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Analysis of different strains of the turquoise killifish identify transcriptomic signatures associated with heritable lifespan differences. 对绿松石鳉不同品系的分析鉴定了与遗传寿命差异相关的转录组特征。
Mariateresa Mazzetto, Kathrin Reichwald, Philipp Koch, Marco Groth, Alessandro Cellerino

The African turquoise killifish Nothobranchius furzeri represents an emerging short-lived model for aging research. Captive strains of this species are characterized by large differences in lifespan. To identify the gene expression correlates of this lifespan differences, we analyzed a public transcriptomic dataset consisting of four different tissues in addition to embryos. We focused on the GRZ and the MZM0410 captive strains, which show a near twofold difference in lifespan, but similar growth and maturation and validated the results in a newly-generated dataset from a third longer-lived strain. The two strains show distinct transcriptome expression patterns already as embryos and the genotype has a larger effect than age on gene expression, both in terms of number of differentially expressed genes and magnitude of regulation. Network analysis detected RNA processing and histone modifications as the most prominent categories upregulated in GRZ that also showed idiosyncratic expression patterns such as high expression of DND is somatic tissues. The short-lived GRZ strain shows transcriptional aging signatures already at sexual maturity (anticipated aging) in all four tissues suggesting that short lifespan is the results of events that occur early in life rather than the progressive accumulation of strain-dependent differences. The GRZ strain is the most commonly used N. furzeri strain in intervention studies and our results warrant replication of at least key intervention studies in longer-lived strains.

非洲绿松石鳉Nothobranchius furzeri代表了一种新兴的寿命较短的衰老研究模型。该物种的圈养菌株的特点是寿命差异很大。为了确定基因表达与这种寿命差异的相关性,我们分析了一个公共转录组数据集,该数据集包括胚胎以外的四种不同组织。我们重点研究了GRZ和MZM0410圈养菌株,它们的寿命相差近两倍,但生长和成熟相似,并在新生成的第三个更长寿菌株的数据集中验证了结果。这两种菌株在胚胎时期就表现出不同的转录组表达模式,基因型对基因表达的影响大于年龄,无论是在差异表达基因的数量还是调控的幅度方面。网络分析发现,RNA加工和组蛋白修饰是GRZ中最突出的上调类别,同时也表现出特异性表达模式,如体细胞组织中DND的高表达。寿命较短的GRZ菌株在性成熟(预期老化)时已经在所有四种组织中显示出转录老化特征,这表明寿命较短是生命早期发生的事件的结果,而不是菌株依赖差异的逐渐积累。GRZ菌株是干预研究中最常用的furzeri菌株,我们的结果保证了至少在较长寿命菌株中进行关键干预研究的复制。
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引用次数: 0
Cardiac Biomarkers, Subclinical Brain Vascular Changes, and Cognitive Decline: Post Hoc Analysis of the SPRINT Trial. 心脏生物标志物,亚临床脑血管变化和认知能力下降:SPRINT试验的事后分析。
Wenxin Zhang, Simon B Ascher, Sudipto Dolui, Ilya M Nasrallah, Yuan Lu, Julia Neitzel, Estefania Toledo, Lidia Glodzik, Hossam A Shaltout, Timothy M Hughes, Jarett D Berry, Yuan Ma

Background: The association between subclinical cardiovascular disease (CVD) and cognitive decline in hypertensive adults and the underlying brain pathologies remain unclear. It is also undetermined whether intensifying blood pressure (BP) treatment slows down cognitive decline associated with subclinical CVD.

Methods: We conducted a post hoc analysis of the Systolic Blood Pressure Intervention Trial. Subclinical CVD at baseline was identified by elevated levels of high-sensitivity cardiac troponin T (hs-cTnT≥14 ng/L) and N-terminal pro-B-type natriuretic peptide (NT-proBNP≥125 pg/mL). Global cognitive function and domain-specific measures (memory, processing speed, language, and executive function) were assessed at baseline and follow-up (years 2, 4, and 6) in 2733 participants. White matter lesions, cerebral blood flow, and brain tissue volume were assessed by MRI at baseline and years 4 in a subset of 639 participants.

Results: Both elevated hs-cTnT and NT-proBNP levels at baseline were associated with accelerated cognitive decline across all domains after adjusting for potential confounding factors. The group with elevated levels of both cardiac biomarkers showed the fastest decline, with a larger annual decline rate of 0.033 (95% CI: 0.024-0.041) in the z-score of global cognitive function compared to the group with normal levels. Elevated levels of both biomarkers were also associated with a faster progression in white matter lesions, but not with changes in total brain tissue volume or cerebral blood flow. Intensive BP treatment did not attenuate these associations compared to standard treatment.

