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Ek S, Wennberg AM, Ding M, Meyer AC, Hedström M, Modig K. Characterizing the Individuals Who Regain or Maintain Walking Ability after a Hip Fracture: Insights Into Physical Resilience. J Am Med Dir Assoc 2024; 25:744-750.e3. [PMID: 38309302 DOI: 10.1016/j.jamda.2023.12.011] [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: 10/06/2023] [Revised: 12/19/2023] [Accepted: 12/19/2023] [Indexed: 02/05/2024]
Abstract
OBJECTIVES Maintaining walking ability is key to healthy aging. Hip fractures often lead to declined walking ability. This study investigated characteristics of individuals who regained walking ability after a hip fracture, an expression of physical resilience. DESIGN Register-based cohort study. SETTING AND PARTICIPANTS A total of 55,467 Swedish residents aged ≥60 years with a first hip fracture (71% women, mean age = 82.3 ± 8) included in the Swedish Hip Fracture Register. METHODS Information about diseases, medications, and socioeconomic (SES) factors came from registers. Individuals were classified by prefracture walking ability (independent or assisted walking) and whether their walking ability 4 months post-fracture was maintained (physical resilience or nonresilience). Cluster analyses were conducted among individuals who maintained their walking ability to assess different physical resilience profiles. RESULTS At baseline, 38,493 individuals walked independently (69%), and 16,982 were assisted walkers. Half of the independent walkers maintained their walking ability 4 months post-fracture. Among them, 3 clusters were identified: a "Low SES, Low Disease" cluster (n = 8580, mean age 81.1 ± 7.5); a "High SES, Low Disease" cluster (n = 7778, mean age 76.7 ± 7.4); and a third "High SES, High Disease" cluster (n = 4320, mean age 77.7 ± 7.4). Sixty percent of the pre-assisted walkers maintained their level of assisted walking ability. Also among them, 3 clusters were identified: a "Low SES-Independent Living" cluster (n = 3077, mean age 85.5 ± 7.1); a second "Care Home" cluster (n = 2912, mean age 87.0 ± 6.5) with a high proportion with dementia diagnosis; and a last "High SES" cluster (n = 4044, mean age 83.0 ± 7.0) with the largest proportion of men. CONCLUSIONS AND IMPLICATIONS Physical resilience is not characterized by one typical healthy profile, and it is possible to regain walking ability after a hip fracture despite unfavorable prerequisites in 1 domain. A favorable status in one domain may compensate for an unfavorable status in another, for example, a high disease burden in combination with high SES.
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Affiliation(s)
- Stina Ek
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Alexandra M Wennberg
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mozhu Ding
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna C Meyer
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Hedström
- Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; Trauma and Reparative Medicine Theme (TRM), Karolinska University Hospital, Stockholm, Sweden
| | - Karin Modig
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Ng TKS, Wee HN, Ching J, Kovalik JP, Chan AW, Matchar DB. Plasma Acylcarnitines as Metabolic Signatures of Declining Health-Related Quality of Life Measure in Community-Dwelling Older Adults: A Combined Cross-sectional and Longitudinal Pilot Study. J Gerontol A Biol Sci Med Sci 2024; 79:glac114. [PMID: 35605263 DOI: 10.1093/gerona/glac114] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Health-related quality of life (HRQoL) measures are predictors of adverse health outcomes in older adults. Studies have demonstrated cross-sectional associations between HRQoL measures and blood-based biochemical markers. Acylcarnitines (ACs) are a class of metabolites generated in the mitochondria and are predictive of multiple geriatric syndromes. Changes in ACs reflect alterations in central carbon metabolic pathways. However, the prospective relationship between plasma ACs and declining HRQoL has not been examined. This study aimed to investigate both cross-sectional and longitudinal associations of baseline ACs with baseline and declining EuroQol-5 Dimension/EuroQol Visual Analogue Scale (EQ-5D/EQ-VAS) in community-dwelling older adults. METHODS One hundred and twenty community-dwelling older adults with EQ-5D/EQ-VAS measurements at baseline and follow-up were included. We quantified ACs at baseline using targeted plasma metabolomics profiling. Multivariate regressions were performed to examine cross-sectional and longitudinal associations between the measures. RESULTS Cross-sectionally, ACs showed no significant associations with either EQ-5D index or EQ-VAS scores. Longitudinally, multiple baseline short-chain ACs were significantly and inversely associated with declining EQ-5D index score, explaining up to 8.5% of variance in the decline. CONCLUSIONS Within a cohort of community-dwelling older adults who had high HRQoL at baseline, we showed that higher levels of short-chain ACs are longitudinally associated with declining HRQoL. These findings reveal a novel association between central carbon metabolic pathways and declining HRQoL. Notably, dysregulation in mitochondrial central carbon metabolism could be detected prior to clinically important decline in HRQoL, providing the first evidence of objective biomarkers as novel predictors to monitor HRQoL in nonpharmacological interventions and epidemiology.
