existing frailty measures in its ability to distinguish the corresponding phenotypes underlying various health consequences. Governments may develop strategies based on frailty phenotypes to mitigate adverse health consequences.

Background and aims

This study set out to examine the stiffness of the gastrocnemius medialis (GM) and Achilles tendon across postmenopausal women with osteosarcopenia (OS), osteoporosis (OP), and normal bone mineral density. Furthermore, we explored the relationship between muscle-tendon stiffness and postural sway during a curve-tracking task in both sagittal (AP) and frontal (ML) planes.

Methods

Seventy-three women volunteered to participate in this study. The participants were classified into OS (T-score ≤ − 2.5 and muscle mass below 5.5 kg/m²), OP (T-score ≤ − 2.5), and healthy (T-score >-1) groups. The shear wave elastography was used to determine GM and Achilles tendon stiffness during rest and activation. The postural sway was recorded using a force plate during the performance-based curve tracking (CT) task.

Results

The stiffness of the GM and Achilles tendon was found to be significantly lower in the OS group compared to the OP and healthy groups (P < 0.05). In the CT task, the OS group exhibited a significant decrease in the mean absolute (P = 0.011) and RMS error (P = 0.022) in the ML direction compared to the OP group. Additionally, a positive correlation was found between the ML mean absolute error and both GM and Achilles’s stiffness during rest and activation (P < 0.05).

Discussion and conclusion

The OS group exhibited the lowest muscle-tendon stiffness. The GM and Achilles stiffness was positively correlated with poor performance-based balance, particularly in the ML direction. This may increase the risk of falls and subsequent hip fractures during simple daily weight- shifting activities in women with osteosarcopenia.

Backgrounds

Whether excess visceral fat tissue increases the risk of death in older individuals remains controversial.

Aims

To investigate the association between the Chinese Visceral Adiposity Index (CVAI) and all-cause mortality risk in older Chinese individuals.

Methods

This cohort study utilized data of individuals aged ≥ 65 years in 2014 to 2018 wave from the Chinese Longitudinal Healthy Longevity Survey database. Older individuals in the 2014 wave were included and followed up in 2018. CVAI was calculated based on age, body size, and blood lipid parameters, with higher values indicating increased visceral fat. Survival status was determined from official death certificates, local primary healthcare providers, or the family members of participants. Kaplan-Meier survival curve and log-rank test were employed to analyze cumulative mortality risk through CVAI tertiles (tertile 1: CVAI index < 97.34; tertile 2: 97.43 ≤ CVAI index < 132.21; and tertile 3: CVAI index ≥ 132.21). A Cox proportional hazards regression model was used to assess the relationship between the CVAI groups and all-cause mortality risk. Additionally, a sensitivity analysis was performed by excluding participants who died within the first year of follow-up. A subgroup analysis was performed based on age and sex, and a restricted cubic spline plot was created to analyze the dose-response relationship between CVAI and mortality risk.

Results

A total of 1414 individuals were included, and the mean age of the participants was 84.6 (standard deviation: 10.9) years, of which 46.4% were women and 32.8% were died during a median follow-up time of 36.4 months. In the multivariable adjusted Cox regression model, we observed a significantly lower risk of mortality in the CVAI tertile 2 and 3 groups than in the tertile 1 group. The hazard ratios (HR) of the tertile 2 and 3 groups were 0.68 (95% CI, approximately 0.52–0.89) and 0.63 (95% CI, approximately 0.48–0.82), respectively. Subgroup analysis revealed that the protective effect of higher CVAI levels on mortality was more pronounced in participants aged 65–79 years and in women.

Conclusion

Our study established a linear relationship between CVAI and mortality risk among community-dwelling older adults, with higher CVAI levels associated with a lower risk of all-cause mortality. These findings highlight the potential importance of visceral adiposity in predicting mortality risk in community-dwelling older adults.

Background

Growth differentiation factor 15 (GDF15) is a crucial biomarker in various physiological and pathological processes. While elevated GDF15 levels are linked to increased mortality risk, the role of DNA methylation (DNAm)-predicted GDF15 in predicting mortality has not been extensively studied. The purpose of the study is to investigate the association between DNAm-predicted GDF15 levels and all-cause and cardiovascular disease (CVD) mortality in a nationally representative cohort.

Methods

Data from NHANES 1999–2002 were analyzed. DNAm-predicted GDF15 levels were estimated using a regression model. Weighted multivariate Cox regressions were employed to assess the relationship between DNAm-predicted GDF15 and mortality outcomes. Restricted cubic splines were used to explore dose-response relationships, and subgroup analyses were conducted to enhance result reliability.

Results

Higher DNAm-predicted GDF15 levels were significantly associated with increased all-cause mortality risk (HR = 1.08, 95% CI: 1.02–1.15). Participants in the highest DNAm-predicted GDF15 tertile showed significantly higher all-cause mortality risk (HR = 1.56, 95% CI: 1.16–2.10) and a 2.52-fold increased risk of cardiovascular mortality (HR = 2.52, 95% CI: 1.22–5.19). Kaplan-Meier curves revealed decreasing survival probability with higher DNAm-predicted GDF15 tertiles. Restricted cubic spline analysis demonstrated a non-linear dose-response relationship between DNAm-predicted GDF15 levels and cardiovascular mortality. The positive correlation between DNAm-predicted GDF15 and mortality remained robust in most of subgroups.

Conclusions

DNAm-predicted GDF15 independently predicts all-cause and cardiovascular mortality. This association persists across multiple models and stratified subgroups, supporting GDF15’s value as a biomarker for mortality risk stratification. Future research should elucidate underlying biological mechanisms and evaluate GDF15’s clinical utility in guiding mortality risk reduction interventions.

Background

The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guideline lowered the diagnostic threshold for hypertension to a systolic/diastolic blood pressure (SBP/DBP) of 130/80 mmHg. However, the predictive value of DBP for cardiovascular (CV) risk assessment diminishes with aging. The study aimed to explore whether the new diagnostic threshold for diastolic hypertension is associated with increased risk of CV organ damage and major adverse cardiovascular events (MACEs) in older adults.

Methods

1181 individuals aged 65 years or older with SBP < 130 mmHg were enrolled a prospective cohort study. They were classified into Low (< 70 mmHg), Optimal (70 to < 80 mmHg), and High (80 to < 90 mmHg) DBP groups. Cardiac, vascular, and renal organ damage were measured at baseline. The endpoint of the study was MACEs.

Results

Among 1181 participants (average age 71.9 years, 44.8% men), 172 MACEs were observed during an average follow-up of 6.4 years. We found no significant differences in CV organ damage or MACEs rates (Log-rank P = 0.73) among three groups. In multivariable Cox regression, compared to the Optimal DBP group, no significant increase in CV risk was observed in the Low DBP group (hazard ratio [HR] 1.02, [95% CI 0.68–1.52], P = 0.93) or the High DBP group (HR 1.04, [95% CI 0.72–1.49], P = 0.85). Propensity score matching showed consistent results.

Conclusion

In older adults with SBP < 130 mmHg, DBP values 80–89 mmHg were not associated with higher risk of CV organ damage, events or mortality.

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.