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Kalyakulina A, Yusipov I, Moskalev A, Franceschi C, Ivanchenko M. eXplainable Artificial Intelligence (XAI) in aging clock models. Ageing Res Rev 2024; 93:102144. [PMID: 38030090 DOI: 10.1016/j.arr.2023.102144] [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: 09/26/2023] [Revised: 11/07/2023] [Accepted: 11/23/2023] [Indexed: 12/01/2023]
Abstract
XAI is a rapidly progressing field of machine learning, aiming to unravel the predictions of complex models. XAI is especially required in sensitive applications, e.g. in health care, when diagnosis, recommendations and treatment choices might rely on the decisions made by artificial intelligence systems. AI approaches have become widely used in aging research as well, in particular, in developing biological clock models and identifying biomarkers of aging and age-related diseases. However, the potential of XAI here awaits to be fully appreciated. We discuss the application of XAI for developing the "aging clocks" and present a comprehensive analysis of the literature categorized by the focus on particular physiological systems.
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Affiliation(s)
- Alena Kalyakulina
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia; Research Center for Trusted Artificial Intelligence, The Ivannikov Institute for System Programming of the Russian Academy of Sciences, Moscow 109004, Russia; Department of Applied Mathematics, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky State University, Nizhny Novgorod 603022, Russia.
| | - Igor Yusipov
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia; Research Center for Trusted Artificial Intelligence, The Ivannikov Institute for System Programming of the Russian Academy of Sciences, Moscow 109004, Russia; Department of Applied Mathematics, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky State University, Nizhny Novgorod 603022, Russia
| | - Alexey Moskalev
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia
| | - Claudio Franceschi
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia
| | - Mikhail Ivanchenko
- Institute of Biogerontology, Lobachevsky State University, Nizhny Novgorod 603022, Russia; Department of Applied Mathematics, Institute of Information Technologies, Mathematics and Mechanics, Lobachevsky State University, Nizhny Novgorod 603022, Russia
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2
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Bernard D, Doumard E, Ader I, Kemoun P, Pagès J, Galinier A, Cussat‐Blanc S, Furger F, Ferrucci L, Aligon J, Delpierre C, Pénicaud L, Monsarrat P, Casteilla L. Explainable machine learning framework to predict personalized physiological aging. Aging Cell 2023; 22:e13872. [PMID: 37300327 PMCID: PMC10410015 DOI: 10.1111/acel.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/17/2023] [Accepted: 05/03/2023] [Indexed: 06/12/2023] Open
Abstract
Attaining personalized healthy aging requires accurate monitoring of physiological changes and identifying subclinical markers that predict accelerated or delayed aging. Classic biostatistical methods most rely on supervised variables to estimate physiological aging and do not capture the full complexity of inter-parameter interactions. Machine learning (ML) is promising, but its black box nature eludes direct understanding, substantially limiting physician confidence and clinical usage. Using a broad population dataset from the National Health and Nutrition Examination Survey (NHANES) study including routine biological variables and after selection of XGBoost as the most appropriate algorithm, we created an innovative explainable ML framework to determine a Personalized physiological age (PPA). PPA predicted both chronic disease and mortality independently of chronological age. Twenty-six variables were sufficient to predict PPA. Using SHapley Additive exPlanations (SHAP), we implemented a precise quantitative associated metric for each variable explaining physiological (i.e., accelerated or delayed) deviations from age-specific normative data. Among the variables, glycated hemoglobin (HbA1c) displays a major relative weight in the estimation of PPA. Finally, clustering profiles of identical contextualized explanations reveal different aging trajectories opening opportunities to specific clinical follow-up. These data show that PPA is a robust, quantitative and explainable ML-based metric that monitors personalized health status. Our approach also provides a complete framework applicable to different datasets or variables, allowing precision physiological age estimation.
