A novel, population-specific approach to define frailty
A novel, population-specific approach to define frailty
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DOI：
10.1007/s11357-010-9136-x
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发表时间：
2010-09-01
期刊：
影响因子：
--
通讯作者：
Passarino, Giuseppe
中科院分区：
文献类型：
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作者：
Montesanto, Alberto;Lagani, Vincenzo;Passarino, Giuseppe
衰弱是一种由于体内平衡能力下降而导致的老年人综合症，它的描述为研究人类衰老的生物学基础开辟了新的机遇。然而，这一特征在不同地理区域存在明显的异质性，使得很难使用标准化方法来衡量不同人群的老龄化质量。因此，有必要进行针对特定人群的调查，以确定能够突出显示每个人群中具有同质衰老表型的受试者群体的工具。我们对意大利南部卡拉布里亚的老年人口状况进行了广泛监测，对 680 名受试者（年龄范围 65-108 岁）进行了老年多维评估。然后，为了对受试者进行分类，我们应用了聚类分析，该分析考虑了分类变量等身体、认知和心理参数。我们确定了衰老表型同质的受试者组。我们的分类的诊断和预测的合理性得到了一项为期 3 年的纵向研究的证实。事实上，Kaplan-Meier 对生存函数的估计和 Cox 比例风险模型都表明，体弱程度较低的受试者的生存机会较高。手术衰弱表型的可用性允许重新评估健康衰老的生物学基础，因为它考虑到与衰弱表型相关的生物标志物和与所识别的表型相关的遗传变异性。事实上，我们发现虚弱表型与营养状况相关的临床参数密切相关。
The description of frailty, a syndrome of the elderly due to the decline of homeostatic capacities, has opened new opportunities in the study of the biological basis of human aging. However, the noticeable heterogeneity for this trait in different geographic areas makes it difficult to use standardized methods for measuring the quality of aging in different populations. Consequently, the necessity to carry out population-specific surveys to define tools which are able to highlight groups of subjects with homogeneous aging phenotype within each population has emerged. We carried out an extensive monitoring of the status of the elderly population in Calabria, southern Italy, performing a geriatric multidimensional evaluation of 680 subjects (age range 65-108 years). Then, in order to classify the subjects, we applied a cluster analysis which considered physical, cognitive, and psychological parameters such as classification variables. We identified groups of subjects homogeneous for the aging phenotypes. The diagnostic and predictive soundness of our classification was confirmed by a 3-year longitudinal study. In fact, both Kaplan-Meier estimates of the survival functions and Cox proportional hazard models indicate higher survival chance for subjects characterized by lower frailty. The availability of operative frailty phenotypes allows a reappraisal of the biological basis of healthy aging as it regards both biomarkers correlated with the frail phenotype and the genetic variability associated with the phenotypes identified. Indeed, we found that the frailty phenotype is strongly correlated with clinical parameters associated with the nutritional status.