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Affiliation(s)
- Ted Kheng Siang Ng
- Edson College of Nursing and Health Innovation, Arizona State University, USA
| | - Hai Ning Wee
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore
| | - Jianhong Ching
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore
- KK Research Centre, KK Women's and Children's Hospital, Singapore
| | - Jean-Paul Kovalik
- Cardiovascular and Metabolic Disorders Program, Duke-National University of Singapore Medical School, Singapore
| | - Angelique W Chan
- Program in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore
- Department of Sociology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
- Center for Aging, Research and Education, Duke-National University of Singapore Medical School, Singapore
| | - David Bruce Matchar
- Program in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore
- Center for Aging, Research and Education, Duke-National University of Singapore Medical School, Singapore
- Department of Medicine (General Internal Medicine), Duke University School of Medicine, USA
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Zhang H, Hao M, Li Y, Hu Z, Liu Z, Jiang S, Jin L, Wang X. Assessment of Physical Resilience Using Residual Methods and Its Association With Adverse Outcomes in Older Adults. Innov Aging 2023; 7:igad118. [PMID: 38024329 PMCID: PMC10652184 DOI: 10.1093/geroni/igad118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Objectives Physical resilience (PR) is recognized as the ability to recover from the adverse effects of a stressor. However, there is a lack of consensus on how to optimally measure PR in older adults in general. We aimed to measure PR using residuals from regression analyses and investigated its association with adverse outcomes in older adults. Research Design and Methods A total of 6 508 older adults were included from the National Health and Aging Trends Study, which was a population-based prospective cohort study. PR was assessed using residual methods from a linear model regressing the short physical performance battery on clinical diseases, age, sex, race/ethnicity, and health condition. Adverse outcomes included all-cause mortality, falls, and overnight hospitalization. Results The mean age was 77.48 (7.84) years. Increased PR was associated with a lower risk of all-cause mortality (hazard ratio [HR] = 0.85, 95% confidence interval [CI]: 0.83-0.87). Compared to participants with reduced PR, those with normal PR had a lower risk for mortality (HR = 0.51, 95% CI: 0.46-0.56). Specifically, restricted cubic spline regression revealed a dose-response relationship between PR and all-cause mortality (p-overall < .0001, p-nonlinear = .011). Additionally, we also found significant associations of increased PR with lower risks of falls (HR = 0.98, 95% CI: 0.96-0.99) and overnight hospitalization (HR = 0.98, 95% CI: 0.97-1.00). Discussion and Implications PR, measured by residual methods, was robustly and independently associated with all-cause mortality, falls, and overnight hospitalization. Our findings provide evidence that this approach may be a simple and feasible strategy to assess PR.
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Affiliation(s)
- Hui Zhang
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
| | - Meng Hao
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
- Fudan Zhangjiang Institute, Shanghai, China
| | - Yi Li
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
| | - Zixin Hu
- Artificial Intelligence Innovation and Incubation Institute, Fudan University, Shanghai, China
| | - Zuyun Liu
- School of Public Health and the Second Affiliated Hospital, The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Shuai Jiang
- Department of Vascular Surgery, Shanghai Key Laboratory of Vascular Lesion Regulation and Remodeling, Shanghai Pudong Hospital, Fudan University Pudong Medical Center, Shanghai, China
| | - Li Jin
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
| | - Xiaofeng Wang
- Human Phenome Institute, Zhangjiang Fudan International Innovation Centre, Fudan University, Shanghai, China
- National Clinical Research Centre for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Colon-Emeric C, Schmader K, Cohen HJ, Morey M, Whitson H. Ageing and physical resilience after health stressors. Stress Health 2023; 39:48-54. [PMID: 36879359 PMCID: PMC10480330 DOI: 10.1002/smi.3241] [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: 12/21/2022] [Revised: 02/15/2023] [Accepted: 02/23/2023] [Indexed: 03/08/2023]
Abstract
The objectives of this article are to introduce a conceptual framework for physical resilience in the context of ageing and to discuss key elements and challenges in the design of studies of physical resilience after health stressors. Advancing age is associated with increasing exposure to multiple stressors and declining capacity to respond to health stressors. Resilience is defined broadly as the ability to resist or recover well from the adverse effects of a health stressor. In ageing-related study designs of physical resilience after a health stressor, this dynamic resilience response can be observed as changes in repeated measures of function or health status in various domains important to older adults. Methodologic issues in selecting the study population, defining the stressor, covariates, outcomes, and analytic strategies are highlighted in the context of an ongoing prospective cohort study of physical resilience after total knee replacement surgery. The article concludes with approaches to intervention development to optimize resilience.
