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Sarcopenic obesity and osteoporosis: Research progress and hot spots. 肥胖症与骨质疏松症:研究进展与热点。
IF 3.9 Pub Date : 2024-10-01 Epub Date: 2024-08-22 DOI: 10.1016/j.exger.2024.112544
Shangheng Fan, Yulan Cai, Yunqin Wei, Jia Yang, Jianmei Gao, Yan Yang

Sarcopenic obesity (SO) and osteoporosis (OP) are associated with aging and obesity. The pathogenesis of SO is complex, including glucolipid and skeletal muscle metabolic disorders caused by inflammation, insulin resistance, and other factors. Growing evidence links muscle damage to bone loss. Muscle-lipid metabolism disorders of SO disrupt the balance between bone formation and bone resorption, increasing the risk of OP. Conversely, bones also play a role in fat and muscle metabolism. In the context of aging and obesity, the comprehensive review focuses on the effects of mechanical stimulation, mesenchymal stem cells (MSCs), chronic inflammation, myokines, and adipokines on musculoskeletal, at the same time, the impact of osteokines on muscle-lipid metabolism were also analyzed. So far, exercise combined with diet therapy is the most effective strategy for increasing musculoskeletal mass. A holistic treatment of musculoskeletal diseases is still in the preliminary exploration stage. Therefore, this article aims to improve the understanding of musculoskeletal -fat interactions in SO and OP, explores targets that can provide holistic treatment for SO combined with OP, and discusses current limitations and challenges. We hope to provide relevant ideas for developing specific therapies and improving disease prognosis in the future.

肌肉松弛性肥胖(SO)和骨质疏松症(OP)与衰老和肥胖有关。肥胖症的发病机制十分复杂,包括炎症、胰岛素抵抗和其他因素引起的糖脂和骨骼肌代谢紊乱。越来越多的证据表明,肌肉损伤与骨质流失有关。骨骼肌脂代谢紊乱会破坏骨形成和骨吸收之间的平衡,增加罹患 OP 的风险。相反,骨骼也在脂肪和肌肉代谢中发挥作用。在衰老和肥胖的背景下,综合综述重点研究了机械刺激、间充质干细胞(MSCs)、慢性炎症、肌激蛋白和脂肪激蛋白对肌肉骨骼的影响,同时还分析了骨激蛋白对肌脂代谢的影响。到目前为止,运动结合饮食疗法是增加肌肉骨骼质量的最有效策略。肌肉骨骼疾病的综合治疗仍处于初步探索阶段。因此,本文旨在加深对 SO 和 OP 中肌肉骨骼-脂肪相互作用的理解,探索可对 SO 合并 OP 进行整体治疗的靶点,并讨论当前的局限性和挑战。我们希望能为未来开发特定疗法和改善疾病预后提供相关思路。
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引用次数: 0
Changes in primitive reflexes in older adults and their relationship to mental health indices: An experimental investigation 老年人原始反射的变化及其与心理健康指数的关系:实验研究
IF 3.9 Pub Date : 2024-09-16 DOI: 10.1016/j.exger.2024.112583

The reemergence of primitive reflexes (PRs) in older age is related to cognitive impairment. Currently, there are no means to prevent or slow their reappearance, but research evidence exists for their control in children. Therefore, this experiment investigated whether a 16-week special sensorimotor exercise program could benefit older adults and whether the intervention-induced changes (if any) may be associated with various indices of mental health. Of 115 adults over 60, 95 completed the study (mean age = 76.37 ± SD = 7.04 years, 22 % men). The experimental group (n = 38) showed an almost threefold decline in PRs compared to controls. In contrast, the control group (n = 57) exhibited a nearly threefold increase in PRs compared to the intervention group. Cognitive function increased in the experimental but not in the control group. Changes in PRs over the 16-week intervention were positively related to negative mental health indices (hopelessness and perceived stress) and negatively related to well-being. These findings suggest that the here-presented mild sensorimotor exercises could affect older adults' reemerging PRs and that changes in PRs are associated with mental health benefits. These results may open new research avenues toward preventing cognitive and psychological decline in older adults.

