The journals of gerontology. Series A, Biological sciences and medical sciences最新文献

Background: Some common infections are associated with poorer age-related health outcomes; however, findings are limited to a small number of pathogens and frequently inconclusive. This study aimed to expand the range of pathogens investigated in relation to frailty and mortality in older age.

Methods: We investigated relationships between seropositivity for 18 viruses, bacteria and protozoa with concurrent frailty and prospective mortality in middle-aged and older adults within two UK population-based cohorts: UK Biobank (N = 9,427; aged 40-70 years) and MRC NSHD (N = 1,791; aged 60-65 years). Multiplex serological assays were used to identify seropositivity for each pathogen and frailty was assessed using a frailty index measuring the accumulation of age-related health deficits. Mortality was determined from linked administrative records.

Results: Adjusting for sex, age, income and education, previous infection with Toxoplasma gondii ((β = 0.77%; 95% CI: 0.42, 1.11) and Helicobacter pylori (0.63%; 95% CI: 0.28, 0.97) were associated with higher frailty equivalent to 3.8 or 3.1 years of aging, as was inflammation-weighted pathogen burden (0.41%/SD, 95% CI: 0.25, 0.57; 0.42%/SD, 95% CI: 0.26, 0.58). Previous infection with Chlamydia trachomatis, human herpes simplex virus 1 and cytomegalovirus were associated with increased frailty after adjustment for sex and age, although relationships were confounded by socioeconomic circumstances. No common infections were robustly associated with mortality.

Conclusions: Our results indicate that infection with H. pylori and T. gondii, and the combined burden of infection may detrimentally impact ageing health. These pathogens may warrant targeting beyond current clinical measures to mitigate the development of frailty.

Background: Although intrinsic capacity (IC) is a multidimensional marker of healthy ageing, cross-country validation in diverse cultural and socioeconomic contexts remains limited. Our study aimed to harmonise the operationalisation of IC and examine its associations with sociodemographic characteristics and health outcomes in the UK and Brazil.

Methods: Nationally representative cohorts of community-dwelling older adults in the UK and Brazil, aged ≥60 years from the English Longitudinal Study of Ageing (n = 3,392) and Brazilian Longitudinal Study of Ageing (n = 3,580). IC was derived using bi-factor models comprising locomotor, cognition, psychological, sensory, and vitality measures, standardised to a 0-100 scale. Linear regressions assessed IC associations with sociodemographic factors. Logistic regressions examined IC associations with poor/fair self-rated health and disability in basic (ADL) and instrumental (IADL) activities of daily living. We tested whether education and wealth modified these associations.

Results: Mean IC scores were lower in women than in men, with differences of 3.06 points (95%CI=2.30-3.82) in the UK and 8.14 (95%CI=7.40-8.90) in Brazil. Older age, non-White race/ethnicity, less education, and lower wealth were also linked to lower IC scores. Higher IC was associated with lower odds of poor/fair self-rated health in the UK (OR = 0.32; 95%CI=0.29-0.35) and Brazil (OR = 0.54; 95%CI=0.48-0.61). Higher IC was also linked to lower odds of ADL and IADL disability in both cohorts. No significant interactions were found.

Conclusions: IC showed consistent associations with sociodemographic factors and health outcomes in the UK and Brazil. IC may inform equitable, person-centred healthy ageing policies for older adults in diverse contexts.

Background: Previous research has suggested a likely reciprocal relationship between physical function and physical activity among older adults, but few assessed those living with dementia. This study examined the bidirectional relationship between physical function and physical activity among older adults living with dementia during hospitalization and post discharge periods, and whether the relationship differs by severity of dementia.

Methods: This secondary analysis included 455 older adult patients aged 55 years and older living with dementia from a randomized clinical trial, assessed during admission, discharge, 1-, 6-, and 12-month post-discharge periods. Random intercept cross-lagged panel models were used to assess the bidirectional relations, controlling for age, comorbidities, admission location, length of stay, discharge location, and intervention status.

Results: Average age was 82.47 (SD = 8.49) and majority were female (62.6%) and White (65.3%). The average SLUMS score was 7.51 (SD = 5.90) with 77% (n = 351) having a severe level of cognitive impairment. Antecedent physical function at admission, discharge, and 1-month predicted physical activity at corresponding cross-lagged timepoint separately (range of unstandardized coefficients b's: .037-.043, p's<.05); physical activity at discharge predicted physical function at 1-month (b=.708, p=.016). This bi-directional relationship varied by severity of dementia, appearing at the first two cross-lagged time points in patients with severe dementia (b's: .039-.049 and .464-.848, all p's <.05), but not in those with moderate dementia.