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Affiliation(s)
- Cathleen Colon-Emeric
- Department of Medicine, Duke University Claude D. Pepper Older Americans Independence Center, Center for Aging, Duke University, Durham, North Carolina, USA
- Geriatric Research Education Clinical Center, Durham Veteran Affairs Health Care System, Durham, North Carolina, USA
| | - Kenneth Schmader
- Department of Medicine, Duke University Claude D. Pepper Older Americans Independence Center, Center for Aging, Duke University, Durham, North Carolina, USA
- Geriatric Research Education Clinical Center, Durham Veteran Affairs Health Care System, Durham, North Carolina, USA
| | - Harvey Jay Cohen
- Department of Medicine, Duke University Claude D. Pepper Older Americans Independence Center, Center for Aging, Duke University, Durham, North Carolina, USA
| | - Miriam Morey
- Department of Medicine, Duke University Claude D. Pepper Older Americans Independence Center, Center for Aging, Duke University, Durham, North Carolina, USA
- Geriatric Research Education Clinical Center, Durham Veteran Affairs Health Care System, Durham, North Carolina, USA
| | - Heather Whitson
- Department of Medicine, Duke University Claude D. Pepper Older Americans Independence Center, Center for Aging, Duke University, Durham, North Carolina, USA
- Geriatric Research Education Clinical Center, Durham Veteran Affairs Health Care System, Durham, North Carolina, USA
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5
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Abadir PM, Bandeen-Roche K, Bergeman C, Bennett D, Davis D, Kind A, LeBrasseur N, Stern Y, Varadhan R, Whitson HE. An overview of the resilience world: Proceedings of the American Geriatrics Society and National Institute on Aging State of Resilience Science Conference. J Am Geriatr Soc 2023; 71:2381-2392. [PMID: 37079440 PMCID: PMC10523918 DOI: 10.1111/jgs.18388] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/04/2023] [Indexed: 04/21/2023]
Abstract
Resilience, which relates to one's ability to respond to stressors, typically declines with age and the development of comorbid conditions in older organisms. Although progress has been made to improve our understanding of resilience in older adults, disciplines have employed different frameworks and definitions to study various aspects of older adults' response to acute or chronic stressors. "Overview of the Resilience World: State of the Science," a bench-to-bedside conference on October 12-13, 2022, was sponsored by the American Geriatrics Society and National Institute on Aging. This conference, summarized in this report, explored commonalities and differences among the frameworks of resilience most commonly used in aging research in the three domains of resilience: physical, cognitive, and psychosocial. These three main domains are intertwined, and stressors in one domain can lead to effects in other domains. The themes of the conference sessions included underlying contributors to resilience, the dynamic nature of resilience throughout the life span, and the role of resilience in health equity. Although participants did not agree on a single definition of "resilience(s)," they identified common core elements of a definition that can be applied to all domains and noted unique features that are domain specific. The presentations and discussions led to recommendations for new longitudinal studies of the impact of exposures to stressors on resilience in older adults, the use of new and existing cohort study data, natural experiments (including the COVID-19 pandemic), and preclinical models for resilience research, as well as translational research to bring findings on resilience to patient care.
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Affiliation(s)
- Peter M Abadir
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | - Amy Kind
- Center for Health Disparities Research, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | | | - Yaakov Stern
- Columbia University, New York City, New York, USA
| | - Ravi Varadhan
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Heather E Whitson
- Duke University, Durham, North Carolina, USA
- Durham VA Geriatrics Research, Education, and Clinical Center, Durham, North Carolina, USA
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Li J, Chhetri JK, Ma L. Physical resilience in older adults: Potential use in promoting healthy aging. Ageing Res Rev 2022; 81:101701. [PMID: 35905815 DOI: 10.1016/j.arr.2022.101701] [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: 05/21/2022] [Revised: 07/06/2022] [Accepted: 07/25/2022] [Indexed: 01/31/2023]
Abstract
Physical resilience is a dynamic concept referring to the physiological response when the body is exposed to stressors. The level of physical resilience is the sum of underlying physiological reserves. Moreover, it may not only be determined by age, genetics, or exposure to a variety of diseases, but is also closely related to the psychological, social, and environmental factors of an individual. This paper summarizes our present understanding of the relationship between physical resilience and other concepts closely related to it. Furthermore, we illustrate the current research progress on physical resilience models and clinical resilience assessment. Besides, this paper intends to present a better understanding of physical resilience and its use in treatment decision-making, personalized diagnosis and disease management, and prevention and rehabilitation strategies.
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Affiliation(s)
- Jiatong Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China
| | - Jagadish K Chhetri
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China.
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing 100053, China.