老年人原始反射(PRs)的重新出现与认知障碍有关。目前,还没有任何方法可以预防或减缓原始反射的再次出现,但有研究证据表明儿童可以控制原始反射。因此,本实验研究了为期 16 周的特殊感觉运动锻炼计划是否能使老年人受益,以及干预引起的变化(如果有的话)是否与各种心理健康指数相关。在 115 名 60 岁以上的成年人中,95 人完成了研究(平均年龄 = 76.37 ± SD = 7.04 岁,22% 为男性)。与对照组相比,实验组(n = 38)的 PR 值下降了近三倍。相比之下,对照组(n = 57)的 PR 值比干预组增加了近三倍。实验组的认知功能有所提高,而对照组则没有。在为期 16 周的干预过程中,PRs 的变化与消极心理健康指数(无望感和感知压力)呈正相关,而与幸福感呈负相关。这些研究结果表明,这里介绍的轻度感官运动锻炼可以影响老年人的再发PRs,而PRs的变化与心理健康的益处相关。这些结果可能会为预防老年人认知和心理衰退开辟新的研究途径。
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引用次数: 0
Correlation between blood pressure and mortality in older critically ill patients: Insights from a large intensive care unit database 老年重症患者血压与死亡率之间的相关性:来自大型重症监护室数据库的启示。
IF 3.9 Pub Date : 2024-09-14 DOI: 10.1016/j.exger.2024.112573

Objectives

The study aimed to investigate the relationship between blood pressure (BP) levels and mortality among critically ill older adults in the intensive care unit (ICU), establish optimal BP target for this population, and assess the mediating effect of severe malnutrition on BP-related mortality.

Methods

Data were extracted from the Medical Information Mart for Intensive Care IV version 2.2 database, focusing on critically ill patients aged 80 years and older. The analysis included various BP parameters, such as systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP).

Results

The study cohort comprised 14,660 critically ill patients, of whom 1558 (10.6 %) experienced ICU mortality and 2493 (17.0 %) experienced in-hospital mortality. Lower BP levels (SBP ≤ 112 mmHg; DBP ≤ 53 mmHg; MAP ≤65 mmHg), were associated with an increased risk of both ICU and in-hospital mortality. Notably, only reduced SBP levels were linked to a higher risk of 1-year mortality, with an adjusted hazard ratio 1.13 (95 % confidence interval 1.05 to 1.23). Additionally, severe malnutrition was identified as a mediator in the relationship between low BP levels and ICU mortality, with BP levels positively correlated with prognostic nutritional indexes.

Conclusion

Among critically ill older adults, lower BP levels are significantly associated with higher risks of ICU and in-hospital mortality, while reduced SBP levels are linked to 1-year mortality. These findings emphasize the importance of assessing nutritional status in older ICU patients with low BP levels to potentially mitigate mortality risk.

研究目的该研究旨在调查重症监护室(ICU)中患重症的老年人的血压(BP)水平与死亡率之间的关系,为这一人群确定最佳血压目标,并评估严重营养不良对血压相关死亡率的中介作用:数据提取自重症监护医学信息市场 IV(MIMIC-IV)2.2 版数据库,主要针对 80 岁及以上的重症患者。分析包括各种血压参数,如收缩压(SBP)、舒张压(DBP)和平均动脉压(MAP):研究队列包括 14,660 名重症患者,其中 1558 人(10.6%)在重症监护室死亡,2493 人(17.0%)在院内死亡。较低的血压水平(SBP ≤ 112 mmHg; DBP ≤ 53 mmHg; MAP ≤ 65 mmHg)与重症监护室和院内死亡风险的增加有关。值得注意的是,只有 SBP 水平降低才与较高的 1 年死亡风险有关,调整后的危险比为 1.13(95 % 置信区间为 1.05 至 1.23)。此外,严重营养不良被认为是血压水平低与重症监护病房死亡率之间关系的中介因素,血压水平与预后营养指数呈正相关:结论:在重症老年人中,较低的血压水平与较高的重症监护室和院内死亡风险显著相关,而较低的血压水平与 1 年死亡率相关。这些发现强调了对血压水平较低的 ICU 老年患者进行营养状况评估以降低死亡风险的重要性。
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引用次数: 0
Exploring the impact of lighting sources on walking behavior in obstructed walkways among older adults 探究照明光源对老年人在有障碍的人行道上行走行为的影响
IF 3.9 Pub Date : 2024-09-14 DOI: 10.1016/j.exger.2024.112580

