Biodemographic trajectories of longevity

Signatures of Nonlinear Aging: Molecular Stages of Life: Sudden Changes During Aging as Potential Biomarkers for an Age Classification System

The traditional view of aging as a gradual, progressive process is increasingly being challenged. A growing body of evidence suggests the existence of abrupt transitions in the aging process, marked by sudden molecular shifts. Interestingly, the data indicates that such transitions occur not only in late life but also throughout the entire lifespan. Further research on the nature of such events could enhance our understanding of aging and pave the way for novel therapeutic strategies, including personalized medicine. We propose that these abrupt molecular shifts could serve as biomarkers, dividing the lifespan into distinct stages and providing the foundation for a much-needed staging system for aging. Furthermore, we argue that the sudden changes may be the hallmarks of aging tipping points, that is, points in time where aging processes are quickly amplified after surpassing critical biological thresholds.

Similarities and differences in the gene expression signatures of physiological age versus future lifespan

Across all taxa of life, individuals within a species exhibit variable lifespans. Differences in genotype or environment are not sufficient to explain this variance, as even isogenic Caenorhabditis elegans nematodes reared under uniform conditions show significant variability in lifespan. To investigate this phenomenon, we used lifespan-predictive biomarkers to isolate, at mid-adulthood, prospectively long- and short-lived individuals from an otherwise identical population. We selected two biomarkers which correlated positively with lifespan, lin-4p::GFP and mir-243p::GFP, and two which correlated negatively, mir-240/786p::GFP and autofluorescence. The gene-expression signature of long versus short future lifespan was strikingly similar across all four biomarkers tested. Since these biomarkers are expressed in different tissues, these results suggest a shared connection to a global health state correlated with future lifespan. To further investigate this underlying state, we compared the transcriptional signature of long versus short future lifespan to that of chronologically young versus old individuals. By comparison to a high-resolution time series of the average aging transcriptome, we determined that subpopulations predicted to be long- or short-lived by biomarker expression had significantly different transcriptional ages despite their shared chronological age. We found that this difference in apparent transcriptional age accounted for the majority of differentially expressed genes associated with future lifespan. Interestingly, we also identified several genes whose expression consistently separated samples by biomarker expression independent of apparent transcriptional age. These results suggest that the commonalities in the long-lived versus short-lived state reported across different biomarkers of aging extends beyond simply transcriptionally young versus transcriptionally old.

Demographics of co-ageing complex systems: from infected worms to chess games

Ageing, as defined in terms of the slope of the probability of death versus time (hazard curve), is a generic phenomenon observed in nearly all complex systems. Theoretical models of ageing predict hazard curves that monotonically increase in time, in discrepancy with the peculiar ups and downs observed empirically. Here we introduce the concept of co-ageing, where the demographic trajectories of multiple cohorts couple together, and show that co-ageing dynamics can account for the anomalous hazard curves exhibited by some species. In our model, multiple interdependency networks inflict damage on one other proportional to their number of functional nodes. We then fit our model predictions to three datasets describing (i) co-ageing worm-pathogen populations and (ii) competing tree species. Lastly, we collect data on the mortality statistics of (iii) chess games to demonstrate that co-ageing dynamics is not exclusive to biological systems.

Implausibility of radical life extension in humans in the twenty-first century

Over the course of the twentieth century, human life expectancy at birth rose in high-income nations by approximately 30 years, largely driven by advances in public health and medicine. Mortality reduction was observed initially at an early age and continued into middle and older ages. However, it was unclear whether this phenomenon and the resulting accelerated rise in life expectancy would continue into the twenty-first century. Here using demographic survivorship metrics from national vital statistics in the eight countries with the longest-lived populations (Australia, France, Italy, Japan, South Korea, Spain, Sweden and Switzerland) and in Hong Kong and the United States from 1990 to 2019, we explored recent trends in death rates and life expectancy. We found that, since 1990, improvements overall in life expectancy have decelerated. Our analysis also revealed that resistance to improvements in life expectancy increased while lifespan inequality declined and mortality compression occurred. Our analysis suggests that survival to age 100 years is unlikely to exceed 15% for females and 5% for males, altogether suggesting that, unless the processes of biological aging can be markedly slowed, radical human life extension is implausible in this century.

Invariances in relations between aging, exposure to external hazards, and mortality reflected in life table aging rate (LAR) patterns examined through the lens of generalized Gompertz-Makeham law

According to the Gompertz law, the age-dependent change in the logarithm of mortality (life-table aging rate, LAR) is equal to the population-averaged age-independent biological aging rate (γ), and LAR would be constant if aging were the only cause of mortality increase. However, LAR is influenced by population exposures to the external hazards. If they were constant, according to the Gompertz-Makeham law (GML), LAR would be below γ at lower ages and asymptotically and monotonically approach γ with increasing age. Actually, LAR trajectories derived from data on mortality in different countries and historical periods feature systematic undulations. In the present investigation, mortality-vs.-age trajectories were modeled based on a generalized GML (gGML). Unlike the canonical GML terms, which are population-specific constants, the respective terms of the gGML are represented with some population-specific functions of age. Invariant in gGML are the modes of translation of these functions into the dependency of mortality on age: linear for population exposure to the irresistible external hazards or exponential for population-averaged ability to withstand the resistible external and internal hazards. Modeling suggests that, at earlier ages, LAR undulations are attributable to changes in population exposures to the former hazards. However, only their unrealistically high levels can produce the transient increase in LAR at about 65 to 90 years. This pervasive undulation of LAR-vs.-age trajectory is rather caused by an increment in γ. Reasons to regard gGML as a genuine natural law, which defines relations between mortality, aging and environment, are discussed.

An underappreciated peculiarity of late-life human mortality kinetics assessed through the lens of a generalization of the Gompertz-Makeham law

Much attention in biogerontology is paid to the deceleration of mortality rate increase with age by the end of a species-specific lifespan, e.g. after ca. 90 years in humans. Being analyzed based on the Gompertz law µ(t)=µ0e^γt with its inbuilt linearity of the dependency of lnµ on t, this is commonly assumed to reflect the heterogeneity of populations where the frailer subjects die out earlier thus increasing the proportions of those whose dying out is slower and leading to decreases in the demographic rates of aging. Using Human Mortality Database data related to France, Sweden and Japan in five periods 1920, 1950, 1980, 2018 and 2020 and to the cohorts born in 1920, it is shown by LOESS smoothing of the lnµ-vs-t plots and constructing the first derivatives of the results that the late-life deceleration of the life-table aging rate (LAR) is preceded by an acceleration. It starts at about 65 years and makes LAR at about 85 years to become 30% higher than it was before the acceleration. Thereafter, LAR decreases and reaches the pre-acceleration level at ca. 90 years. This peculiarity cannot be explained by the predominant dying out of frailer subjects at earlier ages. Its plausible explanation may be the acceleration of the biological aging in humans at ages above 65-70 years, which conspicuously coincide with retirement. The decelerated biological aging may therefore contribute to the subsequent late-life LAR deceleration. The biological implications of these findings are discussed in terms of a generalized Gompertz-Makeham law µ(t) = C(t)+µ0e^f(t).

Developmental origins of exceptional health and survival: A four-generation family cohort study

Background

Previous researched has demonstrated potent health and survival advantages across three-generations in longevity-enriched families. However, the survival advantage associated with familial longevity may manifest earlier in life than previously thought.

Methods

We conducted a matched cohort study comparing early health trajectories in third-generation grandchildren (n = 5,637) and fourth-generation great-grandchildren (n = 14,908) of longevity-enriched sibships to demographically matched births (n = 41,090) in Denmark between 1973 and 2018.

