Insight into the Determinants of Exceptional Aging and Longevity (IDEAL) Project

研究一个非常罕见的高龄化人口代表了BLSA新阶段的一个合乎逻辑的进展。通过纳入一组年龄特别大的新参与者，BLSA将能够充分利用最近在研究中引入的广泛措施。此外，IDEAL衰老的研究与BLSA最初的使命是一致的，即研究健康衰老，不受疾病的影响。尽管在入组时健康状况良好，但目前近500名80岁或以上的BLSA参与者中只有一小部分符合IDEAL标准。通过将IDEAL队列纳入BLSA，他们的生物学、生理学、行为和功能特征将使用与当前队列相同的方法进行评估，该队列将作为一种对照组。按照BLSA的惯例，我们计划对这批人进行终身随访，每年一次。

Studying an exceptionally rare well-aged population represents a logical progression for a new phase of the BLSA. By including a new cohort of participants who have aged exceptionally well, the BLSA will be able to utilize fully the extensive set of measures recently introduced in the study. In addition, the study of IDEAL aging is consistent with the original mission of the BLSA concerning the study of healthy aging, independent of the effects of disease. Despite excellent health at the time of enrollment only a small proportion of the nearly 500 current BLSA participants aged 80 years or older meet IDEAL criteria. By enrolling the IDEAL cohort in the BLSA their biologic, physiologic, behavioral and functional characteristics will be evaluated with using the same methods used with the current cohort who will serve as a type of control group. As is customary in the BLSA, we plan to follow this cohort for life with yearly visits. STUDY AIMS The first aim is to identify factors and characteristics that distinguish IDEAL from non IDEAL individuals. In the current BLSA, an extraordinarily wide range of information is collected on biomarkers, physiological measures, behavioral and environmental risk factors and functional and disease-related outcomes. We intend to compare the two groups to identify factors that discriminate IDEAL aging from non IDEAL aging individuals. The second aim is to identify physiological, environmental and behavioral characteristics that are risk factors for losing the IDEAL condition over several years or longer. We postulate that the mechanisms of extreme longevity probably differ from those associated with delay or escape from disease and disability. For example, we hypothesize that in older persons who escape diseases and disability, homeostatic mechanisms (integrity of anti-oxidant mechanisms, low level of oxidative damage to macromolecules, low inflammation, unimpaired autonomic reflexes, normal hormone levels etc.) are relatively intact, with little accumulated damage. DESIGN The operational definition of IDEAL aging is living until age 80 and meeting the current BLSA enrollment criteria which in brief requires the absence of chronic disease and conditions and mobility and cognitive impairment evaluated using a rigorous screening process. It can be conservatively estimated that approximately 1% of those 80 years or older are IDEAL aged individuals. IDEAL participants will be recruited from the Baltiore-Washington area, which has over 600,000 persons aged 80 years or older of whom an estimated 6,000 should be IDEAL candidates. Enrollment of IDEAL participants in the BLSA is being conducted under an R&D contract, awarded to WESTAT. Recruitment with support of Westat has been completed; over 80 participants have been enrolled.