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Félix J, Martínez de Toda I, Díaz-Del Cerro E, González-Sánchez M, De la Fuente M. Frailty and biological age. Which best describes our aging and longevity? Mol Aspects Med 2024; 98:101291. [PMID: 38954948 DOI: 10.1016/j.mam.2024.101291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 05/01/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024]
Abstract
Frailty and Biological Age are two closely related concepts; however, frailty is a multisystem geriatric syndrome that applies to elderly subjects, whereas biological age is a gerontologic way to describe the rate of aging of each individual, which can be used from the beginning of the aging process, in adulthood. If frailty reaches less consensus on the definition, it is a term much more widely used than this of biological age, which shows a clearer definition but is scarcely employed in social and medical fields. In this review, we suggest that this Biological Age is the best to describe how we are aging and determine our longevity, and several examples support our proposal.
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Affiliation(s)
- Judith Félix
- Department of Genetics, Physiology, and Microbiology (Unit of Animal Physiology), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
| | - Irene Martínez de Toda
- Department of Genetics, Physiology, and Microbiology (Unit of Animal Physiology), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
| | - Estefanía Díaz-Del Cerro
- Department of Genetics, Physiology, and Microbiology (Unit of Animal Physiology), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
| | - Mónica González-Sánchez
- Department of Genetics, Physiology, and Microbiology (Unit of Genetics), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
| | - Mónica De la Fuente
- Department of Genetics, Physiology, and Microbiology (Unit of Animal Physiology), Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain; Institute of Investigation Hospital 12 Octubre (imas12), 28041 Madrid, Spain.
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Alamri SH, Mealif HM. Exploring the correlates of frailty among hospitalized older adults: A cross-sectional study in a Saudi teaching hospital. Medicine (Baltimore) 2024; 103:e38603. [PMID: 38905424 PMCID: PMC11191950 DOI: 10.1097/md.0000000000038603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 05/24/2024] [Indexed: 06/23/2024] Open
Abstract
Frailty is an important public health concern associated with aging. It increases the risk of adverse clinical outcomes, such as falls, late-life dependency, hospitalization, disability, and mortality. The objectives of this study were to estimate the prevalence of frailty and to identify factors associated with frailty among older adults (≥65 years) admitted to King Abdulaziz University Hospital, Jeddah, Saudi Arabia. This cross-sectional study was conducted at King Abdulaziz University Hospital. The data were collected during the months of January and February 2022 and included demographic characteristics, comorbidities, length of stay, and hospital mortality. Frailty status of participants was assessed using the Clinical Frailty Scale. A total of 147 patients (aged ≥ 65 years) were included in our study. The prevalence rates of frailty and non-frailty were 71.4% and 28.6%, respectively. Frail patients had higher comorbidity index (P = .003), polypharmacy (P = .003), heart failure (P = .001), and prolonged hospital stays (P = .007). The results of the multiple logistic regression revealed that the tall patients had a lower risk of frailty (odds ratio = 0.0089, 95% confidence interval: 0.0001-0.7588, P = .042) and patients with higher comorbidity indexes had higher risk of frailty (odds ratio = 1.4907, 95% confidence interval: 1.1449-1.9927, P = .004). In this study, more than two-thirds of the hospitalized older patients were classified as frail. High comorbidity index, heart failure, and polypharmacy were strong predictors of frailty. Patients with frailty were more likely to have a prolonged hospital stay than those without frailty. Therefore, early detection of frailty and proper intervention are essential for improving health outcomes in this vulnerable population.
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Affiliation(s)
- Sultan H. Alamri
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Neuroscience and Geroscience Research Unit, King Fahd Medical Research Center, Abdulaziz University, Jeddah, Saudi Arabia
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Hetaf M. Mealif
- Department of Family Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
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Shaaban CE, Rosano C, Zhu X, Rutherford BR, Witonsky KR, Rosso AL, Yaffe K, Brown PJ. Discordant Biological and Chronological Age: Implications for Cognitive Decline and Frailty. J Gerontol A Biol Sci Med Sci 2023; 78:2152-2161. [PMID: 37480573 PMCID: PMC10613009 DOI: 10.1093/gerona/glad174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND Older adults with discordant biological and chronological ages (BA and CA) may vary in cognitive and physical function from those with concordant BA and CA. METHODS To make our approach clinically accessible, we created easy-to-interpret participant groups in the Health, Aging, and Body Composition Study (N = 2 458, 52% female participants, 65% White participants, age: 73.5 ± 2.8) based on medians of CA, and a previously validated BA index comprised of readily available clinical tests. Joint models estimated associations of BA-CA group with cognition (Modified Mini-Mental State Examination [3MS] and Digit Symbol Substitution Test [DSST]) and frailty over 10 years. RESULTS The sample included the following: 32%, Young group (BA and CA < median); 21%, Prematurely Aging group (BA ≥ median, CA < median), 27%, Old group (BA and CA ≥ median), and 20%, Resilient group (BA < median, CA ≥ median). In education-adjusted models of cognition, among those with CA < median, the Prematurely Aging group performed worse than the Young at baseline (3MS and DSST p < .0001), but among those with CA ≥ median, the Resilient group did not outperform the Old group (3MS p = .31; DSST p = .25). For frailty, the Prematurely Aging group performed worse than the Young group at baseline (p = .0001), and the Resilient group outperformed the Old group (p = .003). For all outcomes, groups did not differ on change over time based on the same pairwise comparisons (p ≥ .40). CONCLUSIONS Discordant BA and CA identify groups who have greater cognitive and physical functional decline or are more protected than their CA would suggest. This information can be used for risk stratification.