Results

Lower risk was observed across a range of adverse early life outcomes in the grandchildren, including infant mortality (Hazard Ratio (HR) = 0.53, 95% CI [0.36, 0.77]), preterm birth (Odds Ratio (OR) = 0.82, [0.72, 0.93]), small for gestational age (OR = 0.83, [0.76, 0.90]) and neonatal respiratory disorders (OR = 0.77, [0.67, 0.88]). Relative advantages in parental education and maternal smoking were observed in both generations to a similar degree. However, a much smaller reduction in infant mortality was observed in the great-grandchildren (HR = 0.90, [0.70, 1.17]) and benefits across other outcomes were also less consistent, despite persisting socioeconomic and behavioural advantages. Lastly, maternal, and paternal lines of transmission were equipotent in the transmission of infant survival advantages.

Conclusions

Descendants of longevity-enriched sibships exhibit a broad health advantage manifesting as early the perinatal period. However, this effect is strongly diluted over successive generations. Our findings suggest that exceptional health and survival may have early developmental components and implicate heritable genetic and or epigenetic factors in their specific transmission.

Ageing as a two-phase process: theoretical framework

Human ageing, along with the ageing of conventional model organisms, is depicted as a continuous and progressive decline of biological capabilities accompanied by an exponentially increasing mortality risk. However, not all organisms experience ageing identically and our understanding of the phenomenon is coloured by human-centric views. Ageing is multifaceted and influences a diverse range of species in varying ways. Some undergo swift declines post-reproduction, while others exhibit insubstantial changes throughout their existence. This vast array renders defining universally applicable "ageing attributes" a daunting task. It is nonetheless essential to recognize that not all ageing features are organism-specific. These common attributes have paved the way for identifying "hallmarks of ageing," processes that are intertwined with age, amplified during accelerated ageing, and manipulations of which can potentially modulate or even reverse the ageing process. Yet, a glaring observation is that individuals within a single population age at varying rates. To address this, demographers have coined the term 'frailty'. Concurrently, scientific advancements have ushered in the era of molecular clocks. These innovations enable a distinction between an individual's chronological age (time since birth) and biological age (physiological status and mortality risk). In 2011, the "Smurf" phenotype was unveiled in Drosophila, delineating an age-linked escalation in intestinal permeability that presages imminent mortality. It not only acts as a predictor of natural death but identifies individuals exhibiting traits normally described as age-related. Subsequent studies have revealed the phenotype in organisms like nematodes, zebrafish, and mice, invariably acting as a death predictor. Collectively, these findings have steered our conception of ageing towards a framework where ageing is not linear and continuous but marked by two distinct, necessary phases, discernible in vivo, courtesy of the Smurf phenotype. This framework includes a mathematical enunciation of longevity trends based on three experimentally measurable parameters. It facilitates a fresh perspective on the evolution of ageing as a function. In this article, we aim to delineate and explore the foundational principles of this innovative framework, emphasising its potential to reshape our understanding of ageing, challenge its conventional definitions, and recalibrate our comprehension of its evolutionary trajectory.

Reduction in metabolic noise reveals rejuvenation following transient severe caloric restriction

Among land vertebrates, the laying hen stands out due to its great reproductive efficiency: producing an egg daily all year long. This production rate makes the laying hen a special model animal to study the general process of reproduction and aging. One unique aspect of hens is their ability to undergo reproductive plasticity and to rejuvenate their reproductive tract during molting, a standard industrial feed restriction protocol for transiently pausing reproduction, followed by improved laying efficiency almost to peak production. Here we use longitudinal metabolomics, immunology, and physiological assays to show that molting promotes reproduction, compresses morbidity, and restores youthfulness when applied to old hens. We identified circulating metabolic biomarkers that quantitatively predict the reproduction and age of individuals. Lastly, we introduce metabolic noise, a robust, unitless, and quantifiable measure for heterogeneity of the complete metabolome as a general marker that can indicate the rate of aging of a population. Indeed, metabolic noise increased with age in control hens, whereas molted hens exhibited reduced noise following molting, indicating systemic rejuvenation. Our results suggest that metabolic noise can be used as a quick and universal proxy for assessing successful aging treatments, accelerating the timeline for drug development.

Calculating Aging: Analysis of Survival Curves in the Norm and Pathology, Fluctuations in Mortality Dynamics, Characteristics of Lifespan Distribution, and Indicators of Lifespan Variation

The article describes the history of studies of survival data carried out at the Research Institute of Physico-Chemical Biology under the leadership of Academician V. P. Skulachev from 1970s until present, with special emphasis on the last decade. The use of accelerated failure time (AFT) model and analysis of coefficient of variation of lifespan (CVLS) in addition to the Gompertz methods of analysis, allows to assess survival curves for the presence of temporal scaling (i.e., manifestation of accelerated aging), without changing the shape of survival curve with the same coefficient of variation. A modification of the AFT model that uses temporal scaling as the null hypothesis made it possible to distinguish between the quantitative and qualitative differences in the dynamics of aging. It was also shown that it is possible to compare the data on the survival of species characterized by the survival curves of the original shape (i.e., "flat" curves without a pronounced increase in the probability of death with age typical of slowly aging species), when considering the distribution of lifespan as a statistical random variable and comparing parameters of such distribution. Thus, it was demonstrated that the higher impact of mortality caused by external factors (background mortality) in addition to the age-dependent mortality, the higher the disorder of mortality values and the greater its difference from the calculated value characteristic of developed countries (15-20%). For comparison, CVLS for the Paraguayan Ache Indians is 100% (57% if we exclude prepuberty individuals as suggested by Jones et al.). According to Skulachev, the next step is considering mortality fluctuations as a measure for the disorder of survival data. Visual evaluation of survival curves can already provide important data for subsequent analysis. Thus, Sokolov and Severin [1] found that mutations have different effects on the shape of survival curves. Type I survival curves generally retains their standard convex rectangular shape, while type II curves demonstrate a sharp increase in the mortality which makes them similar to a concave exponential curve with a stably high mortality rate. It is noteworthy that despite these differences, mutations in groups I and II are of a similar nature. They are associated (i) with "DNA metabolism" (DNA repair, transcription, and replication); (ii) protection against oxidative stress, associated with the activity of the transcription factor Nrf2, and (iii) regulation of proliferation, and (or these categories may overlap). However, these different mutations appear to produce the same result at the organismal level, namely, accelerated aging according to the Gompertz's law. This might be explained by the fact that all these mutations, each in its own unique way, either reduce the lifespan of cells or accelerate their transition to the senescent state, which supports the concept of Skulachev on the existence of multiple pathways of aging (chronic phenoptosis).

Exploring Patterns of Human Mortality and Aging: A Reliability Theory Viewpoint

The most important manifestation of aging is an increased risk of death with advancing age, a mortality pattern characterized by empirical regularities known as mortality laws. We highlight three significant ones: the Gompertz law, compensation effect of mortality (CEM), and late-life mortality deceleration and describe new developments in this area. It is predicted that CEM should result in declining relative variability of mortality at older ages. The quiescent phase hypothesis of negligible actuarial aging at younger adult ages is tested and refuted by analyzing mortality of the most recent birth cohorts. To comprehend the aging mechanisms, it is crucial to explain the observed empirical mortality patterns. As an illustrative example of data-directed modeling and the insights it provides, we briefly describe two different reliability models applied to human mortality patterns. The explanation of aging using a reliability theory approach aligns with evolutionary theories of aging, including idea of chronic phenoptosis. This alignment stems from their focus on elucidating the process of organismal deterioration itself, rather than addressing the reasons why organisms are not designed for perpetual existence. This article is a part of a special issue of the journal that commemorates the legacy of the eminent Russian scientist Vladimir Petrovich Skulachev (1935-2023) and his bold ideas about evolution of biological aging and phenoptosis.

