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Contrast-enhanced ultrasound imaging detects anatomical and functional changes in rat cervical spine microvasculature with normal aging. 对比增强超声成像检测大鼠颈椎微血管随着正常衰老而发生的解剖和功能变化。
Jennifer N Harmon, Preeja Chandran, Abarajithan Chandrasekaran, Jeffrey E Hyde, Gustavo J Hernandez, May J Reed, Matthew F Bruce, Zin Z Khaing

Normal aging is associated with significant deleterious cerebrovascular changes; these have been implicated in disease pathogenesis and increased susceptibility to ischemic injury. While these changes are well documented in the brain, few studies have been conducted in the spinal cord. Here, we utilize specialized contrast-enhanced ultrasound (CEUS) imaging to investigate age-related changes in cervical spinal vascular anatomy and hemodynamics in male Fisher 344 rats, a common strain in aging research. Aged rats (24-26 mo., N=6) exhibited significant tortuosity in the anterior spinal artery and elevated vascular resistance compared to adults (4-6 mo., N=6; tortuosity index 2.20±0.15 vs 4.74±0.45, p<0.05). Baseline blood volume was lower in both larger vessels and the microcirculation in the aged cohort, specifically in white matter (4.44e14±1.37e13 vs 3.66e14±2.64e13 CEUS bolus AUC, p<0.05). To elucidate functional differences, animals were exposed to a hypoxia challenge; whereas adult rats exhibited significant functional hyperemia in both gray and white matter (GM: 1.13±0.10-fold change from normoxia, p<0.05; WM: 1.16±0.13, p<0.05), aged rats showed no response. Immunohistochemistry revealed reduced pericyte coverage and activated microglia behavior in aged rats, which may partially explain the lack of vascular response. This study provides the first in vivo description of age-related hemodynamic differences in the cervical spinal cord.

正常衰老与严重的脑血管有害变化有关;这些变化与疾病的发病机制和缺血性损伤的易感性增加有关。虽然这些变化在大脑中得到了很好的记录,但对脊髓的研究却很少。在这里,我们利用专门的对比增强超声(CEUS)成像技术来研究雄性费舍尔 344 大鼠(衰老研究中常见的品系)颈椎血管解剖结构和血液动力学中与年龄相关的变化。与成年大鼠(4-6 个月,N=6;迂曲指数为 2.20±0.15 vs 4.74±0.45, p)相比,老年大鼠(24-26 个月,N=6)的脊髓前动脉表现出明显的迂曲和血管阻力升高。
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引用次数: 0
Inhibition of OLR1 reduces SASP of nucleus pulposus cells by targeting autophagy-GATA4 axis. 抑制 OLR1 可通过靶向自噬-GATA4 轴减少髓核细胞的 SASP。
Jia-Wei Gao, Hang Shi, Fu-Ping Gao, Zhi-Min Zhou, Xin Peng, Rui Sun, V L F Cabral, Jian Li, Yun-Tao Wang, Xiao-Hu Wang, Xiao-Tao Wu

Targeting cellular senescence and Senescence Associated Secretory Phenotype (SASP) through autophagy has emerged as a promising intervertebral disc (IVD) degeneration (IDD) treatment strategy in recent years. This study aimed to clarify the role and mechanism of autophagy in preventing IVD SASP. Methods involved in vitro experiments with nucleus pulposus (NP) tissues from normal and IDD patients, as well as an in vivo IDD animal model. GATA4's regulatory role in SASP was validated both in vitro and in vivo, while autophagy modulators were employed to assess their impact on GATA4 and SASP. Transcriptomic sequencing identified Oxidized low-density lipoprotein receptor 1 (OLR1) as a key regulator of autophagy and GATA4. A series of experiments manipulated OLR1 expression to investigate associated effects. Results demonstrated significantly increased senescent NP cells (NPCs) and compromised autophagy in IDD patients and animal models, with SASP closely linked to IDD progression. The aged disc milieu impeded autophagic GATA4 degradation, leading to elevated SASP expression in senescent NPCs. Restoring autophagy reversed senescence by degrading GATA4, hence disrupting the SASP cascade. Moreover, OLR1 was identified for its regulation of autophagy and GATA4 in senescent NPCs. Silencing OLR1 enhanced autophagic activity, suppressing GATA4-induced senescence and SASP expression in senescent NPCs. In conclusion, OLR1 was found to control autophagy-GATA4 and SASP, with targeted OLR1 inhibition holding promise in alleviating GATA4-induced senescence and SASP expression while delaying extracellular matrix degradation, offering a novel therapeutic approach for IDD management.

