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Cumulative Socioeconomic Status Risk is Associated with Greater Increase in Serum Neurofilament Light Chain Levels Among Middle-Aged Black Adults. 累积的社会经济地位风险与中年黑人血清神经丝轻链水平的大幅上升有关。
Man-Kit Lei, Steven R H Beach, Ronald L Simons, Michelle M Mielke

Background: This study examined the longitudinal relationship between cumulative socioeconomic status (SES) risk and serum neurofilament light chain (NfL) levels to better understand the association between social factors and a biomarker of neurodegeneration.

Methods: We used data from the Family and Community Health Study (FACHS), collecting psychosocial and blood data at two waves (2008) and (2019) from 254 Black Americans (43 males and 211 females). Blood samples were analyzed at each wave for serum NfL concentrations. Regression analysis and mixed-effect modeling examined relationships between cumulative SES risk and serum NfL, controlling for covariates and assessing time effects.

Results: Utilizing 11-year longitudinal data, serum NfL levels increased with age. Higher cumulative SES risk at baseline correlated with elevated serum NfL at the 11-year follow-up and predicted a greater increase in NfL levels. Clinically, NfL is a sensitive biomarker for axonal injury and neurodegeneration, commonly used to detect early and preclinical stages of conditions such as Alzheimer's disease (AD), multiple sclerosis, and other neurodegenerative disorders.

Conclusions: Our results suggest that exposure to cumulative SES risk among Black adults may contribute to elevated levels of NfL, indicating potential early neurodegeneration. Given the established role of NfL in detecting neurodegenerative processes, these findings underscore the importance of interventions that bolster social safety nets and social connectedness to enhance brain health and mitigate neurodegenerative risks.

背景:本研究考察了累积社会经济地位(SES)风险与血清神经丝蛋白轻链(NfL)水平之间的纵向关系,以更好地了解社会因素与神经变性生物标志物之间的关联:我们使用了家庭与社区健康研究(FACHS)的数据,在两次波次(2008 年和 2019 年)收集了 254 名美国黑人(43 名男性和 211 名女性)的社会心理和血液数据。在每个波次对血液样本进行血清 NfL 浓度分析。回归分析和混合效应模型检验了累积 SES 风险与血清 NfL 之间的关系,控制了协变量并评估了时间效应:结果:利用 11 年的纵向数据,血清 NfL 水平随年龄增长而增加。基线时累积的 SES 风险较高与 11 年随访时血清 NfL 升高相关,并预测 NfL 水平会有更大的升高。在临床上,NfL是轴突损伤和神经退行性变的敏感生物标志物,常用于检测阿尔茨海默病(AD)、多发性硬化症和其他神经退行性疾病的早期和临床前阶段:我们的研究结果表明,黑人成年人所面临的累积性社会经济风险可能会导致 NfL 水平升高,从而显示出潜在的早期神经退行性疾病。鉴于NfL在检测神经退行性病变过程中的既定作用,这些发现强调了加强社会安全网和社会联系的干预措施对于增进大脑健康和降低神经退行性病变风险的重要性。
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引用次数: 0
There are multiple clocks that time us: Cross-sectional and longitudinal associations among 14 alternative indicators of age and aging. 有多种时钟为我们计时:14 个年龄和老化替代指标之间的横向和纵向关联。
Johanna Drewelies, Jan Homann, Valentin Max Vetter, Sandra Duezel, Simone Kühn, Laura Deecke, Elisabeth Steinhagen-Thiessen, Philippe Jawinski, Sebastian Markett, Ulman Lindenberger, Christina M Lill, Lars Bertram, Ilja Demuth, Denis Gerstorf

Aging is a complex process influenced by mechanisms operating at numerous levels of functioning. Multiple biomarkers of age have been identified, yet we know little about how the different alternative age indicators are intertwined. In the Berlin Aging Study II (nmin= 328; nmax= 1,517, women = 51%; 14.27 years of education), we examined how levels and seven-year changes in indicators derived from blood assays, MRI brain scans, other-ratings, and self-reports converge among older adults. We included eight epigenetic biomarkers (incl. five epigenetic "clocks"), a BioAge composite from clinical laboratory parameters, brain age, skin age, subjective age, subjective life expectancy, and future health horizon. We found moderate associations within aging domains, both cross-sectionally and longitudinally over seven years. However, associations across different domains were infrequent and modest. Notably, participants with older BioAge had correspondingly older epigenetic ages. Our results suggest that different aging clocks are only loosely interconnected and that more specific measures are needed to differentiate healthy from unhealthy aging.

