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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 six non-consecutive 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 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
Relationship of body composition with middle cerebral artery hemodynamic using compositional data analysis: Toledo Study for Healthy Ageing in middle age. 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 Alegre Durán, 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) calculated. Body composition was assessed by dual X-ray absorptiometry. Statistical analyses were performed using a compositional data approach including a three-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 non-significant, 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 impact 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
Recommendations on Methods for Assessing Multimorbidity Changes Over Time: Aligning the Method to the Purpose. 关于评估多病症随时间变化的方法的修订建议:使方法与目的相一致。
Corey L Nagel, Nicholas J Bishop, Anda Botoseneanu, Heather G Allore, Jason T Newsom, David A Dorr, Ana R Quiñones

Background: The rapidly growing field of multimorbidity research demonstrates that changes in multimorbidity in mid- and late-life have far reaching effects on important person-centered outcomes, such as health-related quality of life. However, there are few organizing frameworks and comparatively little work weighing the merits and limitations of various quantitative methods applied to the longitudinal study of multimorbidity.

Methods: We identify and discuss methods aligned to specific research objectives with the goals of (i) establishing a common language for assessing longitudinal changes in multimorbidity, (ii) illuminating gaps in our knowledge regarding multimorbidity progression and critical periods of change, and (iii) informing research to identify groups that experience different rates and divergent etiological pathways of disease progression linked to deterioration in important health-related outcomes.

Results: We review practical issues in the measurement of multimorbidity, longitudinal analysis of health-related data, operationalizing change over time, and discuss methods that align with 4 general typologies for research objectives in the longitudinal study of multimorbidity: (i) examine individual change in multimorbidity, (ii) identify subgroups that follow similar trajectories of multimorbidity progression, (iii) understand when, how, and why individuals or groups shift to more advanced stages of multimorbidity, and (iv) examine the coprogression of multimorbidity with key health domains.

Conclusions: This work encourages a systematic approach to the quantitative study of change in multimorbidity and provides a valuable resource for researchers working to measure and minimize the deleterious effects of multimorbidity on aging populations.

背景:快速发展的多病症研究领域表明,中年和晚年多病症的变化会对以人为本的重要结果(如与健康相关的生活质量)产生深远影响。然而,在多病症纵向研究中,很少有组织框架和相对较少的工作来权衡各种定量方法的优点和局限性:我们确定并讨论了与特定研究目标相一致的方法,目的是:1)建立评估多病症纵向变化的通用语言;2)揭示我们在多病症进展和变化关键期方面的知识差距;3)为研究提供信息,以确定哪些群体经历了不同的疾病进展速度和不同的病因途径,并与重要健康相关结果的恶化联系在一起:我们回顾了多病症测量、健康相关数据纵向分析、随时间变化的可操作性等方面的实际问题,并讨论了与多病症纵向研究目标的四种一般类型相一致的方法:1)研究多病症的个体变化;2)识别遵循类似多病症发展轨迹的亚群体;3)了解个体或群体何时、如何以及为何转变到多病症的更晚期阶段;以及 4)研究多病症与关键健康领域的共同发展:这项工作鼓励采用系统的方法对多病症的变化进行定量研究,并为研究人员提供了宝贵的资源,以衡量和尽量减少多病症对老龄人口的有害影响。
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引用次数: 0
Neighborhood Walkability Is Associated With Global Positioning System-Derived Community Mobility of Older Adults. 邻里步行能力与全球定位系统(GPS)得出的老年人社区流动性有关。
Kyle D Moored, Breanna M Crane, Michelle C Carlson, Pamela M Dunlap, Jennifer S Brach, Andrea L Rosso

Background: Neighborhood walkability may encourage greater out-of-home travel (ie, community mobility) to support independent functioning in later life. We examined associations between a novel walkability audit index and Global Positioning System (GPS)-derived community mobility in community-dwelling older adults. We compared associations with the validated Environmental Protection Agency (EPA) National Walkability Index and further examined moderation by clinical walking speed.

Methods: Participants were 146 older adults (Mean = 77.0 ± 6.5 years, 68% women) at baseline of a randomized trial to improve walking speed. A walkability index (range: 0-5; eg, land-use mix, crosswalks, and so on) was created using Google Street View audits within 1/8-mile of the home. Participants carried a GPS device for 5-7 days to derive objective measures of community mobility (eg, time spent out of home, accumulated distance from home).

