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Suriani I, Bouwman RA, Mischi M, Lau KD. An in silico study of the effects of cardiovascular aging on carotid flow waveforms and indexes in a virtual population. Am J Physiol Heart Circ Physiol 2024; 326:H877-H899. [PMID: 38214900 DOI: 10.1152/ajpheart.00304.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024]
Abstract
Cardiovascular aging is strongly associated with increased risk of cardiovascular disease and mortality. Moreover, health and lifestyle factors may accelerate age-induced alterations, such as increased arterial stiffness and wall dilation, beyond chronological age, making the clinical assessment of cardiovascular aging an important prompt for preventative action. Carotid flow waveforms contain information about age-dependent cardiovascular properties, and their ease of measurement via noninvasive Doppler ultrasound (US) makes their analysis a promising tool for the routine assessment of cardiovascular aging. In this work, the impact of different aging processes on carotid waveform morphology and derived indexes is studied in silico, with the aim of establishing the clinical potential of a carotid US-based assessment of cardiovascular aging. One-dimensional (1-D) hemodynamic modeling was employed to generate an age-specific virtual population (VP) of N = 5,160 realistic carotid hemodynamic waveforms. The resulting VP was statistically validated against in vivo aging trends in waveforms and indexes from the literature, and simulated waveforms were studied in relation to age and underlying cardiovascular parameters. In our study, the carotid flow augmentation index (FAI) significantly increased with age (with a median increase of 50% from the youngest to the oldest age group) and was strongly correlated to local arterial stiffening (r = 0.94). The carotid pulsatility index (PI), which showed less pronounced age variation, was inversely correlated with the reflection coefficient at the carotid branching (r = -0.88) and directly correlated with carotid net forward wave energy (r = 0.90), corroborating previous literature where it was linked to increased risk of cerebrovascular damage in the elderly. There was a high correlation between corrected carotid flow time (ccFT) and cardiac output (CO) (r = 0.99), which was not affected by vascular age. This study highlights the potential of carotid waveforms as a valuable tool for the assessment of cardiovascular aging.NEW & NOTEWORTHY An age-specific virtual population was generated based on a 1-D model of the arterial circulation, including newly defined literature-based specific age variations in carotid vessel properties. Simulated carotid flow/velocity waveforms, indexes, and age trends were statistically validated against in vivo data from the literature. A comprehensive study of the impact of aging on carotid flow waveform morphology was performed, and the mechanisms influencing different carotid indexes were elucidated. Notably, flow augmentation index (FAI) was found to be a strong indicator of local carotid stiffness.
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Affiliation(s)
- Irene Suriani
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - R Arthur Bouwman
- Eindhoven University of Technology, Eindhoven, The Netherlands
- Catharina Hospital, Eindhoven, The Netherlands
| | - Massimo Mischi
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Kevin D Lau
- Philips Research, Eindhoven, The Netherlands
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2
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Arbeev KG, Bagley O, Yashkin AP, Duan H, Akushevich I, Ukraintseva SV, Yashin AI. Understanding Alzheimer's disease in the context of aging: Findings from applications of stochastic process models to the Health and Retirement Study. Mech Ageing Dev 2023; 211:111791. [PMID: 36796730 PMCID: PMC10085865 DOI: 10.1016/j.mad.2023.111791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 01/27/2023] [Accepted: 02/13/2023] [Indexed: 02/16/2023]
Abstract
There is growing literature on applications of biodemographic models, including stochastic process models (SPM), to studying regularities of age dynamics of biological variables in relation to aging and disease development. Alzheimer's disease (AD) is especially good candidate for SPM applications because age is a major risk factor for this heterogeneous complex trait. However, such applications are largely lacking. This paper starts filling this gap and applies SPM to data on onset of AD and longitudinal trajectories of body mass index (BMI) constructed from the Health and Retirement Study surveys and Medicare-linked data. We found that APOE e4 carriers are less robust to deviations of trajectories of BMI from the optimal levels compared to non-carriers. We also observed age-related decline in adaptive response (resilience) related to deviations of BMI from optimal levels as well as APOE- and age-dependence in other components related to variability of BMI around the mean allostatic values and accumulation of allostatic load. SPM applications thus allow revealing novel connections between age, genetic factors and longitudinal trajectories of risk factors in the context of AD and aging creating new opportunities for understanding AD development, forecasting trends in AD incidence and prevalence in populations, and studying disparities in those.
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Affiliation(s)
- Konstantin G Arbeev
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC 27705, USA.
| | - Olivia Bagley
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC 27705, USA
| | - Arseniy P Yashkin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC 27705, USA
| | - Hongzhe Duan
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC 27705, USA
| | - Igor Akushevich
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC 27705, USA
| | - Svetlana V Ukraintseva
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC 27705, USA
| | - Anatoliy I Yashin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC 27705, USA
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3
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Tomioka Y, Kitazawa K, Yamashita Y, Numa K, Inomata T, Hughes JWB, Soda R, Nakamura M, Suzuki T, Yokoi N, Sotozono C. Dyslipidemia Exacerbates Meibomian Gland Dysfunction: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:jcm12062131. [PMID: 36983132 PMCID: PMC10055623 DOI: 10.3390/jcm12062131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/02/2023] [Accepted: 03/04/2023] [Indexed: 03/11/2023] Open
Abstract
Dry eye is a multifactorial and common age-related ocular surface disease. Dyslipidemia has been reported to be involved in meibomian gland dysfunction (MGD). However, it has not been clearly identified which lipid abnormality is responsible for MGD. In this systematic review and meta-analysis, we discuss how lipid profile changes with aging is responsible for MGD development. Methods. An article search was performed in PubMed, EMBASE, and Web of Science. Eleven studies involving dyslipidemia in patients with MGD were identified. Five out of eleven studies were further analyzed with meta-analysis. The preferred reporting items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines were followed. Study-specific estimates (prevalence of dyslipidemia in MGD patients) were combined using one-group meta-analysis in a random-effects model. Results. Meta-analysis revealed that high total cholesterol (TC) and high triglycerides (TG) were significantly associated with MGD prevalence, with odds ratios of 5.245 (95% confidence interval [CI]: 1.582–17.389; p < 0.001) and 3.264 (95% CI: 1.047–10.181; p < 0.001), respectively, but high low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) were not identified. Systematic review found that the percentage of MGD patients with TC ≥ 200 mg/dL ranged from 20.0–77.6%, TG ≥ 150 mg/dL ranged from 8.3–89.7%, whereas, in the aged-match-adjusted controls, TC range of 200 mg/dL or higher and TG range of 150 mg/dL was 6.1–45.1% and 1.1–47.8%, respectively. The severity of MGD was higher with dyslipidemia. Conclusion. Dyslipidemia and higher TC and TG are significant risk factors for MGD.
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Affiliation(s)
- Yasufumi Tomioka
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan
| | - Koji Kitazawa
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan
- Correspondence: ; Tel.: +81-75-251-5578
| | - Yohei Yamashita
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan
| | - Kohsaku Numa
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan
- Buck Institute for Research on Aging, Novato, CA 94945, USA
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 1130033, Japan
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo 1130033, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 1130033, Japan
- AI Incubation Farm, Juntendo University Graduate School of Medicine, Tokyo 1130033, Japan
| | | | - Rina Soda
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan
| | - Masahiro Nakamura
- Graduate School of Engineering, University of Tokyo, Tokyo 1138656, Japan
| | - Tomo Suzuki
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan
- Department of Ophthalmology, Kyoto City Hospital Organization, Kyoto 6048845, Japan
| | - Norihiko Yokoi
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan
| | - Chie Sotozono
- Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan
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Suriani I, Bouwman RA, Mischi M, Lau KD. Validation of an aging virtual population for the study of carotid hemodynamics. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:4249-4252. [PMID: 34892161 DOI: 10.1109/embc46164.2021.9630876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The analysis of carotid ultrasound (US) flow, velocity, and diameter waveforms provides important information about cardiovascular and circulatory health. These can be used to derive clinical indices of atherosclerosis, vascular aging, and hemodynamic status. To derive clinical insight from carotid waveforms, it is essential to understand the relationship of the observed variability in morphology with the underlying hemodynamic status and cardiovascular properties. For this purpose, using a one-dimensional modeling approach, we have developed and validated a virtual population that is able to realistically simulate carotid waveforms of healthy subjects aged between 10 and 80 years old.Clinical Relevance-Our virtual population of carotid waveforms can support the interpretation of US patient data. It can be used, e.g., to investigate how waveform morphology and derived indices relate to individual arterial and cardiac properties.