Conclusions: Subclinical CVD may contribute to faster white matter lesion progression and accelerated cognitive decline in patients with hypertension, regardless of intensive BP treatment.

背景:成人高血压患者的亚临床心血管疾病(CVD)与认知能力下降及其潜在的脑部病理之间的关系尚不清楚。强化血压(BP)治疗是否能减缓与亚临床CVD相关的认知能力下降也尚不确定。方法:我们对收缩压干预试验进行了事后分析。基线时亚临床CVD通过高敏感性心肌肌钙蛋白T (hs-cTnT≥14 ng/L)和n端前b型利钠肽(NT-proBNP≥125 pg/mL)水平升高来确定。在基线和随访(第2年、第4年和第6年)对2733名参与者的整体认知功能和特定领域的测量(记忆、处理速度、语言和执行功能)进行了评估。在基线和第4年,通过MRI评估了639名参与者的白质病变、脑血流量和脑组织体积。结果:在调整潜在的混杂因素后,基线时hs-cTnT和NT-proBNP水平的升高与所有领域认知能力的加速下降有关。两种心脏生物标志物水平升高组下降最快,与正常水平组相比,全球认知功能z-score的年下降率为0.033 (95% CI: 0.024-0.041)。这两种生物标志物的升高也与白质病变的更快进展有关,但与脑组织总体积或脑血流量的变化无关。与标准治疗相比,强化降压治疗并没有减弱这些相关性。结论:无论强化降压治疗如何,亚临床CVD可能导致高血压患者白质病变进展加快,认知能力下降加速。
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引用次数: 0
Relationship of Body Composition With Middle Cerebral Artery Hemodynamic Using Compositional Data Analysis in Middle-Age Adults From Toledo Study for Healthy Aging. 利用成分数据分析研究身体成分与大脑中动脉血液动力学的关系:托莱多中年健康老龄化研究。
Miguel Muñoz-Muñoz, Bert Bond, Coral Sánchez-Martín, Irene Rodríguez-Gómez, Max Weston, Mikel García-Aguirre, María M Morín-Martín, Luis M Alegre, Javier Leal-Martín, Julian Alcazar, Ignacio Ara, Francisco José García-García

Excess adipose tissue may promote chronic systemic inflammation and oxidative stress, causing endothelial damage. Early evidence indicates that obesity may be associated with poorer cerebral perfusion. The purpose of this study was to examine the relationship between body composition and cerebral hemodynamics. A total of 248 middle-aged adults (50-58 years old; 55% women) underwent a ramp test on a cycle-ergometer until volitional exhaustion. Gas exchange was assessed on a breath-by-breath basis. Mean middle cerebral artery velocity (MCAv) was measured using transcranial Doppler, and pulsatility index (PI) was calculated. Body composition was assessed by dual X-ray absorptiometry. Statistical analyses were performed using a compositional data approach including a 3-compartment model for body composition (trunk fat mass, extremities fat mass, and fat-free mass). The unadjusted models for the whole sample showed that trunk fat mass relative to other compartments was negatively associated with MCAvrest, MCAvmax, and gain, and positively associated with PImax; extremities fat mass relative to other compartments was positively associated with MCAvrest and MCAvmax, and negatively associated with PImax; and fat-free mass relative to other compartments was positively associated with PImax. These associations were sex-dependent, remaining in the women's subgroup. However, after adjusting for confounders, these associations became nonsignificant, except for PImax in the whole sample and women's subgroup. These findings suggest a possible association between cerebral hemodynamics and body composition in middle-aged adults, highlighting sex-specific differences. Moreover, our results indicate that higher trunk fat mass relative to other compartments may negatively affect cerebral hemodynamics, reducing MCAv and increasing PImax.