The pandemic has reinforced older adults' reliance on their homes and the concept of “aging in place”. Changes like reduced physical strength and cognitive deficit, however, have heightened the challenge of simple tasks like obstacle crossing among older adults, let alone when older adults cannot perceive the surroundings well during the nighttime. The study is, therefore, to evaluate the impact of lighting on older adults' obstacle-crossing behavior during the nighttime. Twenty-seven older adults (81 ± 6 yrs., 171 ± 12 cm, 75 ± 20 kg, 14 females) were recruited. Participants were asked to cross over the obstacle in a dark residential environment under point or line light. We found that the line light tended to (1) induce more external rotation of the trailing hip (p = 0.037) and more internal rotation of the leading ankle (p < 0.001) at leading leg liftoff; and (2) result in a more upright and erect posture during stance phase (less hip flexion, p = 0.006) and swing phase of the trailing leg (reduced pelvic flexion, p = 0.038). Postural changes induced by line light demonstrated improved body control, highlighting the influence of spatial information (horizontal & vertical directions) on crossing behavior in dark environments. The findings can provide additional evidence for the design of light systems in both retirement communities and individual homes. This is particularly important when designing built environments for the aging population, in cases where the surroundings may pose challenges such as obstructed walking, and other complex floor conditions.

大流行病加强了老年人对家的依赖和 "居家养老 "的概念。然而,体力下降和认知缺陷等变化加剧了老年人跨越障碍等简单任务的挑战性,更不用说老年人在夜间无法很好地感知周围环境。因此,本研究旨在评估照明对老年人夜间跨越障碍行为的影响。研究招募了 27 名老年人(81 ± 6 岁,171 ± 12 厘米,75 ± 20 千克,14 名女性)。参与者被要求在黑暗的居住环境中,在点光源或线光源下跨越障碍物。我们发现,线光有以下倾向:(1) 在前腿抬起时,诱导后腿髋关节更多外旋(p = 0.037),前腿踝关节更多内旋(p < 0.001);(2) 在站立阶段(髋关节屈曲较少,p = 0.006)和后腿摆动阶段(骨盆屈曲减少,p = 0.038),导致姿势更加直立和挺拔。线光诱导的姿势变化改善了身体控制,突出了空间信息(水平方向和垂直方向)对黑暗环境中穿越行为的影响。这些发现为养老社区和个人住宅的照明系统设计提供了更多证据。在为老龄人口设计建筑环境时,这一点尤为重要,因为周围环境可能会带来一些挑战,如行走受阻和其他复杂的地面条件。
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引用次数: 0
Association between single-point insulin sensitivity estimator and heart failure in older adults: A cross-sectional study 单点胰岛素敏感性估计值与老年人心力衰竭之间的关系:横断面研究
IF 3.9 Pub Date : 2024-09-11 DOI: 10.1016/j.exger.2024.112578

Background

Heart failure (HF) is a condition caused by a malfunction of the heart's pumping function. The single-point insulin sensitivity estimator (SPISE) index is a novel indicator for assessing insulin resistance in humans. However, the connection between the SPISE index and the risk of HF in the elderly is unknown. Therefore, our study aims to evaluate the connection between the SPISE index and HF in older adults.

Methods

The study was based on data collected from the 1999–2020 National Health and Nutrition Examination Survey database and included 6165 participants aged ≥60 years. The multivariable linear regression model and the smooth fitting curve model were applied to investigate the connection between the SPISE index and HF in the elderly. Furthermore, the subgroup analysis was performed to investigate the interactive factors.