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Wang Y, Chen L, Cheng M, Wang Y, An D, Cai E, Wang Y, Zhang J, Tang X, Li Y, Zhu D. Predictive value of attended automated office blood pressure and resting pulse rate for mortality in community-dwelling octogenarians: Minhang study. J Clin Hypertens (Greenwich) 2021; 23:1239-1245. [PMID: 33949090 PMCID: PMC8678789 DOI: 10.1111/jch.14251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/23/2021] [Accepted: 03/21/2021] [Indexed: 11/28/2022]
Abstract
Systolic blood pressure (SBP) and resting pulse rate (RPR) have been linked to mortality and cardiovascular events in younger population. Till now, no studies simultaneously investigate the non-linear association of SBP and RPR with all-cause and cardiovascular mortality among population aged 80 and older. Data of 2828 eligible participants were selected from electronic health records linked attended automated office blood pressure measurement system. The dose-response relationship between the SBP, RPR, and the risk of all-cause and cardiovascular mortality was analyzed by Cox model with restricted cubic splines. During the 3.6-year follow-up, 442 deaths occurred. Comparing with the optimal SBP (117-145 mmHg), the lower (HR: 1.39, 95% CI: 1.07-1.81) and higher SBP (HR: 1.34, 95% CI: 1.08-1.65) were significantly associated with an increasing risk of all-cause mortality. The higher SBP (>144 mmHg) was associated with cardiovascular mortality, with the HR (95% CI) as 1.51 (1.07-2.12). The faster RPR showed the higher risk of all-cause (HR: 1.36, 95% CI: 1.05-1.76) and cardiovascular (HR: 1.51, 95% CI: 1.07-2.13) mortality. We found both higher SBP and faster RPR were independently associated with all-cause and cardiovascular mortality, and lower SBP was only associated with the increased risk of all-cause mortality in oldest old community-dwelling Chinese population. Our results demonstrate the prognostic importance of both SBP and RPR in the elderly.
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Affiliation(s)
- Yan Wang
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ling Chen
- Xinzhuang Community Health Service Center, Shanghai, China
| | - Minna Cheng
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Centers for Disease Control & Prevention, Shanghai, China
| | - Yajuan Wang
- Xinzhuang Community Health Service Center, Shanghai, China
| | - Dewei An
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Enheng Cai
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuheng Wang
- Department of Chronic Non-Communicable Diseases and Injury, Shanghai Municipal Centers for Disease Control & Prevention, Shanghai, China
| | - Jin Zhang
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaofeng Tang
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Dingliang Zhu
- Department of Cardiovascular Medicine, Research Center for Hypertension Management and Prevention in Community, Shanghai Key Laboratory of Hypertension, Shanghai Institute of Hypertension, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Daniels LB, Antonini P, Marino R, Rizzo M, Navarin S, Lucibello SG, Maisel AS, Pizza V, Brenner DA, Jeste DV, Di Somma S. Cardiovascular health of nonagenarians in southern Italy: a cross-sectional, home-based pilot study of longevity. J Cardiovasc Med (Hagerstown) 2020; 21:89-98. [PMID: 31789688 DOI: 10.2459/jcm.0000000000000910] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The Cilento region of southern Italy has a high prevalence of nonagenarians and centenarians. Few studies of the oldest old have included echocardiographic and/or electrocardiographic data, in a home-based setting. OBJECTIVES The objective of this pilot study was to delineate the key lifestyle, medical, echocardiographic, and electrocardiographic features of a sample of nonagenarians and centenarians and their younger cohabitants from Cilento, via a comprehensive, home-based cardiovascular assessment. The ultimate aim is to identify the cardiovascular profile and lifestyle factors associated with longevity. METHODS Twenty-six nonagenarians and centenarians (mean age 94 ± 3 years) and 48 younger cohabitants aged 50-75 years (mean 62 ± 5) underwent a comprehensive cardiovascular evaluation in their homes. RESULTS In contrast to their younger cohabitants, nonagenarians and centenarians did not smoke, had lower fasting glucose levels, and lower LDL cholesterol despite being half as likely to be taking statins, and showing similar adherence to a Mediterranean diet. Over half of nonagenarians and centenarians (15/26) remained autonomous with their activities of daily living. Prevalence of self-reported coronary artery disease and stroke among nonagenarians and centenarians was low (11.5%), though a significant number had atrial fibrillation (31%) or congestive heart failure (27%). Although 62% of nonagenarians and centenarians had at least moderate valvular disease on echocardiography, less than 25% of those affected reported dyspnea. CONCLUSION Nonagenarians and centenarians in the Cilento region had a healthy metabolic profile and a low prevalence of clinical cardiovascular disease. Even among nonagenarians and centenarians with structural heart abnormalities, report of symptoms is low. Larger studies in the Cilento population may help elucidate the mechanisms underlying cardiovascular health in the oldest old.
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Affiliation(s)
- Lori B Daniels
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | | | | | - Silvia Navarin
- Great Network.,Department of Emergency Medicine, La Sapienza University, Rome, Italy
| | | | - Alan S Maisel
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | | | - David A Brenner
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Dilip V Jeste
- Departments of Psychiatry and Neurosciences, and Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, USA
| | - Salvatore Di Somma
- Great Network.,Department of Emergency Medicine, La Sapienza University, Rome, Italy
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7
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Charlton PH, Mariscal Harana J, Vennin S, Li Y, Chowienczyk P, Alastruey J. Modeling arterial pulse waves in healthy aging: a database for in silico evaluation of hemodynamics and pulse wave indexes. Am J Physiol Heart Circ Physiol 2019; 317:H1062-H1085. [PMID: 31442381 PMCID: PMC6879924 DOI: 10.1152/ajpheart.00218.2019] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/09/2019] [Accepted: 07/28/2019] [Indexed: 11/22/2022]
Abstract
The arterial pulse wave (PW) is a rich source of information on cardiovascular (CV) health. It is widely measured by both consumer and clinical devices. However, the physical determinants of the PW are not yet fully understood, and the development of PW analysis algorithms is limited by a lack of PW data sets containing reference CV measurements. Our aim was to create a database of PWs simulated by a computer to span a range of CV conditions, representative of a sample of healthy adults. The typical CV properties of 25-75 yr olds were identified through a literature review. These were used as inputs to a computational model to simulate PWs for subjects of each age decade. Pressure, flow velocity, luminal area, and photoplethysmographic PWs were simulated at common measurement sites, and PW indexes were extracted. The database, containing PWs from 4,374 virtual subjects, was verified by comparing the simulated PWs and derived indexes with corresponding in vivo data. Good agreement was observed, with well-reproduced age-related changes in hemodynamic parameters and PW morphology. The utility of the database was demonstrated through case studies providing novel hemodynamic insights, in silico assessment of PW algorithms, and pilot data to inform the design of clinical PW algorithm assessments. In conclusion, the publicly available PW database is a valuable resource for understanding CV determinants of PWs and for the development and preclinical assessment of PW analysis algorithms. It is particularly useful because the exact CV properties that generated each PW are known.NEW & NOTEWORTHY First, a comprehensive literature review of changes in cardiovascular properties with age was performed. Second, an approach for simulating pulse waves (PWs) at different ages was designed and verified against in vivo data. Third, a PW database was created, and its utility was illustrated through three case studies investigating the determinants of PW indexes. Fourth, the database and tools for creating the database, analyzing PWs, and replicating the case studies are freely available.
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Affiliation(s)
- Peter H Charlton
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Jorge Mariscal Harana
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
| | - Samuel Vennin
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Ye Li
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Phil Chowienczyk
- Department of Clinical Pharmacology, King's College London, King's Health Partners, London, United Kingdom
| | - Jordi Alastruey
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, London, United Kingdom
- Institute of Personalized Medicine, Sechenov University, Moscow, Russia
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Wagner J, Knaier R, Infanger D, Arbeev K, Briel M, Dieterle T, Hanssen H, Faude O, Roth R, Hinrichs T, Schmidt-Trucksäss A. Functional aging in health and heart failure: the COmPLETE Study. BMC Cardiovasc Disord 2019; 19:180. [PMID: 31362698 PMCID: PMC6664502 DOI: 10.1186/s12872-019-1164-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/18/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Cardiovascular (CV) diseases including heart failure are the leading causes of morbidity, with age being the primary risk factor. The combination of age-related organic functional impairment and reduced physical fitness can drastically impact an individual's healthspan. One's lifespan can potentially be prolonged by the preservation or improvement of physical fitness. However, it remains unclear as to which biomarkers are most suitable for distinguishing between healthy aging and the impaired organ function associated with heart failure. Therefore, a comprehensive assessment of the components of physical fitness and CV function will be performed to identify the most important factors contributing to aging in relation to both health and disease. METHODS This cross-sectional investigation will consist of two parts: COmPLETE-Health (C-Health) and COmPLETE-Heart (C-Heart). C-Health will examine the aging trajectories of physical fitness components and CV properties in a healthy population sample aged between 20 and 100 years (n = 490). Separately, C-Heart will assess the same markers in patients at different stages of chronic heart failure (n = 80). The primary outcome to determine the difference between C-Health and C-Heart will be cardiorespiratory fitness as measured by cardiopulmonary exercise testing on a bicycle ergometer. Secondary outcomes will include walking speed, balance, isometric strength, peak power, and handgrip strength. Physical activity as a behavioural component will be assessed objectively via accelerometry. Further, CV assessments will include pulse wave velocity; retinal, arterial, and venous diameters; brachial and retinal arterial endothelial function; carotid intima-media thickness; and systolic and diastolic function. The health distances for C-Health and C-Heart will be calculated using the methodology based on statistical (Mahalanobis) distance applied to measurements of quantitative biomarkers. DISCUSSION This research seeks to identify physical fitness and CV biomarkers that best resemble underlying CV risk with age. Further, it will examine which physical fitness markers are impaired most in heart failure. The presented integrative approach could define new recommendations for diagnostic guidance in aging. Ultimately, this study is expected to offer a better understanding of which functional characteristics should be specifically targeted in primary and secondary prevention to achieve an optimal healthspan.