Results: Each 1 SD (~1.3-point) greater walkability audit score was associated with a median 2.16% more time spent out of home (95% confidence interval [95% CI]: 0.30-4.03, p = .023), adjusting for individual demographics/health and neighborhood socioeconomic status. For slower walkers (4-m walking speed <1 m/s), each 1 SD greater audit score was also associated with a median 4.54 km greater accumulated distance from home (95% CI: 0.01-9.07, p (interaction) = .034). No significant associations were found for the EPA walkability index.

Conclusions: Walkability immediately outside the home was related to greater community mobility, especially for older adults with slower walking speeds. Results emphasize the need to consider the joint influence of local environment and individual functioning when addressing community mobility in older populations.

背景:邻里步行能力可能会鼓励更多的家庭外出行(即社区流动性),以支持晚年生活的独立功能。我们研究了一种新的步行能力审核指数与全球定位系统(GPS)得出的社区流动性之间的关联。我们比较了与经过验证的美国环境保护署(EPA)国家步行指数之间的关联,并进一步研究了临床步行速度的调节作用:参与者为 146 名老年人(平均年龄为 77.0±6.5 岁,68% 为女性),他们是一项旨在提高步行速度的随机试验的基线参与者。利用谷歌街景对住家 1/8 英里范围内的审核结果,创建了步行能力指数(范围:0-5;如土地使用组合、人行横道等)。参与者携带 GPS 设备 5-7 天,以获得社区流动性的客观测量值(如离家时间、累计离家距离):经个人人口统计学/健康状况和社区社会经济状况调整后,步行能力审核得分每增加 1 个分度值(约 1.3 分),外出时间就会增加 2.16% (95% CI:0.30-4.03,p=.023)。对于步行速度较慢的人来说(4 米步行速度):家门口的步行环境与社区流动性的提高有关,尤其是对于步行速度较慢的老年人而言。研究结果强调,在解决老年人群的社区流动性问题时,需要考虑当地环境和个人功能的共同影响。
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引用次数: 0
Hearing Impairment and Physical Activity and Physical Functioning in Older Adults: Baseline Results From the ACHIEVE Trial. 听力障碍与老年人的体育活动和身体机能:ACHIEVE 试验的基线结果。
Yurun Cai, Pablo Martinez-Amezcua, Joshua F Betz, Talan Zhang, Alison R Huang, Amal A Wanigatunga, Nancy W Glynn, Sheila Burgard, Theresa H Chisolm, Josef Coresh, David Couper, Jennifer A Deal, Theresa Gmelin, Adele M Goman, Lisa Gravens-Mueller, Kathleen M Hayden, Christine M Mitchell, Thomas Mosley, James S Pankow, James R Pike, Nicholas S Reed, Victoria A Sanchez, Frank R Lin, Jennifer A Schrack

Background: Hearing loss is associated with restricted physical activity (PA) and impaired physical functioning, yet the relationship between severity of hearing impairment (HI) and novel PA measures in older adults with untreated HI is not well understood.

Methods: Analyses included 845 participants aged ≥70 years (mean = 76.6 years) with a better-hearing ear pure-tone average (PTA) ≥30 and <70 dB in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study who wore an ActiGraph accelerometer for 7 days. Physical functioning measures included grip strength and the Short Physical Performance Battery (SPPB). Linear regression models estimated the association by HI level (moderate or greater [PTA ≥ 40 dB] vs mild [PTA < 40 dB]) and continuous hearing with total daily activity counts, active minutes/day, activity fragmentation, grip strength, and gait speed. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) of poor performance on the SPPB (≤6) and its subtests (≤2). Mixed-effects models estimated differences by HI level in activity by time of day.

Results: Participants with moderate or greater HI had poorer physical functioning, particularly balance (OR = 2.17, 95% CI = 1.29-3.67), versus those with mild impairment. There was no association of HI level with activity quantities or fragmentation. For diurnal patterns of activity, participants with moderate or greater HI had fewer activity counts in the afternoon (12:00 pm -05:59 pm).

Conclusions: Older adults with worse hearing had shifted diurnal patterns and poorer balance performance. Exercise programs should be tailored to older adults with different levels of HI to maintain PA and physical functioning, particularly balance control.

