Exceptional aging: 12 year trajectories to function

描述（由研究者提供）：随着老年人达到80岁及以上，功能性老化或无残疾生存变得越来越罕见。在心血管健康研究（CHS）队列的长期幸存者中，我们将确定维持功能的可能性，确定区分那些注定做得好的人的轨迹，并定义功能生理预测因子的重要性、独立性和相互作用。CHS队列目前年龄在80至100岁以上，随访时间超过12年，但已有4年未进行检查。通过长期的纵向数据和对功能状态的重新评估，我们可以确定关键的目标和时间点，这些目标和时间点可能导致潜在的干预，以延长功能寿命。我们已经表明，在没有任何临床公认的CVD事件的情况下，单独的亚临床心血管疾病可以预测身体和认知功能受损。然而，心血管疾病并不能完全解释年龄本身对功能下降的强烈影响。我们还可以确定在CVD存在时维持功能的潜力。我们注意到，尽管有广泛的亚临床CVD，但许多80岁以上的参与者仍保持了身体和认知功能。此应用程序的目的是：1)识别和表征80岁后仍保持功能的CHS参与者，特别是确定CVD危险因素和行为因素的轨迹，特别是导致功能衰老的体育活动和CVD治疗，2)确定低水平的IL-6和tnf - α，以及CRP，高水平的肾上腺雄激素，胰岛素样生长因子-1和脂联素，以及空腹胰岛素和血糖水平较低将预测独立于心血管疾病的持续功能，3)识别在存在较大动脉粥样硬化负担的情况下维持功能性衰老的个体，并检查可能在心血管疾病的情况下促进功能的因素，4)确定功能性衰老的预测因子是否可以预测功能的连续参数，包括腿部肌肉力量、握力、步态速度和认知处理速度。有了多年来收集的纵向数据，CHS现在有了独特的定位来回答这些关于老龄化的问题。这项研究是确定干预目标和时间点以保持老年功能的关键一步。

DESCRIPTION (provided by investigator): Functional aging, or disability-free survival, becomes increasingly exceptional as older adults reach age 80 and beyond. In the long- term survivors of the Cardiovascular Health Study (CHS) cohort, we will determine the likelihood of maintaining function, identify the trajectories that distinguish those destined to do well, and define the importance, independence and interactions of physiologic predictors of function. The CHS cohort is now aged 80 to 100+ with over 12 years of follow-up, but have not been examined for 4 years. With the long term, longitudinal data and a reassessment of functional status, we can identify critical targets and time points that could lead to potential intervention to extend functional years of life. We have shown that subclinical cardiovascular disease alone, in the absence of any clinically recognized CVD event, predicts impaired physical and cognitive function. However, CVD does not fully explain the very strong effect of age itself on decline in function. We can also determine the potential for maintaining function in the presence of CVD. We have noted that many participants over age 80 have maintained physical and cognitive function in spite of extensive subclinical CVD. The aims of this application are: 1) to identify and characterize CHS participants who have remained functional after age 80, specifically to determine the trajectories of CVD risk factors and behavioral factors, especially physical activity and CVD treatment that lead to functional aging, 2) to determine whether low levels of IL-6 and TNF-alpha, as well as CRP, high levels of adrenal androgens, and insulin-like growth factor-1 and adiponectin, and lower fasting insulin and glucose will predict continued functioning independently of cardiovascular disease, 3) to identify individuals who have maintained functional aging in the presence of a large atherosclerotic burden and to examine factors that may promote function in spite of CVD, 4) to determine whether the predictors of a functional aging predict continuous parameters of function including leg muscle strength, grip strength, gait speed, and cognitive processing speed. With longitudinal data collected over many years, the CHS is now uniquely positioned to answer these questions about aging. This study is a critical step towards the identification of the targets and the time points for intervention to preserve function in old age.