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Affiliation(s)
- David Bernard
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
- Université Toulouse 1 – Capitole, Institute of Research in Informatics (IRIT) of Toulouse, CNRSToulouseFrance
| | - Emmanuel Doumard
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
| | - Isabelle Ader
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
| | - Philippe Kemoun
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
- Oral Medicine Department and Hospital of ToulouseToulouse Institute of Oral Medicine and Science, CHU de ToulouseToulouseFrance
| | - Jean‐Christophe Pagès
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
- UFR Santé, Département Médecine, Institut Fédératif de Biologie, CHU de ToulouseToulouseFrance
| | - Anne Galinier
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
- UFR Santé, Département Médecine, Institut Fédératif de Biologie, CHU de ToulouseToulouseFrance
| | - Sylvain Cussat‐Blanc
- Université Toulouse 1 – Capitole, Institute of Research in Informatics (IRIT) of Toulouse, CNRSToulouseFrance
- Artificial and Natural Intelligence Toulouse Institute ANITIToulouseFrance
| | - Felix Furger
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
| | - Luigi Ferrucci
- Biomedical Research Centre, National Institute on AgingNIHBaltimoreMarylandUSA
| | - Julien Aligon
- Université Toulouse 1 – Capitole, Institute of Research in Informatics (IRIT) of Toulouse, CNRSToulouseFrance
| | | | - Luc Pénicaud
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
| | - Paul Monsarrat
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
- Oral Medicine Department and Hospital of ToulouseToulouse Institute of Oral Medicine and Science, CHU de ToulouseToulouseFrance
- Artificial and Natural Intelligence Toulouse Institute ANITIToulouseFrance
| | - Louis Casteilla
- RESTORE Research CenterUniversité de Toulouse, INSERM 1301, CNRS 5070, EFS, ENVTFrance
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Bafei SEC, Shen C. Biomarkers selection and mathematical modeling in biological age estimation. NPJ AGING 2023; 9:13. [PMID: 37393295 DOI: 10.1038/s41514-023-00110-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 05/08/2023] [Indexed: 07/03/2023]
Abstract
Biological age (BA) is important for clinical monitoring and preventing aging-related disorders and disabilities. Clinical and/or cellular biomarkers are measured and integrated in years using mathematical models to display an individual's BA. To date, there is not yet a single or set of biomarker(s) and technique(s) that is validated as providing the BA that reflects the best real aging status of individuals. Herein, a comprehensive overview of aging biomarkers is provided and the potential of genetic variations as proxy indicators of the aging state is highlighted. A comprehensive overview of BA estimation methods is also provided as well as a discussion of their performances, advantages, limitations, and potential approaches to overcome these limitations.
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Affiliation(s)
- Solim Essomandan Clémence Bafei
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China
| | - Chong Shen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, Jiangsu, China.
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El Damaty S, Darcey VL, McQuaid GA, Picci G, Stoianova M, Mucciarone V, Chun Y, Laws ML, Campano V, Van Hecke K, Ryan M, Rose EJ, Fishbein DH, VanMeter AS. Introducing an adolescent cognitive maturity index. Front Psychol 2022; 13:1017317. [PMID: 36571021 PMCID: PMC9771453 DOI: 10.3389/fpsyg.2022.1017317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022] Open
Abstract
Children show substantial variation in the rate of physical, cognitive, and social maturation as they traverse adolescence and enter adulthood. Differences in developmental paths are thought to underlie individual differences in later life outcomes, however, there remains a lack of consensus on the normative trajectory of cognitive maturation in adolescence. To address this problem, we derive a Cognitive Maturity Index (CMI), to estimate the difference between chronological and cognitive age predicted with latent factor estimates of inhibitory control, risky decision-making and emotional processing measured with standard neuropsychological instruments. One hundred and forty-one children from the Adolescent Development Study (ADS) were followed longitudinally across three time points from ages 11-14, 13-16, and 14-18. Age prediction with latent factor estimates of cognitive skills approximated age within ±10 months (r = 0.71). Males in advanced puberty displayed lower cognitive maturity relative to peers of the same age; manifesting as weaker inhibitory control, greater risk-taking, desensitization to negative affect, and poor recognition of positive affect.