Results

In this study, the mean age of the population was 69.38 years. After adjusting for all covariates, we observed that the SPISE index was inversely related to the prevalence of HF (OR = 0.87, 95 % CI = 0.80–0.94, P < 0.001) in older adults. The interaction analysis showed that the association might be affected by diabetes mellitus and smoking status. Additionally, an inflection point between the SPISE index and HF was found among older women.

Conclusions

An inverse correlation was detected between the SPISE index and HF in the elderly. This could provide new insight into the prevention and management of HF in the elderly population.

背景:心力衰竭(HF)是一种由心脏泵血功能失常引起的疾病。单点胰岛素敏感性估计指数(SPISE)是评估人体胰岛素抵抗的新指标。然而,SPISE 指数与老年人罹患高血压风险之间的关系尚不清楚。因此,我们的研究旨在评估 SPISE 指数与老年人心房颤动之间的联系:研究基于 1999-2020 年全国健康与营养调查数据库收集的数据,纳入了 6165 名年龄≥60 岁的参与者。应用多变量线性回归模型和平滑拟合曲线模型研究老年人 SPISE 指数与心房颤动之间的关系。此外,还进行了亚组分析以研究交互因素:本研究中,研究对象的平均年龄为 69.38 岁。在对所有协变量进行调整后,我们发现 SPISE 指数与心房颤动的患病率成反比(OR = 0.87,95 % CI = 0.80-0.94,P 结论:SPISE 指数与心房颤动的患病率成反比:在老年人中,SPISE指数与心房颤动之间存在反相关性。这为预防和管理老年人高血压提供了新的思路。
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引用次数: 0
The effect of physical exercise on circulating neurotrophic factors in healthy aged subjects: A meta-analysis and meta-regression 体育锻炼对健康老年人循环神经营养因子的影响:荟萃分析和荟萃回归
IF 3.9 Pub Date : 2024-09-11 DOI: 10.1016/j.exger.2024.112579

Vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor (BDNF), and insulin-like growth factor-1 (IGF-1) may help the brain resist both functional and structural neurodegeneration, which is critical for maintaining cognitive and neurological health in older adults. This meta-analysis and meta-regression seek to elucidate the impact of physical activity on these biomarker levels in healthy seniors, as well as to examine the influence of several moderator factors, including age, sex, period length, and time, for the first time. The standardized mean effect metric was used to assess the influence of weights, which reflected each group's relative importance in comparison to baseline data. The study looked at potential moderating factors including age, gender, and physical activity levels. The analysis of 11 studies indicated no significant effect of physical activity on VEGF levels [0.328, CI 95 % (−0.871 to 1.52); I2 = 0.00; p = 0.592; Q = 4.14]. Physical activity had a substantial impact on brain-derived neurotrophic factor (0.827, 95 % confidence interval: 0.487 to 1.16; I2 = 0.00; p = 0.00; Q = 78.46), with females showing particularly notable effects (Tau2 = 0.327, Tau = 0.571, I2 = 80.90 %, Q = 68.05, df = 15, p = 0.00). Physical activity also had a substantial effect on insulin-like growth factor 1 (0.276, 95 % confidence interval: 0.065 to 0.487; I2 = 0.00; p = 0.10; Q = 8.35), indicating that it positively influences IGF-1 levels. Overall, while physical exercise has a significant effect on BDNF and IGF-1, more research is needed to fully understand its impact on vascular endothelial growth factor and to investigate how individual characteristics may influence exercise outcomes.