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Affiliation(s)
- Jonathan Wagner
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Raphael Knaier
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Denis Infanger
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Konstantin Arbeev
- Biodemography of Aging Research Unit (BARU), Social Science Research Institute, Duke University, Durham, NC 27705 USA
| | - Matthias Briel
- Department of Clinical Research, Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Spitalstrasse 12, 4056 Basel, Switzerland
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street, Hamilton, ONL8S4K1 Canada
| | - Thomas Dieterle
- University Clinic of Medicine, Cantonal Hospital Baselland, University of Basel, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Oliver Faude
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Ralf Roth
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Timo Hinrichs
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
| | - Arno Schmidt-Trucksäss
- Department of Sport, Exercise and Health, University of Basel, Birsstrasse 320 B, 4052 Basel, Switzerland
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Abstract
Various aspects of physical and mental health have been linked to an individual’s ability to perceive the physical condition of their body (‘interoception’). In addition, numerous studies have demonstrated a role for interoception in higher-order cognitive abilities such as decision-making and emotion processing. The importance of interoception for health and typical cognitive functioning has prompted interest in how interoception varies over the lifespan. However, few studies have investigated interoception into older adulthood, and no studies account for the set of physiological changes that may influence task performance. The present study examined interoception from young to very late adulthood (until 90 years of age) utilising a self-report measure of interoception (Study One) and an objective measure of cardiac interoception (Study Two). Across both studies, interoception decreased with age, and changes in interoceptive accuracy were observed which were not explained by accompanying physiological changes. In addition to a direct effect of age on interoception, an indirect effect of ageing on cardiac interoceptive accuracy mediated by body mass index (BMI) was found, such that ageing was associated with increased BMI which was, in turn, associated with reduced interoceptive accuracy. Such findings support and extend previous research demonstrating interoceptive decline with advancing age, and highlight the importance of assessing whether decreasing interoceptive ability is responsible for some aspects of age-related ill-health and cognitive impairment.
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10
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Murphy J, Brewer R, Catmur C, Bird G. Interoception and psychopathology: A developmental neuroscience perspective. Dev Cogn Neurosci 2017; 23:45-56. [PMID: 28081519 PMCID: PMC6987654 DOI: 10.1016/j.dcn.2016.12.006] [Citation(s) in RCA: 198] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 12/15/2022] Open
Abstract
Interoception refers to the perception of the physiological condition of the body, including hunger, temperature, and heart rate. There is a growing appreciation that interoception is integral to higher-order cognition. Indeed, existing research indicates an association between low interoceptive sensitivity and alexithymia (a difficulty identifying one's own emotion), underscoring the link between bodily and emotional awareness. Despite this appreciation, the developmental trajectory of interoception across the lifespan remains under-researched, with clear gaps in our understanding. This qualitative review and opinion paper provides a brief overview of interoception, discussing its relevance for developmental psychopathology, and highlighting measurement issues, before surveying the available work on interoception across four stages of development: infancy, childhood, adolescence and late adulthood. Where gaps in the literature addressing the development of interoception exist, we draw upon the association between alexithymia and interoception, using alexithymia as a possible marker of atypical interoception. Evidence indicates that interoceptive ability varies across development, and that this variance correlates with established age-related changes in cognition and with risk periods for the development of psychopathology. We suggest a theory within which atypical interoception underlies the onset of psychopathology and risky behaviour in adolescence, and the decreased socio-emotional competence observed in late adulthood.
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Affiliation(s)
- Jennifer Murphy
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
| | - Rebecca Brewer
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; School of Psychology, The University of East London, London, UK
| | - Caroline Catmur
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Geoffrey Bird
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK; Institute of Cognitive Neuroscience, UCL, London, UK; Dept of Experimental Psychology, University of Oxford, Oxford, UK
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Kulminski AM, Kernogitski Y, Culminskaya I, Loika Y, Arbeev KG, Bagley O, Duan M, Arbeeva L, Ukraintseva SV, Wu D, Stallard E, Yashin AI. Uncoupling associations of risk alleles with endophenotypes and phenotypes: insights from the ApoB locus and heart-related traits. Aging Cell 2017; 16:61-72. [PMID: 27683205 PMCID: PMC5242299 DOI: 10.1111/acel.12526] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2016] [Indexed: 12/04/2022] Open
Abstract
Traditionally, genomewide association studies (GWAS) have emphasized the benefits of large samples in the analyses of age‐related traits rather than their specific properties. We adopted a realistic concept of genetic susceptibility to inherently heterogeneous, age‐related traits driven by the elusive role of evolution in their properties. We analyzed in detail the associations of rs693 and rs562338 polymorphisms representing the Apolipoprotein B locus with endophenotypes (total cholesterol [TC] and high‐density lipoprotein cholesterol) and phenotypes (myocardial infarction [MI] and survival) in four large‐scale studies, which include 20 748 individuals with 2357 MI events. We showed that a strong, robust predisposition of rs693 and rs562338 to TC (β = 0.72, P = 7.7 × 10−30 for rs693 and β = −1.08, P = 9.8 × 10−42 for rs562338) is not translated into a predisposition to MI and survival. The rs693_A allele influences risks of MI and mortality after MI additively with lipids. This allele shows antagonistic effects—protecting against MI risks (β = −0.18, P = 1.1 × 10−5) or increasing MI risks (β = 0.15, P = 2.8 × 10−3) and mortality after MI, in different populations. Paradoxically, increased TC concentrations can be protective against MI for the rs693_A allele carriers. Our results uncouple the influences of the same alleles on endophenotypes and phenotypes despite potential causal relationships among the latter. Our strategy reveals virtually genomewide significance for the associations of rs693 with MI (P = 5.5 × 10−8) that is contrasted with a weak estimate following the traditional, sample‐size‐centered GWAS strategy (P = 0.16) in the same sample. These results caution against the use of the traditional GWAS strategy for gaining profound insights into genetic predisposition to healthspan and lifespan.
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Affiliation(s)
- Alexander M. Kulminski
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Yelena Kernogitski
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Irina Culminskaya
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Yury Loika
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Konstantin G. Arbeev
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Olivia Bagley
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Matt Duan
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Liubov Arbeeva
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Svetlana V. Ukraintseva
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Deqing Wu
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Eric Stallard
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
| | - Anatoliy I. Yashin
- Biodemography of Aging Research Unit; Social Science Research Institute; Duke University; Durham NC 27708-0408 USA
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12
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Nakamura S, Adachi H, Enomoto M, Fukami A, Kumagai E, Nohara Y, Kono S, Nakao E, Sakaue A, Tsuru T, Morikawa N, Fukumoto Y. Trends in coronary risk factors and electrocardiogram findings from 1977 to 2009 with 10-year mortality in Japanese elderly males - The Tanushimaru Study. J Cardiol 2017; 70:353-358. [PMID: 28109825 DOI: 10.1016/j.jjcc.2016.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 12/02/2016] [Accepted: 12/08/2016] [Indexed: 01/24/2023]
Abstract
BACKGROUND An understanding of the trends in regard to coronary risk factors and electrocardiogram (ECG) findings has an important role in public health. We investigated the trends in coronary risk factors and main ECG findings in 1977, 1989, 1999, and 2009 in the Japanese cohort of the Seven Countries Study, in Tanushimaru, a typical farming town on Kyushu Island. METHODS AND RESULTS A total of 1397 subjects (231 in 1977, 332 in 1989, 389 in 1999, and 445 in 2009) were enrolled in this study, and all of them were males aged over 65 years. In coronary risk factors, total cholesterol levels, diastolic blood pressure, body mass index, and uric acid significantly increased during these 3 decades. The prevalence of smokers markedly decreased from 56.7% in 1977 to 16.8% in 2009. ECG changes during 3 decades were wider QRS interval, increased prevalence of major abnormality, reduced heart rate, shortened PR interval and corrected QT, and decreased prevalence of left ventricular hypertrophy. Age, smoking habits, major and minor abnormalities in ECG were associated with mortality in 1977-1987. Age, total cholesterol levels (inversely) and corrected QT were associated with mortality in 1989-1999. Age, smoking habits, heart rate, and systolic blood pressure were associated with mortality in 1999-2009. CONCLUSIONS Predictors of mortality have changed with the times. Coronary risk factors such as smoking, increased heart rate, and elevated blood pressure have been recently associated with mortalities in elderly male Japanese general population.