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Affiliation(s)
- C Elizabeth Shaaban
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Xiaonan Zhu
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Bret R Rutherford
- Neurobiology and Therapeutics of Aging Division, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, New York, USA
| | - Kailyn R Witonsky
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Andrea L Rosso
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kristine Yaffe
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
- Departments of Psychiatry and Neurology, University of California, San Francisco, California, USA
| | - Patrick J Brown
- Neurobiology and Therapeutics of Aging Division, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, New York, USA
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Arosio B, Ferri E, Mari D, Tobaldini E, Vitale G, Montano N. The influence of inflammation and frailty in the aging continuum. Mech Ageing Dev 2023; 215:111872. [PMID: 37689318 DOI: 10.1016/j.mad.2023.111872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/01/2023] [Accepted: 09/07/2023] [Indexed: 09/11/2023]
Abstract
Inflammaging is a low-grade inflammatory state that can be considered an adaptive process aimed at stimulating appropriate anti-inflammatory response. Frailty is determined by the accumulation of molecular and cellular defects accumulated throughout life; therefore, an appropriate frailty computation could be a valuable tool for measuring biological age. This study aims to analyse the association between inflammatory markers and both chronological age "per se" and frailty. We studied 452 persons aged 43-114 years. A Frailty Index (FI) was computed considering a wide range of age-related signs, symptoms, disabilities, and diseases. Plasma concentrations of inflammatory cytokines and peripheral markers of neuroinflammation were analysed by next-generation ELISA. The mean age of the cohort was 79.7 (from 43 to 114) years and the median FI was 0.19 (from 0.00 to 0.75). The concentrations of most inflammatory markers increased significantly with chronological age, after adjustment for sex and FI. Interferon-γ was significantly affected only by FI, while interleukin (IL)-10 and IL-1β were associated only with chronological age. In conclusion, we described different associations between inflammatory components and chronological vs. biological age. A better characterization of the molecular signature of aging could help to understand the complexity of this process.
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Affiliation(s)
- Beatrice Arosio
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy.
| | - Evelyn Ferri
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Daniela Mari
- Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano IRCCS, Via Zucchi 18, 20095 Cusano Milanino, Italy
| | - Eleonora Tobaldini
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
| | - Giovanni Vitale
- Laboratory of Geriatric and Oncologic Neuroendocrinology Research, Istituto Auxologico Italiano IRCCS, Via Zucchi 18, 20095 Cusano Milanino, Italy; Department of Medical Biotechnologies and Translational Medicine, University of Milan, Via Vanvitelli 32, 20133 Milan, Italy
| | - Nicola Montano
- Department of Clinical Sciences and Community Health, University of Milan, Via della Commenda 19, 20122 Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122 Milan, Italy
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Takele MD, Sany K, Getie K, Wayessa DI, Jember G, Gobezie M, Abich Y, Kibret AK. Prevalence and associated factors of frailty among community dweller older adults living in Gondar town, northwest, Ethiopia: a community based cross-sectional study. BMC Public Health 2023; 23:1309. [PMID: 37420164 PMCID: PMC10329322 DOI: 10.1186/s12889-023-16201-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/27/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Frailty is a multidimensional geriatric condition that increases vulnerability to stressors, increases the risk of negative health outcomes, and lowers quality of life in older people. However, little attention has been paid to frailty in developing countries, particularly in Ethiopia. Therefore, the aim of the study was to investigate the prevalence of frailty syndrome and the sociodemographic, lifestyle, and clinical factors associated with it. METHODS A community-based cross-sectional study design was conducted from April to June 2022. A total of 607 study participants were included using a single cluster sampling technique. The Tilburg frailty indicator, which is a self-reported schedule for assessment of frailty, required respondents to answer 'yes' or 'no' and the total attainable score ranged from 0 to 15. An individual with a score of ≥ 5 considered frail. Data were collected by interviewing the participants using a structured questionnaire, and the data collection tools were pre-tested before the actual data collection period to check for the accuracy of responses, language clarity, and appropriateness of the tools. Statistical analyses were performed using the binary logistic regression model. RESULTS More than half of the study participants were male, and the median age of the study participants was 70, with an age range of 60-95 years. The prevalence of frailty was 39% (CI 95%, 35.51-43.1). In the final multivariate analysis model, the following factors associated with frailty were obtained: older age (AOR = 6.26 CI (3.41-11.48), presence of two or more comorbidities (AOR = 6.05 CI (3.51-10.43), activity of daily life dependency (AOR = 4.12 CI (2.49-6.80), and depression (AOR = 2.68 CI (1.55-4.63) were found to be significant factors. CONCLUSION AND RECOMMENDATIONS Our study provides epidemiological characteristics and the risk factors of frailty in the study area. Efforts to promote physical, psychological, and social health in older adults are a core objective of health policy, especially for older adults aged 80 and above years, and those with two or more comorbidities.