衰老是一个复杂的过程,受到在多个功能层面运行机制的影响。目前已发现多种年龄生物标志物,但我们对不同的替代年龄指标如何相互交织却知之甚少。在柏林老龄化研究 II(nmin= 328;nmax= 1,517,女性=51%;受教育年限 14.27 年)中,我们研究了来自血液化验、核磁共振成像脑部扫描、其他评级和自我报告的指标在老年人中的水平和七年变化是如何趋同的。我们纳入了八个表观遗传生物标志物(包括五个表观遗传 "时钟")、临床实验室参数的生物年龄综合指标、脑年龄、皮肤年龄、主观年龄、主观预期寿命和未来健康状况。我们发现,无论是横向还是纵向,在七年的时间里,各衰老领域之间都存在适度的关联。然而,不同领域之间的关联并不常见,而且程度也不高。值得注意的是,生物年龄较大的参与者的表观遗传年龄也相应较大。我们的研究结果表明,不同的衰老时钟之间只有松散的联系,需要更具体的测量方法来区分健康和不健康的衰老。
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引用次数: 0
Relationships between APOE, Type 2 Diabetes, and Cardiovascular Disease in Postmenopausal Women. 绝经后妇女的 APOE、2 型糖尿病和心血管疾病之间的关系。
Michelle M Dunk, Ira Driscoll, Mark A Espeland, Kathleen M Hayden, Simin Liu, Rami Nassir, Ginny Natale, Aladdin H Shadyab, Jo Ann E Manson

Background: The Apolipoprotein E (APOE) ε4 allele, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CVD) are well-established risk factors for dementia. Relationships between APOE and incidence of T2DM and CVD are not fully understood but may shed light on the mechanisms underlying dementia pathogenesis.

Methods: Postmenopausal women (N=6,795) from the Women's Health Initiative hormone therapy clinical trial with APOE genotyping and no prior diagnosis of T2DM or CVD were included. We examined associations of APOE status (APOE2+ [ε2/ε2, ε2/ε3], APOE3 [ε3/ε3], and APOE4+ [ε4/ε4, ε3/ε4] carriers) with incidence of T2DM, coronary heart disease (CHD), stroke, and total CVD events using Cox regression. CVD outcomes were examined in baseline non-statin users and adjusted for statin initiation over follow-up to account for possible confounding by statins.

Results: Among all participants (mean age 66.7±6.5 years, 100% non-Hispanic white), 451 (6.6%) were using statins at baseline. Over the follow-up (mean 14.9 and 16.0 years for T2DM and CVD, respectively), 1,564 participants developed T2DM and 1,578 developed CVD. T2DM incidence did not differ significantly by APOE status (ps≥0.09). Among non-statin users, APOE4+ had higher incidence of total CVD (hazard ratio [95% confidence interval]=1.18 [1.02-1.38], p=0.03) compared to APOE3 carriers, but risks for CHD (1.09 [0.87-1.36], p=0.47) and stroke (1.14 [0.91-1.44], p=0.27) were not significantly elevated when examined individually. CVD outcomes did not differ between APOE2+ and APOE3 carriers (ps≥0.11).

Conclusions: T2DM risk did not differ by APOE status among postmenopausal women, but APOE4+ carriers not using statins had an increased risk of total CVD events.