The Gompertz Law emerges naturally from the inter-dependencies between sub-components in complex organisms

Understanding and facilitating healthy aging has become a major goal in medical research and it is becoming increasingly acknowledged that there is a need for understanding the aging phenotype as a whole rather than focusing on individual factors. Here, we provide a universal explanation for the emergence of Gompertzian mortality patterns using a systems approach to describe aging in complex organisms that consist of many inter-dependent subsystems. Our model relates to the Sufficient-Component Cause Model, widely used within the field of epidemiology, and we show that including inter-dependencies between subsystems and modeling the temporal evolution of subsystem failure results in Gompertizan mortality on the population level. Our model also provides temporal trajectories of mortality-risk for the individual. These results may give insight into understanding how biological age evolves stochastically within the individual, and how this in turn leads to a natural heterogeneity of biological age in a population.

The African killifish: A short-lived vertebrate model to study the biology of sarcopenia and longevity

Sarcopenia, the age-related decline in muscle function, places a considerable burden on health-care systems. While the stereotypic hallmarks of sarcopenia are well characterized, their contribution to muscle wasting remains elusive, which is partly due to the limited availability of animal models. Here, we have performed cellular and molecular characterization of skeletal muscle from the African killifish-an extremely short-lived vertebrate-revealing that while many characteristics deteriorate with increasing age, supporting the use of killifish as a model for sarcopenia research, some features surprisingly reverse to an "early-life" state in the extremely old stages. This suggests that in extremely old animals, there may be mechanisms that prevent further deterioration of skeletal muscle, contributing to an extension of life span. In line with this, we report a reduction in mortality rates in extremely old killifish. To identify mechanisms for this phenomenon, we used a systems metabolomics approach, which revealed that during aging there is a striking depletion of triglycerides, mimicking a state of calorie restriction. This results in the activation of mitohormesis, increasing Sirt1 levels, which improves lipid metabolism and maintains nutrient homeostasis in extremely old animals. Pharmacological induction of Sirt1 in aged animals was sufficient to induce a late life-like metabolic profile, supporting its role in life span extension in vertebrate populations that are naturally long-lived. Collectively, our results demonstrate that killifish are not only a novel model to study the biological processes that govern sarcopenia, but they also provide a unique vertebrate system to dissect the regulation of longevity.

Cohort Profile: Better Health in Late Life

Purpose

Humans are living longer and may develop multiple chronic diseases in later life. The Better Health in Late Life cohort study aims to improve our understanding of the risks and outcomes of multimorbidity in the Danish population.

Methods

A randomly-selected sample of Danish residents who were 50-65 years of age received a questionnaire and an invitation to participate in this study. Respondents completed an online survey between October 2021 and January 2022 which addressed topics that included self-assessed health, mental health, sleep, specific medical conditions, use of painkillers, diet, alcohol consumption, smoking, physical activity, and body composition. This information was linked to the Danish health and social registries (some established in 1943 and onwards) that maintain data on filled prescriptions, hospital records, socioeconomic status, and health care utilization.

Results

Responses were received from 115,431 of the 301,244 residents invited to participate (38%). We excluded respondents who answered none of the questions as well as those who provided no information on sex or indicated an age other than 50-65 years. Of the 114,283 eligible respondents, 54.8% were female, 30.3% were overweight, and 16.7% were obese. Most participants reported a weekly alcohol consumption of less than seven units and 13.3% were current smokers; 5.2% had a history of hospitalization for solid cancer, and 3.0%, 2.3%, 2.0%, and 0.9% reported chronic pulmonary disease, diabetes, stroke, and myocardial infarction, respectively. The most frequently filled prescriptions were for medications used to treat the nervous system and cardiovascular diseases (38.1% and 37.4%, respectively).

Changes in age at last birth and its determinants in India

In recent years, developing and developed countries are witnessing delayed childbearing among women contributing to the overall decline in fertility rates. The age at which a woman has her last child impacts maternal and child health, especially in a country with high maternal and perinatal mortality rates. This study aims to investigate the trends of age at the last birth among Indian women and to identify the potential factors contributing towards higher maternal age. The present study uses the data from five consecutive rounds (1992-1993, 1998-1999, 2004-2005, 2015-2016, and 2019-2021) of the National Family Health Survey (NFHS). We have used descriptive statistics, bivariate, Cox proportional hazard regression analysis, multiple classification analysis (MCA), Kaplan-Meier curve, life table survival analysis, hierarchical clustered heat map, multivariate decomposition analysis (MDA) and geospatial mapping to fulfill the objective of the study. Results show that the proportion of women with age at last birth before reaching the age of 30 years was less than half (nearly 35%) during NFHS-I while during NFHS-V proportion becomes more than half and reaches 64.3% among 40-49 years women. Within three decades (1992-2021) there has been a decline of 15.8% in median age at last birth among women aged 40-49 years. Additionally, the highest percentage decline in predicted mean age at last birth was noted among individuals from rural area (10.7%, 3.3 years), Hindu religion (10.8%, 3.3 years), poor wealth quantile (12.5%, 4.0 years) and those with mass media exposure (10.6%, 3.2 years) from NFHS-I (1992-1993) to NFHS-V (2019-2021). Although there exists the need to delay age at first childbirth, the age at last childbirth also plays an important role in women's and child health status. Hence, it is important to address the healthcare needs of those delaying their childbirth.

Aging - what it is and how to measure it

The current understanding of the biology of aging is largely based on research aimed at identifying factors that influence lifespan. However, lifespan as a sole proxy measure of aging has limitations because it can be influenced by specific pathologies (not generalized physiological deterioration in old age). Hence, there is a great need to discuss and design experimental approaches that are well-suited for studies targeting the biology of aging, rather than the biology of specific pathologies that restrict the lifespan of a given species. For this purpose, we here review various perspectives on aging, discuss agreement and disagreement among researchers on the definition of aging, and show that while slightly different aspects are emphasized, a widely accepted feature, shared across many definitions, is that aging is accompanied by phenotypic changes that occur in a population over the course of an average lifespan. We then discuss experimental approaches that are in line with these considerations, including multidimensional analytical frameworks as well as designs that facilitate the proper assessment of intervention effects on aging rate. The proposed framework can guide discovery approaches to aging mechanisms in all key model organisms (e.g., mouse, fish models, D. melanogaster, C. elegans) as well as in humans.

Improving disease prevention, diagnosis, and treatment using novel bionic technologies

Increased human life expectancy, due in part to improvements in infant and childhood survival, more active lifestyles, in combination with higher patient expectations for better health outcomes, is leading to an extensive change in the number, type and manner in which health conditions are treated. Over the next decades as the global population rapidly progresses toward a super-aging society, meeting the long-term quality of care needs is forecast to present a major healthcare challenge. The goal is to ensure longer periods of good health, a sustained sense of well-being, with extended periods of activity, social engagement, and productivity. To accomplish these goals, multifunctionalized interfaces are an indispensable component of next generation medical technologies. The development of more sophisticated materials and devices as well as an improved understanding of human disease is forecast to revolutionize the diagnosis and treatment of conditions ranging from osteoarthritis to Alzheimer's disease and will impact disease prevention. This review examines emerging cutting-edge bionic materials, devices and technologies developed to advance disease prevention, and medical care and treatment in our elderly population including developments in smart bandages, cochlear implants, and the increasing role of artificial intelligence and nanorobotics in medicine.