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Affiliation(s)
- Mihret Dejen Takele
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Kedir Sany
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Kefale Getie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Dechasa Imiru Wayessa
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Gashaw Jember
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Melese Gobezie
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Yohannes Abich
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
| | - Alemu Kassaw Kibret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, university of Gondar, Gondar, Ethiopia
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Belenguer-Varea A, Avellana-Zaragoza JA, Inglés M, Cunha-Pérez C, Cuesta-Peredo D, Borrás C, Viña J, Tarazona-Santabalbina FJ. Effect of Familial Longevity on Frailty and Sarcopenia: A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1534. [PMID: 36674289 PMCID: PMC9865421 DOI: 10.3390/ijerph20021534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Familial longevity confers advantages in terms of health, functionality, and longevity. We sought to assess potential differences in frailty and sarcopenia in older adults according to a parental history of extraordinary longevity. A total of 176 community-dwelling subjects aged 65-80 years were recruited in this observational case-control study, pair-matched 1:1 for gender, age, and place of birth and residence: 88 centenarians' offspring (case group) and 88 non-centenarians' offspring (control group). The main variables were frailty and sarcopenia based on Fried's phenotype and the European Working Group on Sarcopenia in Older People (EWGSOP) definitions, respectively. Sociodemographics, comorbidities, clinical and functional variables, the presence of geriatric syndromes, and laboratory parameters were also collected. Related sample tests were applied, and conditional logistic regression was performed. Cases had a higher percentage of robust patients (31.8% vs. 15.9%), lower percentages of frailty (9.1% vs. 21.6%) and pre-frailty (59.1% vs. 62.5%) (p = 0.001), and lower levels of IL-6 (p = 0.044) than controls. The robust adjusted OR for cases was 3.00 (95% CI = 1.06-8.47, p = 0.038). No significant differences in muscle mass were found. Familial longevity was also associated with less obesity, insomnia, pain, and polypharmacy and a higher education level and total and low-density lipoprotein cholesterol. The results suggest an inherited genetic component in the frailty phenotype, while the sarcopenia association with familial longevity remains challenging.
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Affiliation(s)
- Angel Belenguer-Varea
- Division of Geriatrics, Hospital Universitario de la Ribera, 46600 Valencia, Spain
- School of Doctorate, Universidad Católica de Valencia San Vicente Martir, 46001 Valencia, Spain
| | - Juan Antonio Avellana-Zaragoza
- Division of Geriatrics, Hospital Universitario de la Ribera, 46600 Valencia, Spain
- School of Doctorate, Universidad Católica de Valencia San Vicente Martir, 46001 Valencia, Spain
| | - Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, CIBERFES-ISCIII, INCLIVA, 46010 Valencia, Spain
| | - Cristina Cunha-Pérez
- School of Doctorate, Universidad Católica de Valencia San Vicente Martir, 46001 Valencia, Spain
| | - David Cuesta-Peredo
- Department of Quality Management, Hospital Universitario de la Ribera, 46600 Valencia, Spain
| | - Consuelo Borrás
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, 46010 Valencia, Spain
| | - José Viña
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, CIBERFES-ISCIII, INCLIVA, 46010 Valencia, Spain
| | - Francisco José Tarazona-Santabalbina
- Division of Geriatrics, Hospital Universitario de la Ribera, 46600 Valencia, Spain
- School of Doctorate, Universidad Católica de Valencia San Vicente Martir, 46001 Valencia, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), 46010 Valencia, Spain
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Are Skeletal Muscle Changes during Prolonged Space Flights Similar to Those Experienced by Frail and Sarcopenic Older Adults? LIFE (BASEL, SWITZERLAND) 2022; 12:life12122139. [PMID: 36556504 PMCID: PMC9781047 DOI: 10.3390/life12122139] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/13/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
Microgravity exposure causes several physiological and psychosocial alterations that challenge astronauts' health during space flight. Notably, many of these changes are mostly related to physical inactivity influencing different functional systems and organ biology, in particular the musculoskeletal system, dramatically resulting in aging-like phenotypes, such as those occurring in older persons on Earth. In this sense, sarcopenia, a syndrome characterized by the loss in muscle mass and strength due to skeletal muscle unloading, is undoubtedly one of the most critical aging-like adverse effects of microgravity and a prevalent problem in the geriatric population, still awaiting effective countermeasures. Therefore, there is an urgent demand to identify clinically relevant biological markers and to underline molecular mechanisms behind these effects that are still poorly understood. From this perspective, a lesson from Geroscience may help tailor interventions to counteract the adverse effects of microgravity. For instance, decades of studies in the field have demonstrated that in the older people, the clinical picture of sarcopenia remarkably overlaps (from a clinical and biological point of view) with that of frailty, primarily when referred to the physical function domain. Based on this premise, here we provide a deeper understanding of the biological mechanisms of sarcopenia and frailty, which in aging are often considered together, and how these converge with those observed in astronauts after space flight.