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Merchant RA, Izquierdo M, Woo J, Morley JE. Resilience and the Future. J Frailty Aging 2022; 11:339-341. [PMCID: PMC9589833 DOI: 10.14283/jfa.2022.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Reshma A. Merchant
- Division of Geriatric Medicine, Department of Medicine, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block, Singapore, 119228 Singapore ,Department of Medicine, Yong Loo Lin School of Medicine, 1E Kent Ridge Rd., NUHS Tower Block Level 10, Singapore, 19228 Singapore
| | - M. Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN)- Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain ,CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - J. Woo
- Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, SAR, China ,Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - J. E. Morley
- Department of Medicine, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1008 S. Spring Ave., 2nd Floor, St. Louis, Missouri 63110 USA
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Zhang T, Ge J. Mechanism of CREB1 in cardiac function of rats with heart failure via regulating the microRNA-376a-3p/TRAF6 axis. Mamm Genome 2022; 33:490-501. [PMID: 35217880 DOI: 10.1007/s00335-022-09947-y] [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: 10/28/2021] [Accepted: 01/14/2022] [Indexed: 10/19/2022]
Abstract
Heart failure (HF) is a complicated disease resulting from impaired heart function. CREB1 is a candidate target in heart-concerning diseases. This paper attempts to explore the role of CREB1 in HF. Initially, the HF rat model was established by constricted abdominal aortic surgery and the cardiac function of HF rats was assessed by ultrasonic cardiogram. Levels of CK-MB and LDH and activity of Caspase-3 and Caspase-9 in HF rats were determined. Subsequently, myocardium pathological injury and myocardium apoptosis were detected. Additionally, the interactions between CREB1 and miR-376a-3p and between miR-376a-3p and TRAF6 were verified. The roles of CREB1, miR-376a-3p, and TRAF6 in HF were evaluated. In HF rats, CREB1 and miR-376a-3p were both downregulated while TRAF6 was upregulated. Besides, HF rats had decreased values of EF and FS, elevated levels of CK-MB and LDH, inflammatory infiltration, promoted cardiomyocyte apoptosis, and elevated activity of Caspase-3 and Caspase-9, which were all reversed by CREB1. Additionally, CREB1 activated miR-376a-3p expression, and miR-376a-3p targeted TRAF6 transcription. Both miR-376a-3p knockdown and TRAF6 overexpression annulled the protective role of CREB1 overexpression in cardiac function of HF rats. CREB1 activated miR-376a-3p expression to suppress TRAF6, thereby promoting the cardiac function of HF rats.
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Affiliation(s)
- Tao Zhang
- Department of Cardiac Surgery, The Affiliated First Hospital of USTC, No. 1 Swan Lake Road, Shushan District, Hefei, 230000, Anhui, China
| | - Jianjun Ge
- Department of Cardiac Surgery, The Affiliated First Hospital of USTC, No. 1 Swan Lake Road, Shushan District, Hefei, 230000, Anhui, China.
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Araiza-Nava B, Méndez-Sánchez L, Clark P, Peralta-Pedrero ML, Javaid MK, Calo M, Martínez-Hernández BM, Guzmán-Jiménez F. Short- and long-term prognostic factors associated with functional recovery in elderly patients with hip fracture: A systematic review. Osteoporos Int 2022; 33:1429-1444. [PMID: 35247062 DOI: 10.1007/s00198-022-06346-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/10/2022] [Indexed: 01/17/2023]
Abstract
UNLABELLED This systematic review aimed to identify short- and long-term associated factors to functional recovery of elderly hip fracture patients after discharge. We identified 43 studies reporting 74 associated factors to functional recovery; most of them were biological, sociodemographic, or inherent factors to patients' baseline characteristics, including their pre-facture functional capacity. PURPOSE This systematic review aimed to identify short- and long-term associated factors to functional recovery of elderly hip fracture patients after hospital discharge. We assessed the use of the hip fracture core-set and key-performance indicators for secondary fracture reduction. METHODS A search was performed in seven electronic databases. Observational studies reporting predictors after usual care of elderly patients with hip fracture diagnoses receiving surgical or conservative treatment were included. Primary outcomes considered were part of the domains corresponding to functional capacity. RESULTS Of 3873 references identified, and after the screening and selection process, 43 studies were included. Sixty-one functional measures were identified for ten functional outcomes, including BADLs, IADLs, ambulation, and mobility. Biological characteristics such as age, sex, comorbidities, cognitive status, nutritional state, and biochemical parameters are significantly associated. Determinants such as contact and size of social network and those related to institutional care quality are relevant for functional recovery at six and 12 months. Age, pre-fracture function, cognitive status, and complications continue to be associated five years after discharge. We found 74 associated factors to functional recovery of elderly hip fracture patients. Ten of the studies reported rehabilitation programs as suggested in KPI 9; none used the complete hip fracture core-set. CONCLUSION Most of the associated factors for functional recovery of elderly hip fracture were biological, sociodemographic, or inherent factors to patients' baseline characteristics, including their pre-facture functional capacity. For the core-set and KPI's, we found an insufficient use and report. This study reports 61 different instruments to measure functional capacity. REGISTRATION NUMBER PROSPERO (CRD42020149563).