血管内皮生长因子(VEGF)、脑源性神经营养因子(BDNF)和胰岛素样生长因子-1(IGF-1)可帮助大脑抵抗功能性和结构性神经变性,这对维持老年人的认知和神经健康至关重要。这项荟萃分析和荟萃回归试图阐明体育锻炼对健康老年人这些生物标志物水平的影响,并首次研究了一些调节因素的影响,包括年龄、性别、周期长度和时间。标准化平均效应指标用于评估权重的影响,权重反映了与基线数据相比各组的相对重要性。研究考察了潜在的调节因素,包括年龄、性别和体育锻炼水平。对 11 项研究的分析表明,体育锻炼对血管内皮生长因子水平没有显著影响[0.328,CI 95 % (-0.871 to 1.52);I2 = 0.00;p = 0.592;Q = 4.14]。体育锻炼对脑源性神经营养因子有显著影响(0.827,95 % 置信区间:0.487 至 1.16;I2 = 0.00;p = 0.00;Q = 78.46),女性的影响尤为明显(Tau2 = 0.327,Tau = 0.571,I2 = 80.90 %,Q = 68.05,df = 15,p = 0.00)。体育锻炼对胰岛素样生长因子 1 也有很大影响(0.276,95% 置信区间:0.065 至 0.487;I2 = 0.00;P = 0.10;Q = 8.35),表明体育锻炼对 IGF-1 水平有积极影响。总之,虽然体育锻炼对BDNF和IGF-1有显著影响,但要充分了解体育锻炼对血管内皮生长因子的影响,并研究个体特征如何影响锻炼结果,还需要更多的研究。
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引用次数: 0
18F-Fluorodeoxyglucose positron emission tomography/computed tomography imaging reveals the protective effect of docosahexaenoic acid on glucose metabolism by reducing brain 27-hydroxycholesterol 18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描成像显示了二十二碳六烯酸通过降低大脑 27-羟基胆固醇对葡萄糖代谢的保护作用。
IF 3.9 Pub Date : 2024-09-10 DOI: 10.1016/j.exger.2024.112577

Total cholesterol (TC) and the cholesterol oxidation product 27-hydroxycholesterol (27-OHC) are both increased in the elderly. Accumulating evidence has linked 27-OHC to glucose metabolism in the brain, while docosahexaenoic acid (DHA) has been shown to positively regulate the 27-OHC levels. However, it is unclear whether DHA may affect glucose metabolism in the brain by regulating 27-OHC levels. In this study, we hypothesized that DHA supplementation would modulate TC levels and reduce 27-OHC levels, thereby improving brain glucose metabolism in SAMP8 mice. The mice were assigned into the Control group and DHA dietary supplementation group. The study evaluated cholesterol levels, 27-OHC levels, and glucose metabolism in the brain. The results showed that DHA supplementation decreased serum levels of TC, low-density lipoprotein cholesterol (LDL-C), and increased levels of high-density lipoprotein cholesterol (HDL-C); and improved the glucose-corrected standardized uptake value of cortex, hippocampus, and whole brain regions in SAMP8 mice. In conclusion, supplementation of DHA could regulate the cholesterol composition and reduce the level of 27-OHC, thereby improving brain glucose metabolism in SAMP8 mice.

老年人的总胆固醇(TC)和胆固醇氧化产物 27-羟基胆固醇(27-OHC)都会升高。越来越多的证据表明,27-OHC 与大脑中的葡萄糖代谢有关,而二十二碳六烯酸(DHA)已被证明能积极调节 27-OHC 的水平。然而,目前还不清楚 DHA 是否会通过调节 27-OHC 水平来影响大脑中的葡萄糖代谢。在本研究中,我们假设补充 DHA 会调节 TC 水平并降低 27-OHC 水平,从而改善 SAMP8 小鼠的脑糖代谢。小鼠被分为对照组和 DHA 膳食补充剂组。研究评估了胆固醇水平、27-OHC 水平和大脑中的葡萄糖代谢。结果显示,补充 DHA 能降低 SAMP8 小鼠血清中胆固醇、低密度脂蛋白胆固醇(LDL-C)的水平,提高高密度脂蛋白胆固醇(HDL-C)的水平,并能改善大脑皮层、海马和整个脑区的葡萄糖校正标准化摄取值。总之,补充 DHA 可以调节胆固醇组成,降低 27-OHC 水平,从而改善 SAMP8 小鼠的脑糖代谢。
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引用次数: 0
Sarcopenia in cirrhosis: From pathophysiology to interventional therapy 肝硬化患者的肌少症:从病理生理学到介入治疗。
IF 3.9 Pub Date : 2024-09-09 DOI: 10.1016/j.exger.2024.112571

