Frailty phenotypes in the elderly based on cluster analysis: a longitudinal study of two Danish cohorts. Evidence for a genetic influence on frailty
Frailty phenotypes in the elderly based on cluster analysis: a longitudinal study of two Danish cohorts. Evidence for a genetic influence on frailty
复制标题
DOI：
10.1007/s11357-011-9257-x
复制
发表时间：
2012-06-01
期刊：
影响因子：
--
通讯作者：
Passarino, Giuseppe
中科院分区：
文献类型：
--
作者：
Dato, Serena;Montesanto, Alberto;Passarino, Giuseppe
虚弱是一种生理状态，其特征在于衰老生物体的多个生理系统失调，决定了稳态能力的丧失，这使老年人面临残疾、疾病和最终死亡。需要一个可操作的定义，虚弱，有用的分类的个人质量的老化，是必要的。另一方面，不同地理区域之间老龄化质量的记录异质性表明，有必要采用一种提供人群特异性结果的虚弱分类方法。此外，个体遗传背景对虚弱状态的贡献仍然受到质疑。我们研究了适用性的聚类分析方法的基础上，具体的老年参数，以前成立，并在意大利南部人口验证，两个大的纵向丹麦样本。在这两个队列中，我们确定了受试者组的脆弱状态同质，其特征是不同的生存模式。随后的生存分析利用加速失效时间模型，使我们能够制定一个操作指数能够相关的分类变量与生存概率。从这些模型中，我们量化了各种参数对生存的差异影响，并通过利用我们样本中的双胞胎来估计脆弱表型的遗传率。这些数据表明，存在的遗传影响的脆弱性的变化，并表明聚类分析可以定义特定的脆弱表型在每个人口。
Frailty is a physiological state characterized by the deregulation of multiple physiologic systems of an aging organism determining the loss of homeostatic capacity, which exposes the elderly to disability, diseases, and finally death. An operative definition of frailty, useful for the classification of the individual quality of aging, is needed. On the other hand, the documented heterogeneity in the quality of aging among different geographic areas suggests the necessity for a frailty classification approach providing population-specific results. Moreover, the contribution of the individual genetic background on the frailty status is still questioned. We investigated the applicability of a cluster analysis approach based on specific geriatric parameters, previously set up and validated in a southern Italian population, to two large longitudinal Danish samples. In both cohorts, we identified groups of subjects homogeneous for their frailty status and characterized by different survival patterns. A subsequent survival analysis availing of Accelerated Failure Time models allowed us to formulate an operative index able to correlate classification variables with survival probability. From these models, we quantified the differential effect of various parameters on survival, and we estimated the heritability of the frailty phenotype by exploiting the twin pairs in our sample. These data suggest the presence of a genetic influence on the frailty variability and indicate that cluster analysis can define specific frailty phenotypes in each population.