What Is an Aging-Related Disease? An Epidemiological Perspective

There are no established or standardized definitions of aging-related disease. Data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 were used to model the relationship between age and incidence of diseases. Clustering analysis identified 4 groups of noncommunicable diseases: Group A diseases with an exponential increase in incidence with age; Group B diseases with an exponential increase in incidence that usually peaked in late life which then declined or plateaued at the oldest ages; and Groups C and D diseases with an onset in earlier life and where incidence was stable or decreased in old age. From an epidemiological perspective, Group A diseases are "aging-related diseases" because there is an exponential association between age and incidence, and the slope of the incidence curves remains positive throughout old age. These included the major noncommunicable diseases dementia, stroke, and ischemic heart disease. Whether any of the other diseases are aging-related is uncertain because their incidence either does not change or more often decreases in old age. Only biological studies can determine how the aging process contributes to any of these diseases and this may lead to a reclassification of disease on the basis of whether they are directly caused by or are in continuity with the biological changes of aging. In the absence of this mechanistic data, we propose the term "aging-related disease" should be used with precision based on epidemiological evidence.

Unsupervised learning of aging principles from longitudinal data

Age is the leading risk factor for prevalent diseases and death. However, the relation between age-related physiological changes and lifespan is poorly understood. We combined analytical and machine learning tools to describe the aging process in large sets of longitudinal measurements. Assuming that aging results from a dynamic instability of the organism state, we designed a deep artificial neural network, including auto-encoder and auto-regression (AR) components. The AR model tied the dynamics of physiological state with the stochastic evolution of a single variable, the "dynamic frailty indicator" (dFI). In a subset of blood tests from the Mouse Phenome Database, dFI increased exponentially and predicted the remaining lifespan. The observation of the limiting dFI was consistent with the late-life mortality deceleration. dFI changed along with hallmarks of aging, including frailty index, molecular markers of inflammation, senescent cell accumulation, and responded to life-shortening (high-fat diet) and life-extending (rapamycin) treatments.

Clinical Status, Nutritional Behavior, and Lifestyle, and Determinants of Community Well-Being of Patients from the Perspective of Physicians: A Cross-Sectional Study of Young Older Adults, Nonagenarians, and Centenarians in Salerno and Province, Italy

Longevity is rightly considered one of the greatest achievements of modern society. Biomedical research has shown that aging is the major risk factor for many diseases, so to find the right answers to aging it is necessary to identify factors that can positively influence longevity. This study investigated the clinical status, nutritional behavior, lifestyle, and social and community determinants of the well-being of young older adults and nonagenarians/centenarians in Salerno and province through the judgment of their physicians. Data were collected through an online survey. Multivariate Poisson and logistic regression models were used to calculate significant predictors of the outcomes of interest. The interesting finding was that cardiovascular disease was a risk factor for young older adults, while it was a protective factor for nonagenarians/centenarians, meaning that as age increased, heart problems tended to decrease. Certain foods were found to be a significant protective factor for both young older adult and nonagenarian-centenarian patients. In addition, psychosomatic disorders were found to be determinant for the young older adults, while depression was a risk factor for the nonagenarians/centenarians because they were not always gratified by their long lives and often felt like a burden on the family. The protective significant variable among the determinants of community well-being for both young older adults and nonagenarians/centenarians was the retention of honorary achievement. Based on our results, we are able to support the hypothesis of a difference between the young older adults and the nonagenarians/centenarians in clinical status, nutritional behaviors, lifestyle, and determinants of community well-being. However, societies need more social and educational programs that are able to build "a new idea of old age" by improving and supporting the young older adults and the nonagenarians/centenarians, with the goal of intergenerational solidarity, well-being, and social inclusion, as well as preventive interventions on lifestyles and nutrition, which will allow us to provide a new key to understanding aging.

Safety and Feasibility of Microwave Ablation for Hepatocellular Carcinomas in the Elderly: A Systematic Review

Background

Microwave ablation (MWA) for hepatocellular carcinomas (HCCs) in the elderly has been the subject of new research in recent years. However, there are currently no strong lines of evidence for the prognosis following MWA treatment for HCC in the elderly. Therefore, we conducted a systematic review to assess the safety and feasibility of MWA for HCC in elderly patients.

Methods

Up until August 15, 2021, a comprehensive literature search was undertaken in PubMed, Scopus, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar databases for all published articles. Observational studies reporting the safety and feasibility of MWA for HCC in elderly patients were included. The Newcastle–Ottawa Scale (NOS) was used to measure the quality assessment.

Results

Our review, composed of 7 observational studies, including a total of 7,683 HCC patients, looked at the safety and feasibility of MWA for HCC in the elderly. Current lines of evidence on the risks and outcomes of MWA of HCC treatments in elderly patients are discussed.

Conclusions

According to our findings, elderly patients, even those with a high comorbidity index, benefited from MWA of HCC similar to younger patients. More clinical data are needed to determine selection criteria for elderly HCC patients to increase the possibility of receiving MWA as a potential lifesaving option. As such, further studies evaluating the outcomes of MWA for HCC treatment modalities in elderly patients are warranted.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42021273091.

The Impact of Frailty and Comorbidities on Heart Failure Outcomes

Frailty is a multisystemic process leading to reduction of physiological reserve and a reduction in physical activity. Heart failure (HF) is recognised as a global cause of morbidity and mortality, increasing in prevalence over recent decades. Because of shared phenotypes and comorbidities, there is significant overlap and a bidirectional relationship, with frail patients being at increased risk of developing HF and vice versa. Despite this, frailty is not routinely assessed in patients with HF. Identification of these patients to direct multidisciplinary care is key, and the development of a frailty assessment tool validated in a large HF population is also an unmet need that would be of considerable benefit in directing multidisciplinary-team management. Non-pharmacological treatment should be included, as exercise and physical rehabilitation programmes offer dual benefit in frail HF patients, by treating both conditions simultaneously. The evidence for nutritional supplementation is mixed, but there is evidence that a personalised approach to nutritional support in frail HF patients can improve outcomes.

Variability of Mortality: Additional Information on Mortality and Morbidity Curves under Normal and Pathological Conditions [Commentary on the Article by A. G. Malygin "Programmed Risks of Death in Male Patients with Diabetes" Published in Biochemistry (Moscow), vol. 86, pp. 1553-1562 (2021)]

Analysis of demographic data indicates uneven distribution of mortality within a year, month, and even week time period. This is of great practical importance for the operation of medical institutions, including intensive care units, and makes it possible to calculate economic and labor requirements of medical institutions. All the above is especially relevant during the era of the COVID-19 pandemic. Malygin showed the presence of one to two fluctuations per week in the mortality of male patients with type 2 diabetes. The height of the peaks of such fluctuations is determined, as expected, by the regular parameter indicating their position on the axis of lifespan and random parameter reflecting adverse effects of external environmental factors on the body, as well as the extent of the periodically occurring sharp decrease in the nonspecific resistance. This article discusses results of recent research in the field of small (semi-weekly, weekly, monthly, and seasonal) fluctuations of mortality. Based on a large array of accumulated data, it can be concluded that the decrease in seasonal variability of mortality accompanies an increase in the life expectancy. Studying characteristics of mortality fluctuations makes it possible to move from investigating the impact of biorhythms (Master Clock) on the development of acute and chronic phenoptotic processes directly to studying the patterns of mortality rhythms themselves (rhythms of phenoptosis).