过多的脂肪组织可能会促进慢性全身性炎症和氧化应激,造成内皮损伤。早期证据表明,肥胖可能与较差的脑灌注有关。本研究旨在探讨身体成分与脑血流动力学之间的关系。共有 248 名中年人(50-58 岁;55% 为女性)在循环测力计上进行了斜坡测试,直至自愿力竭。对气体交换进行了逐次评估。使用经颅多普勒测量大脑中动脉平均速度(MCAv),并计算搏动指数(PI)。身体成分通过双 X 射线吸收测定法进行评估。统计分析采用成分数据方法,包括身体成分三室模型(躯干脂肪量、四肢脂肪量和无脂肪量)。整个样本的未调整模型显示,躯干脂肪量相对于其他分区与MCAvrest、MCAvmax和增益呈负相关,与PImax呈正相关;四肢脂肪量相对于其他分区与MCAvrest和MCAvmax呈正相关,与PImax呈负相关;而无脂肪量相对于其他分区与PImax呈正相关。这些关联与性别有关,在女性亚组中依然如此。然而,在对混杂因素进行调整后,除了在整个样本和女性亚组中的 PImax 外,这些关联变得不显著。这些研究结果表明,中年人的脑血流动力学与身体成分之间可能存在关联,并突出了性别差异。此外,我们的研究结果表明,相对于其他部位,躯干脂肪含量较高可能会对脑血流动力学产生负面影响,从而降低 MCAv 并增加 PImax。
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引用次数: 0
Impact of Frailty, Early Vascular Decline, and Subclinical Cognitive Impairment in Midlife Adults: Study Protocol of the Toledo Study for Healthy Ageing in Middle Age. 中年人虚弱、早期血管衰退和亚临床认知障碍的影响:托莱多中年健康老龄化研究的研究方案。
Julian Alcazar, Miguel Muñoz-Muñoz, Iván Baltasar-Fernández, Javier Leal-Martín, Mikel García-Aguirre, Coral Sánchez-Martín, Héctor Gutiérrez-Reguero, Miguel Sierra-Ramon, Ana Alfaro-Acha, José Losa-Reyna, Luis M Alegre, Ignacio Ara, Francisco José García-García

Life expectancy has increased worldwide alongside a rise in disability prevalence during old age. The impact and interrelationship among the precursors of disability in midlife remain to be better understood. Furthermore, investigating whether lifestyle factors may potentially influence health outcomes and the prognosis of vascular disease could be especially relevant among the middle-aged population, which is a priority subpopulation when prevention is the goal. This is an observational, cross-sectional, and population-based study. Participants, between 50 and 55 years old, are randomly selected from the municipality of Toledo (Spain). There are 6 nonconsecutive days for the assessments, providing enough rest between evaluations. Participants perform the interview of the Toledo Study for Healthy Aging. Blood pressure monitoring and a resting electrocardiogram are also recorded. Then, resting peripheral and cerebral vascular measurements along with muscle size and architecture are assessed. Blood and urine samples and body composition data are collected after an overnight fasting. On a different visit, physical performance and muscle function tests are performed. Additionally, brain magnetic resonance imaging is conducted. And finally, an accelerometer is given to the participants for a week. Frailty is evaluated by the Frailty Trait Scale and Fried Frailty Phenotype. This project will shed light on the associations between frailty, early cognitive impairment, and vascular aging during midlife, and on the role that lifestyles play in their development. Lastly, this project will provide meaningful implications for public health strategies aimed at promoting healthy aging in later life.

在全球预期寿命延长的同时,老年残疾的发生率也在上升。中年残疾前兆的影响和相互关系仍有待进一步了解。此外,调查生活方式因素是否会对健康结果和血管疾病的预后产生潜在影响对中年人群尤为重要,而中年人群是以预防为目标的重点亚人群。这是一项基于人群的横断面观察性研究。参与者年龄在 50 至 55 岁之间,从托莱多市(西班牙)随机抽取。评估时间为不连续的六天,两次评估之间有足够的休息时间。参与者进行托莱多健康老龄化研究访谈。同时还记录血压监测和静息心电图。然后,对静息状态下的外周血管和脑血管测量以及肌肉大小和结构进行评估。在一夜禁食后收集血液和尿液样本以及身体成分数据。在另一次就诊时,还要进行体能和肌肉功能测试。此外,还要进行脑磁共振成像。最后,给参与者佩戴加速度计一周。通过 "虚弱特质量表 "和 "弗里德虚弱表型 "对虚弱程度进行评估。该项目将揭示中年虚弱、早期认知障碍和血管老化之间的关联,以及生活方式在其发展过程中扮演的角色。最后,该项目将为旨在促进晚年健康老龄化的公共卫生战略提供有意义的启示。
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引用次数: 0
Association of Low Muscle Strength With Incident Pneumonia in Older Patients With Heart Failure. 老年心力衰竭患者肌肉力量不足与肺炎事件的关系。
Kenta Yamaguchi, Masaaki Konishi, Nobuyuki Kagiyama, Takatoshi Kasai, Kentaro Kamiya, Hiroshi Saito, Kazuya Saito, Emi Maekawa, Takeshi Kitai, Kentaro Iwata, Kentaro Jujo, Hiroshi Wada, Satoru Shinoda, Eiichi Akiyama, Shin-Ichi Momomura, Kiyoshi Hibi, Yuya Matsue

Background: Patients with heart failure (HF) are at an increased risk of developing pneumonia, leading to a high mortality. A decrease in muscle strength due to aging or concomitant disease may contribute to the development of pneumonia in older adults. We sought to investigate the relationship between low muscle strength and pneumonia incidence in older patients hospitalized for worsening HF.