Conclusions: Physical activity and physical function commonly co-occur among older adults with dementia. Intervention studies promoting both physical function and physical activity among older adults with dementia may achieve greater effectiveness when tailored to differences in dementia severity.

Background: Research suggests aging is a coordinated physiological decline occurring in multiple systems and at multiple biological levels. However, it is largely unknown how general biological aging and specific systemic aging co-occur and influence one another to affect health outcomes. There is also emerging interest in understanding how social exposures may differentially accelerate decline in individual physiological systems.

Methods: We utilize data from the Health and Retirement Study, a nationally representative sample of about 4000 US adults over age 55. We used eXtreme Gradient Boosting (xgboost) in a training subsample to create system-specific mortality risk scores based on sets of biomarkers representing biological systems (e.g., brain and nervous system, adaptive immune system, cardiovascular system, renal system) as well as general multisystem aging.

Results: Results suggest that the effects of most biological systems may be well captured by one or a small number of biomarkers and that female sex appears to be a protective or risk factor depending on specific biological system.

Conclusions: The importance of studying both general and system-specific aging is discussed.

Background: Obesity increases risks for mobility limitations and disability in older adults. We examined the long-term effects of an intensive lifestyle intervention (ILI) versus diabetes support and education (DSE) and body mass index (BMI) on disability.

Methods: Disability was assessed using the Pepper Assessment Tool for Disability (PAT-D) over four post-trial visits in Look AHEAD participants with type 2 diabetes and overweight/obesity. Disability and severe disability were defined as self-reporting "a lot of difficulty" or "unable" to perform ≥1 and ≥3 activities, respectively, on PAT-D subscales for mobility, instrumental, and basic activities of daily living (IADLs and BADLs). Associations between intervention group and BMI with disability prevalence were analyzed with GEE regression models, adjusting for demographics, multimorbidity index, cognition, physical performance, and diabetes control.

Results: Among 1191 participants at the first post-trial visit, mean (±SD) age was 68.7 ± 5.7 years, BMI was 34.4 ± 6.1 kg/m2; 61% were female, 69% White, and 52% assigned to ILI. Over nine years of follow-up, odds of severe mobility disability were higher for ILI participants aged ≥70 years (OR [95% CI]: 1.50 [1.02-2.20]) but lower for those in ILI <70 years (0.69 [0.48-0.99]) compared to controls (interaction p = .0043). Participants with BMI ≥35 kg/m2 had higher odds of mobility disability (2.06 [1.57-2.70]), severe mobility disability (2.52 [1.79-3.56]), and IADL disability (OR [95% CI]: 2.15 [1.53-3.02]) compared to those with BMI <30 kg/m2.

Conclusion: ILI was associated with greater severe mobility disability in participants ≥70. Regardless of age, those with higher BMI had increased late-life mobility and IADL disability.

Background: Aging is a complex process, starting early in life, manifesting across a hierarchy of biological bodily domains with heterogeneity by sex and increasing age. Several molecular and organ-level biological aging measurements have been developed. Reported associations of these measurements with aging-related functional health status are typically limited to cross-sectional research and studies in old people only.

Methods: Using data from UK Household Longitudinal Study, we examined associations between composite biological aging measures (Biological Health Score and DNA methylation algorithms) and grip strength, cognitive function, Short Form 12-item Survey scores, self-rated health cross-sectionally (up to 13 231 participants), as well as subsequent 12-year trajectories of Short Form 12-item Survey scores and self-rated health (up to 112 915 observations).

Results: Accelerated biological aging was found to be associated with worse functioning both cross-sectionally and longitudinally. However, associations can be moderated by sex and age group. For example, longitudinally, Biological Health Score was negatively associated with self-rated health (coefficient = -0.06) with a moderating effect of sex (coefficient = -0.02, p < .05; male = reference) and some age groups (40-52 years: coefficient = -0.04, p < .001; 53-65 years: coefficient = -0.03, p < .01; reference = 16-39 years), but not for the oldest group (66+ years: coefficient = -0.01, p = .34).

Conclusions: We conclude that measures of biological age are associated with individual functioning trajectories across the entire adult age span, and studies should consider sex differences and examine the entire age range to fully capture distinct facets of aging complexity.

Background: Adverse childhood experiences (ACEs) have detrimental health effects later in life. Our objective was to assess the association between ACEs and falls among middle-aged and older adults in the United States.