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Affiliation(s)
- Berenice Araiza-Nava
- Clinical Epidemiology Research Unit, Hospital Infantil de Mexico "Federico Gomez", Mexico city, Mexico. Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico
| | - Lucia Méndez-Sánchez
- Clinical Epidemiology Research Unit, Hospital Infantil de Mexico "Federico Gomez", Mexico city, Mexico. Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico.
| | - Patricia Clark
- Clinical Epidemiology Research Unit, Hospital Infantil de Mexico "Federico Gomez", Mexico city, Mexico. Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico
| | | | - Muhammad Kassim Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Mónica Calo
- Regional Manager of IOF Latin America, Buenos Aires, Argentina
| | - Brenda María Martínez-Hernández
- Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico
| | - Fabiola Guzmán-Jiménez
- Medical Unit of High Specialty Traumatology and Orthopaedics Hospital "Lomas Verdes", Mexican Institute of Social Security (UMAE Hospital de Traumatología Y Ortopedia "Lomas Verdes", Instituto Mexicano del Seguro Social), Naucalpan de Juárez, Mexico. Faculty of Medicine of National Autonomous University of Mexico (Universidad Nacional Autónoma de México), Mexico City, Mexico
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Zhang X, Baht GS, Huang R, Chen Y, Molitoris KH, Miller SE, Kraus VB. Rejuvenation of neutrophils and their extracellular vesicles is associated with enhanced aged fracture healing. Aging Cell 2022; 21:e13651. [PMID: 35657721 PMCID: PMC9282841 DOI: 10.1111/acel.13651] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/26/2022] [Accepted: 05/18/2022] [Indexed: 12/25/2022] Open
Abstract
Tissue repair is negatively affected by advanced age. Recent evidence indicates that hematopoietic cell-derived extracellular vesicles (EVs) are modulators of regenerative capacity. Here, we report that plasma EVs carrying specific surface markers indicate the degree of age-associated immunosenescence; moreover, this immunosenescence phenotype was accentuated by fracture injury. The number of CD11b+ Ly6Cintermediate Ly6Ghigh neutrophils significantly decreased with age in association with defective tissue regeneration. In response to fracture injury, the frequencies of neutrophils and associated plasma EVs were significantly higher in fracture calluses than in peripheral blood. Exposure of aged mice to youthful circulation through heterochronic parabiosis increased the number of neutrophils and their correlated Ly6G+ plasma EVs, which were associated with improved fracture healing in aged mice of heterochronic parabiosis pairs. Our findings create a foundation for utilizing specific immune cells and EV subsets as potential biomarkers and therapeutic strategies to promote resilience to stressors during aging.
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Affiliation(s)
- Xin Zhang
- Duke Molecular Physiology Institute, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
- Department of Orthopaedic Surgery, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Gurpreet Singh Baht
- Duke Molecular Physiology Institute, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
- Department of Orthopaedic Surgery, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Rong Huang
- Duke Molecular Physiology Institute, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
- Department of Orthopaedic Surgery, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Yu‐Hsiu Chen
- Duke Molecular Physiology Institute, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Kristin Happ Molitoris
- Duke Molecular Physiology Institute, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
- Department of Orthopaedic Surgery, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Sara E. Miller
- Department of PathologyDuke University Medical CenterDurhamNorth CarolinaUSA
- Center for Electron Microscopy and Nanoscale Technology, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
- Department of Orthopaedic Surgery, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
- Department of Medicine, Duke University School of MedicineDuke UniversityDurhamNorth CarolinaUSA
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Hladek MD, Zhu J, Crews DC, McAdams-DeMarco MA, Buta B, Varadhan R, Shafi T, Walston JD, Bandeen-Roche K. Physical Resilience Phenotype Trajectories in Incident Hemodialysis: Characterization and Mortality Risk Assessment. Kidney Int Rep 2022; 7:2006-2015. [PMID: 36090502 PMCID: PMC9459128 DOI: 10.1016/j.ekir.2022.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 06/13/2022] [Indexed: 12/19/2022] Open
Abstract
Introduction Methods Results Conclusion
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12