Methods: We carried out a subanalysis of the FRAGILE-HF, a prospective multicenter observational study, including 1 266 consecutive older (≥65 years) patients hospitalized with HF (mean age 80.2 ± 7.8 years; 57.4% male; left ventricular ejection fraction 46% ± 17%) and information of incident pneumonia observed after discharge. Patients were followed up for 2 years post-discharge.

Results: A total of 88 patients (7.0%) developed pneumonia after discharge, with an incidence of 42.7 per 1 000 person-years. A total of 893 patients with low muscle strength, defined as handgrip strength <28 kg for men and <18 kg for women according to international criteria, were more likely to develop pneumonia than those with normal muscle strength (p < .001; log-rank test). Low muscle strength was a significant predictor of incident pneumonia (adjusted hazard ratio with 95% confidence interval: 2.65 [1.31-5.35], p = .007). Furthermore, the mortality rates were 43.2% in patients who developed pneumonia and 19.3% in those who did not, indicating a heightened risk of death following the onset of pneumonia (adjusted hazard ratio: 4.25 [2.91-6.19], p < .001).

Conclusions: In older patients hospitalized for HF, low muscle strength was associated with incident pneumonia after discharge.

背景:心力衰竭(HF)患者罹患肺炎的风险增加,导致死亡率居高不下。衰老或伴随疾病导致的肌力下降可能会导致老年人肺炎的发生。我们试图研究因高血压恶化而住院的老年患者中低肌力与肺炎发病率之间的关系:我们对 FRAGILE-HF 这一前瞻性多中心观察研究进行了子分析,研究对象包括 1266 名连续住院的老年(≥65 岁)心房颤动患者(平均年龄为 80.2±7.8 岁;57.4% 为男性;左室射血分数为 46±17%)以及出院后观察到的偶发肺炎信息。患者出院后随访两年:共有 88 名患者(7.0%)在出院后患上肺炎,发病率为每千人年 42.7 例。共有 893 名患者肌力低下,定义为手部握力不足:在因心房颤动住院的老年患者中,低肌力与出院后发生肺炎有关。
{"title":"Association of Low Muscle Strength With Incident Pneumonia in Older Patients With Heart Failure.","authors":"Kenta Yamaguchi, Masaaki Konishi, Nobuyuki Kagiyama, Takatoshi Kasai, Kentaro Kamiya, Hiroshi Saito, Kazuya Saito, Emi Maekawa, Takeshi Kitai, Kentaro Iwata, Kentaro Jujo, Hiroshi Wada, Satoru Shinoda, Eiichi Akiyama, Shin-Ichi Momomura, Kiyoshi Hibi, Yuya Matsue","doi":"10.1093/gerona/glae266","DOIUrl":"10.1093/gerona/glae266","url":null,"abstract":"<p><strong>Background: </strong>Patients with heart failure (HF) are at an increased risk of developing pneumonia, leading to a high mortality. A decrease in muscle strength due to aging or concomitant disease may contribute to the development of pneumonia in older adults. We sought to investigate the relationship between low muscle strength and pneumonia incidence in older patients hospitalized for worsening HF.</p><p><strong>Methods: </strong>We carried out a subanalysis of the FRAGILE-HF, a prospective multicenter observational study, including 1 266 consecutive older (≥65 years) patients hospitalized with HF (mean age 80.2 ± 7.8 years; 57.4% male; left ventricular ejection fraction 46% ± 17%) and information of incident pneumonia observed after discharge. Patients were followed up for 2 years post-discharge.</p><p><strong>Results: </strong>A total of 88 patients (7.0%) developed pneumonia after discharge, with an incidence of 42.7 per 1 000 person-years. A total of 893 patients with low muscle strength, defined as handgrip strength <28 kg for men and <18 kg for women according to international criteria, were more likely to develop pneumonia than those with normal muscle strength (p < .001; log-rank test). Low muscle strength was a significant predictor of incident pneumonia (adjusted hazard ratio with 95% confidence interval: 2.65 [1.31-5.35], p = .007). Furthermore, the mortality rates were 43.2% in patients who developed pneumonia and 19.3% in those who did not, indicating a heightened risk of death following the onset of pneumonia (adjusted hazard ratio: 4.25 [2.91-6.19], p < .001).</p><p><strong>Conclusions: </strong>In older patients hospitalized for HF, low muscle strength was associated with incident pneumonia after discharge.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640536","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
Inflammatory Indices and Their Associations With Postoperative Delirium. 炎症指标及其与术后谵妄的关系
Gabrielle E Mintz, Edward R Marcantonio, Jeremy D Walston, Simon T Dillon, Yoojin Jung, Shrunjal Trivedi, Xuesong Gu, Tamara G Fong, Michele Cavallari, Alexandra Touroutoglou, Bradford C Dickerson, Richard N Jones, Mouhsin M Shafi, Alvaro Pascual-Leone, Thomas G Travison, Sharon K Inouye, Towia A Libermann, Long H Ngo, Sarinnapha M Vasunilashorn