背景:载脂蛋白E(APOE)ε4等位基因、2型糖尿病(T2DM)和心血管疾病(CVD)是公认的痴呆症风险因素。APOE与T2DM和心血管疾病发病率之间的关系尚不完全清楚,但可能揭示痴呆症发病机制:方法:研究人员纳入了来自妇女健康倡议激素疗法临床试验的绝经后妇女(N=6795),这些妇女进行了 APOE 基因分型,且之前未诊断出 T2DM 或心血管疾病。我们使用 Cox 回归法研究了 APOE 状态(APOE2+ [ε2/ε2、ε2/ε3]、APOE3 [ε3/ε3]和 APOE4+ [ε4/ε4、ε3/ε4] 携带者)与 T2DM、冠心病 (CHD)、中风和总心血管疾病事件发生率的关系。对基线非他汀类药物使用者的心血管疾病结果进行了研究,并根据随访期间他汀类药物的使用情况进行了调整,以考虑他汀类药物可能造成的混杂因素:在所有参与者(平均年龄为 66.7±6.5 岁,100% 为非西班牙裔白人)中,有 451 人(6.6%)在基线时使用他汀类药物。在随访期间(T2DM 和心血管疾病的平均随访时间分别为 14.9 年和 16.0 年),分别有 1,564 人和 1,578 人罹患 T2DM 和心血管疾病。T2DM发病率与APOE状态无显著差异(ps≥0.09)。在非他汀类药物使用者中,与 APOE3 携带者相比,APOE4+ 的总心血管疾病发病率更高(危险比 [95% 置信区间]=1.18 [1.02-1.38],P=0.03),但单独研究时,冠心病(1.09 [0.87-1.36],P=0.47)和中风(1.14 [0.91-1.44],P=0.27)的风险并无显著升高。APOE2+和APOE3携带者之间的心血管疾病结果没有差异(ps≥0.11):结论:绝经后妇女的 T2DM 风险在 APOE 状态上没有差异,但未使用他汀类药物的 APOE4+ 携带者发生总心血管疾病事件的风险增加。
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引用次数: 0
Disentangling Anemia in Frailty: Exploring the role of Inflammation. 厘清虚弱中的贫血:探索炎症的作用
Catrin Herpich, Lea Göger, Lea Faust, Magdalena Kalymon, Christiane Ott, Sophia Walter, Elke Lehmkuhl, Tilman Grune, Varvara Moskiou, Ursula Müller-Werdan, Kristina Norman

Background: In older patients, frailty and anemia frequently coexist. However, only few studies have been conducted in older patients with multimorbidity and several overlapping causes of anemia, such as inflammation, inadequate nutrition or certain pathologies. This analysis aims to decipher potential factors associated with anemia in older hospital patients with frailty.

Methods: Patients (n=208, age: 62-98 years) were categorized as pre-frail (n=68) and frail (n=140) using the Fried frailty phenotype. We quantified serum concentrations of markers of iron-metabolism (iron, ferritin, transferrin, soluble transferrin receptor, hepcidin), inflammation (interleukin (IL) 6, IL-10 C-reactive protein) and haematology (hemoglobin). Principal component analysis was conducted to evaluate biomarker patterns and associations with frailty were assessed with logistic regression analysis.

Results: Anemia prevalence was higher in patients with frailty (84.3% versus 70.6%, p=0.021). Three principal components (PC1-3) were identified. PC1 was characterized by high factor loadings representing inflammation and factor scores differed between patients with pre-frailty and frailty [-0.04 (IQR:1.45) versus -0.51 (IQR:0.87), p<0.001]. PC2 represents macrocytic anemia and thus vitamin B12 or folate deficiency, whereas PC3 indicates hematological pathologies. Only PC1 was associated with frailty status when controlled for age, sex, number of drugs and comorbidities (OR: 2.018, 95%CI: 1.316; 3.094, p=0.001). PC2 and PC3 were not associated with frailty.

Conclusion: Our results suggest that anemia in patients with frailty is driven by inflammation rather than being disease-related or solely the result of micronutrient deficiencies.