近年来,通过自噬靶向细胞衰老和衰老相关分泌表型(SASP)已成为一种很有前景的椎间盘(IVD)变性(IDD)治疗策略。本研究旨在阐明自噬在预防 IVD SASP 中的作用和机制。研究方法包括利用正常和IDD患者的髓核组织进行体外实验,以及建立体内IDD动物模型。GATA4在SASP中的调控作用在体外和体内都得到了验证,同时采用自噬调节剂来评估它们对GATA4和SASP的影响。转录组测序发现氧化低密度脂蛋白受体1(OLR1)是自噬和GATA4的关键调控因子。一系列实验操纵了 OLR1 的表达,以研究其相关效应。结果表明,在IDD患者和动物模型中,衰老NP细胞(NPC)明显增加,自噬功能受到损害,SASP与IDD进展密切相关。老化的椎间盘环境阻碍了自噬GATA4的降解,导致衰老NPC中SASP的表达升高。恢复自噬可通过降解 GATA4 逆转衰老,从而破坏 SASP 级联。此外,OLR1还被鉴定为可调节衰老NPC中的自噬和GATA4。沉默 OLR1 可增强自噬活性,抑制 GATA4 诱导的衰老和衰老 NPC 中 SASP 的表达。总之,研究发现OLR1能控制自噬-GATA4和SASP,靶向抑制OLR1有望缓解GATA4诱导的衰老和SASP表达,同时延缓细胞外基质降解,为IDD管理提供了一种新的治疗方法。
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引用次数: 0
Adverse Childhood Experiences and Later-Life Cognitive Aging: Persistent Methodological Challenges Limit the Evidence Base. 童年不良经历与晚年认知老化:持续的方法挑战限制了证据基础。
Lindsay C Kobayashi
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引用次数: 0
Somatic Factors Predict On-Road Driving Skills in Older Drivers and Drivers with Mild Cognitive Impairment. 躯体因素可预测老年驾驶员和轻度认知障碍驾驶员的道路驾驶技能。
Maximilian Flieger, Wolf Schäbitz, Daniel A Schlueter, Kim L Austerschmidt, Jessica Koenig, Thomas Beblo, Martin Driessen, Max Toepper

Background: On-road driving skills can be impaired in older drivers and drivers with mild cognitive impairment (MCI) due to different driving-relevant deficits. Among these deficits, somatic factors have received little attention so far.

Methods: In a prospective observational on-road driving study, we examined whether somatic factors can predict on-road driving skills in a mixed sample of healthy older drivers and drivers with MCI (n = 99) and whether the inclusion of age explains additional variance. Somatic factors included the number of prescribed drugs, visual acuity, peripheral visual field integrity, mobility of the cervical spine, and hearing impairment. A hierarchical regression analysis was used to predict on-road driving skills by adding the somatic factors in the first step and age in the second step.

Results: Results revealed that the combination of somatic factors significantly predicted on-road driving skills (R2adjusted = 0.439). The inclusion of age led to a significant increase of explained variance (R2adjusted = 0.466).

Conclusions: Our results suggest that somatic factors can accurately predict on-road driving skills in healthy older drivers and drivers with MCI. In addition, our results suggest that there is a significant but rather small effect of age beyond somatic changes.