Background: Although the pathogenesis of delirium is poorly understood, increasing evidence supports a role for inflammation. Previously, individual inflammatory biomarkers have been associated with delirium. Aggregating biomarkers into an index may provide more information than individual biomarkers in predicting certain health outcomes (eg, mortality); however, inflammatory indices have not yet been examined in delirium.

Methods: Four inflammatory markers, C-reactive protein, interleukin-6, soluble tumor necrosis factor alpha receptor-1, and chitinase-3 like protein-1, were measured preoperatively and on postoperative day 2 in 548 adults aged 70+ undergoing major noncardiac surgery (mean age 76.7 [standard deviation 5.2], 58% female, 24% delirium). From these markers, 4 inflammatory indices were considered: (i) quartile summary score, (ii) weighted summary score, (iii) principal component score, and (iv) a well-established inflammatory (least absolute shrinkage and selection operator-derived) index associated with mortality. Delirium was assessed using the Confusion Assessment Method, supplemented by chart review. Generalized linear models with a log-link term were used to determine the association between each inflammatory index and delirium incidence.

Results: Among the inflammatory indices, the weighted summary score demonstrated the strongest association with delirium: participants in the weighted summary score quartile (Q)4 had a higher risk of delirium versus participants in Q1, after clinical variable adjustment (relative risk, 95% confidence interval for preoperatively: 3.07, 1.80-5.22; and postoperative day 2: 2.65, 1.63-4.30). The weighted summary score was more strongly associated with delirium than the strongest associated individual inflammatory marker (preoperatively chitinase-3 like protein-1 [relative risk 2.45, 95% confidence interval 1.53-3.92]; postoperative day 2 interleukin-6 [relative risk 2.39, 95% confidence interval 1.50-3.82]).

Conclusions: A multi-protein inflammatory index using a weighted summary score provides a slight advantage over individual inflammatory markers in their association with delirium.

背景:尽管人们对谵妄的发病机制知之甚少,但越来越多的证据表明炎症在其中发挥了作用。以前,个别炎症生物标志物与谵妄有关。在预测某些健康结果(如死亡率)时,将生物标志物汇总成一个指数可能会比单个生物标志物提供更多的信息;然而,尚未对谵妄中的炎症指数进行研究:对 548 名 70 岁以上接受非心脏大手术的成人(平均年龄 76.7 [标准差 5.2],58% 为女性,24% 有谵妄)进行了术前(PREOP)和术后第 2 天(POD2)的四项炎症指标测量,包括 C 反应蛋白、白细胞介素-6、可溶性肿瘤坏死因子 Alpha 受体-1 和几丁质酶-3 类蛋白-1 (CHI3L1)。根据这些标记物,考虑了四种炎症指数:1)四分位汇总得分;2)加权汇总得分(WSS);3)主成分得分;4)与死亡率相关的成熟炎症(LASSO 衍生)指数。谵妄采用意识模糊评估法(CAM)进行评估,并辅以病历审查。使用带有对数链接项的广义线性模型(GLM)来确定每种炎症指数与谵妄发生率之间的关系:在各种炎症指数中,WSS 与谵妄的关系最为密切:经临床变量调整后,WSS 四分位数 (Q)4 的参与者与 Q1 的参与者相比,谵妄风险更高(相对风险 [RR],95% 置信区间 [CI],PREOP:3.07,1.80-5.22;POD2:2.65,1.63-4.30)。WSS与谵妄的相关性强于最强的单个炎症标志物(PREOP CHI3L1 [RR 2.45, 95% CI 1.53-3.92];POD2白细胞介素-6 [RR 2.39, 95% CI 1.50-3.82]):使用 WSS 的多蛋白炎症指数与单个炎症标志物相比,在与谵妄的关联性方面略胜一筹。
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引用次数: 0
Nonparticipation in a Digital Health Intervention Study Among Older Adults: Uneven Involvement, Biased Outcomes, and the Effect of Weighting. 老年人不参与数字健康干预研究:不均衡的参与、有偏差的结果以及加权的影响。
Arianna Poli, Ingemar Kåreholt, Susanne Kelfve, Katarina Berg, Andreas Motel-Klingebiel