Sarcopenia, characterized by the loss of skeletal muscle mass and function, is a significant complication in patients with cirrhosis. This condition not only exacerbates the overall morbidity and mortality associated with liver disease but also complicates patient management, increasing the risk of hospitalization, infections, and hepatic encephalopathy. Despite its clinical significance, sarcopenia in cirrhotic patients remains underdiagnosed and undertreated. This review aims to summarize current knowledge on the pathophysiology of sarcopenia in cirrhosis, including mechanisms such as altered metabolism, hormonal imbalances, and inflammation. Additionally, we explore diagnostic challenges and discuss emerging therapeutic strategies, including nutritional support, exercise, and pharmacological interventions. By highlighting the gaps in existing research and proposing directions for future studies, this review seeks to improve the management and outcomes of cirrhotic patients affected by sarcopenia.

以骨骼肌质量和功能丧失为特征的 "肌肉疏松症 "是肝硬化患者的一个重要并发症。这种情况不仅会加重肝病的总体发病率和死亡率,还会使患者的管理复杂化,增加住院、感染和肝性脑病的风险。尽管具有重要的临床意义,但肝硬化患者的肌肉疏松症仍未得到充分诊断和治疗。本综述旨在总结肝硬化患者肌肉疏松症病理生理学的现有知识,包括新陈代谢改变、激素失衡和炎症等机制。此外,我们还探讨了诊断方面的挑战,并讨论了新出现的治疗策略,包括营养支持、运动和药物干预。本综述强调了现有研究的不足,并提出了未来研究的方向,旨在改善受肌肉疏松症影响的肝硬化患者的管理和治疗效果。
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引用次数: 0
A randomized, placebo-controlled trial of purified anthocyanins on cognitive function in individuals at elevated risk for dementia: Analysis of inflammatory biomarkers toward personalized interventions 纯化花青素对痴呆症高危人群认知功能的随机安慰剂对照试验:分析炎症生物标志物,实现个性化干预。
IF 3.9 Pub Date : 2024-09-09 DOI: 10.1016/j.exger.2024.112569

Background

Dementia poses a significant global health challenge. Anthocyanins neutralize free radicals, modulate signaling pathways, inhibit pro-inflammatory genes, and suppress cytokine production and may thus have positive cognitive effects in people at increased risk of dementia. We aim to investigate the effects of purified anthocyanins on cognitive function in people at increased risk of dementia according to their inflammation status based on blood-based inflammatory biomarkers.

Methods

This is a secondary analysis of a 24-week randomized, double-blind, placebo-controlled trial. Cluster analysis was performed to categorize two groups based on their individual inflammatory biomarker profile using multiplex sandwich ELISA for the quantitative measurement of cytokines. Descriptive statistics and longitudinal models assessed cognitive outcomes. The primary comparison was the group difference at week 24 based on a modified intention-to-treat analysis.

Results

Cluster analysis revealed two distinct inflammatory biomarker profiles. In Cluster 1 (high levels of inflammation biomarkers), anthocyanin treatment showed a statistically significant improvement on cognitive function compared to placebo at 24 weeks. No significant differences were observed in Cluster 2 (low levels of inflammation biomarkers). The demographic characteristics, cognitive scores, and biomarker distributions were similar between treatment groups at baseline. However, cluster 1 exhibited higher BMI, diabetes prevalence, medication usage, and lower HDL cholesterol levels.

Conclusion

Individuals with elevated levels of inflammation markers benefited from anthocyanin treatment to enhance cognitive performance, whereas those with lower levels did not. The anti-inflammatory and antioxidant properties of anthocyanins make them a promising intervention, and future prospective trials in people with increased inflammation are warranted.

