Latent Mobility Abnormalities And Frailty

描述（由申请者提供）：这是一份修订后的新研究者提交资料（AGO 25119 -01），以回应关于虚弱的PA。超过三分之一的65岁以上的成年人报告至少有一种严重残疾。“虚弱”的概念已被用来确定老年人的生理储备低，残疾的风险增加。然而，缺乏老年人早期虚弱的临床和生物学标志物。我们计划通过一项正在进行的老年人前瞻性队列研究，即爱因斯坦衰老研究，来解决这一差距。 非残疾老年人的亚临床功能丧失在常规评估中可能不明显，但可能表现为压力，因为储备低，提供了一种临床相关的方法来识别有残疾风险的个体。在这个提议中，我们将潜在的活动异常定义为由身体和认知压力所掩盖的亚临床活动能力丧失。有待评估的具体假设是，潜在的活动异常将识别脆弱和预测残疾的非残疾老年人与正常的流动性。具体来说，我们将1）检查潜在的运动异常，以应对身体和认知压力测试作为残疾的预测因素。2)建立潜伏性运动异常的生物学基础，重点关注炎症标志物。3）。由于亚临床疾病可能导致次优的移动性能，我们还将在一个亚组的受试者中研究两周内六个疗程中的移动性的每日个体内变异性，作为极早期虚弱的标志。 为了实现这些目标，将招募300名最初参与爱因斯坦老龄化研究的非残疾老年人，并在五年内每六个月进行一次全面的定性和定量流动性评估。这些研究将提供有关早期虚弱的认知和身体属性及其生物学基础的新的重要信息，并确定在高危老年人中尽早引入特定干预措施的机会，以改善残疾并保持功能独立性。

DESCRIPTION (provided by applicant): This is a revised new investigator submission (AGO25119-01) in response to a PA on frailty. Over one-third of adults over age 65 report at least one severe disability. The concept of "frailty" has been used to identify older adults with low physiological reserves at increased risk for disability. However, clinical and biological markers of early frailty in older adults are lacking. We plan to address this gap by building on an ongoing, prospective cohort study of older adults, the Einstein Aging Study. Subclinical functional loss in nondisabled older adults may not be apparent on routine evaluation, but may manifest in stress due to low reserves providing a clinically relevant approach to identify individuals at risk for disability. In this proposal, we define latent mobility abnormalities as subclinical mobility loss unmasked by physical and cognitive stresses. The specific hypothesis to be evaluated is that latent mobility abnormalities will identify frailty and predict disability in nondisabled older adults with normal mobility. Specifically, we will 1) Examine latent mobility abnormalities in response to physical and cognitive stress tests as predictors of disability. 2) Establish the biological basis of latent mobility abnormalities, focusing on inflammatory markers. 3). Since subclinical disease may lead to suboptimal mobility performance, we will also study daily intra-individual variability in mobility in six sessions over a two-week period in a subset of subjects as a marker of very early frailty. To achieve these aims, 300 initially nondisabled older adults participating in the Einstein Aging Study will be recruited and assessed with comprehensive qualitative and quantitative mobility assessments at six monthly intervals over five years. These studies will provide new and vital information about the cognitive and physical attributes of early frailty, their biological basis, and identify opportunities to introduce specific interventions very early in at-risk older adults to ameliorate disability and maintain functional independence.