Background: The involvement of older adults in research on digital health is uneven with respect to, for example, age, gender, health status, and digital skills. However, little is known regarding the effect of the uneven involvement of older adults in digital health research on researched outcomes. This study helps to fill this knowledge gap, identifies the effects of uneven involvement of older adults in digital health research on researched outcomes, and also develops a correction for this.

Methods: Data are retrieved from a digital health intervention for postoperative monitoring of people who underwent day surgery in Sweden. Based on field information on the recruitment process and researched outcomes for the intervention, this study (i) tested intervention effects by using 2 standard unweighted procedures in a sample of 281 individuals aged 50 years or older, and then (ii) used the information on participants, nonparticipants, and their respective probabilities to be involved in the intervention study to perform a weighting of the intervention effects for each step of selection and for the study group membership.

Results: The intervention effects were found to be overestimated due to overrepresentation of groups that gained from receiving the intervention. No intervention effects were found after adjustment for participation bias.

Conclusions: Selective participation of older adults in digital health research biases research outcomes and can lead to overestimation of intervention effects. Weighting allows researchers to correct and describe the effect of selective participation on researched outcomes.

背景:根据年龄、性别、健康状况和数字技能等因素,老年人参与数字健康研究的情况并不均衡。然而,人们对老年人参与数字健康研究的不均衡性对研究成果的影响知之甚少。本研究有助于填补这一知识空白,确定老年人参与数字健康研究的不均衡性对研究成果的影响,并对此进行修正:方法:从瑞典一项针对日间手术患者术后监测的数字健康干预中获取数据。根据有关干预措施的招募过程和研究结果的实地信息,本研究(1)在 281 个 50 岁或以上的样本中使用两种标准的非加权程序测试干预效果,然后(2)使用有关参与者、非参与者及其各自参与干预研究的概率的信息,对每一步选择和研究组成员的干预效果进行加权:结果发现,由于接受干预的群体比例过高,干预效果被高估了。在对参与偏差进行调整后,没有发现干预效果:选择性地让老年人参与数字健康研究会使研究结果产生偏差,并可能导致干预效果被高估。通过加权法,研究人员可以纠正和描述选择性参与对研究结果的影响。
{"title":"Nonparticipation in a Digital Health Intervention Study Among Older Adults: Uneven Involvement, Biased Outcomes, and the Effect of Weighting.","authors":"Arianna Poli, Ingemar Kåreholt, Susanne Kelfve, Katarina Berg, Andreas Motel-Klingebiel","doi":"10.1093/gerona/glae265","DOIUrl":"10.1093/gerona/glae265","url":null,"abstract":"<p><strong>Background: </strong>The involvement of older adults in research on digital health is uneven with respect to, for example, age, gender, health status, and digital skills. However, little is known regarding the effect of the uneven involvement of older adults in digital health research on researched outcomes. This study helps to fill this knowledge gap, identifies the effects of uneven involvement of older adults in digital health research on researched outcomes, and also develops a correction for this.</p><p><strong>Methods: </strong>Data are retrieved from a digital health intervention for postoperative monitoring of people who underwent day surgery in Sweden. Based on field information on the recruitment process and researched outcomes for the intervention, this study (i) tested intervention effects by using 2 standard unweighted procedures in a sample of 281 individuals aged 50 years or older, and then (ii) used the information on participants, nonparticipants, and their respective probabilities to be involved in the intervention study to perform a weighting of the intervention effects for each step of selection and for the study group membership.</p><p><strong>Results: </strong>The intervention effects were found to be overestimated due to overrepresentation of groups that gained from receiving the intervention. No intervention effects were found after adjustment for participation bias.</p><p><strong>Conclusions: </strong>Selective participation of older adults in digital health research biases research outcomes and can lead to overestimation of intervention effects. Weighting allows researchers to correct and describe the effect of selective participation on researched outcomes.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Temporal Sequence of Incident Mild Cognitive Impairment, Incident Parkinsonism, and Risk of Death in Unimpaired Community-Dwelling Older Adults. 在社区居住的无障碍老年人中,轻度认知障碍事件、帕金森病事件和死亡风险的时间顺序。
Andrea R Zammit, Lei Yu, Shahram Oveisgharan, Julie A Schneider, David A Bennett, Aron S Buchman

Background: Mild cognitive impairment (MCI) and parkinsonism affect many older adults. The objective of this study was to determine the sequence of their occurrence and associated risk of death.