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Affiliation(s)
- Sachiko Nakamura
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hisashi Adachi
- Department of Community Medicine, Kurume University School of Medicine, Kurume, Japan.
| | - Mika Enomoto
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ako Fukami
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Eita Kumagai
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yume Nohara
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shoko Kono
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Erika Nakao
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Akiko Sakaue
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Tomoko Tsuru
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Nagisa Morikawa
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
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13
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Arbeev KG, Ukraintseva SV, Yashin AI. Dynamics of biomarkers in relation to aging and mortality. Mech Ageing Dev 2016; 156:42-54. [PMID: 27138087 PMCID: PMC4899173 DOI: 10.1016/j.mad.2016.04.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/08/2016] [Accepted: 04/26/2016] [Indexed: 02/06/2023]
Abstract
Contemporary longitudinal studies collect repeated measurements of biomarkers allowing one to analyze their dynamics in relation to mortality, morbidity, or other health-related outcomes. Rich and diverse data collected in such studies provide opportunities to investigate how various socio-economic, demographic, behavioral and other variables can interact with biological and genetic factors to produce differential rates of aging in individuals. In this paper, we review some recent publications investigating dynamics of biomarkers in relation to mortality, which use single biomarkers as well as cumulative measures combining information from multiple biomarkers. We also discuss the analytical approach, the stochastic process models, which conceptualizes several aging-related mechanisms in the structure of the model and allows evaluating "hidden" characteristics of aging-related changes indirectly from available longitudinal data on biomarkers and follow-up on mortality or onset of diseases taking into account other relevant factors (both genetic and non-genetic). We also discuss an extension of the approach, which considers ranges of "optimal values" of biomarkers rather than a single optimal value as in the original model. We discuss practical applications of the approach to single biomarkers and cumulative measures highlighting that the potential of applications to cumulative measures is still largely underused.
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Affiliation(s)
- Konstantin G Arbeev
- Biodemography of Aging Research Unit (BARU), Social Science Research Institute, Duke University, 2024 W. Main St., Room A102F, Box 90420, Durham, NC 27705, USA.
| | - Svetlana V Ukraintseva
- Biodemography of Aging Research Unit (BARU), Social Science Research Institute, Duke University, 2024 W. Main St., Room A102F, Box 90420, Durham, NC 27705, USA
| | - Anatoliy I Yashin
- Biodemography of Aging Research Unit (BARU), Social Science Research Institute, Duke University, 2024 W. Main St., Room A102F, Box 90420, Durham, NC 27705, USA
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14
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Poon LW, Martin P, Hagberg B. Understanding Very Old Age: Looking Back and Thinking Forward. J Aging Soc Policy 2016; 28:208-17. [DOI: 10.1080/08959420.2016.1163954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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15
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Zhang WB, Pincus Z. Predicting all-cause mortality from basic physiology in the Framingham Heart Study. Aging Cell 2016; 15:39-48. [PMID: 26446764 PMCID: PMC4717277 DOI: 10.1111/acel.12408] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2015] [Indexed: 01/21/2023] Open
Abstract
Using longitudinal data from a cohort of 1349 participants in the Framingham Heart Study, we show that as early as 28-38 years of age, almost 10% of variation in future lifespan can be predicted from simple clinical parameters. Specifically, we found diastolic and systolic blood pressure, blood glucose, weight, and body mass index (BMI) to be relevant to lifespan. These and similar parameters have been well-characterized as risk factors in the relatively narrow context of cardiovascular disease and mortality in middle to old age. In contrast, we demonstrate here that such measures can be used to predict all-cause mortality from mid-adulthood onward. Further, we find that different clinical measurements are predictive of lifespan in different age regimes. Specifically, blood pressure and BMI are predictive of all-cause mortality from ages 35 to 60, while blood glucose is predictive from ages 57 to 73. Moreover, we find that several of these parameters are best considered as measures of a rate of 'damage accrual', such that total historical exposure, rather than current measurement values, is the most relevant risk factor (as with pack-years of cigarette smoking). In short, we show that simple physiological measurements have broader lifespan-predictive value than indicated by previous work and that incorporating information from multiple time points can significantly increase that predictive capacity. In general, our results apply equally to both men and women, although some differences exist.
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Affiliation(s)
- William B. Zhang
- Department of Genetics Washington University in St. Louis St. Louis MO 63130 USA
- Department of Developmental Biology Washington University in St. Louis MO 63130 USA
| | - Zachary Pincus
- Department of Genetics Washington University in St. Louis St. Louis MO 63130 USA
- Department of Developmental Biology Washington University in St. Louis MO 63130 USA
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16
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Kulminski AM, Arbeev KG, Culminskaya I, Ukraintseva SV, Stallard E, Province MA, Yashin AI. Trade-offs in the effects of the apolipoprotein E polymorphism on risks of diseases of the heart, cancer, and neurodegenerative disorders: insights on mechanisms from the Long Life Family Study. Rejuvenation Res 2016; 18:128-35. [PMID: 25482294 DOI: 10.1089/rej.2014.1616] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The lack of evolutionary established mechanisms linking genes to age-related traits makes the problem of genetic susceptibility to health span inherently complex. One complicating factor is genetic trade-off. Here we focused on long-living participants of the Long Life Family Study (LLFS), their offspring, and spouses to: (1) Elucidate whether trade-offs in the effect of the apolipoprotein E e4 allele documented in the Framingham Heart Study (FHS) are a more general phenomenon, and (2) explore potential mechanisms generating age- and gender-specific trade-offs in the effect of the e4 allele on cancer, diseases of the heart, and neurodegenerative disorders assessed retrospectively in the LLFS populations. The e4 allele can diminish risks of cancer and diseases of the heart and confer risks of diseases of the heart in a sex-, age-, and LLFS-population-specific manner. A protective effect against cancer is seen in older long-living men and, potentially, their sons (>75 years, relative risk [RR]>75=0.48, p=0.086), which resembles our findings in the FHS. The protective effect against diseases of the heart is limited to long-living older men (RR>76=0.50, p=0.016), as well. A detrimental effect against diseases of the heart is characteristic for a normal LLFS population of male spouses and is specific for myocardial infarction (RR=3.07, p=2.1×10(-3)). These trade-offs are likely associated with two inherently different mechanisms, including disease-specific (detrimental; characteristic for a normal male population) and systemic, aging-related (protective; characteristic for older long-living men) mechanisms. The e4 allele confers risks of neurological disorders in men and women (RR=1.98, p=0.046). The results highlight the complex role of the e4 allele in genetic susceptibility to health span.
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17
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Wu L, Lewis MW. Disabilities among veterans and their utilization of health care. Health Psychol Behav Med 2015. [DOI: 10.1080/21642850.2015.1089176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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18
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Quarles EK, Dai DF, Tocchi A, Basisty N, Gitari L, Rabinovitch PS. Quality control systems in cardiac aging. Ageing Res Rev 2015; 23:101-15. [PMID: 25702865 PMCID: PMC4686341 DOI: 10.1016/j.arr.2015.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 02/02/2015] [Accepted: 02/12/2015] [Indexed: 12/31/2022]
Abstract
Cardiac aging is an intrinsic process that results in impaired cardiac function, along with cellular and molecular changes. These degenerative changes are intimately associated with quality control mechanisms. This review provides a general overview of the clinical and cellular changes which manifest in cardiac aging, and the quality control mechanisms involved in maintaining homeostasis and retarding aging. These mechanisms include autophagy, ubiquitin-mediated turnover, apoptosis, mitochondrial quality control and cardiac matrix homeostasis. Finally, we discuss aging interventions that have been observed to impact cardiac health outcomes. These include caloric restriction, rapamycin, resveratrol, GDF11, mitochondrial antioxidants and cardiolipin-targeted therapeutics. A greater understanding of the quality control mechanisms that promote cardiac homeostasis will help to understand the benefits of these interventions, and hopefully lead to further improved therapeutic modalities.
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Affiliation(s)
- Ellen K Quarles
- University of Washington School of Medicine, Department of Pathology, Box 357470, Seattle, WA 98195-7470, United States.
| | - Dao-Fu Dai
- University of Washington School of Medicine, Department of Pathology, Box 357470, Seattle, WA 98195-7470, United States.
| | - Autumn Tocchi
- University of Washington School of Medicine, Department of Pathology, Box 357470, Seattle, WA 98195-7470, United States.
| | - Nathan Basisty
- University of Washington School of Medicine, Department of Pathology, Box 357470, Seattle, WA 98195-7470, United States.
| | - Lemuel Gitari
- University of Washington School of Medicine, Department of Pathology, Box 357470, Seattle, WA 98195-7470, United States.
| | - Peter S Rabinovitch
- University of Washington School of Medicine, Department of Pathology, Box 357470, Seattle, WA 98195-7470, United States.