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Hu FW, Lin CH, Yueh FR, Lo YT, Lin CY. Development and psychometric evaluation of the Physical Resilience Instrument for Older Adults (PRIFOR). BMC Geriatr 2022; 22:229. [PMID: 35313802 PMCID: PMC8935854 DOI: 10.1186/s12877-022-02918-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Background Physical resilience is known to minimize the adverse outcomes of health stressors for older people. However, validated instruments that assess physical resilience in older adults are rare. Therefore, we aimed to validate the Physical Resilience Instrument for Older Adults (PRIFOR) to fill the literature gap. Methods Content analysis with content validity was first carried out to generate relevant items assessing physical resilience for older adults, and 19 items were developed. Psychometric evaluation of the 19 items was then tested on 200 older adults (mean [SD] age = 76.4 [6.6] years; 51.0% women) for item properties, factor structure, item fit, internal consistency, criterion-related validity, and known-group validity. Results All 19 items had satisfactory item properties, as they were normally distributed (skewness = -1.03 to 0.38; kurtosis = -1.05 to 0.32). However, two items were removed due to substantial ceiling effects. The retained 17 items were embedded in three factors as suggested by the exploratory factor analysis (EFA) results. All items except one had satisfactory item fit statistics in Rasch model; thus, the unidimensionality was supported for the three factors on 16 items. The retained 16 items showed promising properties in known-group validity, criterion-related validity, and internal consistency (α = 0.94). Conclusions The 16-item PRIFOR exhibits good psychometric properties. Using this instrument to measure physical resilience would be beneficial to identify factors that could protect older people from negative health consequence. With the use of the PRIFOR, intervention effects could also be evaluated. It is helpful to strengthen resilience and thereby facilitate successful aging. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02918-7.
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Affiliation(s)
- Fang-Wen Hu
- Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No.138, Sheng-Li Road, Tainan, 70403, Taiwan
| | - Cheng-Han Lin
- Department of Health-Business Administration, Fooyin University, No.151, Jinxue Road, Kaohsiung, 83102, Taiwan
| | - Fang-Ru Yueh
- Department of Nursing, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No.138, Sheng-Li Road, Tainan, 70403, Taiwan
| | - Yu-Tai Lo
- Department of Geriatrics and Gerontology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, No.138, Sheng-Li Road, Tainan, 70403, Taiwan
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Road, Tainan, 70101, Taiwan. .,Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, 70101, Taiwan. .,Department of Public Health, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 70101, Taiwan. .,Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, 70101, Taiwan.
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13
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Cesari M, Azzolino D, LeBrasseur NK, Whitson H, Rooks D, Sourdet S, Angioni D, Fielding RA, Vellas B, Rolland Y, Andrieu S, Leheudre MA, Barcons N, Beliën A, de Souto Barreto P, Delannoy C, John G, Robledo LMG, Hwee D, Mariani J, Reshma M, Morley J, Pereira S, Erin Q, Michelle R, Rueda R, Tarasenko L, Tourette C, Van Maanen R, Waters DL. Resilience: Biological Basis and Clinical Significance - A Perspective Report from the International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force. J Frailty Aging 2022; 11:342-347. [PMID: 36346720 PMCID: PMC9589704 DOI: 10.14283/jfa.2022.62] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Resilience is a construct receiving growing attention from the scientific community in geriatrics and gerontology. Older adults show extremely heterogeneous (and often unpredictable) responses to stressors. Such heterogeneity can (at least partly) be explained by differences in resilience (i.e., the capacity of the organism to cope with stressors). The International Conference on Frailty and Sarcopenia Research (ICFSR) Task Force met in Boston (MA,USA) on April 20, 2022 to discuss the biological and clinical significance of resilience in older adults. The identification of persons with low resilience and the prompt intervention in this at-risk population may be critical to develop and implement preventive strategies against adverse events. Unfortunately, to date, it is still challenging to capture resilience, especially due to its dynamic nature encompassing biological, clinical, subjective, and socioeconomic factors. Opportunities to dynamically measure resilience were discussed during the ICFSR Task Force meeting, emphasizing potential biomarkers and areas of intervention. This article reports the results of the meeting and may serve to support future actions in the field.