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Inglés M, Belenguer-Varea A, Serna E, Mas-Bargues C, Tarazona-Santabalbina FJ, Borrás C, Vina J. Functional transcriptomic analysis of centenarians' offspring reveals a specific genetic footprint that may explain that they are less frail than age-matched non-centenarians' offspring. J Gerontol A Biol Sci Med Sci 2022; 77:1931-1938. [PMID: 35640160 DOI: 10.1093/gerona/glac119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Centenarians exhibit extreme longevity and compression of morbidity and display a unique genetic signature. Centenarians' offspring seem to inherit centenarians' compression of morbidity, as measured by lower rates of age-related pathologies. We aimed to ascertain whether centenarians' offspring are less frail and whether they are endowed with a "centenarian genetic footprint" in a case-control study, matched 1:1 for gender, age ±5 years, and place of birth and residence. Cases must have a living parent aged 97 years or older, aged 65-80 years, community-dwelling, not suffering from a terminal illness, or less than 6 months of life expectancy. Controls had to meet the same criteria as cases except for the age of death of their parents (not older than 89 years). Centenarians were individuals 97 years or older. Frailty phenotype was determined by Fried's Criteria. We collected plasma and peripheral blood mononuclear cells from 63 centenarians, 88 centenarians' offspring, and 88 non-centenarians' offspring. miRNA expression and mRNA profiles were performed by the GeneChip miRNA 4.0 Array (Thermo Fisher Scientific) and GeneChip Clariom S Human Array (Thermo Fisher Scientific), respectively. We found a lower incidence of frailty among centenarians' offspring when compared to their contemporaries' non- centenarians' offspring (p <0.01). Both miRNA and mRNA expression patterns in centenarians' offspring were more like those of centenarians than those of non-centenarians' offspring (p <0.01). in conclusion, centenarians' offspring are less frail than age-matched non-centenarians' offspring, and this may be explained by their unique genetic endowment.
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Affiliation(s)
- Marta Inglés
- Freshage Research Group, Department of Physiotherapy, Faculty of Physiotherapy, University of Valencia, CIBERFES-ISCIII, INCLIVA, Valencia, Spain
| | - Angel Belenguer-Varea
- Division of Geriatrics, Hospital Universitario de La Ribera Alzira, Valencia, Spain.,School of Doctorate, Universidad Católica de Valencia, San Vicente Martir, Valencia, Spain
| | - Eva Serna
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable-Instituto de Salud Carlos III (CIBERFES-ISCIII), INCLIVA, Valencia, Spain
| | - Cristina Mas-Bargues
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable-Instituto de Salud Carlos III (CIBERFES-ISCIII), INCLIVA, Valencia, Spain
| | - Francisco J Tarazona-Santabalbina
- Division of Geriatrics, Hospital Universitario de La Ribera Alzira, Valencia, Spain.,School of Doctorate, Universidad Católica de Valencia, San Vicente Martir, Valencia, Spain
| | - Consuelo Borrás
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable-Instituto de Salud Carlos III (CIBERFES-ISCIII), INCLIVA, Valencia, Spain
| | - Jose Vina
- Freshage Research Group, Department of Physiology, Faculty of Medicine, University of Valencia, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable-Instituto de Salud Carlos III (CIBERFES-ISCIII), INCLIVA, Valencia, Spain
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9
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Arosio B, Geraci A, Ferri E, Mari D, Cesari M. Biological Frailty Index in centenarians. Aging Clin Exp Res 2022; 34:687-690. [PMID: 34655428 PMCID: PMC8894165 DOI: 10.1007/s40520-021-01993-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022]
Abstract
This study measured the subclinical frailty of centenarians by looking at the accumulation of their biological abnormalities. For this aim, a biological Frailty Index (FI) was computed in centenarians living in Northern Italy. The median value of the biological FI was 0.33 (interquartile range, IQR 0.28–0.41). The biological FI did not significantly differ between women (0.34, IQR 0.31–0.39) and men (0.32, IQR 0.26–0.43). The biological FI seems to have a narrower distribution compared to clinical FI we previously computed in the same cohort. In conclusion, our study suggests that centenarians benefit from exceptional biological reserves that might be underestimated by clinical appearances.