背景:在老年患者中,虚弱和贫血经常同时存在。然而,针对老年患者的研究却寥寥无几,这些患者多病共存,而且贫血的原因也相互重叠,如炎症、营养不足或某些病症。本分析旨在解读与老年虚弱住院患者贫血相关的潜在因素:采用弗里德虚弱表型将患者(208 人,年龄 62-98 岁)分为虚弱前期(68 人)和虚弱期(140 人)。我们对血清中铁代谢标记物(铁、铁蛋白、转铁蛋白、可溶性转铁蛋白受体、血红细胞生成素)、炎症(白细胞介素(IL)6、IL-10 C-反应蛋白)和血液学(血红蛋白)的浓度进行了量化。通过主成分分析评估了生物标志物的模式,并通过逻辑回归分析评估了与虚弱的关系:结果:虚弱患者的贫血发生率更高(84.3% 对 70.6%,P=0.021)。确定了三个主成分(PC1-3)。PC1 的特点是代表炎症的因子载荷较高,且虚弱前期和虚弱期患者的因子得分不同[-0.04 (IQR:1.45) 对 -0.51 (IQR:0.87), p结论:我们的研究结果表明,虚弱患者的贫血是由炎症引起的,而不是与疾病相关或仅仅是微量元素缺乏的结果。
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引用次数: 0
Using Physiological System Networks to Elaborate Resilience Across Frailty States. 利用生理系统网络来阐述脆弱状态下的恢复能力。
Meng Hao, Hui Zhang, Yi Li, Xiaoxi Hu, Zixin Hu, Xiaoyan Jiang, Jiucun Wang, Xuehui Sun, Zuyun Liu, Daniel Davis, Li Jin, Xiaofeng Wang

Background: Aging is characterized by loss of resilience, the ability to resist or recover from stressors. Network analysis has shown promise in investigating dynamic relationships underlying resilience. We aimed to use network analysis to measure resilience in a longitudinal cohort of older adults and quantify whole-system vulnerabilities associated with frailty.

Methods: We used data from the Rugao Longitudinal Ageing Study, including 71 biomarkers from participants classified as robust, prefrail, or frail. We quantified biomarker correlations and topological parameters. Additionally, we proposed propagation models to simulate damage and recovery dynamics, investigating network resilience under various conditions.

Results: We classified 1 754 individuals into robust (n = 369), prefrail (n = 1 103), and frail (n = 282) groups with 71 biomarkers. Several biomarkers were linked to frailty, including those related to blood pressure, electrocardiogram (ECG), kidney function, platelets, and white blood cells. Each frailty stage was associated with increased network correlations. The frail network showed increased average degree and connectance, decreased average path length and diameter, and reduced modularity compared to robust and prefrail networks. Hub biomarkers, particularly β2-microglobulin and platelet count, played a significant role, potentially propagating dysfunction across physiological systems. Simulations revealed that damage to critical hubs led to longer recovery times in the frail network than robust and prefrail networks.

Conclusions: Network analysis could serve as a valuable tool for quantifying resilience and identifying vulnerabilities in older adults with frailty. Our findings contribute to understanding frailty-related physiological disturbances and offer potential for personalized healthcare interventions targeting resilience in older populations.