Methods: A total of 1255 community-dwelling unimpaired participants from 2 epidemiological cohorts were examined annually. MCI was based on neuropsychological testing and parkinsonism was based on the motor portion of the modified Unified Parkinson's Disease Rating Scale. A multistate Cox proportional hazards model simultaneously examined incidences of MCI, parkinsonism, and death.

Results: The average age at baseline was 76.5 years (standard deviation [SD] = 7.2) and 73% were female. Incident MCI occurred almost as commonly as incident parkinsonism, yet compared with no impairment, the risk of death was higher for MCI (hazard ratio [HR] = 1.82, 95% confidence interval [CI] = 1.34, 2.47), but it was not different for parkinsonism (HR = 1.29; 95% CI =0.95, 1.75). The risk of death for participants with incident MCI who progressed to parkinsonism (40%) was not significantly different from those with MCI alone (HR = 1.25, 95% CI = 0.93, 1.69). However, the risk of death for participants with incident parkinsonism who progressed to MCI (51%) was significantly higher than those who did not progress (HR = 1.67, 95% CI = 1.27, 2.18), indicating that the risk of death is highest with the incidence of MCI.

Conclusions: The varied patterns of sequential occurrence of cognitive and motor impairment and associated risk of death suggest much greater heterogeneity than previously recognized. Further work is needed to determine the biology underlying the temporal evolution of these phenotypes, and if identification of the various subtypes improves risk stratification.

背景:轻度认知障碍(MCI)和帕金森病影响着许多老年人。本研究的目的是确定它们的发生顺序和相关的死亡风险。方法:每年对来自两个流行病学队列的 1,255 名居住在社区的无障碍参与者进行检查。MCI 以神经心理学测试为依据,帕金森病以改良的统一帕金森病评分量表的运动部分为依据。一个多州 Cox 比例危险模型同时检测了 MCI、帕金森病和死亡的发病率:基线时的平均年龄为 76.5 岁(SD = 7.2),73% 为女性。发生 MCI 的频率几乎与发生帕金森病的频率相同,但与无障碍相比,MCI 的死亡风险更高(HR = 1.82,95%CI = 1.34,2.47),而帕金森病的死亡风险则没有差异(HR = 1.29;95%CI = 0.95,1.75)。患有 MCI 并发展为帕金森病的参与者(40%)的死亡风险与仅患有 MCI 的参与者无显著差异(HR = 1.25;95%CI = 0.93,1.69)。然而,帕金森病患者中发展为MCI的患者(51%)的死亡风险明显高于未发展为MCI的患者(HR = 1.67, 95%CI = 1.27, 2.18),这表明死亡风险随着MCI发病率的升高而升高:认知障碍和运动障碍的相继发生以及相关死亡风险的不同模式表明,其异质性远大于之前所认识到的。还需要进一步研究,以确定这些表型在时间上演变的生物学基础,以及识别各种亚型是否能改善风险分层。
{"title":"Temporal Sequence of Incident Mild Cognitive Impairment, Incident Parkinsonism, and Risk of Death in Unimpaired Community-Dwelling Older Adults.","authors":"Andrea R Zammit, Lei Yu, Shahram Oveisgharan, Julie A Schneider, David A Bennett, Aron S Buchman","doi":"10.1093/gerona/glae275","DOIUrl":"10.1093/gerona/glae275","url":null,"abstract":"<p><strong>Background: </strong>Mild cognitive impairment (MCI) and parkinsonism affect many older adults. The objective of this study was to determine the sequence of their occurrence and associated risk of death.</p><p><strong>Methods: </strong>A total of 1255 community-dwelling unimpaired participants from 2 epidemiological cohorts were examined annually. MCI was based on neuropsychological testing and parkinsonism was based on the motor portion of the modified Unified Parkinson's Disease Rating Scale. A multistate Cox proportional hazards model simultaneously examined incidences of MCI, parkinsonism, and death.</p><p><strong>Results: </strong>The average age at baseline was 76.5 years (standard deviation [SD] = 7.2) and 73% were female. Incident MCI occurred almost as commonly as incident parkinsonism, yet compared with no impairment, the risk of death was higher for MCI (hazard ratio [HR] = 1.82, 95% confidence interval [CI] = 1.34, 2.47), but it was not different for parkinsonism (HR = 1.29; 95% CI =0.95, 1.75). The risk of death for participants with incident MCI who progressed to parkinsonism (40%) was not significantly different from those with MCI alone (HR = 1.25, 95% CI = 0.93, 1.69). However, the risk of death for participants with incident parkinsonism who progressed to MCI (51%) was significantly higher than those who did not progress (HR = 1.67, 95% CI = 1.27, 2.18), indicating that the risk of death is highest with the incidence of MCI.</p><p><strong>Conclusions: </strong>The varied patterns of sequential occurrence of cognitive and motor impairment and associated risk of death suggest much greater heterogeneity than previously recognized. Further work is needed to determine the biology underlying the temporal evolution of these phenotypes, and if identification of the various subtypes improves risk stratification.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11701745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction to: Impairment of Renal and Hematopoietic Stem/Progenitor Cell Compartments in Frailty Syndrome: Link With Oxidative Stress, Plasma Cytokine Profiles, and Nuclear DNA Damage. 修正:衰弱综合征中肾和造血干细胞/祖细胞区室的损伤:与氧化应激、血浆细胞因子谱和核DNA损伤有关。
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引用次数: 0
Higher-Order Disease Interactions in Multimorbidity Measurement: Marginal Benefit Over Additive Disease Summation. 多病测量中的高阶疾病相互作用:与疾病加总法相比的边际效益。
Melissa Y Wei, Chi-Hong Tseng, Ashley J Kang