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19
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Kulminski AM, Culminskaya I, Arbeev KG, Arbeeva L, Ukraintseva SV, Stallard E, Wu D, Yashin AI. Birth Cohort, Age, and Sex Strongly Modulate Effects of Lipid Risk Alleles Identified in Genome-Wide Association Studies. PLoS One 2015; 10:e0136319. [PMID: 26295473 PMCID: PMC4546650 DOI: 10.1371/journal.pone.0136319] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Accepted: 08/02/2015] [Indexed: 02/07/2023] Open
Abstract
Insights into genetic origin of diseases and related traits could substantially impact strategies for improving human health. The results of genome-wide association studies (GWAS) are often positioned as discoveries of unconditional risk alleles of complex health traits. We re-analyzed the associations of single nucleotide polymorphisms (SNPs) associated with total cholesterol (TC) in a large-scale GWAS meta-analysis. We focused on three generations of genotyped participants of the Framingham Heart Study (FHS). We show that the effects of all ten directly-genotyped SNPs were clustered in different FHS generations and/or birth cohorts in a sex-specific or sex-unspecific manner. The sample size and procedure-therapeutic issues play, at most, a minor role in this clustering. An important result was clustering of significant associations with the strongest effects in the youngest, or 3rd Generation, cohort. These results imply that an assumption of unconditional connections of these SNPs with TC is generally implausible and that a demographic perspective can substantially improve GWAS efficiency. The analyses of genetic effects in age-matched samples suggest a role of environmental and age-related mechanisms in the associations of different SNPs with TC. Analysis of the literature supports systemic roles for genes for these SNPs beyond those related to lipid metabolism. Our analyses reveal strong antagonistic effects of rs2479409 (the PCSK9 gene) that cautions strategies aimed at targeting this gene in the next generation of lipid drugs. Our results suggest that standard GWAS strategies need to be advanced in order to appropriately address the problem of genetic susceptibility to complex traits that is imperative for translation to health care.
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Affiliation(s)
- Alexander M. Kulminski
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, 27708–0408, United States of America
- * E-mail:
| | - Irina Culminskaya
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, 27708–0408, United States of America
| | - Konstantin G. Arbeev
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, 27708–0408, United States of America
| | - Liubov Arbeeva
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, 27708–0408, United States of America
| | - Svetlana V. Ukraintseva
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, 27708–0408, United States of America
| | - Eric Stallard
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, 27708–0408, United States of America
| | - Deqing Wu
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, 27708–0408, United States of America
| | - Anatoliy I. Yashin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, 27708–0408, United States of America
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20
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Arbeev KG, Akushevich I, Kulminski AM, Ukraintseva SV, Yashin AI. Biodemographic Analyses of Longitudinal Data on Aging, Health, and Longevity: Recent Advances and Future Perspectives. ADVANCES IN GERIATRICS 2015; 2014:957073. [PMID: 25590047 PMCID: PMC4290867 DOI: 10.1155/2014/957073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Biodemography became one of the most innovative and fastest growing areas in demography. This progress is fueled by the growing variability and amount of relevant data available for analyses as well as by methodological developments allowing for addressing new research questions using new approaches that can better utilize the potential of these data. In this review paper, we summarize recent methodological advances in biodemography and their diverse practical applications. Three major topics are covered: (1) computational approaches to reconstruction of age patterns of incidence of geriatric diseases and other characteristics such as recovery rates at the population level using Medicare claims data; (2) methodological advances in genetic and genomic biodemography and applications to research on genetic determinants of longevity and health; and (3) biodemographic models for joint analyses of time-to-event data and longitudinal measurements of biomarkers collected in longitudinal studies on aging. We discuss how such data and methodology can be used in a comprehensive prediction model for joint analyses of incomplete datasets that take into account the wide spectrum of factors affecting health and mortality transitions including genetic factors and hidden mechanisms of aging-related changes in physiological variables in their dynamic connection with health and survival.
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Affiliation(s)
- Konstantin G Arbeev
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
| | - Igor Akushevich
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
| | - Alexander M Kulminski
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
| | - Svetlana V Ukraintseva
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
| | - Anatoliy I Yashin
- Center for Population Health and Aging, Duke University, Erwin Mill Building, 2024 W. Main Street, P.O. Box 90420, Durham, NC 27705, USA
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21
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Heart rate reduction and longevity in mice. Basic Res Cardiol 2015; 110:2. [PMID: 25589054 DOI: 10.1007/s00395-014-0460-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 12/03/2014] [Accepted: 12/19/2014] [Indexed: 12/19/2022]
Abstract
Heart rate correlates inversely with life span across all species, including humans. In patients with cardiovascular disease, higher heart rate is associated with increased mortality, and such patients benefit from pharmacological heart rate reduction. However, cause-and-effect relationships between heart rate and longevity, notably in healthy individuals, are not established. We therefore prospectively studied the effects of a life-long pharmacological heart rate reduction on longevity in mice. We hypothesized, that the total number of cardiac cycles is constant, and that a 15% heart rate reduction might translate into a 15% increase in life span. C57BL6/J mice received either placebo or ivabradine at a dose of 50 mg/kg/day in drinking water from 12 weeks to death. Heart rate and body weight were monitored. Autopsy was performed on all non-autolytic cadavers, and parenchymal organs were evaluated macroscopically. Ivabradine reduced heart rate by 14% (median, interquartile range 12-15%) throughout life, and median life span was increased by 6.2% (p = 0.01). Body weight and macroscopic findings were not different between placebo and ivabradine. Life span was not increased to the same extent as heart rate was reduced, but nevertheless significantly prolonged by 6.2%.
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22
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Arbeev KG, Akushevich I, Kulminski AM, Ukraintseva SV, Yashin AI. Joint Analyses of Longitudinal and Time-to-Event Data in Research on Aging: Implications for Predicting Health and Survival. Front Public Health 2014; 2:228. [PMID: 25414844 PMCID: PMC4222133 DOI: 10.3389/fpubh.2014.00228] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 10/24/2014] [Indexed: 12/23/2022] Open
Abstract
Longitudinal data on aging, health, and longevity provide a wealth of information to investigate different aspects of the processes of aging and development of diseases leading to death. Statistical methods aimed at analyses of time-to-event data jointly with longitudinal measurements became known as the "joint models" (JM). An important point to consider in analyses of such data in the context of studies on aging, health, and longevity is how to incorporate knowledge and theories about mechanisms and regularities of aging-related changes that accumulate in the research field into respective analytic approaches. In the absence of specific observations of longitudinal dynamics of relevant biomarkers manifesting such mechanisms and regularities, traditional approaches have a rather limited utility to estimate respective parameters that can be meaningfully interpreted from the biological point of view. A conceptual analytic framework for these purposes, the stochastic process model of aging (SPM), has been recently developed in the biodemographic literature. It incorporates available knowledge about mechanisms of aging-related changes, which may be hidden in the individual longitudinal trajectories of physiological variables and this allows for analyzing their indirect impact on risks of diseases and death. Despite, essentially, serving similar purposes, JM and SPM developed in parallel in different disciplines with very limited cross-referencing. Although there were several publications separately reviewing these two approaches, there were no publications presenting both these approaches in some detail. Here, we overview both approaches jointly and provide some new modifications of SPM. We discuss the use of stochastic processes to capture biological variation and heterogeneity in longitudinal patterns and important and promising (but still largely underused) applications of JM and SPM to predictions of individual and population mortality and health-related outcomes.
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Affiliation(s)
| | - Igor Akushevich
- Center for Population Health and Aging, Duke University, Durham, NC, USA
| | | | | | - Anatoliy I. Yashin
- Center for Population Health and Aging, Duke University, Durham, NC, USA
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23
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Kulminski AM. Unraveling genetic origin of aging-related traits: evolving concepts. Rejuvenation Res 2014; 16:304-12. [PMID: 23768105 DOI: 10.1089/rej.2013.1441] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Discovering the genetic origin of aging-related traits could greatly advance strategies aiming to extend health span. The results of genome-wide association studies (GWAS) addressing this problem are controversial, and new genetic concepts have been fostered to advance the progress in the field. A limitation of GWAS and new genetic concepts is that they do not thoroughly address specifics of aging-related traits. Integration of theoretical concepts in genetics and aging research with empirical evidence from different disciplines highlights the conceptual problems in studies of genetic origin of aging-related traits. To address these problems, novel approaches of systemic nature are required. These approaches should adopt the non-deterministic nature of linkage of genes with aging-related traits and, consequently, reinforce research strategies for improving our understanding of mechanisms shaping genetic effects on these traits. Investigation of mechanisms will help determine conditions that activate specific genetic variants or profiles and explore to what extent these conditions that shape genetic effects are conserved across human lives and generations.
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Affiliation(s)
- Alexander M Kulminski
- Center for Population Health and Aging, Duke University, Durham, North Carolina 27708, USA.