背景:衰老的特点是失去弹性,即抵抗压力或从压力中恢复的能力。网络分析在研究弹性背后的动态关系方面显示出了前景。我们旨在使用网络分析来衡量老年人的纵向队列中的恢复力,并量化与虚弱相关的整个系统的脆弱性。方法:我们使用了如皋纵向衰老研究的数据,包括71个来自参与者的生物标志物,这些生物标志物被分类为强壮、运动前或虚弱。我们量化了生物标志物相关性和拓扑参数。此外,我们提出了传播模型来模拟损伤和恢复动态,研究了各种条件下的网络弹性。结果:我们用71种生物标志物将1754个个体分为强壮组(n=369)、运动前组(n=1103)和虚弱组(n=282)。一些生物标志物与虚弱有关,包括与血压、心电图、肾功能、血小板和白细胞有关的生物标志物。每个虚弱阶段都与网络相关性增加有关。与稳健和预轨道网络相比,脆弱网络的平均程度和连通性增加,平均路径长度和直径减少,模块性降低。中枢生物标志物,特别是β2-微球蛋白和血小板计数,发挥了重要作用,可能在整个生理系统中传播功能障碍。模拟显示,关键枢纽的损坏导致脆弱网络的恢复时间比稳健和铁路前网络更长。结论:网络分析可以作为一种有价值的工具来量化老年体弱者的复原力和识别其脆弱性。我们的研究结果有助于理解与虚弱相关的生理障碍,并为针对老年人群的复原力的个性化医疗干预提供了潜力。
{"title":"Using Physiological System Networks to Elaborate Resilience Across Frailty States.","authors":"Meng Hao, Hui Zhang, Yi Li, Xiaoxi Hu, Zixin Hu, Xiaoyan Jiang, Jiucun Wang, Xuehui Sun, Zuyun Liu, Daniel Davis, Li Jin, Xiaofeng Wang","doi":"10.1093/gerona/glad243","DOIUrl":"10.1093/gerona/glad243","url":null,"abstract":"<p><strong>Background: </strong>Aging is characterized by loss of resilience, the ability to resist or recover from stressors. Network analysis has shown promise in investigating dynamic relationships underlying resilience. We aimed to use network analysis to measure resilience in a longitudinal cohort of older adults and quantify whole-system vulnerabilities associated with frailty.</p><p><strong>Methods: </strong>We used data from the Rugao Longitudinal Ageing Study, including 71 biomarkers from participants classified as robust, prefrail, or frail. We quantified biomarker correlations and topological parameters. Additionally, we proposed propagation models to simulate damage and recovery dynamics, investigating network resilience under various conditions.</p><p><strong>Results: </strong>We classified 1 754 individuals into robust (n = 369), prefrail (n = 1 103), and frail (n = 282) groups with 71 biomarkers. Several biomarkers were linked to frailty, including those related to blood pressure, electrocardiogram (ECG), kidney function, platelets, and white blood cells. Each frailty stage was associated with increased network correlations. The frail network showed increased average degree and connectance, decreased average path length and diameter, and reduced modularity compared to robust and prefrail networks. Hub biomarkers, particularly β2-microglobulin and platelet count, played a significant role, potentially propagating dysfunction across physiological systems. Simulations revealed that damage to critical hubs led to longer recovery times in the frail network than robust and prefrail networks.</p><p><strong>Conclusions: </strong>Network analysis could serve as a valuable tool for quantifying resilience and identifying vulnerabilities in older adults with frailty. Our findings contribute to understanding frailty-related physiological disturbances and offer potential for personalized healthcare interventions targeting resilience in older populations.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Power of a Complex Systems Perspective to Elucidate Aging. 从复杂系统的角度阐明衰老的力量。
Alan A Cohen, Marcel G M Olde Rikkert

It is becoming highly accepted that aging, age-related diseases, and geriatric healthcare can move forward if reductionist research is complemented by integrative research uniting knowledge on specific aging mechanisms, multiple biomedical, social, psychological, lifestyle, and environmental factors and their interactions. In this special issue, we present exciting papers that illustrate how complexity science theory and practice can be applied to aging research and provide a better understanding and quantification of healthy aging and vulnerability to disease. Recent insights on biomarkers, clocks of aging, frailty, and resilience are covered and studied in interaction with a dynamic multiscale perspective. The editorial and closing viewpoint guide you through basic principles of gerontological complexity science and shed light on new research horizons, including innovative systems-based interventions.

越来越多的人认为,如果能将特定的衰老机制、多种生物医学、社会、心理、生活方式和环境因素及其相互作用的知识结合起来进行综合研究,那么衰老、与年龄有关的疾病和老年医疗保健就能向前发展。在本特刊中,我们将介绍一些令人振奋的论文,说明如何将复杂性科学理论和实践应用于老龄化研究,并更好地理解和量化健康老龄化和疾病易感性。文章从动态多尺度的视角,对生物标志物、衰老时钟、虚弱和恢复力等方面的最新观点进行了阐述和研究。社论和结语将引导您了解老年学复杂性科学的基本原理,并揭示新的研究视野,包括基于系统的创新干预措施。
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引用次数: 0
Introduction to Special Issue on Complexity. 复杂性特刊导言。
Lewis A Lipsitz
{"title":"Introduction to Special Issue on Complexity.","authors":"Lewis A Lipsitz","doi":"10.1093/gerona/glae213","DOIUrl":"10.1093/gerona/glae213","url":null,"abstract":"","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Safe(r) Landing by Older People: A Matter of Complexity. 老年人安全着陆:复杂性问题。
Rich S W Masters, Liis Uiga

Maintaining balance is a complex motor problem that requires coordinated contributions from multiple biological systems. Aging inevitably lessens the fidelity of biological systems, which can result in an increased risk of falling and associated injuries. It is advantageous to land safely, but falls manifest in diverse ways, so different motor solutions are required to land safely. However, without considerable practice, it is difficult to recall the appropriate motor solution for a fall and then apply it effectively in the brief duration before hitting the ground. A complex systems perspective provides a lens through which to view the problem of safe(r) landing. It may be possible to use motor analogies to promote degeneracy within the perceptual motor system so that, regardless of the direction in which an older person falls, their body self-organizes to land with less likelihood of injury.

