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

研究一个非常罕见的老龄人口代表了BLSA新阶段的逻辑进展。通过纳入一批年龄特别好的新参与者，BLSA将能够充分利用最近在研究中引入的广泛措施。此外，IDEAL老化的研究与BLSA关于健康老化研究的最初使命一致，独立于疾病的影响。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队列入组BLSA，将使用与当前队列（作为对照组）相同的方法评价其生物学、生理学、行为和功能特征。按照BLSA的惯例，我们计划每年随访一次，终身随访该队列。 研究旨在 第一个目标是确定区分理想和非理想个体的因素和特征。 在目前的BLSA中，收集了关于生物标志物、生理测量、行为和环境风险因素以及功能和疾病相关结果的非常广泛的信息。我们打算比较这两组人，以确定区分理想衰老和非理想衰老个体的因素。 第二个目标是确定生理，环境和行为特征，这些特征是在几年或更长时间内失去理想状态的风险因素。 我们假设，长寿的机制可能不同于那些与延迟或逃避疾病和残疾有关的机制。 例如，我们假设，在逃避疾病和残疾的老年人中，稳态机制（抗氧化机制的完整性，对大分子的氧化损伤水平低，炎症低，自主反射未受损，激素水平正常等）。相对完整，几乎没有累积损坏。 设计 理想老龄化的操作定义是活到80岁，并符合当前的BLSA入组标准，简而言之，这要求没有慢性疾病和病症，以及使用严格的筛选过程评估的活动性和认知障碍。据保守估计，80岁或以上的人中约有1%是理想年龄的人。 将从巴尔的摩-华盛顿地区招募IDEAL的参与者，该地区有60多万80岁或80岁以上的人，其中估计有6 000人应该是IDEAL的候选人。 目前正在根据授予西非统计局的一项研究与发展合同，为劳工和社会事务管理局招收“发展教育和就业”方案的参与者。招募工作正在进行中，第一批参与者已经登记。

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 is ongoing and the first few participants have been enrolled.