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24
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Engelfriet PM, Jansen EHJM, Picavet HSJ, Dollé MET. Biochemical markers of aging for longitudinal studies in humans. Epidemiol Rev 2013; 35:132-51. [PMID: 23382477 PMCID: PMC4707878 DOI: 10.1093/epirev/mxs011] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2013] [Indexed: 12/21/2022] Open
Abstract
Much progress has been made in the past decades in unraveling the mechanisms that are responsible for aging. The discovery that particular gene mutations in experimental species such as yeast, flies, and nematodes are associated with longevity has led to many important insights into pathways that regulate aging processes. However, extrapolating laboratory findings in experimental species to knowledge that is valid for the complexity of human physiology remains a major challenge. Apart from the restricted experimental possibilities, studying aging in humans is further complicated by the development of various age-related diseases. The availability of a set of biomarkers that really reflect underlying aging processes would be of much value in disentangling age-associated pathology from specific aging mechanisms. In this review, we survey the literature to identify promising biochemical markers of aging, with a particular focus on using them in longitudinal studies of aging in humans that entail repeated measurements on easily obtainable material, such as blood samples. Our search strategy was a 2-pronged approach, one focused on general mechanisms of aging and one including studies on clinical biomarkers of age-related diseases.
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Affiliation(s)
- Peter M. Engelfriet
- Correspondence to Dr. Peter M. Engelfriet, National Institute for Public Health and the Environment (RIVM), Centre for Prevention and Health Services Research, P.O. Box 1, 3720 BA Bilthoven, The Netherlands (e-mail: )
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Yashin AI, Arbeev KG, Wu D, Arbeeva LS, Kulminski A, Akushevich I, Culminskaya I, Stallard E, Ukraintseva SV. How lifespan associated genes modulate aging changes: lessons from analysis of longitudinal data. Front Genet 2013; 4:3. [PMID: 23346098 PMCID: PMC3551204 DOI: 10.3389/fgene.2013.00003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/04/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The influence of genes on human lifespan is mediated by biological processes that characterize body's functioning. The age trajectories of these processes contain important information about mechanisms linking aging, health, and lifespan. The objective of this paper is to investigate regularities of aging changes in different groups of individuals, including individuals with different genetic background, as well as their connections with health and lifespan. DATA AND METHOD To reach this objective we used longitudinal data on four physiological variables, information about health and lifespan collected in the Framingham Heart Study (FHS), data on longevity alleles detected in earlier study, as well as methods of statistical modeling. RESULTS We found that phenotypes of exceptional longevity and health are linked to distinct types of changes in physiological indices during aging. We also found that components of aging changes differ in groups of individuals with different genetic background. CONCLUSIONS These results suggest that factors responsible for exceptional longevity and health are not necessary the same, and that postponing aging changes is associated with extreme longevity. The genetic factors which increase lifespan are associated with physiological changes typical of healthy and long-living individuals, smaller mortality risks from cancer and CVD and better estimates of adaptive capacity in statistical modeling. This indicates that extreme longevity and health related traits are likely to be less heterogeneous phenotypes than lifespan, and studying these phenotypes separately from lifespan may provide additional information about mechanisms of human aging and its relation to chronic diseases and lifespan.
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Stessman J, Jacobs JM, Stessman-Lande I, Gilon D, Leibowitz D. Aging, Resting Pulse Rate, and Longevity. J Am Geriatr Soc 2013; 61:40-5. [DOI: 10.1111/jgs.12060] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Jochanan Stessman
- Jerusalem Institute of Aging Research; Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School; Jerusalem Israel
- Department of Geriatrics and Rehabilitation; Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School; Jerusalem Israel
| | - Jeremy M. Jacobs
- Jerusalem Institute of Aging Research; Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School; Jerusalem Israel
- Department of Geriatrics and Rehabilitation; Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School; Jerusalem Israel
| | - Irit Stessman-Lande
- Heart Institute; Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School; Jerusalem Israel
| | - Dan Gilon
- Heart Institute; Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School; Jerusalem Israel
| | - David Leibowitz
- Jerusalem Institute of Aging Research; Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School; Jerusalem Israel
- Heart Institute; Hadassah-Hebrew University Medical Center and Hebrew University-Hadassah Medical School; Jerusalem Israel
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Yashin AI, Arbeev KG, Ukraintseva SV, Akushevich I, Kulminski A. Patterns of Aging-Related Changes on the Way to 100. ACTA ACUST UNITED AC 2012. [DOI: 10.1080/10920277.2012.10597640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Steiner UK, Tuljapurkar S, Coulson T, Horvitz C. Trading stages: life expectancies in structured populations. Exp Gerontol 2012; 47:773-81. [PMID: 22664576 DOI: 10.1016/j.exger.2012.05.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 05/22/2012] [Accepted: 05/25/2012] [Indexed: 10/28/2022]
Abstract
Interest in stage-and age structured models has recently increased because they can describe quantitative traits such as size that are left out of age-only demography. Available methods for the analysis of effects of vital rates on lifespan in stage-structured models have not been widely applied because they are hard to use and interpret, and tools for age and stage structured populations are missing. We present easily interpretable expressions for the sensitivities and elasticities of life expectancy to vital rates in age-stage models, and illustrate their application with two biological examples. Much of our approach relies on trading of time and mortality risk in one stage for time and risk in others. Our approach contributes to the new framework of the study of age- and stage-structured biodemography.
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Affiliation(s)
- Ulrich K Steiner
- Department of Biology, Stanford University, Stanford, CA 94305-5020, USA
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Yashin AI, Wu D, Arbeev KG, Stallard E, Land KC, Ukraintseva SV. How genes influence life span: the biodemography of human survival. Rejuvenation Res 2012; 15:374-80. [PMID: 22607627 DOI: 10.1089/rej.2011.1290] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In genome-wide association studies (GWAS) of human life span, none of the genetic variants has reached the level of genome-wide statistical significance. The roles of such variants in life span regulation remain unclear. DATA AND METHOD A biodemographic analyses was done of genetic regulation of life span using data on low-significance longevity alleles selected in the earlier GWAS of the original Framingham cohort. RESULTS Age-specific survival curves considered as functions of the number of longevity alleles exhibit regularities known in demography as "rectangularization" of survival curves. The presence of such pattern confirms observations from experimental studies that regulation of life span involves genes responsible for stress resistance. CONCLUSION Biodemographic analyses could provide important information about the properties of genes affecting phenotypic traits.
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Affiliation(s)
- Anatoliy I Yashin
- Center for Population Health and Aging, Duke University, Durham, North Carolina 27708-0408, USA.
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Arbeev KG, Ukraintseva SV, Kulminski AM, Akushevich I, Arbeeva LS, Culminskaya IV, Wu D, Yashin AI. Effect of the APOE Polymorphism and Age Trajectories of Physiological Variables on Mortality: Application of Genetic Stochastic Process Model of Aging. SCIENTIFICA 2012; 2012:568628. [PMID: 23682334 PMCID: PMC3653307 DOI: 10.6064/2012/568628] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2012] [Accepted: 06/21/2012] [Indexed: 05/24/2023]
Abstract
We evaluated effects of the APOE polymorphism (carriers versus noncarriers of the e4 allele) and age trajectories of total cholesterol (CH) and diastolic blood pressure (DBP) on mortality risk in the Framingham Heart Study (original cohort). We found that long-lived carriers and noncarriers have different average age trajectories and long-lived individuals have consistently higher levels and less steep declines at old ages compared to short-lived individuals. We applied the stochastic process model of aging aimed at joint analyses of genetic and nongenetic subsamples of longitudinal data and estimated different aging-related characteristics for carriers and noncarriers which otherwise cannot be evaluated from data. We found that such characteristics differ in carriers and noncarriers: (1) carriers have better adaptive capacity than noncarriers in case of CH, whereas for DBP the opposite situation is observed; (2) mean allostatic trajectories are higher in carriers and they differ from “optimal” trajectories minimizing mortality risk; (3) noncarriers have lower baseline mortality rates at younger ages but they increase faster than those for carriers resulting in intersection at the oldest ages. Such observations strongly indicate the presence of a genetic component in respective aging-related mechanisms. Such differences may contribute to patterns of allele- and sex-specific mortality rates.