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Affiliation(s)
- Beatrice Arosio
- Laboratorio di Geriatria, Department of Clinical Sciences and Community Health, University of Milan, Via Pace 9, 20122, Milan, Italy.
| | - Annalisa Geraci
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy
| | - Evelyn Ferri
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Pace 9, 20122, Milan, Italy
| | - Daniela Mari
- Laboratorio Sperimentale di Ricerche di Neuroendocrinologia Geriatrica ed Oncologica, Istituto Auxologico Italiano, IRCCS, Via Zucchi 18, 20095, Cusano Milanino, Italy
| | - Matteo Cesari
- Laboratorio di Geriatria, Department of Clinical Sciences and Community Health, University of Milan, Via Pace 9, 20122, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Via Camaldoli 64, 20138, Milan, Italy
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10
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Govoni S, Fagiani F, Lanni C, Allegri N. The Frailty Puzzle: Searching for Immortality or for Knowledge Survival? Front Cell Neurosci 2022; 16:838447. [PMID: 35250489 PMCID: PMC8891148 DOI: 10.3389/fncel.2022.838447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/25/2022] [Indexed: 12/18/2022] Open
Abstract
What is the value of assessing the biological age and frailty and predicting residual lifespan and health status? The benefit is obvious if we have means to alter the pace of aging and the development of frailty. So far, limited but increasing examples of interventions altering the predicted status indicate that, at least in some cases, this is possible through interventions spanning from the economic-social through drug treatments. Thus, why searching for biological markers, when some clinical and socio-economic indicators do already provide sufficiently accurate predictions? Indeed, the search of frailty biomarkers and of their biological clocks helps to build up a mechanistic frame that may orientate the design of interventions and the time window of their efficacy. Among the candidate biomarkers identified, several studies converge to indicate epigenetic clocks as a promising sensitive biomarker of the aging process. Moreover, it will help to establish the relationship between personal aging and health trajectories and to individuate the check points beyond which biological changes are irreversible.
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Affiliation(s)
- Stefano Govoni
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
| | - Francesca Fagiani
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
| | - Cristina Lanni
- Department of Drug Sciences (Pharmacology Section), University of Pavia, Pavia, Italy
| | - Nicola Allegri
- CEFAT (Center of Pharmaceuticals Economics and Medical Technologies Evaluation), University of Pavia, Pavia, Italy
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Abstract
OBJECTIVES The study aimed to apply the frailty index (FI) to assess frailty status among Chinese centenarians and analyse its associated factors. DESIGN The study was a cross-sectional study. SETTING AND PARTICIPANTS The study included 1043 centenarians (742 females and 301 males) aged ≥100 years from the 2018 wave of the China Longitudinal Healthy Longevity Survey. MEASUREMENTS All participants were assessed for frailty by the FI. Basic characteristics, including age, height, weight, calf circumference, waist circumference, hip circumference, sex, years of education, financial status, exercise, fall status, coresidence, smoking, alcohol consumption, number of natural teeth, denture use, toothache, and tooth brushing, were collected. Multivariate logistic regression was used to analyse the associations between risk factors and frailty. RESULTS The average age of the participants was 102.06±2.55 years (range: 100-117 years). The FI ranged between 0.00 and 0.63. The mean FI for all participants was 0.27±0.13 (median 0.25; interquartile range 0.20-0.35). Participants were divided into quartiles. The number of natural teeth and denture use, coresidence, sex, exercise, and financial status showed significant associations with frailty classes (all P<0.05). Multivariate logistic regression analysis indicated that having ≤20 natural teeth without dentures (OR, 95% CI= 1.89(0.004-1.246), P<0.05), having ≤20 natural teeth with dentures (OR, 95% CI=2.21(0.158,1.432), P=0.015), living alone or in an institution (OR, 95% CI=1.68(0.182-0.849), P=0.002), lacking exercise (OR, 95% CI=2.54(0.616-1.246), P<0.001), having insufficient financial resources (OR, 95% CI=2.9(0.664-1.468), P<0.001), and being female (OR, 95% CI=1.47(0.137,0.634), P=0.002) were independent risk factors for frailty. CONCLUSION Chinese centenarian women are frailer than men. Having fewer natural teeth, living alone or in an institution, lacking exercise, and having insufficient financial resources were the factors associated with frailty among Chinese centenarians. Family conditions and healthy lifestyles may be important for frailty status in centenarians.
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Affiliation(s)
- J Zhang
- Liyu Xu, Department of Geriatrics, Zhejiang Hospital, Hangzhou, Zhejiang, People's Republic of China, Tel +86 13486183817, Fax +86 0571 87985201, Email
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12
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Zhang L, Ji T, Sun F, Li Y, Tang Z, Ma L. A Simplified Frailty Index Predicts Mortality in Older Adults in Beijing. Risk Manag Healthc Policy 2021; 14:4867-4873. [PMID: 34887689 PMCID: PMC8650771 DOI: 10.2147/rmhp.s302354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
Objective The comprehensive geriatric assessment (CGA) is an integral tool used to identify vulnerable older adults in need of individualized plans to delay the course of diseases and monitor treatment outcomes. We previously developed and validated a 68-item frailty index (FI) based on the CGA in a large, older, Chinese population. However, substantial time is needed to evaluate the 68 items. Therefore, we aimed to develop and validate a simplified FI for use in Chinese older population. Design Longitudinal study. Setting and Participants Data were drawn from the Beijing Longitudinal Study of Aging. The study was conducted in 2004 with 1808 participants evaluated using the CGA and was followed-up for 13 years. Mortality was recorded at 3, 5, 8, 10, and 13 years intervals. Measures 27-Item, 50-item, and 68-item frailty indices were investigated. A Cox proportional hazards model and area under the curve of the receiver operating characteristic (AUC-ROC) were calculated to compare mortality predictions. Results The FI was positively correlated with age in males (r = 0.174, P <0.001) and females (r = 0.270, P <0.001). The mean baseline FI was 0.225 ± 0.085 (range: 0.04-0.56) as evaluated by the 27-item FI, 0.181 ± 0.117 (range: 0.02-0.62) by the 50-item FI, and 0.167 ± 0.101 (range: 0.02-0.59) by the 68-item FI. Cox regression models showed that mortality was significantly higher in frail people than in non-frail people for all 3 indices (p<0.001). The AUCs of the 68-item FI, 50-item FI, and 27-item FI for predicting mortality were 0.720, 0.717, and 0.677, respectively (p<0.001). Conclusion The 27-item FI is reasonable to expect that the AUC of the indices with the higher items number is inferior to the performance of the indices with higher number of items (FI50 and FI68). But 27-item maybe used as a tool to identify frail older adults and predict mortality in clinical and primary care practices in China.