保持平衡是一个复杂的运动问题,需要多个生物系统的协调配合。衰老不可避免地会降低生物系统的保真度,从而增加跌倒的风险和相关伤害。安全着陆是有利的,但跌倒的表现形式多种多样,因此需要不同的运动解决方案才能安全着陆。然而,如果没有大量的练习,就很难在坠落时想起适当的电机解决方案,然后在落地前的短暂时间内有效地加以应用。复杂系统的视角为我们提供了一个观察安全着陆问题的视角。也许可以利用运动类比来促进感知-运动系统的退化,这样,无论老年人从哪个方向跌倒,他们的身体都会自我组织,使落地时受伤的可能性降低。
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引用次数: 0
Temporal Dynamics of Epigenetic Aging and Frailty From Midlife to Old Age. 从中年到老年的表观遗传衰老和虚弱的时间动力学。
Jonathan K L Mak, Ida K Karlsson, Bowen Tang, Yunzhang Wang, Nancy L Pedersen, Sara Hägg, Juulia Jylhävä, Chandra A Reynolds

Background: DNA methylation-derived epigenetic clocks and frailty are well-established biological age measures capturing different aging processes. However, whether they are dynamically linked to each other across chronological age remains poorly understood.

Methods: This analysis included 1 309 repeated measurements in 524 individuals aged 50-90 years from the Swedish Adoption/Twin Study of Aging. Frailty was measured using a validated 42-item frailty index (FI). Five epigenetic clocks were calculated, including 4 principal component (PC)-based clocks trained on chronological age (PCHorvathAge and PCHannumAge) and aging-related physiological conditions (PCPhenoAge and PCGrimAge), and a pace of aging clock (DunedinPACE). Using dual change score models, we examined the dynamic, bidirectional associations between each of the epigenetic clocks and the FI over age to test for potential causal associations.

Results: The FI exhibited a nonlinear, accelerated increase across the older adulthood, whereas the epigenetic clocks mostly increased linearly with age. For PCHorvathAge, PCHannumAge, PCPhenoAge, and PCGrimAge, their associations with the FI were primarily due to correlated levels at age 50 but with no evidence of a dynamic longitudinal association. In contrast, we observed a unidirectional association between DunedinPACE and the FI, where a higher DunedinPACE predicted a subsequent increase in the FI, but not vice versa.

Conclusions: Our results highlight a temporal order between epigenetic aging and frailty such that changes in DunedinPACE precede changes in the FI. This potentially suggests that the pace of aging clock can be used as an early marker of the overall physiological decline at system level.

背景:DNA甲基化衍生的表观遗传时钟和虚弱是公认的生物年龄测量,捕捉不同的衰老过程。然而,人们对它们是否在按时间顺序排列的年龄段内动态地相互联系仍知之甚少。方法:该分析包括瑞典收养/双胞胎老龄化研究中524名50至90岁的个体的1309次重复测量。虚弱是使用经验证的42项虚弱指数(FI)来测量的。计算了五个表观遗传学时钟,包括四个基于主成分(PC)的时钟,这些时钟根据时间年龄(PCHorvathAge、PCHannumAge)和衰老相关的生理条件(PCPhenoAge、PCGrimAge)以及衰老速度时钟(DunedinPACE)进行训练。使用双重变化评分模型,我们检查了每个表观遗传时钟和FI之间随年龄变化的动态双向关联,以测试潜在的因果关联。结果:FI在整个成年期呈非线性加速增长,而表观遗传学时钟大多随年龄呈线性增长。对于PCHorvathAge、PCHannumAge、PCPhenoAge和PCGrimAge,它们与FI的相关性主要是由于50岁时的相关水平,但没有证据表明存在动态纵向相关性。相反,我们观察到DunedinPACE和FI之间存在单向关联,其中较高的DunedinPPACE预测FI随后会增加,但反之亦然。结论:我们的研究结果强调了表观遗传衰老和虚弱之间的时间顺序,因此DunedinPACE的变化先于FI的变化。这可能表明衰老时钟的速度可以作为系统水平整体生理下降的早期标志。
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引用次数: 0
Differences in Cumulative Long-Term Care Costs by Dental Visit Pattern Among Japanese Older Adults: The JAGES Cohort Study. 日本老年人牙科就诊模式的累积长期护理成本差异:JAGES 队列研究。
Sakura Kiuchi, Kenji Takeuchi, Masashige Saito, Taro Kusama, Noriko Nakazawa, Kinya Fujita, Katsunori Kondo, Jun Aida, Ken Osaka