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Affiliation(s)
- Shady El Damaty
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States,Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States,*Correspondence: Shady El Damaty
| | - Valerie L. Darcey
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States,Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
| | - Goldie A. McQuaid
- Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
| | - Giorgia Picci
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, United States,Center for Pediatric Brain Health, Boys Town National Research Hospital, Boys Town, NE, United States
| | - Maria Stoianova
- Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
| | - Veronica Mucciarone
- Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
| | - Yewon Chun
- Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
| | - Marissa L. Laws
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States
| | - Victor Campano
- Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
| | - Kinney Van Hecke
- Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
| | - Mary Ryan
- Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
| | - Emma Jane Rose
- Department of Psychology, The Pennsylvania State University, University Park, PA, United States
| | - Diana H. Fishbein
- Translational Neuro-Prevention Research, Frank Porter Graham Child Development Institute, University of Northern Carolina, Chapel Hill, NC, United States
| | - Ashley S. VanMeter
- Interdisciplinary Program in Neuroscience, Georgetown University, Washington, DC, United States,Center for Functional & Molecular Imaging, Georgetown University Medical Center, Department of Neurology, Washington, DC, United States
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5
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Solary E, Abou-Zeid N, Calvo F. Ageing and cancer: a research gap to fill. Mol Oncol 2022; 16:3220-3237. [PMID: 35503718 PMCID: PMC9490141 DOI: 10.1002/1878-0261.13222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/01/2022] [Accepted: 05/02/2022] [Indexed: 12/03/2022] Open
Abstract
The complex mechanisms of ageing biology are increasingly understood. Interventions to reduce or delay ageing‐associated diseases are emerging. Cancer is one of the diseases promoted by tissue ageing. A clockwise mutational signature is identified in many tumours. Ageing might be a modifiable cancer risk factor. To reduce the incidence of ageing‐related cancer and to detect the disease at earlier stages, we need to understand better the links between ageing and tumours. When a cancer is established, geriatric assessment and measures of biological age might help to generate evidence‐based therapeutic recommendations. In this approach, patients and caregivers would include the respective weight to give to the quality of life and survival in the therapeutic choices. The increasing burden of cancer in older patients requires new generations of researchers and geriatric oncologists to be trained, to properly address disease complexity in a multidisciplinary manner, and to reduce health inequities in this population of patients. In this review, we propose a series of research challenges to tackle in the next few years to better prevent, detect and treat cancer in older patients while preserving their quality of life.
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Affiliation(s)
- Eric Solary
- Fondation « Association pour la Recherche sur le Cancer », Villejuif, France.,Université Paris Saclay, Faculté de Médecine, Le Kremlin-Bicêtre, France.,Gustave Roussy Cancer Center, INSERM U1287, Villejuif, France
| | - Nancy Abou-Zeid
- Fondation « Association pour la Recherche sur le Cancer », Villejuif, France
| | - Fabien Calvo
- Fondation « Association pour la Recherche sur le Cancer », Villejuif, France.,Université de Paris, Paris, France
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6
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Wei K, Peng S, Liu N, Li G, Wang J, Chen X, He L, Chen Q, Lv Y, Guo H, Lin Y. All-Subset Analysis Improves the Predictive Accuracy of Biological Age for All-Cause Mortality in Chinese and U.S. Populations. J Gerontol A Biol Sci Med Sci 2022; 77:2288-2297. [PMID: 35417546 PMCID: PMC9923798 DOI: 10.1093/gerona/glac081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Klemera-Doubal's method (KDM) is an advanced and widely applied algorithm for estimating biological age (BA), but it has no uniform paradigm for biomarker processing. This article proposed all subsets of biomarkers for estimating BAs and assessed their association with mortality to determine the most predictive subset and BA. METHODS Clinical biomarkers, including those from physical examinations and blood assays, were assessed in the China Health and Nutrition Survey (CHNS) 2009 wave. Those correlated with chronological age (CA) were combined to produce complete subsets, and BA was estimated by KDM from each subset of biomarkers. A Cox proportional hazards regression model was used to examine and compare each BA's effect size and predictive capacity for all-cause mortality. Validation analysis was performed in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) and National Health and Nutrition Examination Survey (NHANES). KD-BA and Levine's BA were compared in all cohorts. RESULTS A total of 130 918 panels of BAs were estimated from complete subsets comprising 3-17 biomarkers, whose Pearson coefficients with CA varied from 0.39 to 1. The most predictive subset consisted of 5 biomarkers, whose estimated KD-BA had the most predictive accuracy for all-cause mortality. Compared with Levine's BA, the accuracy of the best-fitting KD-BA in predicting death varied among specific populations. CONCLUSION All-subset analysis could effectively reduce the number of redundant biomarkers and significantly improve the accuracy of KD-BA in predicting all-cause mortality.