背景:听力损失与体力活动(PA)受限和身体机能受损有关,然而,在听力损失未得到治疗的老年人中,听力损伤(HI)的严重程度与新型 PA 测量之间的关系尚不十分清楚:分析对象包括 845 名年龄≥70 岁(平均年龄为 76.6 岁)、较好听力耳纯音平均值(PTA)≥30 的参与者:与轻度听力障碍者相比,中度或重度听力障碍者的身体功能较差,尤其是平衡能力(OR=2.17,95% CI=1.29-3.67)。HI水平与活动量或活动碎片没有关系。就昼夜活动模式而言,中度或更严重听力障碍的参与者在下午(12:00pm-05:59pm)的活动次数较少:结论:听力较差的老年人的昼夜活动模式有所改变,平衡能力较差。运动计划应针对不同听力水平的老年人量身定制,以保持老年人的活动量和身体机能,尤其是平衡控制能力。
{"title":"Hearing Impairment and Physical Activity and Physical Functioning in Older Adults: Baseline Results From the ACHIEVE Trial.","authors":"Yurun Cai, Pablo Martinez-Amezcua, Joshua F Betz, Talan Zhang, Alison R Huang, Amal A Wanigatunga, Nancy W Glynn, Sheila Burgard, Theresa H Chisolm, Josef Coresh, David Couper, Jennifer A Deal, Theresa Gmelin, Adele M Goman, Lisa Gravens-Mueller, Kathleen M Hayden, Christine M Mitchell, Thomas Mosley, James S Pankow, James R Pike, Nicholas S Reed, Victoria A Sanchez, Frank R Lin, Jennifer A Schrack","doi":"10.1093/gerona/glae117","DOIUrl":"10.1093/gerona/glae117","url":null,"abstract":"<p><strong>Background: </strong>Hearing loss is associated with restricted physical activity (PA) and impaired physical functioning, yet the relationship between severity of hearing impairment (HI) and novel PA measures in older adults with untreated HI is not well understood.</p><p><strong>Methods: </strong>Analyses included 845 participants aged ≥70 years (mean = 76.6 years) with a better-hearing ear pure-tone average (PTA) ≥30 and <70 dB in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study who wore an ActiGraph accelerometer for 7 days. Physical functioning measures included grip strength and the Short Physical Performance Battery (SPPB). Linear regression models estimated the association by HI level (moderate or greater [PTA ≥ 40 dB] vs mild [PTA < 40 dB]) and continuous hearing with total daily activity counts, active minutes/day, activity fragmentation, grip strength, and gait speed. Logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) of poor performance on the SPPB (≤6) and its subtests (≤2). Mixed-effects models estimated differences by HI level in activity by time of day.</p><p><strong>Results: </strong>Participants with moderate or greater HI had poorer physical functioning, particularly balance (OR = 2.17, 95% CI = 1.29-3.67), versus those with mild impairment. There was no association of HI level with activity quantities or fragmentation. For diurnal patterns of activity, participants with moderate or greater HI had fewer activity counts in the afternoon (12:00 pm -05:59 pm).</p><p><strong>Conclusions: </strong>Older adults with worse hearing had shifted diurnal patterns and poorer balance performance. Exercise programs should be tailored to older adults with different levels of HI to maintain PA and physical functioning, particularly balance control.</p>","PeriodicalId":94243,"journal":{"name":"The journals of gerontology. Series A, Biological sciences and medical sciences","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11170292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856333","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
The Association Between Cardiometabolic Risk and Cognitive Function Among Older Americans and Chinese. 美国老人和中国老人的心脏代谢风险与认知功能之间的关系。
Qiao Wu, Jennifer A Ailshire, Jung Ki Kim, Eileen M Crimmins

Background: Cardiometabolic risk (CMR) is associated with cognitive health, but the association can be affected by broader social, economic, and medical contexts. The United States and China have very different developmental and epidemiological histories, and thus CMR among older people could be linked to cognitive function differently in the 2 countries.

Methods: Cross-sectional and longitudinal ordinary least squares regression models were estimated for each country using nationally representative samples of populations over age 50: 7 430/4 474 Americans and 6 108/3 655 Chinese in the cross-sectional/longitudinal samples.