Improved cardiovascular profile in Danish centenarians? A comparative study of two birth cohorts born 20 years apart

PURPOSE

Cardiovascular health among middle-aged and older people has improved in high-income countries. It is unknown whether this also applies for the oldest-old and if so, is it driven by better treatment or by a health improvement? Therefore, we compared two Danish centenarian birth cohorts born in 1895 and 1915, respectively, to investigate if the cardiovascular profile had improved in the most recent born cohort.

METHODS

All individuals turning 100 years old in 1995 and 2015, respectively, were included with participation rates of 74% (n = 106) and 79% (n = 238), respectively. Data were collected through structured in-home interviews. Cardiovascular profile was obtained by measured blood pressure, electrocardiogram (ECG), and information on medication. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg.

RESULTS

Mean SBP and DBP were almost identical in the two cohorts. Yet, the prevalence of measured hypertension was non-significantly higher in the 1895 cohort [73%, 95% CI (61;82)] compared to the 1915 cohort [63%, 95% CI (55;70)]. The proportion receiving at least one type of cardiovascular drug was significantly higher in the 1915 cohort [80%, 95% CI (74;86)] compared to 1895 cohort [66%, 95% CI 55;76)]. ECG findings were similar in the two cohorts, e.g., atrial fibrillation was present in 17% of the 1895 cohort and 20% of the 1915 cohort.

CONCLUSION

This comparison study found a non-significant improvement in measured hypertension irrespective of medical treatment in the recent born cohort. Also, the recent born cohort was treated more intensively with cardiovascular drugs than earlier. However, the prevalence of pathological ECG-findings was unchanged.

The selection force weakens with age because ageing evolves and not vice versa

According to the classic theory of life history evolution, ageing evolves because selection on traits necessarily weakens throughout reproductive life. But this inexorable decline of the selection force with adult age was shown to crucially depend on specific assumptions that are not necessarily fulfilled. Whether ageing still evolves upon their relaxation remains an open problem. Here, we propose a fully dynamical model of life history evolution that does not presuppose any specific pattern the force of selection should follow. The model shows: (i) ageing can stably evolve, but negative ageing cannot; (ii) when ageing is a stable equilibrium, the associated selection force decreases with reproductive age; (iii) non-decreasing selection is either a transient or an unstable phenomenon. Thus, we generalize the classic theory of the evolution of ageing while overturning its logic: the decline of selection with age evolves dynamically, and is not an implicit consequence of certain assumptions.

A decline of selection with age is generally seen as the reason that ageing evolves. But selection can also increase with age. What happens then? This work shows that ageing nevertheless evolves, and so does the decline of selection with age.

Role of the Histone Acetyl Transferase MOF and the Histone Deacetylase Sirtuins in Regulation of H4K16ac During DNA Damage Repair and Metabolic Programming: Implications in Cancer and Aging

The accurate repair of genomic damage mediated by ionizing radiation (IR), chemo- or radiomimetic drugs, or other exogenous agents, is necessary for maintenance of genome integrity, preservation of cellular viability and prevention of oncogenic transformation. Eukaryotes have conserved mechanisms designed to perceive and repair the damaged DNA quite efficiently. Among the different types of DNA damage, double strand breaks (DSB) are the most detrimental. The cellular DNA DSB response is a hierarchical signaling network that integrates damage sensing and repair with chromatin structural changes that involve a range of pre-existing and induced covalent modifications. Recent studies have revealed that pre-existing histone modifications are important contributors within this signaling/repair network. This chapter discusses the role of a critical histone acetyl transferase (HAT) known as MOF (males absent on the first) and the histone deacetylases (HDACs) Sirtuins on histone H4K16 acetylation (H4K16ac) and DNA damage repair. We also discuss the role of this important histone modification in light of metabolic rewiring and its role in regulating human pathophysiologic states.

Clinical course of the longest-lived man in the world: A case report

BACKGROUND AND OBJECTIVE

Supercentenarians, people who have reached 110 years of age, represent an ultimate model of human longevity. We have conducted research from both biomedical and psychosocial perspectives to clarify the factors that contribute to healthy longevity. The current study described the clinical course of the oldest lived man in the world.

METHODS

Kimura Jiroemon, who is the verified oldest man in recorded history, lived for more than 116 years. We conducted a longitudinal investigation including physical and psychological assessments, blood data, and electrocardiogram (ECG) from the age of 111 and obtained medical data such as computed tomography (CT) images during the course of hospitalizations in the last year of his life.

RESULTS

At the age of 111, Jiroemon was almost independent regarding activities of daily living. Additionally, his Philadelphia Geriatric Center Morale Scale score was 15/17, indicating high psychological well-being. His biological data included first-degree atrioventricular (AV) block on ECG; mild decreases of hemoglobin (11.6 g/dL), hematocrit (36.2%), and albumin levels (3.5 g/dL); and elevated serum cystatin C levels (1.32 mg/L), indicating potential dysfunction of the renal and electrical conduction systems. He then lived without fatal illness until the age of 115 years. At this age, he lost consciousness, and his ECG revealed complete AV block. At the first hospitalization for intensive examination, his doctor recommended implanting a cardiac pacemaker, but he and his family declined. On December 12, 2012, his condition rapidly worsened, and he was hospitalized twice for heart failure because of AV block. On May 11, 2013, he lost consciousness after breakfast, and he was hospitalized for the fourth time. He was diagnosed with pneumonia and heart failure based on his chest CT findings and elevated brain natriuretic peptide levels (160 pg/mL), and died on June 12, 2013 at the age of 116.

CONCLUSIONS

Despite having no cardiovascular risk factors throughout his life, Jiroemon developed heart failure from potential heart and kidney dysfunction, suggesting that aging of the cardiorenal system was the ultimate pathology of the oldest man in the world. His clinical course represents a model of both suppression of morbidity and extreme longevity. Comprehensive health and longevity research studies from physical and psychological aspects are required.

What have we learned about mortality patterns over the past 25 years?

In this paper, I examine progress in the field of mortality over the past 25 years. I argue that we have been most successful in taking advantage of an increasingly data-rich environment to improve aggregate mortality models and test pre-existing theories. Less progress has been made in relating our estimates of mortality risk at the individual level to broader mortality patterns at the population level while appropriately accounting for contextual differences and compositional change. Overall, I find that the field of mortality continues to be highly visible in demographic journals, including Population Studies. However much of what is published today in field journals could just as easily appear in neighbouring disciplinary journals, as disciplinary boundaries are shrinking.

Population Studies at 75 years: An empirical review

Population Studies advances research on fertility, mortality, family, migration, methods, policy, and beyond, yet it lacks a recent, rigorous review. We examine all papers published between 1947 and 2020 (N = 1,901) and their authors, using natural language processing, social network analysis, and mixed methods that combine unsupervised machine learning with qualitative coding. After providing a brief history, we map the evolution in authorship and papers towards shorter, multi-authored papers, also finding that females comprise 33.5 per cent of authorship across the period under study, with varied sex ratios across topics. Most papers examine fertility, mortality, and family, studying groups and change, but topics vary over time. Children are rarely studied, and research on women focuses on family planning, fertility decline, and unions, whereas key domains for research on men are migration, historical demography (war, famine), and employment. Research on Africa and Asia focuses on family planning, with work on fertility decline concentrated on North America and Europe, consistent with theories of demographic transition. Our resulting discussion identifies future directions for demographic research.