背景:老年驾驶员和轻度认知障碍(MCI)驾驶员的道路驾驶技能会因不同的驾驶相关缺陷而受损。在这些缺陷中,躯体因素至今很少受到关注:在一项前瞻性道路驾驶观察研究中,我们考察了躯体因素是否能预测健康老年驾驶者和 MCI 患者(n = 99)混合样本的道路驾驶技能,以及年龄是否能解释更多差异。躯体因素包括处方药数量、视力、周边视野完整性、颈椎活动度和听力损伤。通过分层回归分析,第一步加入躯体因素,第二步加入年龄,从而预测道路驾驶技能:结果表明,躯体因素的组合可显著预测道路驾驶技能(R2调整后=0.439)。结论:我们的研究结果表明,躯体因素可以预测道路驾驶技能(R2调整值=0.439),而年龄因素则可以显著增加解释方差(R2调整值=0.466):我们的研究结果表明,躯体因素可以准确预测健康老年驾驶者和患有 MCI 的驾驶者的道路驾驶技能。此外,我们的研究结果还表明,年龄对躯体变化的影响虽然显著,但却很小。
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引用次数: 0
DNA Methylation at C-Reactive Protein-Associated CpG Sites May Mediate the Pathway Between Educational Attainment and Cognition. CRP相关CpG位点的DNA甲基化可能介导教育成就与认知之间的途径
Meike Stoldt, Farah Ammous, Lisha Lin, Scott M Ratliff, Erin B Ware, Jessica D Faul, Wei Zhao, Sharon L R Kardia, Jennifer A Smith

Growing evidence has linked inflammatory processes to cognitive decline and dementia. This work examines whether an epigenetic marker of C-reactive protein (CRP), a common clinical inflammatory biomarker, may mediate the relationship between educational attainment and cognition. We first evaluated whether 53 previously reported CRP-associated DNA methylation sites (CpGs) are associated with CRP, both individually and aggregated into a methylation risk score (MRSCRP), in 3 298 participants from the Health and Retirement Study (HRS, mean age = 69.7 years). Forty-nine CpGs (92%) were associated with the natural logarithm of CRP in HRS after adjusting for age, sex, smoking, BMI, genetic ancestry, and white blood cell counts (p < .05), and each standard deviation increase in MRSCRP was associated with a 0.38 unit increase in lnCRP (p = 4.02E-99). In cross-sectional analysis, for each standard deviation increase in MRSCRP, total memory score and total cognitive score decreased, on average, by 0.28 words and 0.43 items, respectively (p < .001). Further, MRSCRP mediated 6.9% of the relationship between high school education and total memory score in a model adjusting for age, sex, and genetic ancestry (p < .05); this was attenuated to 2.4% with additional adjustment for marital status, APOE ε4 status, health behaviors, and comorbidities (p < .05). Thus, CRP-associated methylation may partially mediate the relationship between education and cognition at older ages. Further research is warranted to determine whether DNA methylation at these sites may improve current prediction models for cognitive impairment in older adults.

越来越多的证据表明,炎症过程与认知能力下降和痴呆症有关。这项研究探讨了 C 反应蛋白(CRP)这一常见的临床炎症生物标志物的表观遗传标志物是否可能介导教育程度与认知能力之间的关系。我们首先在健康与退休研究(HRS,平均年龄=69.7 岁)的 3298 名参与者中评估了 53 个先前报告的与 CRP 相关的 DNA 甲基化位点(CpGs)是否与 CRP 相关,包括单独评估和汇总成一个甲基化风险评分(MRSCRP)。在对年龄、性别、吸烟、体重指数、遗传血统和白细胞计数进行调整后,49 个 CpGs(92%)与 HRS 中 CRP 的自然对数相关(p
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引用次数: 0
Whole Genome Linkage and Association Analyses Identify DLG Associated Protein-1 as a Novel Positional and Biological Candidate Gene for Muscle Strength: The Long Life Family Study. 全基因组关联和关联分析发现 DLG 相关蛋白-1 是肌肉力量的一个新的位置和生物学候选基因:长寿家族研究
Adam J Santanasto, Sandeep Acharya, Mary K Wojczynski, Ryan K Cvejkus, Shiow Lin, Michael R Brent, Jason A Anema, Lihua Wang, Bharat Thyagarajan, Kaare Christensen, E Warwick Daw, Joseph M Zmuda