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Affiliation(s)
- Li Zhang
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.,Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
| | - Tong Ji
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.,Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
| | - Fei Sun
- Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
| | - Yun Li
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China
| | - Zhe Tang
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.,Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, People's Republic of China.,Beijing Geriatric Healthcare Center, Xuanwu Hospital Capital Medical University, Beijing, 100053, People's Republic of China
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13
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Bacalini MG, Gentilini D, Monti D, Garagnani P, Mari D, Cesari M, Ogliari G, Passarino G, Franceschi C, Pirazzini C, Arosio B. No association between frailty index and epigenetic clocks in Italian semi-supercentenarians. Mech Ageing Dev 2021; 197:111514. [PMID: 34098514 DOI: 10.1016/j.mad.2021.111514] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/20/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
Centenarians experience successful ageing, although they still present high heterogeneity in their health status. The frailty index is a biomarker of biological age, able to capture such heterogeneity, even at extreme old age. At the same time, other biomarkers (e.g., epigenetic clocks) may be informative the biological age of the individual and potentially describe the ageing status in centenarians. In this article, we explore the relationship between epigenetic clocks and frailty index in a cohort of Italian centenarians. No association was reported, suggesting that these two approaches may describe different aspects of the same ageing process.
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Affiliation(s)
| | - Davide Gentilini
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy; Bioinformatics and Statistical Genomics Unit, Istituto Auxologico Italiano IRCCS, Cusano Milanino, Milan, Italy
| | - Daniela Monti
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Paolo Garagnani
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy; Alma Mater Research Institute on Global Challenges and Climate Change (Alma Climate), University of Bologna, Bologna, Italy; Department of Laboratory Medicine, Clinical Chemistry, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; CNR Institute of Molecular Genetics "Luigi Luca Cavalli-Sforza", Unit of Bologna, Bologna, Italy
| | - Daniela Mari
- Laboratorio Sperimentale di Ricerche di Neuroendocrinologia Geriatrica ed Oncologica, Istituto Auxologico Italiano, IRCCS, Milano, Italy
| | - Matteo Cesari
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Milan, Italy
| | - Giulia Ogliari
- Department of Health Care for Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, Nottinghamshire, NG7 2UH, UK
| | - Giuseppe Passarino
- Dipartimento di Biologia, Ecologia e Scienze della Terra, Università della Calabria, Rende, Italy
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy; Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky University, Nizhniy Novgorod, Russia
| | - Chiara Pirazzini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
| | - Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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14
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Guerini FR, Cesari M, Arosio B. Hypothetical COVID-19 protection mechanism: hints from centenarians. IMMUNITY & AGEING 2021; 18:15. [PMID: 33785044 PMCID: PMC8008020 DOI: 10.1186/s12979-021-00226-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 03/15/2021] [Indexed: 01/06/2023]
Abstract
The risk of serious complications and the fatality rate due to COVID-19 pandemic have proven particularly higher in older persons, putting a further strain in healthcare system as we dramatically observed. COVID-19 is not exclusively gerophile (géro “old” and philia “love”) as young people can be infected, even if older people experience more severe symptoms and mortality due to their greater frailty. Indeed, frailty could complicate the course of COVID-19, much more than the number of years lived. As demonstration, there are centenarians showing remarkable capacity to recover after coronavirus infection. We hypothesize that centenarian’s portfolio could help in identifying protective biological mechanisms underlying the coronavirus infection. The human leukocyte antigen (HLA) is one of the major genetic regions associated with human longevity, due to its central role in the development of adaptive immune response and modulation of the individual’s response to life threatening diseases. The HLA locus seems to be crucial in influencing susceptibility and severity of COVID-19. In this hypothesis, we assume that the biological process in which HLA are involved may explain some aspects of coronavirus infection in centenarians, although we cannot rule out other biological mechanisms that these extraordinary persons are able to adopt to cope with the infection.