Methods: We used data from 38 437 participants aged 45 to 80 years from the 2023 Behavioral Risk Factor Surveillance System. The outcome was falling during the past 12 months. Adverse childhood experiences included questions about events before age 18, and 2 main domains of abuse (5 questions) and household dysfunction (6 questions), with a total score of 0 to 11, dichotomized as ≥2 ACEs versus 0-1. We assessed the association between ACEs and falling and explored whether risk factors for falling mediate the association between ACEs and falling.

Results: Among middle-aged adults (45-64 years), 22.3% had fallen, and 46.4% had ≥2 ACEs. Among older adults (≥65), 27.7% had fallen, and 31.7% had ≥2 ACEs. In multivariate analyses, participants with ≥2 ACEs have increased odds of falling compared to those with 0-1 ACEs among middle-aged (odds ratio [OR] = 1.34) and older adult participants (OR = 1.28). Even one individual ACE question, such as living with anyone who served in prison (among 45-64; OR = 1.43) or being sexually touched (among ≥65; OR = 1.45), has an independent association with falling. People with depression, functional difficulties, multimorbidity, and difficulty remembering exhibited higher proportions (%) for mediation.

Conclusions: Adverse childhood experiences are an additional risk factor for falling among middle-aged and older adults in the United States. Clinicians and public health practitioners should also consider ACEs when exploring determinants for falling across the life course.

Background: Social isolation is a key social determinant of health, yet research on its relationship with functional impairment is limited. We compared functional impairment score trajectories of older adults who experienced social isolation versus those who did not, using 2 different statistical approaches to handle attrition due to dropout and death.

Methods: Data were from 2 Northern California observational cohorts of people aged 50+ (n = 2476): Kaiser Healthy Aging and Different Life Experiences (KHANDLE) and Study of Healthy Aging in African Americans (STAR). We fit linear mixed effects models for functional impairment scores (sum of 12 items measuring basic activities of daily living [ADLs], instrumental ADLs, and mobility; range: 0-36) by baseline social isolation status (yes/no; 3-5 positive answers on 5 social contact items), adjusted for age and sex/gender. We estimated average marginal wave-specific differences in functional impairment scores, comparing approaches to address attrition.

Results: At baseline, 30% of participants reported social isolation; the median functional impairment score was 2 (Q1, Q3 = 0, 5). Baseline functional impairment scores were 1.03 points (95% CI, 0.84-1.20) higher among participants experiencing social isolation versus not. At wave 4, this difference decreased to 0.80 (95% CI, 0.52-1.07) among those remaining in the study and increased to 1.16 (95% CI, 0.83-1.42) assuming attrition was eliminated. Dropout and death were higher among participants experiencing social isolation.

Conclusion: In a diverse cohort of older adults, those experiencing social isolation tend to experience greater functional impairment, but differences in trajectories depend on how attrition is handled.

Background: While associations between poor oral health and cognitive impairment are documented, research on how different oral health conditions relate to specific cognitive measures remains limited.

Methods: Using data from 756 Baltimore Longitudinal Study of Aging 2005-2024 participants (mean age = 72.0 years, 52.5% women, 24.2% Black), we investigated the association between the first oral health assessment and subsequent cognitive decline across domains in older adults aged 60+ who were free of cognitive impairment at baseline over an average of 7.7 follow-up. Cognitive function was assessed across language, executive function, attention, memory, and visuospatial ability domains, with domain-specific composite scores calculated using various cognitive tests. Oral health was evaluated for clinically-assessed tooth loss and dental plaque, alongside self-reported periodontal symptoms. Linear mixed-effect models were used to examine the longitudinal associations with cognitive decline, adjusted for socio-demographic and clinical characteristics.

Results: After covariates adjustment, more tooth loss was associated with greater declines across all cognitive domains, including language (β = -0.0017; 95% CI = -0.0025, -0.0008), executive function (β = -0.0011; 95% CI = -0.0019, -0.0002), attention (β = -0.0011; 95% CI = -0.0021, -0.0001), memory (β = -0.0018; 95% CI = -0.0030, -0.0005), and visuospatial ability (β = -0.0017; 95% CI = -0.0029, -0.0006). Dental plaque was associated with executive function (β = -0.0165; 95% CI = -0.0276, -0.0054) and memory (β = -0.0279; 95% CI = -0.0444, -0.0115) declines. Presence of periodontal symptoms was only associated with executive function decline (β = -0.0004; 95% CI = -0.0007, -0.0001).

Conclusions: Tooth loss may indicate broader cognitive decline, while other oral health conditions, such as plaque and periodontal symptoms, particularly affect memory or executive function. Future studies are warranted to investigate underlying mechanisms.