Background: Grip strength is a robust indicator of overall health, is moderately heritable, and predicts longevity in older adults.

Methods: Using genome-wide linkage analysis, we identified a novel locus on chromosome 18p (mega-basepair region: 3.4-4.0) linked to grip strength in 3 755 individuals from 582 families aged 64 ± 12 years (range 30-110 years; 55% women). There were 26 families that contributed to the linkage peak (cumulative logarithm of the odds [LOD] score = 10.94), with 6 families (119 individuals) accounting for most of the linkage signal (LOD = 6.4). In these 6 families, using whole genome sequencing data, we performed association analyses between the 7 312 single nucleotide (SNVs) and insertion deletion (INDELs) variants in the linkage region and grip strength. Models were adjusted for age, age2, sex, height, field center, and population substructure.

Results: We found significant associations between genetic variants (8 SNVs and 4 INDELs, p < 5 × 10-5) in the Disks Large-associated Protein 1 (DLGAP1) gene and grip strength. Haplotypes constructed using these variants explained up to 98.1% of the LOD score. Finally, RNAseq data showed that these variants were significantly associated with the expression of nearby Myosin Light Chain 12A (MYL12A), Structural Maintenance of Chromosomes Flexible Hinge Domain Containing 1 (SMCHD1), Erythrocyte Membrane Protein Band 4.1 Like 3 (EPB41L3) genes (p < .0004).

Conclusions: The DLGAP1 gene plays an important role in the postsynaptic density of neurons; thus, it is both a novel positional and biological candidate gene for follow-up studies aimed at uncovering genetic determinants of muscle strength.