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Affiliation(s)
- Kai Wei
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shanshan Peng
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Na Liu
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Guyanan Li
- Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China
| | - Jiangjing Wang
- Shanghai Advanced Institute of Finance, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaotong Chen
- Department of Clinical Laboratory, Central Laboratory, Jing’an District Central Hospital of Shanghai, Fudan University, Shanghai, China
| | - Leqi He
- Department of Clinical Laboratory Medicine, Fifth People’s Hospital of Shanghai Fudan University, Shanghai, China
| | - Qiudan Chen
- Department of Clinical Laboratory, Central Laboratory, Jing’an District Central Hospital of Shanghai, Fudan University, Shanghai, China
| | - Yuan Lv
- Department of Laboratory Medicine, Huashan Hospital, Fudan University, Shanghai, China,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Huan Guo
- Department of Occupational and Environmental Health, State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Lin
- Address correspondence to: Yong Lin, PhD, Department of Laboratory Medicine, Huashan Hospital, Fudan University, 12 Middle Urumqi Road, Jing’an District, Shanghai 200040, People’s Republic of China. E-mail:
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Ren B, Wu Y, Huang L, Zhang Z, Huang B, Zhang H, Ma J, Li B, Liu X, Wu G, Zhang J, Shen L, Liu Q, Ni J. Deep transfer learning of structural magnetic resonance imaging fused with blood parameters improves brain age prediction. Hum Brain Mapp 2021; 43:1640-1656. [PMID: 34913545 PMCID: PMC8886664 DOI: 10.1002/hbm.25748] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/14/2021] [Accepted: 12/01/2021] [Indexed: 12/27/2022] Open
Abstract
Machine learning has been applied to neuroimaging data for estimating brain age and capturing early cognitive impairment in neurodegenerative diseases. Blood parameters like neurofilament light chain are associated with aging. In order to improve brain age predictive accuracy, we constructed a model based on both brain structural magnetic resonance imaging (sMRI) and blood parameters. Healthy subjects (n = 93; 37 males; aged 50–85 years) were recruited. A deep learning network was firstly pretrained on a large set of MRI scans (n = 1,481; 659 males; aged 50–85 years) downloaded from multiple open‐source datasets, to provide weights on our recruited dataset. Evaluating the network on the recruited dataset resulted in mean absolute error (MAE) of 4.91 years and a high correlation (r = .67, p <.001) against chronological age. The sMRI data were then combined with five blood biochemical indicators including GLU, TG, TC, ApoA1 and ApoB, and 9 dementia‐associated biomarkers including ApoE genotype, HCY, NFL, TREM2, Aβ40, Aβ42, T‐tau, TIMP1, and VLDLR to construct a bilinear fusion model, which achieved a more accurate prediction of brain age (MAE, 3.96 years; r = .76, p <.001). Notably, the fusion model achieved better improvement in the group of older subjects (70–85 years). Extracted attention maps of the network showed that amygdala, pallidum, and olfactory were effective for age estimation. Mediation analysis further showed that brain structural features and blood parameters provided independent and significant impact. The constructed age prediction model may have promising potential in evaluation of brain health based on MRI and blood parameters.