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Affiliation(s)
| | - Matteo Cesari
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Beatrice Arosio
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy. .,Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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15
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Arosio B, Guerini FR, Costa AS, Dicitore A, Ferri E, Mari D, Torresani E, Clerici M, Cesari M, Vitale G. Vitamin D Receptor Polymorphisms in Sex-Frailty Paradox. Nutrients 2020; 12:nu12092714. [PMID: 32899460 PMCID: PMC7551757 DOI: 10.3390/nu12092714] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 02/07/2023] Open
Abstract
The “male-female health-survival paradox” evidences that the survival advantage observed in women is linked to higher rates of disability and poor health status compared to men, a phenomenon also called the “sex-frailty paradox”. The depletion of vitamin D seems to play a role in the fragilization of old persons, and genetic polymorphisms of the vitamin D receptor (VDR) gene seem to be involved in regulating the vitamin D pathway. This study correlated the VDR gene polymorphisms (FokI, ApaI, BsmiI, and TaqI) with frailty, computed by frailty index (FI), in 202 persons (127 women and 75 men, aged from 60 to 116 years), aiming to capture the involvement of vitamin D in the sex-frailty paradox. The results showed slightly higher FI (p = 0.05), lower levels of 25(OH)D (p = 0.04), and higher levels of parathyroid hormone PTH (p = 0.002) and phosphorus (p < 0.001) in women than in men. Interestingly, the ApaI minor allele (Aa + aa) showed a significant positive association with FI (p = 0.03) and a negative association with inorganic phosphorus values (p = 0.04) compared to AA genotype only in women, regardless of age. The exact mechanism and the causal role that, in old women, links ApaI polymorphism with frailty are still unclear. However, we could speculate that a specific genetic profiling, other than 25(OH)D levels, play a role in the sex-frailty paradox.
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Affiliation(s)
- Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.); (E.F.); (M.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy;
| | - Franca Rosa Guerini
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (A.S.C.); (M.C.)
- Correspondence: ; Tel.: +39-02-4030-8376; Fax: +39-02-4030-8438
| | - Andrea Saul Costa
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (A.S.C.); (M.C.)
| | - Alessandra Dicitore
- Laboratorio Sperimentale di Ricerche di Neuroendocrinologia Geriatrica ed Oncologica, Istituto Auxologico Italiano, IRCCS, 20095 Cusano Milanino, Italy; (A.D.); (D.M.)
| | - Evelyn Ferri
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.); (E.F.); (M.C.)
| | - Daniela Mari
- Laboratorio Sperimentale di Ricerche di Neuroendocrinologia Geriatrica ed Oncologica, Istituto Auxologico Italiano, IRCCS, 20095 Cusano Milanino, Italy; (A.D.); (D.M.)
| | - Erminio Torresani
- Laboratorio Analisi Cliniche Centro di Ricerche e Tecnologie Biomediche, Istituto Auxologico Italiano, IRCCS, 20095 Cusano Milanino, Italy;
| | - Mario Clerici
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (A.S.C.); (M.C.)
- Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy; (B.A.); (E.F.); (M.C.)
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy;
| | - Giovanni Vitale
- Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy;
- Laboratorio Sperimentale di Ricerche di Neuroendocrinologia Geriatrica ed Oncologica, Istituto Auxologico Italiano, IRCCS, 20095 Cusano Milanino, Italy; (A.D.); (D.M.)
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16
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Thyroid hormones and frailty in persons experiencing extreme longevity. Exp Gerontol 2020; 138:111000. [PMID: 32525032 DOI: 10.1016/j.exger.2020.111000] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/22/2020] [Accepted: 06/03/2020] [Indexed: 12/21/2022]
Abstract
CONTEXT The aging phenotype is quite heterogeneous, being the result of the capability of each individual to successfully or unsuccessfully response to stressors. The reduction of homeostatic reserve characterizing aging is accompanied by a remodeling of the endocrine system. Frailty has been indicated as a promising way for capturing the physiological decline as well as the biological aging of the individuals. In particular, the Frailty Index (FI), based on the assumption that health deficits tend to accumulate with aging, represents a quantitative measure of extreme interest. OBJECTIVE The study aims to correlate the thyroid hormone levels with FI in a population of centenarians and their offspring to capture the effects of thyroid remodeling in extreme longevity. STUDY DESIGN The study described 593 well-characterized Italian subjects, including 180 centenarians, as well as 276 centenarian's offspring and 137 age-matched controls. RESULTS FT3 levels and FT3/FT4 ratio were significantly lower (p < 0.001) and TSH levels higher (p < 0.001) in centenarians compared to the other groups, analysing both overall subjects and excluding subjects with hormone levels out of the normal ranges. In overall centenarians, we observed a negative correlation between FI and FT3 (ρ: -0.281, p < 0.001), FT3/FT4 (ρ: -0.344, p < 0.001) and TSH (ρ: -0.223, p 0.003) and a positive association between FI and FT4 (ρ: 0.189, p = 0.001). In centenarians with hormone levels within the normal ranges, similar negative correlations were observed between FI and FT3 (ρ: -0.201, p = 0.02) and FT3/FT4 (ρ: -0.264, p = 0.002). In this sub-analysis, FI positively correlated with FT4 and age (ρ: 0.167, p = 0.05; ρ: 0.219, p = 0.005, respectively). Conversely, no significant correlations were observed between hormone levels and FI in offspring and controls. CONCLUSIONS We found an association between thyroid hormone levels and frailty in centenarians, underlying the significant role of thyroid in the aging process and longevity.