背景:痴呆症对全球健康构成重大挑战。花青素能中和自由基、调节信号通路、抑制促炎基因、抑制细胞因子的产生,因此可能对痴呆症高危人群的认知功能产生积极影响。我们的目的是根据基于血液炎症生物标志物的炎症状态,研究纯化花青素对痴呆症高危人群认知功能的影响:这是一项为期 24 周的随机、双盲、安慰剂对照试验的二次分析。采用多重夹心酶联免疫吸附法(multiplex sandwich ELISA)对细胞因子进行定量测量,并根据炎症生物标志物的个体特征进行聚类分析,从而划分出两组。描述性统计和纵向模型评估了认知结果。主要比较结果是根据修改后的意向治疗分析得出的第24周时的组间差异:聚类分析显示了两种不同的炎症生物标志物特征。在群组 1(高水平的炎症生物标志物)中,花青素治疗与安慰剂相比,在 24 周时对认知功能的改善具有统计学意义。在第 2 组(低水平炎症生物标志物)中没有观察到明显差异。各治疗组的人口统计学特征、认知评分和生物标志物分布在基线时相似。然而,第 1 组的体重指数、糖尿病患病率、药物使用率较高,高密度脂蛋白胆固醇水平较低:结论:炎症标志物水平升高的人可以从花青素治疗中获益,从而提高认知能力,而水平较低的人则不能。花青素的抗炎和抗氧化特性使其成为一种很有前景的干预措施,未来有必要对炎症加重的人群进行前瞻性试验。
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引用次数: 0
The influence of ageism on the hallmarks of aging: Where age stigma and biology collide 年龄歧视对衰老特征的影响:年龄耻辱与生物学的碰撞
IF 3.9 Pub Date : 2024-09-07 DOI: 10.1016/j.exger.2024.112575

Ageism encompasses the creation of negative stereotypes of aging that culminate in the development of prejudicial thoughts and discriminatory actions against people in advanced age. Stereotypes refer to major characteristics, overgeneralized, not supported by observations, that are created to categorize, simplify, and combine complex characteristics, attributes, and behaviors shared by members of a group into more simplistic categories. Negative aging stereotypes include the assumption that old people are weak, reminiscent, sick, and tired, to quote a few. In early age, these views may generate intergenerational conflicts between young and old people, but they seem to have little effect on other aspects of life. However, in middle-aged and older adults, the presence of negative-self stereotypes of aging are significantly associated with several health parameters, including walking speed, cognitive function, mental health problems, and accumulation of amyloid plaques and neurofibrillary tangles. Furthermore, observational studies found that ageism might be associated with cardiovascular events, obesity, dementia, and death. These harmful effects are possibly mediated by the interaction between ageism and fundamental mechanisms of aging, mainly inflammation. Given the clinical implications of this relationship, the present manuscript provides a critical review of the available literature that examined associations between ageism and health parameters. We also discuss the main possible mechanisms underlying this association, the main limitations of the current literature, candidate strategies to counteract ageism, and directions to future studies. Finally, we provide a critical opinion of the current scenario and its potential adaptability to the clinical practice.

老龄歧视包括对老龄化的负面成见,这种成见最终导致对高龄者的偏见思想和歧视行为。刻板印象指的是过度概括的主要特征,没有观察结果的支持,是为了将一个群体成员共有的复杂特征、属性和行为归类、简化和组合成更简单的类别而产生的。消极的老龄化刻板印象包括认为老年人软弱、爱回忆、生病和疲惫等。在年轻时,这些观点可能会引发年轻人和老年人之间的代际冲突,但似乎对生活的其他方面影响不大。然而,在中老年人中,对衰老的负面自我刻板印象与几项健康指标有显著关联,包括行走速度、认知功能、心理健康问题、淀粉样蛋白斑块和神经纤维缠结的积累。此外,观察性研究发现,老龄歧视可能与心血管事件、肥胖、痴呆和死亡有关。这些有害影响可能是由老龄歧视与衰老的基本机制(主要是炎症)之间的相互作用介导的。鉴于这种关系的临床意义,本手稿对研究老龄化与健康参数之间关系的现有文献进行了批判性回顾。我们还讨论了这种情况的主要可能机制、现有文献的主要局限性、应对老龄化的候选策略以及未来研究的方向。最后,我们对目前的情况及其在临床实践中的潜在适应性提出了批判性意见。
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Experimental gerontology
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