The Baltimore Longitudinal Study Of Aging

巴尔的摩老龄化纵向研究（BLSA）是NIA目前关于人类老龄化的主要研究项目，自1958年以来一直在老年学研究中心进行，现在活跃在位于海港医院（巴尔的摩）的NIA-ASTRA（老龄化转化研究）单位。这项研究继续代表着一个致力于表征正常和病理性衰老的科学家联盟。目前管理该研究的研究人员团队正在对其设计和评估技术进行重大更改。主要的科学目标仍然是那些在原始BLSA遗产中报告的目标：1）识别无法用疾病解释的个体之间与年龄相关的差异，2）表征影响从正常衰老到病理衰老转变的因素。然而，正在采取新的措施，以便更好地了解年龄和疾病对导致许多老年人行动不便和生活质量低下的过程的影响。重点是采取综合和多学科的办法，以及在多个层面（细胞、组织、器官、全身、社会）自然发挥作用的补偿机制，使许多老年人能够在多种病理过程中保持高度的活动能力。 研究人群是在多次随访访视期间接受终身随访的志愿者队列。许多积极的参与者已经在这项研究中工作了20多年，有些甚至长达44年。在未来，将实施一项筛查计划，以长期保持极高水平的身体和神经功能。 在过去，BLSA一直是所有老龄化流行病学研究的金标准参考。近年来，在心血管研究、影响前列腺癌风险的因素、与年龄相关的认知功能下降、肌肉力量和骨骼强度等领域也发表了重要发现。将BLSA转移到ASTRA单元对于从临床角度实施一些新知识至关重要。这一目标将通过平行开展BLSA辅助研究来实现，这些研究仅限于少数受试者，并针对单一的预先制定的假设，更有可能提供可直接应用于临床医学的信息。 新BLSA设计的结构基于三个层次的测量： 1.参考水平是主要受身体和认知功能影响的行为水平。因此，BLSA包括从不同角度对身体和认知功能的综合测量; 2.中间水平包括对活动性重要的生理系统的解剖完整性和功能性的测量：中枢神经系统、周围神经系统、肌肉、骨骼和关节、对能量产生重要的物质的输送、提供环境反馈的感觉系统; 3.第三个层次包括对维持稳定的生物稳态很重要的生理系统，包括免疫功能、激素、氧化应激/抗氧化剂、自主神经系统、营养摄入和身体活动的测量。

The Baltimore Longitudinal Study of Aging (BLSA), the Intramural NIA's current major research program on human aging, has been conducted at the Gerontology Research Center since 1958, and is now active at the NIA-ASTRA (Translational Research on Aging) Unit located at Harbor Hospital (Baltimore). The study continues to represent a consortium of scientists who work to characterize normal and pathological aging. The team of researchers currently managing the study is implementing major changes in its design and assessment technology. The primary scientific goals remain those that were reported in the original BLSA legacy: 1) to identify age-associated differences among individuals which are not explained by diseases, and 2) to characterize factors that affect the transitions from normal to pathological aging. However, new measures are being implemented that are aimed at gaining a better understanding of the effect of age and diseases on the process that leads to mobility disability and poor quality of life in many older adults. The focus is on an integrative and multidisciplinary approach, and the compensatory mechanisms that, naturally implemented at multiple levels (cells, tissues, organs, whole body, society) allow many older persons to maintain a high level of mobility, in spite of multiple pathological process. The study population is a cohort of volunteers that are followed for life over multiple follow-up visits. Many of the active participants have been in the study for more than 20 years, and some for as long as 44 years. In the future, a screening program will be implemented to longeve individuals that have maintained an extraordinary high level of physical and congnitive functioning. In the past, the BLSA has been the gold-standard reference for all epidemiological studies on aging. Important findings in the area of cardiovascular research, factors affecting the risk of prostate cancer, age-associated decline of cognitive function, muscle strength and bone strength were published even in recent years. Moving the BLSA to the ASTRA unit was vital to implementing some of the new knowledge in a clinical perspective. This goal will be pursued by conducting, in parallel, the BLSA ancillary studies that, being limited to a small number of participants and adressing a single, pre-formulated hypothesis, are more likely to provide information that can be directly applied in clinical medicine. The structure of the new BLSA design is based on three levels of measures: 1. The reference level is the level of behavior that is mostly influenced by physical and cognitive function. Accordingly, the BLSA includes comprehensive measures of physical and cognitive function from different perspectives; 2. The intermediate level includes measures of anatomical integrity and functionality of the physiological systems that are important for mobility: central nervous system, peripheral nervous system, muscle, bone and joints, delivery of substances important for energy production, sensory systems that provide feedback from the environment; 3. The third level includes the physiological systems that are important to maintain a stable biological homeostasis and include measures for immune function, hormones, oxidative stress/antioxidants, autonomic nervous system, nutritional intake, and physical activity.