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Affiliation(s)
- Matteo Cesari
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Via Camaldoli 64, 20138 Milano, Italy
| | - D. Azzolino
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, University of Milan, Via Camaldoli 64, 20138 Milano, Italy
| | - N. K. LeBrasseur
- Robert and Arlene Kodod Center on Aging, Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, USA
| | - H. Whitson
- Duke University School of Medicine & Durham VA Medical Center, Durham, USA
| | - D. Rooks
- Translational Medicine, Novartis Institutes for Biomedical Research Inc., Cambridge, USA
| | - S. Sourdet
- Gérontopôle de Toulouse, Centre Hospitalier-Universitaire de Toulouse, Inserm 1295, Université de Toulouse, Toulouse, France
| | - D. Angioni
- Gérontopôle de Toulouse, Centre Hospitalier-Universitaire de Toulouse, Inserm 1295, Université de Toulouse, Toulouse, France
| | - R. A. Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA, Human Nutrition Research Center on Aging at Tufts University, Boston, MA USA
| | - B. Vellas
- Gérontopôle de Toulouse, Centre Hospitalier-Universitaire de Toulouse, Inserm 1295, Université de Toulouse, Toulouse, France
| | - Y. Rolland
- Gérontopôle de Toulouse, Centre Hospitalier-Universitaire de Toulouse, Inserm 1295, Université de Toulouse, Toulouse, France
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14
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Merchant RA, Aprahamian I, Woo J, Vellas B, Morley JE. Editorial: Resilience And Successful Aging. J Nutr Health Aging 2022; 26:652-656. [PMID: 35842754 PMCID: PMC9209635 DOI: 10.1007/s12603-022-1818-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Reshma A Merchant
- Dr Reshma A Merchant, Division of Geriatric Medicine. Department of Medicine, 1E Kent Ridge Road, NUHS Tower Block, Singapore 119228. , ORCID iD: 0000-0002-9032-0184
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15
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Low Psychological Resilience in Older Individuals: An Association with Increased Inflammation, Oxidative Stress and the Presence of Chronic Medical Conditions. Int J Mol Sci 2021; 22:ijms22168970. [PMID: 34445675 PMCID: PMC8396457 DOI: 10.3390/ijms22168970] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/04/2021] [Accepted: 08/17/2021] [Indexed: 01/12/2023] Open
Abstract
The term resilience, which has been present in science for almost half a century, stands for the capacity of some system needed to overcome an amount of disturbance from the environment in order to avoid a change to another stable state. In medicine, the concept of resilience means the ability to deal with daily stress and disturbance to our homeostasis with the intention of protecting it from disturbance. With aging, the organism becomes more sensitive to environmental impacts and more susceptible to changes. Mental disturbances and a decline in psychological resilience in older people are potentiated with many social and environmental factors along with a subjective perception of decreasing health. Distinct from findings in younger age groups, mental and physical medical conditions in older people are closely associated with each other, sharing common mechanisms and potentiating each other’s development. Increased inflammation and oxidative stress have been recognized as the main driving mechanisms in the development of aging diseases. This paper aims to reveal, through a translational approach, physiological and molecular mechanisms of emotional distress and low psychological resilience in older individuals as driving mechanisms for the accelerated development of chronic aging diseases, and to systematize the available information sources on strategies for mitigation of low resilience in order to prevent chronic diseases.
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16
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Whitson HE, Crabtree D, Pieper CF, Ha C, Au S, Berger M, Cohen HJ, Feld J, Smith P, Hall K, Parker D, Kraus VB, Kraus WE, Schmader K, Colón-Emeric C. A template for physical resilience research in older adults: Methods of the PRIME-KNEE study. J Am Geriatr Soc 2021; 69:3232-3241. [PMID: 34325481 DOI: 10.1111/jgs.17384] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 06/14/2021] [Accepted: 07/07/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Older adults with similar health conditions often experience widely divergent outcomes following health stressors. Variable recovery after a health stressor may be due in part to differences in biological mechanisms at the molecular, cellular, or system level, that are elicited in response to stressors. We describe the PRIME-KNEE study as an example of ongoing research to validate provocative clinical tests and biomarkers that predict resilience to specific health stressors. METHODS PRIME-KNEE is an ongoing, prospective cohort study that will enroll 250 adults ≥60 years undergoing total knee arthroplasty. Data are collected at baseline (pre-surgery), during surgery, daily for 7 days after surgery, and at 1, 2, 4, and 6 months post-surgery. Provocative tests include a cognition-motor dual-task walking test, cerebrovascular reactivity assessed by functional near-infrared spectroscopy, peripheral blood mononuclear cell reactivity ex vivo to lipopolysaccharide toxin and influenza vaccine, and heart rate variability during surgery. Cognitive, psychological, and physical performance batteries are collected at baseline to estimate prestressor reserve. Demographics, medications, comorbidities, and stressor characteristics are abstracted from the electronic medical record and via participant interview. Blood-based biomarkers are collected at baseline and postoperative day 1. Repeated measures after surgery include items from a delirium assessment tool and pain scales administered daily by telephone for 7 days and cognitive change index (participant and informant), lower extremity activities of daily living, pain scales, and step counts assessed by Garmin actigraphy at 1, 2, 4, and 6 months after surgery. Statistical models use these measures to characterize resilience phenotypes and evaluate prestressor clinical indicators associated with poststressor resilience. CONCLUSION If PRIME-KNEE validates feasible clinical tests and biomarkers that predict recovery trajectories in older surgical patients, these tools may inform surgical decision-making, guide pre-habilitation efforts, and elucidate mechanisms underlying resilience. This study design could motivate future geriatric research on resilience.