背景:握力是整体健康的有力指标,具有中度遗传性,可预测老年人的寿命:握力是衡量总体健康状况的可靠指标,具有中度遗传性,可预测老年人的寿命:通过全基因组关联分析,我们在来自 582 个家庭的 3755 名 64 ± 12 岁(年龄范围 30-110 岁;55% 为女性)的个体中发现了染色体 18p 上与握力相关的一个新位点(巨基对区域:3.4 - 4.0)。有 26 个家族贡献了连接峰值(累积几率对数 [LOD] 得分 = 10.94),其中 6 个家族(119 人)占连接信号的大部分(LOD = 6.4)。在这 6 个家族中,我们利用全基因组测序数据,对连接区的 7312 个单核苷酸(SNV)和插入缺失(INDEL)变异与握力进行了关联分析。模型根据年龄、年龄2、性别、身高、田野中心和人群亚结构进行了调整:结果:我们发现基因变异(8 个 SNV 和 4 个 INDEL,pConclusions)与握力之间存在显着关联:DLGAP1基因在神经元突触后密度中起着重要作用;因此,它既是一个新的位置候选基因,也是一个生物学候选基因,可用于旨在揭示肌肉力量遗传决定因素的后续研究。
{"title":"Whole Genome Linkage and Association Analyses Identify DLG Associated Protein-1 as a Novel Positional and Biological Candidate Gene for Muscle Strength: The Long Life Family Study.","authors":"Adam J Santanasto, Sandeep Acharya, Mary K Wojczynski, Ryan K Cvejkus, Shiow Lin, Michael R Brent, Jason A Anema, Lihua Wang, Bharat Thyagarajan, Kaare Christensen, E Warwick Daw, Joseph M Zmuda","doi":"10.1093/gerona/glae144","DOIUrl":"10.1093/gerona/glae144","url":null,"abstract":"<p><strong>Background: </strong>Grip strength is a robust indicator of overall health, is moderately heritable, and predicts longevity in older adults.</p><p><strong>Methods: </strong>Using genome-wide linkage analysis, we identified a novel locus on chromosome 18p (mega-basepair region: 3.4-4.0) linked to grip strength in 3 755 individuals from 582 families aged 64 ± 12 years (range 30-110 years; 55% women). There were 26 families that contributed to the linkage peak (cumulative logarithm of the odds [LOD] score = 10.94), with 6 families (119 individuals) accounting for most of the linkage signal (LOD = 6.4). In these 6 families, using whole genome sequencing data, we performed association analyses between the 7 312 single nucleotide (SNVs) and insertion deletion (INDELs) variants in the linkage region and grip strength. Models were adjusted for age, age2, sex, height, field center, and population substructure.</p><p><strong>Results: </strong>We found significant associations between genetic variants (8 SNVs and 4 INDELs, p < 5 × 10-5) in the Disks Large-associated Protein 1 (DLGAP1) gene and grip strength. Haplotypes constructed using these variants explained up to 98.1% of the LOD score. Finally, RNAseq data showed that these variants were significantly associated with the expression of nearby Myosin Light Chain 12A (MYL12A), Structural Maintenance of Chromosomes Flexible Hinge Domain Containing 1 (SMCHD1), Erythrocyte Membrane Protein Band 4.1 Like 3 (EPB41L3) genes (p < .0004).</p><p><strong>Conclusions: </strong>The DLGAP1 gene plays an important role in the postsynaptic density of neurons; thus, it is both a novel positional and biological candidate gene for follow-up studies aimed at uncovering genetic determinants of muscle strength.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11226997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162703","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
Links of Previous Incarceration With Geriatric Syndromes and Chronic Health Conditions Among Older Adults in the United States. 美国老年人曾被监禁与老年综合症和慢性健康状况之间的联系。
Alexander Testa, Dylan B Jackson, Meghan Novisky, Christopher Kaufmann, Carmen Gutierrez, Jack Tsai, Adam P Spira, Roland J Thorpe

Background: This study investigated the association between previous incarceration and various geriatric and chronic health conditions among adults 50 and older in the United States.

Methods: Data came from the National Longitudinal Study of Adolescent to Adult Health-Parent Study (AHPS) collected in 2015-2017, including 2 007 individuals who participated in the parent study (Parent Sample) and 976 individuals who participated in the spouse/partner study (Spouse/Partner Sample). Multiple logistic regression was used to investigate the relationship between previous incarceration and geriatric syndromes (dementia, difficulty walking, difficulty seeing, difficulty with activities of daily living) and chronic health conditions (self-reported poor/fair health, diagnosis of cancer, hypertension, diabetes, heart disease, stroke, chronic lung disease, depression, and alcohol use [4 or more drinks per week]).

Results: In adjusted analyses, respondents with previous incarceration in the AHPS had significantly higher odds of reporting difficulty walking, activities of daily living difficulty, cancer diagnosis, depression diagnosis, and chronic lung disease (adjusted odds ratios [aORs] = 2.21-2.95). Respondents in the AHPS spouse/partner study reported higher odds of difficulty seeing, cancer, depression, chronic lung disease, and heavy alcohol use (aORs = 1.02-2.15).

Conclusions: Previous incarceration may have an adverse impact on healthy aging. Findings highlight the importance of addressing the enduring health impacts of incarceration, particularly as individual transition into older adulthood.