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Affiliation(s)
- Bingyu Ren
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Yingtong Wu
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Liumei Huang
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Zhiguo Zhang
- MIND Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Bingsheng Huang
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| | - Huajie Zhang
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Jinting Ma
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Bing Li
- Medical AI Lab, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, China
| | - Xukun Liu
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Guangyao Wu
- Radiology Department, Shenzhen University General Hospital and Shenzhen University Clinical Medical Academy, Shenzhen University, Shenzhen, China
| | - Jian Zhang
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.,Health Science Center, Shenzhen University, Shenzhen, China
| | - Liming Shen
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
| | - Qiong Liu
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China.,Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China.,Shenzhen Bay Laboratory, Shenzhen, China
| | - Jiazuan Ni
- Shenzhen Key Laboratory of Marine Biotechnology and Ecology, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, China
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Netz Y, Argov E, Yekutieli Z, Ayalon M, Tchelet K, Ben-Sira D, Amar Y, Jacobs JM. Personalized multicomponent exercise programs using smartphone technology among older people: protocol for a randomized controlled trial. BMC Geriatr 2021; 21:605. [PMID: 34702168 PMCID: PMC8547559 DOI: 10.1186/s12877-021-02559-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 10/15/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Optimal application of the recently updated World Health Organization (WHO) guidelines for exercise in advanced age necessitates an accurate adjustment for the age-related increasing variability in biological age and fitness levels, alongside detailed recommendations across a range of motor fitness components, including balance, strength, and flexibility. We previously developed and validated a novel tool, designed to both remotely assess these fitness components, and subsequently deliver a personalized exercise program via smartphone. We describe the design of a prospective randomized control trial, comparing the effectiveness of the remotely delivered personalized multicomponent exercise program to either WHO exercise guidelines or no intervention. METHODS Participants (n = 300) are community dwelling, healthy, functionally independent, cognitively intact volunteers aged ≥65 at low risk for serious fall injuries, assigned using permuted block randomization (age/gender) to intervention, active-control, or control group. The intervention is an 8-week program including individually tailored exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, vestibular); active-controls receive exercising counselling according to WHO guidelines; controls receive no guidance. Primary outcome is participant fitness level, operationalized as 42 digital markers generated from 10 motor fitness measures (balance, strength, flexibility); measured at baseline, mid-trial (4-weeks), trial-end (8-weeks), and follow-up (12-weeks). Target sample size is 300 participants to provide 99% power for moderate and high effect sizes (Cohen's f = 0.25, 0.40 respectively). DISCUSSION The study will help understand the value of individualized motor fitness assessment used to generate personalized multicomponent exercise programs, delivered remotely among older adults. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04181983.
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Affiliation(s)
- Yael Netz
- The Academic College at Wingate, 4209200, Netanya, Israel.
| | - Esther Argov
- The Academic College at Wingate, 4209200, Netanya, Israel
| | | | - Moshe Ayalon
- The Academic College at Wingate, 4209200, Netanya, Israel
| | | | - David Ben-Sira
- The Academic College at Wingate, 4209200, Netanya, Israel
| | - Yihya Amar
- Faculty of Medicine, Department of Geriatric Rehabilitation, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Jeremy M Jacobs
- Faculty of Medicine, Department of Geriatric Rehabilitation, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
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The Role of Big Data in Aging and Older People’s Health Research: A Systematic Review and Ecological Framework. SUSTAINABILITY 2021. [DOI: 10.3390/su132111587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Big data has been prominent in studying aging and older people’s health. It has promoted modeling and analyses in biological and geriatric research (like cellular senescence), developed health management platforms, and supported decision-making in public healthcare and social security. However, current studies are still limited within a single subject, rather than flourished as interdisciplinary research in the context of big data. The research perspectives have not changed, nor has big data brought itself out of the role as a modeling tool. When embedding big data as a data product, analysis tool, and resolution service into different spatial, temporal, and organizational scales of aging processes, it would present as a connection, integration, and interaction simultaneously in conducting interdisciplinary research. Therefore, this paper attempts to propose an ecological framework for big data based on aging and older people’s health research. Following the scoping process of PRISMA, 35 studies were reviewed to validate our ecological framework. Although restricted by issues like digital divides and privacy security, we encourage researchers to capture various elements and their interactions in the human-environment system from a macro and dynamic perspective rather than simply pursuing accuracy.