Season of Birth and Cardiovascular Mortality in Atrial Fibrillation: A Population-Based Cohort Study

Background: The fetal origins hypothesis have associated early life exposures with the development of adverse health outcomes in adulthood. Season of birth has been shown to be associated with overall and cardiovascular mortality. Methods: We performed a retrospective database study to explore the association between season of birth and mortality in patients with atrial fibrillation. Results: A total of 8962 patients with AF were identified in the database with 1253 deaths recorded. AF patients born in spring and summer had a higher mortality rate when compared to those born in autumn and winter (hazard ratio (HR) 1.13, 95% confidence interval (CI) 1.01–1.26, p = 0.03). This effect was consistent in the male subgroup (HR 1.25, 95% CI 1.03–1.51, p = 0.02 for males born in spring; HR 1.24, 95% CI 1.03–1.51, p = 0.03 for males born in summer when compared to winter as the reference) but not in females (HR 1.02, 95% CI 0.79–1.31, p = 0.88 for females born in spring; HR 1.11, 95% CI 0.87–1.42, p = 0.39 for females born in summer when compared to winter as the reference). Results persisted after adjustment for baseline characteristics and clinical risk profile. A similar pattern was observed with cardiovascular mortality. Conclusion: Birth in spring or summer is associated with a higher risk of cardiovascular mortality in male AF patients, but not in females. This could be related to the underlying differences in rates of major adverse clinical events between genders. Further studies should aim at clarifying the mechanisms behind this association, which may help us understand the higher level of risk in female patients with AF.

Programmed Risks of Death in Male Patients with Diabetes

Lifespan has been studied in a cohort of male patients with diabetes mellitus. It was shown that the rate of death displays significant fluctuations over the course of ontogenesis. On the curves of dependence of the rate of death on the age at time of death (differential mortality curves) these fluctuations are visualized as peaks. Positions of the peaks on the lifespan axis are to a significant degree the same in the independent subgroups of the patients. This is equally observed both in the parallel subgroups composed from the first and second halves of the list of the patients arranged by the date of death and in the subgroups of the odd- and even-numbered patients in this list. Coincidence in the peak positions in the differential curves of mortality in the independent subgroups of the patients indicate regularity in augmentation of the mortality rate at certain age. This regularity can be explained by programmed alternating periods of increased risk of death and periods of steady development separating them in ontogenesis. As a consequence, the peaks are characterized by two parameters: regular parameter indicating peak position on the lifespan axis, and random parameter, peak intensity, reflecting unfavorable effects of the external environment on the organism and degree of a periodically occurring sharp decrease in the nonspecific resistance of the organism.

Medawar and Hamilton on the selective forces in the evolution of ageing

Both Medawar and Hamilton contributed key ideas to the modern evolutionary theory of ageing. In particular, they both suggested that, in populations with overlapping generations, the force with which selection acts on traits declines with the age at which traits are expressed. This decline would eventually cause ageing to evolve. However, the biological literature diverges on the relationship between Medawar's analysis of the force of selection and Hamilton's. Some authors appear to believe that Hamilton perfected Medawar's insightful, yet ultimately erroneous analysis of this force, while others see Hamilton's analysis as a coherent development of, or the obvious complement to Medawar's. Here, the relationship between the two analyses is revisited. Two things are argued for. First, most of Medawar's alleged errors that Hamilton would had rectified seem not to be there. The origin of these perceived errors appears to be in a misinterpretation of Medawar's writings. Second, the mathematics of Medawar and that of Hamilton show a significant overlap. However, different meanings are attached to the same mathematical expression. Medawar put forth an expression for the selective force on age-specific fitness. Hamilton proposed a full spectrum of selective forces each operating on age-specific fitness components, i.e. mortality and fertility. One of Hamilton's expressions, possibly his most important, is of the same form as Medawar's expression. But Hamilton's selective forces on age-specific fitness components do not add up to yield Medawar's selective force on age-specific fitness. It is concluded that Hamilton's analysis should be considered neither as a correction to Medawar's analysis nor as its obvious complement.

Explaining the longevity characteristics in China from a geographical perspective: A multi-scale geographically weighted regression analysis

Longevity is a near-universal human aspiration that can affect moral progress and economic development at the social level. In rapidly developing China, questions about the geographical distribution and environmental factors of longevity phenomenon need to be answered more clearly. This study calculated the longevity index (LI), longevity index for females (LIF) and longevity index for males (LIM) based on the percentage of the long-lived population among the total number of elderly people to investigate regional and gender characteristics at the county level in China. A new multi-scale geographically weighted regression (MGWR) model and four possible geographical environmental factors were applied to explore environmental effects. The results indicate that the LIs of 2838 counties ranged from 1.3% to 16.3%, and the distribution showed obvious regional and gender differences. In general, the LI was high in the East and low in the West, and the LIF was higher than the LIM in 2614 counties (92.1%). The MGWR model performed well explaining that geographical environmental factors, including topographic features, vegetation conditions, human social activity and air pollution factors have a variable influence on longevity at different spatial scales and in different regions. These findings enrich our understanding of the spatial distribution, gender differences and geographical environmental effects on longevity in China, which provides an important reference for people interested in the variations in the associations between different geographical factors.

Evolution, Chance, and Aging

Aging has provided fruitful challenges for evolutionary theory, and evolutionary theory has deepened our understanding of aging. A great deal of genetic and molecular data now exists concerning mortality regulation and there is a growing body of knowledge concerning the life histories of diverse species. Assimilating all relevant data into a framework for the evolution of aging promises to significantly advance the field. We propose extensions of some key concepts to provide greater precision when applying these concepts to age-structured contexts. Secondary or byproduct effects of mutations are proposed as an important factor affecting survival patterns, including effects that may operate in small populations subject to genetic drift, widening the possibilities for mutation accumulation and pleiotropy. Molecular and genetic studies have indicated a diverse array of mechanisms that can modify aging and mortality rates, while transcriptome data indicate a high level of tissue and species specificity for genes affected by aging. The diversity of mechanisms and gene effects that can contribute to the pattern of aging in different organisms may mirror the complex evolutionary processes behind aging.

Smoothing, Decomposing and Forecasting Mortality Rates

The Lee-Carter (LC) model represents a landmark paper in mortality forecasting. While having been widely accepted and adopted, the model has some limitations that hinder its performance. Some variants of the model have been proposed to deal with these drawbacks individually, none coped with them all at the same time. In this paper, we propose a Three-Component smooth Lee-Carter (3C-sLC) model which overcomes many of the issues simultaneously. It decomposes mortality development into childhood, early-adult and senescent mortality, which are described, individually, by a smooth variant of the LC model. Smoothness is enforced to avoid irregular patterns in projected life tables, and complexity in the forecasting methodology is unaltered with respect to the original LC model. Component-specific schedules are considered in projections, providing additional insights into mortality forecasts. We illustrate the proposed approach to mortality data for ten low-mortality populations. The 3C-sLC captures mortality developments better than a smooth improved version of the LC model, and it displays wider prediction intervals. The proposed approach provides actuaries, demographers, epidemiologists and social scientists in general with a unique and valuable tool to simultaneously smooth, decompose and forecast mortality.