Results: In the United States, higher CMR is associated with worse cognitive function (b = -0.08, p < .016). Longitudinally, CMR increase is associated with worse cognitive function at a marginally significant level (b = -0.10, p = .055). No relationship between CMR level or change and cognitive function is observed in China. Higher education levels are linked to better cognitive function and slower cognitive decline in both countries. Unlike older Americans, relative to those with very low education levels, among older Chinese with the highest education level, a higher CMR links to better cognitive function (b = 0.63, p = .013) and slower cognitive decline (b = 0.35, p = .062); Nevertheless, a rapid increase in CMR is additionally harmful (b = -0.54, p = .050) for cognitive function and may lead to faster cognitive decline (b = -0.35, p = .079).

Conclusions: The significant relationship between CMR and cognitive function in the United States suggests the importance of monitoring and controlling CMR factors at older ages. The insignificant relationship in China may be explained by the high CMR among those with high education levels, highlighting the need for improving cardiometabolic health through education and promoting healthy lifestyles.

背景:心脏代谢风险(CMR)与认知健康有关,但这种关联会受到更广泛的社会、经济和医疗背景的影响。中美两国的发展历史和流行病学历史大相径庭,因此两国老年人的心脏代谢风险与认知功能的关系可能不同:方法:使用具有全国代表性的 50 岁以上人口样本对两国的横截面和纵向 OLS 回归模型进行估计:横截面/纵向样本中,美国有 7,430/4,474 人,中国有 6,108/3,655 人:结果:在美国,CMR 越高,认知功能越差(b=-0.08,p):在美国,CMR 与认知功能之间的重要关系表明,在老年人中监测和控制 CMR 因素非常重要。中国的CMR与认知功能之间的关系不显著,这可能是由于高教育水平人群的CMR较高,这突出表明需要通过教育和推广健康的生活方式来改善心脏代谢健康。
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引用次数: 0
Navigating the Landscape of Translational Geroscience in Canada: A Comprehensive Evaluation of Current Progress and Future Directions. 领航加拿大老年转化科学:对当前进展和未来方向的全面评估》。
Guy Hajj-Boutros, Andréa Faust, John Muscedere, Perry Kim, Naji Abumrad, Stéphanie Chevalier, Mylene Aubertin-Leheudre, Howard Bergman, Dawn Bowdish, Jessica Burford, Stacy Carrington-Lawrence, Hélène Côté, David E Dawe, Philipe de Souto Barreto, Colin Farrelly, Robert Fowler, Gilles Gouspillou, Lea Harrington, Sofie Lautrup, Susan Howlett, Mahdi Imani, James Kirkland, George Kuchel, Frédérick A Mallette, José A Morais, John C Newman, Daryl Pullman, Felipe Sierra, Jeremy Van Raamsdonk, Jennifer Watt, Rebecca Jane Rylett, Gustavo Duque

The inaugural Canadian Conferences on Translational Geroscience were held as 2 complementary sessions in October and November 2023. The conferences explored the profound interplay between the biology of aging, social determinants of health, the potential societal impact of geroscience, and the maintenance of health in aging individuals. Although topics such as cellular senescence, molecular and genetic determinants of aging, and prevention of chronic disease were addressed, the conferences went on to emphasize practical applications for enhancing older people's quality of life. This article summarizes the proceeding and underscores the synergy between clinical and fundamental studies. Future directions highlight national and global collaborations and the crucial integration of early-career investigators. This work charts a course for a national framework for continued innovation and advancement in translational geroscience in Canada.