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Netz Y, Yekutieli Z, Arnon M, Argov E, Tchelet K, Benmoha E, Jacobs JM. Personalized Exercise Programs Based upon Remote Assessment of Motor Fitness: A Pilot Study among Healthy People Aged 65 Years and Older. Gerontology 2021; 68:465-479. [PMID: 34515118 DOI: 10.1159/000517918] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 06/15/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The World Health Organization has recently updated exercise guidelines for people aged >65 years, emphasizing the inclusion of multiple fitness components. However, without adequate recognition of individual differences, these guidelines may be applied using an approach that "one-size-fits-all." Within the shifting paradigm toward an increasingly personalized approach to medicine and health, it is apparent that fitness components display a significant age-related increase in variability. Therefore, it is both logical and necessary to perform an accurate individualized assessment of multiple fitness components prior to optimal prescription for a personalized exercise program. OBJECTIVE The aim of the study was to test the feasibility and effectiveness of a novel tool able to remotely assess balance, flexibility, and strength using smartphone sensors (accelerometer/gyroscope), and subsequently deliver personalized exercise programs via the smartphone. METHODS We enrolled 52 healthy volunteers (34 females) aged 65+ years, with normal cognition and low fall risk. Baseline data from remote smartphone fitness assessment were analyzed to generate 42 fitness digital markers (DMs), used to guide personalized exercise programs (×5/week for 6 weeks) delivered via smartphone. Programs included graded exercises for upper/lower body, flexibility, strength, and balance (dynamic, static, and vestibular). Participants were retested after 6 weeks. RESULTS Average age was 74.7 ± 6.4 years; adherence was 3.6 ± 1.7 exercise sessions/week. Significant improvement for pre-/posttesting was observed for 10/12 DMs of strength/flexibility for upper/lower body (sit-to-stand repetitions/duration; arm-lift duration; torso rotation; and arm extension/flexion). Balance improved significantly for 6/10 measures of tandem stance, with consistent (nonsignificant) trends observed across 20 balance DMs of tandem walk and 1 leg stance. Balance tended to improve among the 37 participants exercising ≥3/week. DISCUSSION These preliminary results provide a proof of concept, with high adherence and improved fitness confirming the benefits of remote fitness assessment for guiding home personalized exercise programs among healthy adults aged >65 years. Further examination of the application within a randomized control study is necessary, comparing the personalized exercise program to general guidelines among healthy older adults, as well as specific populations, such as those with frailty, deconditioning, cognitive, or functional impairment. The study tool offers the opportunity to collect big data, including additional variables, with subsequent utilization of artificial intelligence to optimize the personalized exercise program.
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Affiliation(s)
- Yael Netz
- The Academic College at Wingate, Netanya, Israel
| | | | - Michal Arnon
- The Academic College at Wingate, Netanya, Israel
| | - Esther Argov
- The Academic College at Wingate, Netanya, Israel
| | | | - Eti Benmoha
- The Academic College at Wingate, Netanya, Israel
| | - Jeremy M Jacobs
- Department of Geriatric Rehabilitation, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Biological age in healthy elderly predicts aging-related diseases including dementia. Sci Rep 2021; 11:15929. [PMID: 34354164 PMCID: PMC8342513 DOI: 10.1038/s41598-021-95425-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 07/22/2021] [Indexed: 11/09/2022] Open
Abstract
Application of biological age as a measure of an individual´s health status offers new perspectives into extension of both lifespan and healthspan. While algorithms predicting mortality and most aging-related morbidities have been reported, the major shortcoming has been an inability to predict dementia. We present a community-based cohort study of 1930 participants with a mean age of 72 years and a follow-up period of over 7 years, using two variants of a phenotypic blood-based algorithm that either excludes (BioAge1) or includes (BioAge2) neurofilament light chain (NfL) as a neurodegenerative marker. BioAge1 and BioAge2 predict dementia equally well, as well as lifespan and healthspan. Each one-year increase in BioAge1/2 was associated with 11% elevated risk (HR 1.11; 95%CI 1.08-1.14) of mortality and 7% elevated risk (HR 1.07; 95%CI 1.05-1.09) of first morbidities. We additionally tested the association of microRNAs with age and identified 263 microRNAs significantly associated with biological and chronological age alike. Top differentially expressed microRNAs based on biological age had a higher significance level than those based on chronological age, suggesting that biological age captures aspects of aging signals at the epigenetic level. We conclude that accelerated biological age for a given age is a predictor of major age-related morbidity, including dementia, among healthy elderly.