研究背景本研究调查了美国 50 岁及以上成年人曾被监禁与各种老年病和慢性病之间的关系:数据来自2015-2017年收集的全国青少年到成人健康纵向研究--父母研究(AHPS),包括参加父母研究(父母样本)的2007人和参加配偶/伴侣研究(配偶/伴侣样本)的976人。研究人员使用多元逻辑回归法调查了以前的监禁与老年综合症(痴呆、行走困难、视力困难、日常生活活动困难)和慢性健康状况(自我报告的健康状况差/一般、癌症诊断、高血压、糖尿病、心脏病、中风、慢性肺病、抑郁症和饮酒[每周饮酒 4 次或以上])之间的关系:在调整后的分析中,AHPS 中曾被监禁的受访者报告行走困难、日常生活活动困难、癌症诊断、抑郁症诊断和慢性肺病的几率明显更高(aORs= 2.21-2.95)。AHPS配偶/伴侣研究中的受访者报告视力困难、癌症、抑郁症、慢性肺病和酗酒的几率更高(aORs=1.02-2.15):结论:曾经的监禁可能会对健康老龄化产生不利影响。研究结果凸显了解决监禁对健康的持久影响的重要性,尤其是在个人过渡到老年期时。
{"title":"Links of Previous Incarceration With Geriatric Syndromes and Chronic Health Conditions Among Older Adults in the United States.","authors":"Alexander Testa, Dylan B Jackson, Meghan Novisky, Christopher Kaufmann, Carmen Gutierrez, Jack Tsai, Adam P Spira, Roland J Thorpe","doi":"10.1093/gerona/glae084","DOIUrl":"10.1093/gerona/glae084","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the association between previous incarceration and various geriatric and chronic health conditions among adults 50 and older in the United States.</p><p><strong>Methods: </strong>Data came from the National Longitudinal Study of Adolescent to Adult Health-Parent Study (AHPS) collected in 2015-2017, including 2 007 individuals who participated in the parent study (Parent Sample) and 976 individuals who participated in the spouse/partner study (Spouse/Partner Sample). Multiple logistic regression was used to investigate the relationship between previous incarceration and geriatric syndromes (dementia, difficulty walking, difficulty seeing, difficulty with activities of daily living) and chronic health conditions (self-reported poor/fair health, diagnosis of cancer, hypertension, diabetes, heart disease, stroke, chronic lung disease, depression, and alcohol use [4 or more drinks per week]).</p><p><strong>Results: </strong>In adjusted analyses, respondents with previous incarceration in the AHPS had significantly higher odds of reporting difficulty walking, activities of daily living difficulty, cancer diagnosis, depression diagnosis, and chronic lung disease (adjusted odds ratios [aORs] = 2.21-2.95). Respondents in the AHPS spouse/partner study reported higher odds of difficulty seeing, cancer, depression, chronic lung disease, and heavy alcohol use (aORs = 1.02-2.15).</p><p><strong>Conclusions: </strong>Previous incarceration may have an adverse impact on healthy aging. Findings highlight the importance of addressing the enduring health impacts of incarceration, particularly as individual transition into older adulthood.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11214062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140190536","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
Consideration of T-Cell Profile in the Examination of Statin Efficacy in Inflammatory Diseases, Neurodegeneration, and Neurocognitive Performance. 在研究他汀类药物对炎症性疾病、神经变性和神经认知能力的疗效时考虑 T 细胞特征。
Matthew A Hintermayer, Daniel Mendelson, Jae Hyun Byun

Statins are a cornerstone in the medical management of cardiovascular disease, yet their efficacy varies greatly between individuals. In this commentary, we outline the evidence for the role of CD4+CD28null T-cell expansion as a critical moderator of the effects of statins in preventing cardiovascular events via the reduction of pathological inflammation. Given this relationship, we argue that T-cell profiles should be considered as a patient characteristic in clinical and preclinical studies examining statin efficacy in other age- and inflammation-related pathologies. We discuss the implications this may have for studies of statin use in numerous disease processes-notably, dementia and neurocognitive dysfunction-and the potential for T-cell profiles to be used as a prognosticator for statin efficacy in rheumatoid arthritis, Alzheimer's disease, and multiple sclerosis.