Assessing excess mortality in times of pandemics based on principal component analysis of weekly mortality data-the case of COVID-19

The COVID-19 outbreak has called for renewed attention to the need for sound statistical analyses to monitor mortality patterns and trends over time. Excess mortality has been suggested as the most appropriate indicator to measure the overall burden of the pandemic in terms of mortality. As such, excess mortality has received considerable interest since the outbreak of COVID-19 began. Previous approaches to estimate excess mortality are somewhat limited, as they do not include sufficiently long-term trends, correlations among different demographic and geographic groups, or autocorrelations in the mortality time series. This might lead to biased estimates of excess mortality, as random mortality fluctuations may be misinterpreted as excess mortality. We propose a novel approach that overcomes the named limitations and draws a more realistic picture of excess mortality. Our approach is based on an established forecasting model that is used in demography, namely, the Lee-Carter model. We illustrate our approach by using the weekly age- and sex-specific mortality data for 19 countries and the current COVID-19 pandemic as a case study. Our findings show evidence of considerable excess mortality during 2020 in Europe, which affects different countries, age, and sex groups heterogeneously. Our proposed model can be applied to future pandemics as well as to monitor excess mortality from specific causes of death.

The degree of frailty as a translational measure of health in aging

Frailty is a multiply determined, age-related state of increased risk for adverse health outcomes. We review how the degree of frailty conditions the development of late-life diseases and modifies their expression. The risks for frailty range from subcellular damage to social determinants. These risks are often synergistic-circumstances that favor damage also make repair less likely. We explore how age-related damage and decline in repair result in cellular and molecular deficits that scale up to tissue, organ and system levels, where they are jointly expressed as frailty. The degree of frailty can help to explain the distinction between carrying damage and expressing its usual clinical manifestations. Studying people-and animals-who live with frailty, including them in clinical trials and measuring the impact of the degree of frailty are ways to better understand the diseases of old age and to establish best practices for the care of older adults.

Senescence in Bacteria and Its Underlying Mechanisms

Bacteria have been thought to flee senescence by dividing into two identical daughter cells, but this notion of immortality has changed over the last two decades. Asymmetry between the resulting daughter cells after binary fission is revealed in physiological function, cell growth, and survival probabilities and is expected from theoretical understanding. Since the discovery of senescence in morphologically identical but physiologically asymmetric dividing bacteria, the mechanisms of bacteria aging have been explored across levels of biological organization. Quantitative investigations are heavily biased toward Escherichia coli and on the role of inclusion bodies—clusters of misfolded proteins. Despite intensive efforts to date, it is not evident if and how inclusion bodies, a phenotype linked to the loss of proteostasis and one of the consequences of a chain of reactions triggered by reactive oxygen species, contribute to senescence in bacteria. Recent findings in bacteria question that inclusion bodies are only deleterious, illustrated by fitness advantages of cells holding inclusion bodies under varying environmental conditions. The contributions of other hallmarks of aging, identified for metazoans, remain elusive. For instance, genomic instability appears to be age independent, epigenetic alterations might be little age specific, and other hallmarks do not play a major role in bacteria systems. What is surprising is that, on the one hand, classical senescence patterns, such as an early exponential increase in mortality followed by late age mortality plateaus, are found, but, on the other hand, identifying mechanisms that link to these patterns is challenging. Senescence patterns are sensitive to environmental conditions and to genetic background, even within species, which suggests diverse evolutionary selective forces on senescence that go beyond generalized expectations of classical evolutionary theories of aging. Given the molecular tool kits available in bacteria, the high control of experimental conditions, the high-throughput data collection using microfluidic systems, and the ease of life cell imaging of fluorescently marked transcription, translation, and proteomic dynamics, in combination with the simple demographics of growth, division, and mortality of bacteria, make the challenges surprising. The diversity of mechanisms and patterns revealed and their environmental dependencies not only present challenges but also open exciting opportunities for the discovery and deeper understanding of aging and its mechanisms, maybe beyond bacteria and aging.

Genes Related to Education Predict Frailty Among Older Adults in the United States

OBJECTIVE

This article expands on research that links education and frailty among older adults by considering the role of genes associated with education.

METHOD

Data come from a sample of 7,064 non-Hispanic, white adults participating in the 2004-2012 waves of the Health and Retirement Study. Frailty was measured with two indices: (a) The Frailty Index which corresponds to a deficit accumulation model; and (b) The Paulson-Lichtenberg Frailty Index which corresponds to the biological syndrome/phenotype model. Genes associated with education were quantified using an additive polygenic score. Associations between the polygenic score and frailty indices were tested using a series of multilevel models, controlling for multiple observations for participants across waves.

RESULTS

Results showed a strong and negative association between genes for education and frailty symptoms in later life. This association exists above and beyond years of completed education and we demonstrate that this association becomes weaker as older adults approach their 80s.

DISCUSSION

The results contribute to the education-health literature by highlighting new and important pathways through which education might be linked to successful aging.

Global, cell non-autonomous gene regulation drives individual lifespan among isogenic C. elegans

Across species, lifespan is highly variable among individuals within a population. Even genetically identical Caenorhabditis elegans reared in homogeneous environments are as variable in lifespan as outbred human populations. We hypothesized that persistent inter-individual differences in expression of key regulatory genes drives this lifespan variability. As a test, we examined the relationship between future lifespan and the expression of 22 microRNA promoter::GFP constructs. Surprisingly, expression of nearly half of these reporters, well before death, could effectively predict lifespan. This indicates that prospectively long- vs. short-lived individuals have highly divergent patterns of transgene expression and transcriptional regulation. The gene-regulatory processes reported on by two of the most lifespan-predictive transgenes do not require DAF-16, the FOXO transcription factor that is a principal effector of insulin/insulin-like growth factor (IGF-1) signaling. Last, we demonstrate a hierarchy of redundancy in lifespan-predictive ability among three transgenes expressed in distinct tissues, suggesting that they collectively report on an organism-wide, cell non-autonomous process that acts to set each individual's lifespan.

Cognition in Healthy Aging

The study of cognitive change across a life span, both in pathological and healthy samples, has been heavily influenced by developments in cognitive psychology as a theoretical paradigm, neuropsychology and other bio-medical fields; this alongside the increase in new longitudinal and cohort designs, complemented in the last decades by the evaluation of experimental interventions. Here, a review of aging databases was conducted, looking for the most relevant studies carried out on cognitive functioning in healthy older adults. The aim was to review not only longitudinal, cross-sectional or cohort studies, but also by intervention program evaluations. The most important studies, searching for long-term patterns of stability and change of cognitive measures across a life span and in old age, have shown a great range of inter-individual variability in cognitive functioning changes attributed to age. Furthermore, intellectual functioning in healthy individuals seems to decline rather late in life, if ever, as shown in longitudinal studies where age-related decline of cognitive functioning occurs later in life than indicated by cross-sectional studies. The longitudinal evidence and experimental trials have shown the benefits of aerobic physical exercise and an intellectually engaged lifestyle, suggesting that bio-psycho-socioenvironmental factors concurrently with age predict or determine both positive or negative change or stability in cognition in later life.

Telomere length as a function of age at population level parallels human survival curves

Telomeres are subject to age related shortening which can be accelerated by oxidative stress and inflammation. Many studies have reported an inverse correlation between telomere length and survival, but such inverse correlation has not been always confirmed in different populations. We analyzed the trend of Leukocyte Telomere Length (LTL) as a function of age in a cohort of 516 subjects aged 65-106 years from Southern Italy. The trend of LTL obtained was quite similar to demographic survival curves reported with data of western societies. We observed a decrease of LTL after 70 years of age and then an increase after 92 years, in agreement with the sharp decrease of survival after 70 years of age and its increase after 90 years, due to the deceleration of mortality at old ages. Our data suggest that a generalized LTL attrition after 70 years of age, associated to organismal decline, affects most of the population. Such generalized attrition may exacerbate senescence in these subjects, predisposing them to high mortality risk. Conversely, the subjects with better physical conditions, experience a lower attrition and, consequently, a delayed senescence, contributing to the deceleration of mortality which has been observed among very old subjects in modern societies.