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Muscari A, Bianchi G, Forti P, Magalotti D, Pandolfi P, Zoli M. The association of proBNPage with manifestations of age-related cardiovascular, physical, and psychological impairment in community-dwelling older adults. GeroScience 2021; 43:2087-2100. [PMID: 33987773 PMCID: PMC8492850 DOI: 10.1007/s11357-021-00381-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/28/2021] [Indexed: 11/29/2022] Open
Abstract
NT-proB-type natriuretic peptide (NT-proBNP) serum concentration can be transformed by simple formulas into proBNPage, a surrogate of biological age strongly associated with chronological age, all-cause mortality, and disease count. This cross-sectional study aimed to assess whether proBNPage is also associated with other manifestations of the aging process in comparison with other variables. The study included 1117 noninstitutionalized older adults (73.1 ± 5.6 years, 537 men). Baseline measurements of serum NT-proBNP, erythrocyte sedimentation rate, hemoglobin, lymphocytes, and creatinine, which have previously been shown to be highly associated with both age and all-cause mortality, were performed. These variables were compared between subjects with and without manifestations of cardiovascular impairment (myocardial infarction (MI), stroke, peripheral artery disease (PAD), arterial revascularizations (AR)), physical impairment (long step test duration (LSTD), walking problems, falls, deficit in one or more activities of daily living), and psychological impairment (poor self-rating of health (PSRH), anxiety/depression, Mini Mental State Examination (MMSE) score < 24). ProBNPage (years) was independently associated (OR, 95% CI) with MI (1.08, 1.07-1.10), stroke (1.02, 1.00-1.05), PAD (1.04, 1.01-1.06), AR (1.06, 1.04-1.08), LSTD (1.03, 1.02-1.04), walking problems (1.02, 1.01-1.03), and PSRH (1.02, 1.01-1.02). For 5 of these 7 associations, the relationship was stronger than that of chronological age. In addition, proBNPage was univariately associated with MMSE score < 24, anxiety/depression, and falls. None of the other variables provided comparable performances. Thus, in addition to the known associations with mortality and disease count, proBNPage is also associated with cardiovascular manifestations as well as noncardiovascular manifestations of the aging process.
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Affiliation(s)
- Antonio Muscari
- Department of Medical and Surgical Sciences, University of Bologna, Via Albertoni, 15 40138 Bologna, Italy
- Medical Department of Continuity of Care and Disability, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giampaolo Bianchi
- Department of Medical and Surgical Sciences, University of Bologna, Via Albertoni, 15 40138 Bologna, Italy
- Medical Department of Continuity of Care and Disability, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Paola Forti
- Department of Medical and Surgical Sciences, University of Bologna, Via Albertoni, 15 40138 Bologna, Italy
- Medical Department of Continuity of Care and Disability, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Donatella Magalotti
- Medical Department of Continuity of Care and Disability, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Paolo Pandolfi
- Epidemiological and Health Promotion Unit, Department of Public Health, AUSL Bologna, Bologna, Italy
| | - Marco Zoli
- Department of Medical and Surgical Sciences, University of Bologna, Via Albertoni, 15 40138 Bologna, Italy
- Medical Department of Continuity of Care and Disability, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - the Pianoro Study Group
- Department of Medical and Surgical Sciences, University of Bologna, Via Albertoni, 15 40138 Bologna, Italy
- Medical Department of Continuity of Care and Disability, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Epidemiological and Health Promotion Unit, Department of Public Health, AUSL Bologna, Bologna, Italy
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Geva A, Liu M, Panickan VA, Avillach P, Cai T, Mandl KD. A high-throughput phenotyping algorithm is portable from adult to pediatric populations. J Am Med Inform Assoc 2021; 28:1265-1269. [PMID: 33594412 DOI: 10.1093/jamia/ocaa343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/27/2020] [Accepted: 12/28/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Multimodal automated phenotyping (MAP) is a scalable, high-throughput phenotyping method, developed using electronic health record (EHR) data from an adult population. We tested transportability of MAP to a pediatric population. MATERIALS AND METHODS Without additional feature engineering or supervised training, we applied MAP to a pediatric population enrolled in a biobank and evaluated performance against physician-reviewed medical records. We also compared performance of MAP at the pediatric institution and the original adult institution where MAP was developed, including for 6 phenotypes validated at both institutions against physician-reviewed medical records. RESULTS MAP performed equally well in the pediatric setting (average AUC 0.98) as it did at the general adult hospital system (average AUC 0.96). MAP's performance in the pediatric sample was similar across the 6 specific phenotypes also validated against gold-standard labels in the adult biobank. CONCLUSIONS MAP is highly transportable across diverse populations and has potential for wide-scale use.
