Heterogeneity of Human Aging and Its Assessment
Heterogeneity of Human Aging and Its Assessment
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DOI：
10.1093/gerona/glw089
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发表时间：
2017-07-01
影响因子：
5.1
通讯作者：
Rockwood, Kenneth
中科院分区：
文献类型：
--
作者：
Mitnitski, Arnold;Howlett, Susan E.;Rockwood, Kenneth
了解老年人健康的异质性是衰老生物学中一个引人注目的问题。我们分析了五种健康异质性指标的表现，并根据它们预测死亡率的能力来判断它们。使用加拿大健康与老龄化研究的 1,013 名参与者的临床和生物标志物数据，并对其进行长达 6 年的随访，我们使用 Klemera 和 Doubal 方法计算了两个生物年龄指数，其中有争议地包括使用实际年龄作为“生物标志物”，以及三个不包括实际年龄的虚弱指数 (FI)：标准临床 FI、标准实验室血液测试和血压的 FI 及其组合（FI 组合）。使用 Cox 比例风险分析和接受者操作特征曲线下面积的判别能力来测试预测有效性。所有五项指标均显示出中等绩效，通过结合评估更多项目的指标而得到改善。解释力的最大增加来自于 FI 组合，它显示了年龄调整模型中的最佳死亡率预测。需要对不同数据库进行更广泛的比较，但这些结果不支持将实际年龄作为生物标志物。
Understanding the heterogeneity in health of older adults is a compelling question in the biology of aging. We analyzed the performance of five measures of health heterogeneity, judging them by their ability to predict mortality. Using clinical and biomarker data on 1,013 participants of the Canadian Study of Health and Aging who were followed for up to 6 years, we calculated two indices of biological age using the Klemera and Doubal method, which controversially includes using chronological age as a "biomarker," and three frailty indices (FIs) that do not include chronological age: a standard clinical FI, an FI from standard laboratory blood tests and blood pressure, and their combination (FI-combined). Predictive validity was tested using Cox proportional hazards analysis and discriminative ability by the area under the receiver-operating characteristic curves. All five measures showed moderate performance that was improved by combining measures to evaluate larger numbers of items. The greatest addition in explanatory power came from the FI-combined that showed the best mortality prediction in an age-adjusted model. More extensive comparisons across different databases are required, but these results do not support including chronological age as a biomarker.