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Escourrou E, Durrieu F, Chicoulaa B, Dupouy J, Oustric S, Andrieu S, Gardette V. Cognitive, functional, physical, and nutritional status of the oldest old encountered in primary care: a systematic review. BMC FAMILY PRACTICE 2020; 21:58. [PMID: 32220228 PMCID: PMC7099824 DOI: 10.1186/s12875-020-01128-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 03/18/2020] [Indexed: 11/23/2022]
Abstract
Background The oldest old (individuals over 90 years) are a fast-growing population. Characterizing their specificity would be helpful to adapt health care. This study aimed to characterize the cognitive, functional, nutritional, and physical status of individuals over 90. Methods We conducted a systematic review of cross-sectional or cohort studies of individuals aged 90 years old or more, living at home or in a nursing home, in April 2018. Two reviewers selected eligible articles, extracted data, and evaluated the risk of bias (assessed by the Newcastle-Ottawa Scale). Results The search strategy identified 3086 references; 35 articles were included referring to 8 cross-sectional and 27 longitudinal studies. Dementia was diagnosed in 30–42.9% of study participants, cognitive impairment in 12–50%, and 31–65% had no cognitive impairment. In terms of activities of daily living, 14–72.6% of individuals had no difficulty, 35.6–38% had difficulty, and 14.4–55.5% were dependent. For instrumental activities of daily living, 20–67.9% needed help. Regarding nutritional status, the Mini Nutritional Assessment Short Form mean score ranged from 10.3 (SD: 1.8) to 11.1 (SD: 2.4). Eight to 32% of individuals could not stand up from a chair, 19–47% could stand without the use of their arms; and 12.9–15% were not able to walk 4 m. Conclusions These results suggest a heterogeneous population with a certain proportion of oldest old with a low level of disability. These findings suggest that a specific approach in the care of the oldest old could help prevent disability.
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Affiliation(s)
- Emile Escourrou
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France. .,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France. .,Maison de Santé Pluri Professionnelle Universitaire La Providence, 1 avenue Louis Blériot, 31500, Toulouse, France.
| | - Florence Durrieu
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Bruno Chicoulaa
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Julie Dupouy
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France.,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France
| | - Stéphane Oustric
- Département Universitaire de Médecine Générale, Faculté de Médecine Rangueil, Université Paul Sabatier Toulouse III, Toulouse, France.,UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Maison de Santé Pluri Professionnelle Universitaire La Providence, 1 avenue Louis Blériot, 31500, Toulouse, France
| | - Sandrine Andrieu
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Service d'épidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Virginie Gardette
- UMR 1027 INSERM, Université Paul Sabatier Toulouse III, Toulouse, France.,Service d'épidémiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
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Ferri E, Casati M, Cesari M, Vitale G, Arosio B. Vitamin D in physiological and pathological aging: Lesson from centenarians. Rev Endocr Metab Disord 2019; 20:273-282. [PMID: 31654261 DOI: 10.1007/s11154-019-09522-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Vitamin D is a secosteroid hormone that exerts a pleiotropic action on a wide spectrum of tissues, apparatuses and systems. Thus, vitamin D has assumed an increasingly dominant role as a key determinant of biological mechanisms and specific clinical conditions. Older people frequently present vitamin D deficiency, a status potentially influencing several mechanisms responsible for different age-related diseases. Centenarians symbolize the ideal model for investigating the peculiar traits of longevity, as they have reached an age close to the estimated limit of the human lifespan. Interestingly, despite the profound heterogeneity of centenarians in terms of health status, all these people share the same condition of severe vitamin D deficiency, suggesting that they may have implemented a number of adaptive strategies to cope with the age-related physiological derangement of vitamin D metabolism. The lesson deriving from centenarians' experience suggests that: i) severe vitamin D deficiency does not preclude the possibility of reaching extreme longevity, ii) strategies to prevent hypovitaminosis D may be useful to slow down the processes of "fragilization" occurring in aged people, iii) beneficial effects of vitamin D supplementation need to be confirmed regarding longevity.
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Affiliation(s)
- Evelyn Ferri
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Martina Casati
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Cesari
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Via Pace 9, 20122, Milan, Italy
| | - Giovanni Vitale
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Via Pace 9, 20122, Milan, Italy
- Istituto Auxologico Italiano, IRCCS, Laboratorio Sperimentale di Ricerche di Neuroendocrinologia Geriatrica ed Oncologica, Milan, Cusano Milanino, Italy
| | - Beatrice Arosio
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
- Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Via Pace 9, 20122, Milan, Italy.
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