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Affiliation(s)
- Alon Geva
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.,Division of Critical Care Medicine, Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Molei Liu
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Vidul A Panickan
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Paul Avillach
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Tianxi Cai
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Kenneth D Mandl
- Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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Lehallier B, Shokhirev MN, Wyss‐Coray T, Johnson AA. Data mining of human plasma proteins generates a multitude of highly predictive aging clocks that reflect different aspects of aging. Aging Cell 2020; 19:e13256. [PMID: 33031577 PMCID: PMC7681068 DOI: 10.1111/acel.13256] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/21/2020] [Accepted: 09/15/2020] [Indexed: 12/14/2022] Open
Abstract
We previously identified 529 proteins that had been reported by multiple different studies to change their expression level with age in human plasma. In the present study, we measured the q-value and age coefficient of these proteins in a plasma proteomic dataset derived from 4263 individuals. A bioinformatics enrichment analysis of proteins that significantly trend toward increased expression with age strongly implicated diverse inflammatory processes. A literature search revealed that at least 64 of these 529 proteins are capable of regulating life span in an animal model. Nine of these proteins (AKT2, GDF11, GDF15, GHR, NAMPT, PAPPA, PLAU, PTEN, and SHC1) significantly extend life span when manipulated in mice or fish. By performing machine-learning modeling in a plasma proteomic dataset derived from 3301 individuals, we discover an ultra-predictive aging clock comprised of 491 protein entries. The Pearson correlation for this clock was 0.98 in the learning set and 0.96 in the test set while the median absolute error was 1.84 years in the learning set and 2.44 years in the test set. Using this clock, we demonstrate that aerobic-exercised trained individuals have a younger predicted age than physically sedentary subjects. By testing clocks associated with 1565 different Reactome pathways, we also show that proteins associated with signal transduction or the immune system are especially capable of predicting human age. We additionally generate a multitude of age predictors that reflect different aspects of aging. For example, a clock comprised of proteins that regulate life span in animal models accurately predicts age.
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Affiliation(s)
- Benoit Lehallier
- Department of Neurology and Neurological SciencesStanford UniversityStanfordCaliforniaUSA
- Wu Tsai Neurosciences InstituteStanford UniversityStanfordCaliforniaUSA
- Paul F. Glenn Center for the Biology of AgingStanford UniversityStanfordCaliforniaUSA
| | - Maxim N. Shokhirev
- Razavi Newman Integrative Genomics and Bioinformatics CoreThe Salk Institute for Biological StudiesLa JollaCaliforniaUSA
| | - Tony Wyss‐Coray
- Department of Neurology and Neurological SciencesStanford UniversityStanfordCaliforniaUSA
- Wu Tsai Neurosciences InstituteStanford UniversityStanfordCaliforniaUSA
- Paul F. Glenn Center for the Biology of AgingStanford UniversityStanfordCaliforniaUSA
- Department of Veterans AffairsVA Palo Alto Health Care SystemPalo AltoCaliforniaUSA
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