首届加拿大老年转化科学会议于 2023 年 10 月和 11 月举行,是两个互补的会议。会议探讨了衰老生物学、健康的社会决定因素、老年科学的潜在社会影响以及衰老个体的健康维护之间的深刻相互作用。虽然会议讨论了细胞衰老、老龄化的分子和遗传决定因素以及慢性疾病预防等主题,但会议接着强调了提高老年人生活质量的实际应用。本手稿对会议进行了总结,并强调了临床和基础研究之间的协同作用。未来的发展方向突出了国家和全球合作以及早期研究人员的重要整合。这项工作为加拿大地质科学转化领域的持续创新和进步制定了国家框架。
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引用次数: 0
Response to Letter to the Editor. 回应致编辑的信。
Scott R Bauer, Marvin E Langston, Luigi Ferrucci, Eleanor M Simonsick
{"title":"Response to Letter to the Editor.","authors":"Scott R Bauer, Marvin E Langston, Luigi Ferrucci, Eleanor M Simonsick","doi":"10.1093/gerona/glae103","DOIUrl":"10.1093/gerona/glae103","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":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961113","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
Associations of Lower Extremity Muscle Strength, Area, and Specific Force With Lower Urinary Tract Symptoms in Older Men: The Baltimore Longitudinal Study of Aging. 老年男性下肢肌肉力量、面积和特定力量与下尿路症状的关系:巴尔的摩老龄化纵向研究。
Marvin E Langston, Peggy M Cawthon, Kaiwei Lu, Rebecca Scherzer, John C Newman, Kenneth Covinsky, Luigi Ferrucci, Eleanor M Simonsick, Scott R Bauer

Background: Lower urinary tract symptoms (LUTS) in older men are associated with an increased risk of mobility limitations. Lower extremity muscle quality may represent a novel shared mechanism of both LUTS and mobility limitations.

Methods: We evaluated associations of thigh skeletal muscle measures (strength, area, and specific force) with total LUTS severity (American Urologic Association Symptom Index; AUASI) and voiding and storage subscores among 352 men aged ≥60 years enrolled in the Baltimore Longitudinal Study of Aging. Thigh muscle strength (Nm) was defined as maximum concentric 30°/s knee extensor torque, area (cm2), and specific force (Nm/cm2) defined as strength/area. Associations with AUASI score were estimated using multivariable linear regression and linear mixed models.

Results: Mean thigh muscle strength at baseline was 139.7Nm. In cross-sectional multivariable models, each 39Nm increment in thigh muscle strength and 0.28Nm/cm2 increment in specific force was associated with -1.17 point (95% CI: -1.93 to -.41) and -0.95 point (95% CI: -1.63 to -0.27) lower AUASI score, respectively. Similar associations were observed for voiding and storage subscores, although somewhat attenuated. In longitudinal analyses, baseline muscle measures were not associated with annual change in AUASI, and current changes in muscle measures and AUASI were unrelated.

Conclusions: Cross-sectionally, higher thigh muscle strength and specific force were associated with decreased LUTS severity in older men. However, we did not observe concurrent worsening LUTS severity with declining thigh muscle strength, area, or specific force in longitudinal analyses.

背景:老年男性的下尿路症状(LUTS)与行动不便的风险增加有关。下肢肌肉质量可能是导致下尿路症状和行动不便的一个新的共同机制:我们评估了巴尔的摩老龄化纵向研究(Baltimore Longitudinal Study of Aging)中 352 名年龄≥60 岁男性的大腿骨骼肌测量指标(力量、面积和比力)与 LUTS 总严重程度(美国泌尿协会症状指数 AUASI)以及排尿和储尿子分数之间的关系。大腿肌肉力量(牛顿米)定义为最大同心30°/秒膝关节伸肌扭矩、面积(平方厘米)和比力(牛顿米/平方厘米),定义为力量/面积。使用多变量线性回归和线性混合模型估计了与 AUASI 评分的关系:结果:基线时的平均大腿肌肉力量为 139.7 牛米。在横断面多变量模型中,大腿肌力每增加 39Nm 和比肌力每增加 0.28Nm/cm2 分别与 AUASI 评分降低-1.17 分(95%CI -1.93, -0.41)和-0.95 分(95%CI -1.63, -0.27)有关。在排尿和储尿子评分中也观察到了类似的关联,但有所减弱。在纵向分析中,基线肌肉测量值与 AUASI 的年度变化无关,当前肌肉测量值的变化与 AUASI 无关:横截面来看,大腿肌肉力量和比肌力的提高与老年男性尿失禁严重程度的降低有关。然而,在纵向分析中,我们并未观察到LUTS严重程度的恶化与大腿肌肉力量、面积或比肌力的下降同时发生。
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引用次数: 0
Urinary Incontinence and Voiding Dysfunction with Aging: A Multifaceted Geriatric Syndrome in Search of Multidisciplinary Research Solutions. 老年尿失禁和排尿功能障碍:寻找多学科研究解决方案的多方面老年综合症》。
George A Kuchel
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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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