他汀类药物是治疗心血管疾病的基石,但其疗效却因人而异。在这篇评论中,我们概述了 CD4+CD28 空 T 细胞扩增作为他汀类药物通过减少病理炎症预防心血管事件效果的关键调节因子所起作用的证据。鉴于这种关系,我们认为,在对他汀类药物对其他年龄和炎症相关病症的疗效进行临床和临床前研究时,应将 T 细胞特征作为患者特征加以考虑。我们讨论了这可能对他汀类药物用于多种疾病过程(尤其是痴呆症和神经认知功能障碍)的研究产生的影响,以及 T 细胞特征作为他汀类药物对类风湿性关节炎、阿尔茨海默病和多发性硬化症疗效的预后指标的潜力。
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引用次数: 0
Is the Risk of Alzheimer's Disease and Related Dementias Among U.S. Veterans Influenced by the Intersectionality of Housing Status, HIV/AIDS, Hepatitis C, and Psychiatric Disorders? 美国退伍军人罹患阿尔茨海默病和相关痴呆症的风险是否受到住房状况、艾滋病毒/艾滋病、丙型肝炎和精神疾病的交叉影响?
Hind A Beydoun, Dorota Szymkowiak, Rebecca Kinney, May A Beydoun, Alan B Zonderman, Jack Tsai

Background: Homelessness and housing instability disproportionately affect U.S. veterans with psychiatric disorders, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), hepatitis C, and Alzheimer's disease and related disorders (ADRD). We examined housing status and/or HIV/AIDS in relation to ADRD risk and evaluated hepatitis C, substance use, and mental health disorders as mediators and/or moderators of hypothesized relationships, among U.S. veterans ≥50 years of age seeking Department of Veterans Affairs (VA) healthcare services.

Methods: A retrospective cohort study was conducted using linked VA Homeless Operations Management and Evaluation System and Corporate Data Warehouse databases (2017-2023) on 3 275 098 eligible veterans yielding 133 388 ADRD cases over 5 years of follow-up. Multivariable regression and causal mediation analyses were performed, controlling for demographic and clinical characteristics.

Results: Taking stably housed veterans without HIV/AIDS as referent, ADRD risk was higher among veterans with homelessness/housing instability alone (adjusted hazard ratio [aHR] = 1.67, 95% confidence interval [CI]: 1.63,1.72), lower among veterans with HIV/AIDS alone (aHR = 0.65, 95% CI: 0.58,0.73), but similar to veterans with homelessness/housing instability and HIV/AIDS (aHR = 1.01, 95% CI: 0.79,1.29). In adjusted models, hepatitis C and psychiatric disorders were positively related to homelessness/housing instability and ADRD risk, but negatively related to HIV/AIDS. Statistically significant mediation and/or moderation of hepatitis C and psychiatric disorders were observed, although <10% of total effects were explained by these characteristics, controlling for confounders.

Conclusions: Among older veterans, ADRD diagnoses over 5 years were less among those with HIV/AIDS, but more among those with homelessness/housing instability, and these relationships were partly explained by hepatitis C and psychiatric disorders.