'The Devil's Company': A Grounded Theory Study on Aging, Loneliness and Social Change Among 'Older Adult Children' in Rural Indonesia

Introduction: As a consequence of rising life expectancies, many families are no longer made up of one, but two simultaneously aging generations. This elderly parent-older adult child (OAC) dyad has emerged as a newly overserved yet little explored demographic phenomenon. Studies on this intergenerational aging dyad and the possible ramifications of when caregivers are simultaneously aging with care-receivers are scarce, especially in low and middle-income countries. This study explored the process by which rural Indonesian OACs experience their own aging, thereby gaining insights into how this newly evolving reality impacts the traditional ways of old-age care provision. Methods: This study has a qualitative design and draws on eight focus group discussions with 48 community-dwelling OACs (23 men, 25 women; mean age 64 years) in four rural villages in the Yogyakarta Special Region, Indonesia. The theoretical framework was largely inspired by symbolic interactionism aided by the sensitizing concepts of social network deficits, interpersonal emotions, and the social construction of risks. Data were analyzed using Grounded Theory as outlined by Corbin and Strauss. Results: Respondents' accounts reflected four categories: 1) aging in a welt of chronic insecurity; 2) OACs: a generation "betwixt and between" expected demands and unmet expectations; 3) landscapes of loneliness; and 4) compromising against conventions. As depicted in a conceptual model, these categories interrelated with each other and were linked by a core category, "bargaining for a sense of security", which collectively summarized a process by which OACs' experienced their own course of aging. Conclusion: Our study provided insights into how and why loneliness emerged amidst the challenges of social and demographic transformations and how in response to this unconventional compromises were made, which affect both the networks of caretakers and the places of old-age care. It is doing so by including the perspectives of rural Indonesian OACs. The results showed how multiple intersecting negative experiences constrained the aging experiences of OACs and produced precarious aging trajectories. Our findings highlight the importance of old-age loneliness as an emerging public health and social problem by discussing how intrinsically this emotion was interwoven with social life.

Tissue Failure Propagation as Mediated by Circulatory Flow

Aging is driven by subcellular processes that are relatively well understood. However, the qualitative mechanisms and quantitative dynamics of how these micro-level failures cascade to a macro-level catastrophe in a tissue or organs remain largely unexplored. Here, we experimentally and theoretically study how cell failure propagates in an engineered tissue in the presence of advective flow. We argue that cells secrete cooperative factors, thereby forming a network of interdependence governed by diffusion and flow, which fails with a propagating front parallel to advective circulation.

Why Does Child Mortality Decrease With Age? Modeling the Age-Associated Decrease in Mortality Rate Using WHO Metadata From 14 European Countries

Background: Mortality rate rapidly decreases with age after birth, and, simultaneously, the spectrum of death causes show remarkable changes with age. This study analyzed age-associated decreases in mortality rate from diseases of all main chapters of the 10th revision of the International Classification of Diseases. Methods: The number of deaths was extracted from the mortality database of the World Health Organization. As zero cases could be ascertained for a specific age category, the Halley method was used to calculate the mortality rates in all possible calendar years and in all countries combined. Results: All causes mortality from the 1st day of life to the age of 10 years can be represented by an inverse proportion model with a single parameter. High coefficients of determination were observed for total mortality in all populations (arithmetic mean = 0.9942 and standard deviation = 0.0039). Slower or no mortality decrease with age was detected in the 1st year of life, while the inverse proportion method was valid for the age range [1, 10) years in most of all main chapters with three exceptions. The decrease was faster for the chapter "Certain conditions originating in the perinatal period" (XVI).The inverse proportion was valid already from the 1st day for the chapter "Congenital malformations, deformations and chromosomal abnormalities" (XVII).The shape of the mortality decrease was very different for the chapter "Neoplasms" (II) and the rates of mortality from neoplasms were age-independent in the age range [1, 10) years in all populations. Conclusion: The theory of congenital individual risks of death is presented and can explain the results. If it is valid, latent congenital impairments may be present among all cases of death that are not related to congenital impairments. All results are based on published data, and the data are presented as a supplement.

Why are supercentenarians so frequently found in French Overseas Departments? The cases of Guadeloupe and Martinique

Many more cases of supercentenarians are observed in the French Départements d’Outre-Mer (DOM) than in metropolitan France. A first possible explanation is that the standard French protocol for validating age does not sufficiently cover DOMs. However, if additional checks can confirm the verity of this phenomenon, forming explanatory hypotheses can be relevant and quite interesting. Thanks to an INED research funding, a special protocol of deep age checking has been established to be applied to the two DOMs where the phenomenon is the most pronounced: Guadeloupe and Martinique. First results not only show that combining several additional checks does not leave much room for further doubting the ages of supercentenarians but they also support some arguments in favor of a possible fundamental explanation: genetic selection due to the extreme severity of mortality inflicted on their slave ancestors.

The influence of birth month on total and cardiovascular mortality: a population-based surveillance study

There is little evidence about the impact of birth month on total and cardiovascular disease mortality in developing countries. We evaluated these associations using the population health registration data of Hefei City, China from 2014 to 2017. After controlling for the fixed effects of gender, education, and occupation, we fitted the Cox proportional hazard regression model to assess the relationship between birth month and mortality. Hazard ratio (HR) with corresponding 95% confidence interval (CI) was calculated. All data analyses were performed by R 3.6.0 software. The data of 44 665 participants were analyzed in the study. Compared to people born in January, people born between May and October had higher total and cardiovascular mortality, being highest in June, respectively, HR: 1.130 (95%CI: 1.074 to 1.190) and HR: 1.200 (95%CI: 1.115 to 1.290). After stratification by gender, males born in June had highest risk total and cardiovascular mortality, with an increase in risk of 14.8% and 24.7%, respectively. For females, highest risk of total mortality was increased by 11.1% in those born in July, while those born in December had highest increase in cardiovascular mortality risk by 15.7%. Our results indicate in Hefei City, China month of birth is associated with total and cardiovascular disease mortality.

Terminal life history: late-life fecundity and survival in experimental populations of Drosophila melanogaster

There are two life history landmarks that can be used to define the terminal period in individual Drosophila melanogaster females: the cessation of daily oviposition, which defines the start of the retired stage, and final oviposition, which defines the start of post-ovipository survival. The terminal period is a substantial component of D. melanogaster life history. Analysis of published data on the daily fecundity and survival of 3971 individually maintained, mated female flies reveals that the terminal period is far more variable within populations than other life history components, including total adult life span. It has been reported that there is a negative correlation between fecundity and duration of the terminal state in recently collected wild stocks. Here I show that the negative correlation occurs in multiple inbred and outbred lab-adapted populations as well. In terms of proportion of adult life, lower fecundity flies spend on average twice as much time in the terminal stage as higher fecundity flies from the same population. Both high and low fecundity flies experience end-of-life plateaus in mortality, with the former exhibiting higher plateau levels. The negative correlation between fecundity and terminal survival is of sufficient magnitude to create heterogeneity among the oldest old: the final 10% of survivors are predominately flies with a history of high fecundity, but about one in five is a low fecundity fly with long terminal stage.