Background: Long-term care (LTC) costs create burdens on aging societies. Maintaining oral health through dental visits may result in shorter LTC periods, thereby decreasing LTC costs; however, this remains unverified. We examined whether dental visits in the past 6 months were associated with cumulative LTC insurance (LTCI) costs.

Methods: This cohort study of the Japan Gerontological Evaluation Study targeted independent adults aged≥65 years in 2010 over an 8-year follow-up. We used data from a self-reported questionnaire and LTCI records from the municipalities. The outcome was cumulative LTCI costs, and exposure was dental visits within 6 months for prevention, treatment, and prevention or treatment. A 2-part model was used to estimate the differences in the predicted cumulative LTCI costs and 95% confidence intervals (CIs) for each dental visit.

Results: The mean age of the 8 429 participants was 73.7 years (standard deviation [SD] = 6.0), and 46.1% were men. During the follow-up period, 17.6% started using LTCI services. The mean cumulative LTCI cost was USD 4 877.0 (SD = 19 082.1). The predicted cumulative LTCI costs were lower among those had dental visits than among those who did not. The differences in predicted cumulative LTCI cost were -USD 1 089.9 (95% CI = -1 888.5 to -291.2) for dental preventive visits, -USD 806.7 (95% CI = -1 647.4 to 34.0) for treatment visits, and -USD 980.6 (95% CI = -1 835.7 to -125.5) for preventive or treatment visits.

Conclusions: Dental visits, particularly preventive visits, were associated with lower cumulative LTCI costs. Maintaining oral health through dental visits may effectively reduce LTCI costs.

背景:长期护理(LTC)费用给老龄化社会造成了负担。通过看牙来保持口腔健康可能会缩短长期护理时间,从而降低长期护理成本;然而,这一点仍未得到证实。我们研究了过去 6 个月的牙科就诊是否与累积的 LTC 保险(LTCI)费用有关:这项日本老年学评估研究的队列研究以 2010 年年龄≥65 岁的独立成年人为对象,随访八年。我们使用的数据来自自我报告问卷和各市的 LTCI 记录。结果是累计的 LTCI 费用,暴露是 6 个月内为预防、治疗和预防或治疗而进行的牙科就诊。我们使用了一个由两部分组成的模型来估算每次牙科就诊的累计 LTCI 费用预测差异和 95% 置信区间 (CI):8429 名参与者的平均年龄为 73.7 岁(标准差 [SD] =6.0),46.1% 为男性。在随访期间,17.6%的人开始使用 LTCI 服务。平均累计长期护理保险费用为 4877.0 美元(标准差=19082.1)。接受过牙科检查者的预测累计 LTCI 费用低于未接受过牙科检查者。牙科预防性就诊的预测累积 LTCI 成本差异为-1089.9 美元(95%CI = -1,888.5 --291.2),治疗性就诊的预测累积 LTCI 成本差异为-806.7 美元(95%CI = -1,647.4 --34.0),预防性或治疗性就诊的预测累积 LTCI 成本差异为-980.6 美元(95%CI = -1,835.7 --125.5):结论:牙科就诊,尤其是预防性就诊,与较低的累计 LTCI 成本相关。通过牙科就诊保持口腔健康可有效降低长期护理保险费用。
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引用次数: 0
期刊
The journals of gerontology. Series A, Biological sciences and medical sciences
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