背景:无家可归和住房不稳定对患有精神疾病、艾滋病毒/艾滋病、丙型肝炎和阿尔茨海默病及相关疾病(ADRD)的美国退伍军人的影响尤为严重。我们研究了寻求退伍军人事务部(VA)医疗保健服务的年龄≥50 岁的美国退伍军人中,住房状况和/或艾滋病毒/艾滋病与 ADRD 风险的关系,并评估了丙型肝炎、药物使用和精神疾病作为假设关系的中介和/或调节因素的作用:使用链接的退伍军人事务部无家可归者运营管理与评估系统和企业数据仓库数据库(2017-2023 年)对 3,275,098 名符合条件的退伍军人进行了一项回顾性队列研究,在 5 年的随访中发现了 133,388 例 ADRD 病例。在控制人口统计学和临床特征的基础上,进行了多变量回归和因果中介分析:以无艾滋病毒/艾滋病的稳定住房退伍军人为参照,仅有无家可归/住房不稳定的退伍军人的ADRD风险较高(调整后危险比[aHR]=1.67,95%置信区间[CI]:1.63,1.72),仅有艾滋病毒/艾滋病的退伍军人的ADRD风险较低(aHR=0.65,95%置信区间[CI]:0.58,0.73),但与有无家可归/住房不稳定和艾滋病毒/艾滋病的退伍军人相似(aHR=1.01,95%置信区间[CI]:0.79,1.29)。在调整模型中,丙型肝炎和精神障碍与无家可归/住房不稳定和 ADRD 风险呈正相关,但与艾滋病毒/艾滋病呈负相关。结论:丙型肝炎和精神障碍在统计学上具有重要的中介和/或调节作用:在老年退伍军人中,感染艾滋病毒/艾滋病的退伍军人在五年内被诊断出患有急性营养不良症的比例较低,而无家可归/住房不稳定的退伍军人被诊断出患有急性营养不良症的比例较高,丙型肝炎和精神障碍可部分解释这些关系。
{"title":"Is the Risk of Alzheimer's Disease and Related Dementias Among U.S. Veterans Influenced by the Intersectionality of Housing Status, HIV/AIDS, Hepatitis C, and Psychiatric Disorders?","authors":"Hind A Beydoun, Dorota Szymkowiak, Rebecca Kinney, May A Beydoun, Alan B Zonderman, Jack Tsai","doi":"10.1093/gerona/glae153","DOIUrl":"10.1093/gerona/glae153","url":null,"abstract":"<p><strong>Background: </strong>Homelessness and housing instability disproportionately affect U.S. veterans with psychiatric disorders, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), hepatitis C, and Alzheimer's disease and related disorders (ADRD). We examined housing status and/or HIV/AIDS in relation to ADRD risk and evaluated hepatitis C, substance use, and mental health disorders as mediators and/or moderators of hypothesized relationships, among U.S. veterans ≥50 years of age seeking Department of Veterans Affairs (VA) healthcare services.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using linked VA Homeless Operations Management and Evaluation System and Corporate Data Warehouse databases (2017-2023) on 3 275 098 eligible veterans yielding 133 388 ADRD cases over 5 years of follow-up. Multivariable regression and causal mediation analyses were performed, controlling for demographic and clinical characteristics.</p><p><strong>Results: </strong>Taking stably housed veterans without HIV/AIDS as referent, ADRD risk was higher among veterans with homelessness/housing instability alone (adjusted hazard ratio [aHR] = 1.67, 95% confidence interval [CI]: 1.63,1.72), lower among veterans with HIV/AIDS alone (aHR = 0.65, 95% CI: 0.58,0.73), but similar to veterans with homelessness/housing instability and HIV/AIDS (aHR = 1.01, 95% CI: 0.79,1.29). In adjusted models, hepatitis C and psychiatric disorders were positively related to homelessness/housing instability and ADRD risk, but negatively related to HIV/AIDS. Statistically significant mediation and/or moderation of hepatitis C and psychiatric disorders were observed, although <10% of total effects were explained by these characteristics, controlling for confounders.</p><p><strong>Conclusions: </strong>Among older veterans, ADRD diagnoses over 5 years were less among those with HIV/AIDS, but more among those with homelessness/housing instability, and these relationships were partly explained by hepatitis C and psychiatric disorders.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312646","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
Addressing Enduring Health Impacts of Incarceration on Older Adults: A Call for Academic and Policy Reform. 解决监禁对老年人健康的持久影响:呼吁学术和政策改革。
Raya Elfadel Kheirbek, Kenzie Latham-Mintus
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引用次数: 0
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The journals of gerontology. Series A, Biological sciences and medical sciences
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