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Affiliation(s)
- Konstantin G. Arbeev
- Center for Population Health and Aging, Duke University, P.O. Box 90408, Durham, NC 27708-0408, USA
| | - Svetlana V. Ukraintseva
- Center for Population Health and Aging, Duke University, P.O. Box 90408, Durham, NC 27708-0408, USA
- Duke Cancer Institute, Duke University, Durham, NC 27710, USA
| | - Alexander M. Kulminski
- Center for Population Health and Aging, Duke University, P.O. Box 90408, Durham, NC 27708-0408, USA
| | - Igor Akushevich
- Center for Population Health and Aging, Duke University, P.O. Box 90408, Durham, NC 27708-0408, USA
| | - Liubov S. Arbeeva
- Center for Population Health and Aging, Duke University, P.O. Box 90408, Durham, NC 27708-0408, USA
| | - Irina V. Culminskaya
- Center for Population Health and Aging, Duke University, P.O. Box 90408, Durham, NC 27708-0408, USA
| | - Deqing Wu
- Center for Population Health and Aging, Duke University, P.O. Box 90408, Durham, NC 27708-0408, USA
| | - Anatoliy I. Yashin
- Center for Population Health and Aging, Duke University, P.O. Box 90408, Durham, NC 27708-0408, USA
- Duke Cancer Institute, Duke University, Durham, NC 27710, USA
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Willcox DC, Willcox BJ, Poon LW. Centenarian studies: important contributors to our understanding of the aging process and longevity. Curr Gerontol Geriatr Res 2011; 2010:484529. [PMID: 21804821 PMCID: PMC3143446 DOI: 10.1155/2010/484529] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2010] [Accepted: 12/31/2010] [Indexed: 11/17/2022] Open
Affiliation(s)
- Donald Craig Willcox
- Okinawa International University, Okinawa 901-2701, Japan
- Okinawa Research Center for Longevity Science, Okinawa 901-2114, Japan
- Pacific Health Research and Education Institute, Honolulu, HI 96813, USA
| | - Bradley J. Willcox
- Okinawa Research Center for Longevity Science, Okinawa 901-2114, Japan
- Pacific Health Research and Education Institute, Honolulu, HI 96813, USA
- Department of Research, Kuakini Medical Center, Honolulu, HI 96817, USA
- Department of Research, Planning and Development, The Queen's Medical Center, Honolulu, HI 96813, USA
- Department of Geriatric Medicine, John A. Burns School of Medicine, University of Hawaii, HI 96817, USA
| | - Leonard W. Poon
- The Institute of Gerontology, University of Georgia, UGA, Athens, GA 30602, USA
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Berstein LM. Interrelations between cancer of hormone-dependent tissues and other major noncommunicable diseases: The age-specific aspect. ADVANCES IN GERONTOLOGY 2011. [DOI: 10.1134/s2079057011020032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Glei DA, Goldman N, Lin YH, Weinstein M. Age-Related Changes in Biomarkers: Longitudinal Data from a Population-Based Sample. Res Aging 2011; 33:312-326. [PMID: 21666867 DOI: 10.1177/0164027511399105] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Identifying how biological parameters change with age can provide insights into the physiological determinants of disease, and ultimately, death. Most prior studies of age-related change in biomarkers are based on cross-sectional data, small or selective samples, or a limited number of biomarkers. We use data from a nationally-representative longitudinal sample of 639 Taiwanese aged 54 and older in 2000 to assess changes over a six-year period in a wide range of biomarkers. Markers that increased most with age were glycoslyated hemoglobin, interleukin-6, and norepinephrine. Markers that decreased most with age were diastolic blood pressure and creatinine clearance. For example, glycoslyated hemoglobin increased by 8-13%, on average, over this six-year period. Several standard clinical risk factors exhibited little evidence of age-related change. Further research is needed to determine whether the observed variation between individuals in biomarker changes represents differences in underlying physiological function that are predictive of future health and survival.
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Age trajectories of physiological indices in relation to healthy life course. Mech Ageing Dev 2011; 132:93-102. [PMID: 21262255 DOI: 10.1016/j.mad.2011.01.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 12/22/2010] [Accepted: 01/16/2011] [Indexed: 11/24/2022]
Abstract
We analysed relationship between the risk of onset of "unhealthy life" (defined as the onset of cancer, cardiovascular diseases, or diabetes) and longitudinal changes in body mass index, diastolic blood pressure, hematocrit, pulse pressure, pulse rate, and serum cholesterol in the Framingham Heart Study (Original Cohort) using the stochastic process model of human mortality and aging. The analyses demonstrate how decline in resistance to stresses and adaptive capacity accompanying human aging can be evaluated from longitudinal data. We showed how these components of the aging process, as well as deviation of the trajectories of physiological indices from those minimising the risk at respective ages, can lead to an increase in the risk of onset of unhealthy life with age. The results indicate the presence of substantial gender difference in aging related decline in stress resistance and adaptive capacity, which can contribute to differences in the shape of the sex-specific patterns of incidence rates of aging related diseases.
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Dynamic determinants of longevity and exceptional health. Curr Gerontol Geriatr Res 2010. [PMID: 20953403 PMCID: PMC2952789 DOI: 10.1155/2010/381637] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Revised: 07/12/2010] [Accepted: 09/01/2010] [Indexed: 01/26/2023] Open
Abstract
It is well known from epidemiology that values of indices describing physiological state in a given age may influence human morbidity and mortality risks. Studies of connection between aging and life span suggest a possibility that dynamic properties of age trajectories of the physiological indices could also be important contributors to morbidity and mortality risks. In this paper we use data on longitudinal changes in body mass index, diastolic blood pressure, pulse pressure, pulse rate, blood glucose, hematocrit, and serum cholesterol in the Framingham Heart Study participants, to investigate this possibility in depth. We found that some of the variables describing individual dynamics of the age-associated changes in physiological indices influence human longevity and exceptional health more substantially than the variables describing physiological state. These newly identified variables are promising targets for prevention aiming to postpone onsets of common elderly diseases and increase longevity.
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Swindell WR, Ensrud KE, Cawthon PM, Cauley JA, Cummings SR, Miller RA. Indicators of "healthy aging" in older women (65-69 years of age). A data-mining approach based on prediction of long-term survival. BMC Geriatr 2010; 10:55. [PMID: 20716351 PMCID: PMC2936300 DOI: 10.1186/1471-2318-10-55] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Accepted: 08/17/2010] [Indexed: 12/16/2022] Open
Abstract
Background Prediction of long-term survival in healthy adults requires recognition of features that serve as early indicators of successful aging. The aims of this study were to identify predictors of long-term survival in older women and to develop a multivariable model based upon longitudinal data from the Study of Osteoporotic Fractures (SOF). Methods We considered only the youngest subjects (n = 4,097) enrolled in the SOF cohort (65 to 69 years of age) and excluded older SOF subjects more likely to exhibit a "frail" phenotype. A total of 377 phenotypic measures were screened to determine which were of most value for prediction of long-term (19-year) survival. Prognostic capacity of individual predictors, and combinations of predictors, was evaluated using a cross-validation criterion with prediction accuracy assessed according to time-specific AUC statistics. Results Visual contrast sensitivity score was among the top 5 individual predictors relative to all 377 variables evaluated (mean AUC = 0.570). A 13-variable model with strong predictive performance was generated using a forward search strategy (mean AUC = 0.673). Variables within this model included a measure of physical function, smoking and diabetes status, self-reported health, contrast sensitivity, and functional status indices reflecting cumulative number of daily living impairments (HR ≥ 0.879 or RH ≤ 1.131; P < 0.001). We evaluated this model and show that it predicts long-term survival among subjects assigned differing causes of death (e.g., cancer, cardiovascular disease; P < 0.01). For an average follow-up time of 20 years, output from the model was associated with multiple outcomes among survivors, such as tests of cognitive function, geriatric depression, number of daily living impairments and grip strength (P < 0.03). Conclusions The multivariate model we developed characterizes a "healthy aging" phenotype based upon an integration of measures that together reflect multiple dimensions of an aging adult (65-69 years of age). Age-sensitive components of this model may be of value as biomarkers in human studies that evaluate anti-aging interventions. Our methodology could be applied to data from other longitudinal cohorts to generalize these findings, identify additional predictors of long-term survival, and to further develop the "healthy aging" concept.
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Affiliation(s)
- William R Swindell
- Department of Pathology, University of Michigan, School of Medicine, Ann Arbor, MI 48109-2200, USA.
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"Predicting" parental longevity from offspring endophenotypes: data from the Long Life Family Study (LLFS). Mech Ageing Dev 2010; 131:215-22. [PMID: 20184914 DOI: 10.1016/j.mad.2010.02.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2009] [Revised: 01/04/2010] [Accepted: 02/14/2010] [Indexed: 10/19/2022]
Abstract
While there is evidence that longevity runs in families, the study of long-lived families is complicated by the fact that longevity-related information is available only for the oldest old, many of whom may be deceased and unavailable for testing, and information on other living family members, primarily descendents, is censored. This situation requires a creative approach for analyzing determinants of longevity in families. There are likely biomarkers that predict an individual's longevity, suggesting the possibility that those biomarkers which are heritable may constitute valuable endophenotypes for exceptional survival. These endophenotypes could be studied in families to identify human longevity genes and elucidate possible mechanisms of their influence on longevity. In this paper, we analyze data collected in the Long Life Family Study (LLFS) investigating whether indicators of physiological state, cognitive functioning and health/well-being among offspring predict longevity in parents. Good predictors can be used as endophenotypes for exceptional survival. Our analyses revealed significant associations between cumulative indices describing physiological state, as well as a number of offspring phenotypes, and parental lifespan, supporting both their familial basis and relevance to longevity. We conclude that the study of endophenotypes within families is a valid approach to the genetics of human longevity.