Background: Current multimorbidity measures often oversimplify complex disease interactions by assuming a merely additive impact of diseases on health outcomes. This oversimplification neglects clinical observations that certain disease combinations can exhibit synergistic effects. Thus, we aimed to incorporate simultaneous higher-order disease interactions into the validated ICD-coded multimorbidity-weighted index, to assess for model improvement.

Methods: Health and Retirement Study participants with linked Medicare data contributed ICD-9-CM claims, 1991-2012. Top 20 most prevalent and impactful conditions (based on associations with decline in physical functioning) were assessed through higher-order interactions (2-way, 3-way). We applied the least absolute shrinkage and selection operator and bootstrapping to identify and retain statistically significant disease interactions. We compared model fit in multimorbidity-weighted index with and without disease interactions in linear models.

Results: We analyzed 73 830 observations from 18 212 participants (training set N = 14 570, testing set N = 3 642). Multimorbidity-weighted index without interactions produced an overall R2 = 0.26. Introducing 2-way interactions for the top 10 most prevalent and impactful conditions resulted in a R2 = 0.27, while expanding to top 20 most prevalent and impactful conditions yielded a R2 = 0.26. When adding 3-way interactions, the same top 10 conditions produced a R2 = 0.26, while expanding to top 20 conditions resulted in a R2 = 0.24.

Conclusions: We present novel insights into simultaneous higher-order disease interactions for potential integration into multimorbidity measurement. Incorporating 2-way disease interactions for the top 10 most prevalent and impactful conditions showed a minimal improvement in model fit. A more precise multimorbidity index may incorporate both the main effects of diseases and their significant interactions.

背景:目前的多病症衡量标准往往过于简化复杂的疾病相互作用,认为疾病对健康结果的影响只是相加的。这种过度简化忽略了临床观察,即某些疾病组合会产生协同效应。因此,我们旨在将同时存在的高阶疾病相互作用纳入经过验证的 ICD 编码多病加权指数 (MICD),以评估模型的改进情况。通过高阶交互(双向、三向)评估了前 20 种最普遍和影响最大的病症(基于与身体机能下降的关联)。我们采用最小绝对收缩和选择算子(LASSO)和引导法来识别和保留具有统计学意义的疾病交互作用。我们比较了线性模型中包含和不包含疾病相互作用的 MICD 模型拟合情况:我们分析了来自 18,212 名参与者的 73,830 个观测值(训练集 N=14,570,测试集 N=3,642)。无交互作用的 MICD 的总体 R2=0.26.在前 10 个最普遍和影响最大的条件中引入双向交互作用,R2=0.27,而扩展到前 20 个最普遍和影响最大的条件,R2=0.26。当加入三向交互作用时,同样是前 10 种情况,R2=0.26,而扩大到前 20 种情况,R2=0.24:我们对同时发生的高阶疾病相互作用提出了新的见解,以便将其纳入多病测量。将双向疾病相互作用纳入前 10 种最流行、影响最大的疾病,对模型拟合的改善微乎其微。更精确的多病症指数可能同时包含疾病的主要影响及其显著的相互作用。
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The journals of gerontology. Series A, Biological sciences and medical sciences
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