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Affiliation(s)
- Heather E Whitson
- Duke University School of Medicine, Durham, North Carolina, USA.,Geriatric Research Education and Clinical Center, Durham VA Health System, Durham, North Carolina, USA
| | - Donna Crabtree
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Carl F Pieper
- Duke University School of Medicine, Durham, North Carolina, USA.,Geriatric Research Education and Clinical Center, Durham VA Health System, Durham, North Carolina, USA
| | - Christine Ha
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Sandra Au
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Miles Berger
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Harvey J Cohen
- Duke University School of Medicine, Durham, North Carolina, USA.,Geriatric Research Education and Clinical Center, Durham VA Health System, Durham, North Carolina, USA
| | - Jody Feld
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Patrick Smith
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Katherine Hall
- Duke University School of Medicine, Durham, North Carolina, USA.,Geriatric Research Education and Clinical Center, Durham VA Health System, Durham, North Carolina, USA
| | - Daniel Parker
- Duke University School of Medicine, Durham, North Carolina, USA
| | | | - William E Kraus
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Kenneth Schmader
- Duke University School of Medicine, Durham, North Carolina, USA.,Geriatric Research Education and Clinical Center, Durham VA Health System, Durham, North Carolina, USA
| | - Cathleen Colón-Emeric
- Duke University School of Medicine, Durham, North Carolina, USA.,Geriatric Research Education and Clinical Center, Durham VA Health System, Durham, North Carolina, USA
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17
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Blum J, Epstein R, Watts S, Thalacker-Mercer A. Importance of Nutrient Availability and Metabolism for Skeletal Muscle Regeneration. Front Physiol 2021; 12:696018. [PMID: 34335302 PMCID: PMC8322985 DOI: 10.3389/fphys.2021.696018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022] Open
Abstract
Skeletal muscle is fundamentally important for quality of life. Deterioration of skeletal muscle, such as that observed with advancing age, chronic disease, and dystrophies, is associated with metabolic and functional decline. Muscle stem/progenitor cells promote the maintenance of skeletal muscle composition (balance of muscle mass, fat, and fibrotic tissues) and are essential for the regenerative response to skeletal muscle damage. It is increasing recognized that nutrient and metabolic determinants of stem/progenitor cell function exist and are potential therapeutic targets to improve regenerative outcomes and muscle health. This review will focus on current understanding as well as key gaps in knowledge and challenges around identifying and understanding nutrient and metabolic determinants of skeletal muscle regeneration.
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Affiliation(s)
- Jamie Blum
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Rebekah Epstein
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States
| | - Stephen Watts
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, United States.,Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Anna Thalacker-Mercer
- Division of Nutritional Sciences, Cornell University, Ithaca, NY, United States.,Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL, United States.,Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, United States.,UAB Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
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18
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Sedrak MS, Gilmore NJ, Carroll JE, Muss HB, Cohen HJ, Dale W. Measuring Biologic Resilience in Older Cancer Survivors. J Clin Oncol 2021; 39:2079-2089. [PMID: 34043454 PMCID: PMC8260901 DOI: 10.1200/jco.21.00245] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/24/2021] [Accepted: 03/15/2021] [Indexed: 12/15/2022] Open
Affiliation(s)
| | | | - Judith E. Carroll
- University of California, Los Angeles, David Geffen School of Medicine, Jonsson Comprehensive Cancer Center, Jane & Terry Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, Los Angeles, CA
| | - Hyman B. Muss
- Department of Medicine and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | | | - William Dale
- City of Hope National Medical Center, Duarte, CA
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19
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Decline in biological resilience as key manifestation of aging: Potential mechanisms and role in health and longevity. Mech Ageing Dev 2020; 194:111418. [PMID: 33340523 DOI: 10.1016/j.mad.2020.111418] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/14/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
Decline in biological resilience (ability to recover) is a key manifestation of aging that contributes to increase in vulnerability to death with age eventually limiting longevity even in people without major chronic diseases. Understanding the mechanisms of this decline is essential for developing efficient anti-aging and pro-longevity interventions. In this paper we discuss: a) mechanisms of the decline in resilience with age, and aging components that contribute to this decline, including depletion of body reserves, imperfect repair mechanisms, and slowdown of physiological processes and responses with age; b) anti-aging interventions that may improve resilience or attenuate its decline; c) biomarkers of resilience available in human and experimental studies; and d) genetic factors that could influence resilience. There are open questions about optimal anti-aging interventions that would oppose the decline in resilience along with extending longevity limits. However, the area develops quickly, and prospects are exciting.
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