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Kannel WB, Vasan RS. Is age really a non-modifiable cardiovascular risk factor? Am J Cardiol 2009; 104:1307-10. [PMID: 19840582 DOI: 10.1016/j.amjcard.2009.06.051] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2009] [Revised: 06/11/2009] [Accepted: 06/11/2009] [Indexed: 10/20/2022]
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Brachial artery retrograde flow increases with age: relationship to physical function. Eur J Appl Physiol 2009; 107:219-25. [PMID: 19565260 DOI: 10.1007/s00421-009-1117-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2009] [Indexed: 01/09/2023]
Abstract
The purpose of this study was to examine the flow velocity pattern of the brachial artery and to determine its relationship to measures of physical function. Subjects from the Louisiana Healthy Aging Study (n = 95; age = 84 +/- 10 years) were evaluated. Brachial artery flow velocities and dimensions were measured using high-resolution ultrasonography. The continuous scale of physical function and performance test (CS-PFP10) was used to assess physical function. This test is based on the performance of 11 activities of daily living. Total CS-PFP10 score was 39.51 +/- 21.21 U. Mean antegrade and retrograde velocities at rest were 14.2 +/- 4.7 and 3.6 +/- 2.2 cm/s, respectively. Ante-/retrograde ratio was 5.5 +/- 4.6. Brachial artery diameter was 4.3 +/- 0.7 mm. Pulse pressure and vascular conductance were 66 +/- 18 mmHg, and 0.9 +/- 0.5 ml/min/mmHg, respectively. Vascular conductance (r = -0.34), ante-/retrograde ratio (r = -0.42) and CS-PFP10 (r = -0.65) were inversely and retrograde velocity (r = 0.40) and pulse pressure (r = 0.36), were directly associated with age. Retrograde velocity was inversely related to vascular conductance (r = -0.27) and CS-PFP10 total score (r = -0.45). A MANOVA revealed that those with the higher CS-PFP10 scores had a lower retrograde velocity (P = 0.0001), but this association was, in part, age-dependent. Among nonagenarians (n = 52), those in the lower tertiles of the CS-PFP10 scores had significantly higher retrograde velocities compared to those in the higher tertiles (P = 0.035). These data indicate an increase in brachial retrograde velocity with age. These hemodynamic changes are related to a decline in physical function.
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Yashin AI, Akushevich I, Arbeev K, Akushevich L, Kulminski A, Ukraintseva S. Studying health histories of cancer: a new model connecting cancer incidence and survival. Math Biosci 2009; 218:88-97. [PMID: 19167410 PMCID: PMC2692256 DOI: 10.1016/j.mbs.2008.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2008] [Revised: 09/30/2008] [Accepted: 12/30/2008] [Indexed: 12/17/2022]
Abstract
The results of recent experimental and epidemiological studies provide evidence on the connection between carcinogenesis, cancer progression, and aging. Existing models, however, are traditionally focused only on one of these aspects of health deterioration. In this paper, we derive a new model of cancer, which describes the connection between the ages at disease onset, the duration of disease, and life span of respective individuals. The model combines ideas used in the two hits model of carcinogenesis with those used in the Le Bras multistate model of aging with constant transition intensities. The model is used in the joint analyses of the US demographic mortality data and SEER data for selected cancers. The results show that the developed approach is capable of explaining links among health history data and provides useful insights on mechanisms of cancer occurrence, disease progression, other aging-related changes, and mortality. Further developments of this model are discussed.
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Affiliation(s)
- Anatoli I Yashin
- Department of Sociology, Duke University, 002 Trent Hall, Box 90408 Durham, NC 27708-0408, USA
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Arbeev KG, Akushevich I, Kulminski AM, Arbeeva LS, Akushevich L, Ukraintseva SV, Culminskaya IV, Yashin AI. Genetic model for longitudinal studies of aging, health, and longevity and its potential application to incomplete data. J Theor Biol 2009; 258:103-11. [PMID: 19490866 DOI: 10.1016/j.jtbi.2009.01.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2008] [Revised: 01/14/2009] [Accepted: 01/23/2009] [Indexed: 10/21/2022]
Abstract
Many longitudinal studies of aging collect genetic information only for a sub-sample of participants of the study. These data also do not include recent findings, new ideas and methodological concepts developed by distinct groups of researchers. The formal statistical analyses of genetic data ignore this additional information and therefore cannot utilize the entire research potential of the data. In this paper, we present a stochastic model for studying such longitudinal data in joint analyses of genetic and non-genetic sub-samples. The model incorporates several major concepts of aging known to date and usually studied independently. These include age-specific physiological norms, allostasis and allostatic load, stochasticity, and decline in stress resistance and adaptive capacity with age. The approach allows for studying all these concepts in their mutual connection, even if respective mechanisms are not directly measured in data (which is typical for longitudinal data available to date). The model takes into account dependence of longitudinal indices and hazard rates on genetic markers and permits evaluation of all these characteristics for carriers of different alleles (genotypes) to address questions concerning genetic influence on aging-related characteristics. The method is based on extracting genetic information from the entire sample of longitudinal data consisting of genetic and non-genetic sub-samples. Thus it results in a substantial increase in the accuracy of statistical estimates of genetic parameters compared to methods that use only information from a genetic sub-sample. Such an increase is achieved without collecting additional genetic data. Simulation studies illustrate the increase in the accuracy in different scenarios for datasets structurally similar to the Framingham Heart Study. Possible applications of the model and its further generalizations are discussed.
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Affiliation(s)
- Konstantin G Arbeev
- Center for Population Health and Aging, Duke University, Trent Hall, Room 002, Box 90408, Durham, NC 27708-0408, USA.
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Kaplan MS, Huguet N, Orpana H, Feeny D, McFarland BH, Ross N. Prevalence and factors associated with thriving in older adulthood: a 10-year population-based study. J Gerontol A Biol Sci Med Sci 2008; 63:1097-104. [PMID: 18948561 DOI: 10.1093/gerona/63.10.1097] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Interest in the determinants of "successful aging" is growing. Nonetheless, successful aging remains ill defined, and its appropriate measurement is hotly contested. Most studies have focused on the absence of disability or deficits in physical performance as outcomes. The present study extends this research by using the Health Utilities Index Mark 3 (HUI3), a multidimensional measure of health status, to examine the maintenance of exceptionally good health among older participants in the Canadian National Population Health Survey (1994--2004). METHODS The maintenance of exceptionally good health in old age was examined prospectively among 2432 individuals (65-85 years old at baseline) who met the inclusion criteria. The participants were classified into one of four health trajectories: thrivers (who maintained exceptional health with no or only mild disability), nonthrivers (who experienced a moderate or severe disability), the deceased, and the institutionalized. RESULTS In 10 years of follow-up, 190 (8%) were thrivers (HUI3 score > or = 0.89 at all interviews), 1076 (47%) were nonthrivers, 893 (36%) died, and 273 (9%) were institutionalized. The maintenance of exceptionally good health among the elderly participants was related to younger age at baseline, socioeconomic status (higher income), psychosocial factors (including lower psychological distress), and behavioral factors (never smoked and moderate alcohol use). CONCLUSIONS The maintenance of exceptionally good health in old age is related, at least in part, to modifiable lifestyle factors. However, elevated socioeconomic status also distinguishes those who are able to maintain exceptionally good health.
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Affiliation(s)
- Mark S Kaplan
- School of Community Health, Portland State University, P.O. Box 751, Portland, OR 97207, USA.
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Kulminski A, Ukraintseva SV, Akushevich I, Arbeev KG, Land K, Yashin AI. Accelerated accumulation of health deficits as a characteristic of aging. Exp Gerontol 2007; 42:963-70. [PMID: 17601693 PMCID: PMC2096614 DOI: 10.1016/j.exger.2007.05.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2007] [Revised: 05/17/2007] [Accepted: 05/22/2007] [Indexed: 10/23/2022]
Abstract
Cross-sectional analyses show that an index of aging-associated health/well-being deficits, called the "frailty index", can characterize the aging process in humans. This study provides support for such characterization from a longitudinal analysis of the frailty index properties. The data are from the National Long Term Care Survey assessed longitudinally health and functioning of the U.S. elderly in the period 1982-1999. In cross-sectional analysis, the frailty index exhibits accelerated increase with age till oldest-old ages (95+), with possible deceleration thereafter. Longitudinal analysis confirms the accelerated accumulation of deficits in aging individuals. The time-dynamics of the frailty index is affected by two sex-sensitive processes: (i) selection of robust individuals, resulting in a decline of the mean frailty index with age and (ii) accumulation of deficits associated with physiological aging and its interaction with environment, which results in an accelerated increase of individual frailty index prior to death irrespective of chronological age. Current frailty index levels in individuals are more predictive of death than the index past values. Longitudinal analysis provides strong evidence that the cumulative index of health/well-being deficits can characterize aging-associated processes in humans and predict death better than chronological age during short-term periods.
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Affiliation(s)
- Alexander Kulminski
- Center for Population Health and Aging, Duke University Population Research Institute, Trent Drive, Box 90408, Durham, NC 27708, USA.
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