Multilevel model estimation of age-dependent individual-specific trajectories for left ventricular echocardiographic indexes in an asymptomatic elderly cohort

2012 ◽  
Vol 112 (7) ◽  
pp. 1128-1134 ◽  
Author(s):  
Yu-hong Wang ◽  
Yu-ping Jiang ◽  
Shan-shun Luo ◽  
Fang-fang Qiao ◽  
Hui Han
Keyword(s):  
Multilevel Models ◽  
The Elderly ◽  
Left Ventricular ◽  
Individual Variability ◽  
Ratio Test ◽  
Age Related ◽  
Age Dependent ◽  
Aging Study ◽  
Elderly Cohort ◽  
The Individual

Few studies have been performed on the individual-specific trajectory of left ventricular aging as assessed by echocardiography in an asymptomatic elderly cohort. In the present study, a representative cohort of elderly men, who were long-term asymptomatic for cardiovascular issues, were selected from an ongoing observational aging study. Annual echocardiographic data were used to establish an age-dependent hierarchical model. Based on two-level linear regression results, four echocardiographic indexes [left ventricular mass (LVmass; −1.872 g/yr), posterior ventricular wall thickness (−0.048 mm/yr), fraction shortening (0.097/yr), and transmitral peak A velocity (−0.006 m·s−1·yr−1)] changed significantly with increasing age and were age- and subject-dependent. The most characterized results of the study were the significant, age-related, within-individual variances in echocardiographic results, which were observed using the likelihood ratio test at an occasion-dependent level. Of these, fluctuated amplitudes of two systolic variables [i.e., LVmass (con/age = −0.012 ± 0.004; P = 0.0007) and fraction shortening (con/age = −0.001 ± 0.004; P = 0.05)] were significantly attenuated with increasing age within individuals. On the other hand, the age-related variability of four diastolic Doppler variables [i.e., peak A velocity (con/age = 0.003 ± 0.002; P = 0.0009), peak E velocity (con/age = 0.004 ± 0.003; P = 0.01), E/A ratio (con/age = 0.007 ± 0.003; P = 0.0002), and deceleration time of E wave (con/age = 0.025 ± 0.007; P < 0.0001)] significantly increased with increasing age within individuals. The age-related individual variability of left ventricular indexes observed in this continuous asymptomatic cohort may reflect the mechanism of preclinical, individualized heart aging. In conclusion, successfully fitted multilevel models were applied as a valuable tool to determine the mechanism of individual cardiac aging in the elderly.

scholarly journals Inter-Individual Variability in Xenobiotic-Metabolizing Enzymes: Implications for Human Aging and Longevity

Genes ◽  
2019 ◽  
Vol 10 (5) ◽  
pp. 403 ◽  
Author(s):  
Paolina Crocco ◽  
Alberto Montesanto ◽  
Serena Dato ◽  
Silvana Geracitano ◽  
Francesca Iannone ◽  
...  
Keyword(s):  
Genetic Variability ◽  
The Elderly ◽  
Individual Variability ◽  
Genetic Determinants ◽  
Metabolizing Enzymes ◽  
Xenobiotic Metabolizing Enzymes ◽  
Age Related ◽  
Gene Environment ◽  
Disease Predisposition ◽  
The Individual

Xenobiotic-metabolizing enzymes (XME) mediate the body’s response to potentially harmful compounds of exogenous/endogenous origin to which individuals are exposed during their lifetime. Aging adversely affects such responses, making the elderly more susceptible to toxics. Of note, XME genetic variability was found to impact the ability to cope with xenobiotics and, consequently, disease predisposition. We hypothesized that the variability of these genes influencing the interaction with the exposome could affect the individual chance of becoming long-lived. We tested this hypothesis by screening a cohort of 1112 individuals aged 20–108 years for 35 variants in 23 XME genes. Four variants in different genes (CYP2B6/rs3745274-G/T, CYP3A5/rs776746-G/A, COMT/rs4680-G/A and ABCC2/rs2273697-G/A) differently impacted the longevity phenotype. In particular, the highest impact was observed in the age group 65–89 years, known to have the highest incidence of age-related diseases. In fact, genetic variability of these genes we found to account for 7.7% of the chance to survive beyond the age of 89 years. Results presented herein confirm that XME genes, by mediating the dynamic and the complex gene–environment interactions, can affect the possibility to reach advanced ages, pointing to them as novel genes for future studies on genetic determinants for age-related traits.

scholarly journals Age and oral health: current considerations

2007 ◽  
Vol 21 (spe) ◽  
pp. 29-33 ◽  
Author(s):  
Andrew Tawse-Smith
Keyword(s):  
Risk Factors ◽  
Periodontal Disease ◽  
Dental Plaque ◽  
Alveolar Bone ◽  
Periodontal Diseases ◽  
The Elderly ◽  
Preventive Program ◽  
Age Related ◽  
The Individual ◽  
Complex Scenario

Dental plaque is still considered the main etiological factor for periodontal diseases. Our understanding of periodontal disease has advanced from the previous concepts where gingivitis slowly progressed to periodontitis to a more complex scenario that correlates several risk factors in the pathogenesis of periodontal disease. Among these factors, age has been associated with increased rates of periodontal disease as the population gets older. Although the loss of alveolar bone and periodontal attachment is common in the elderly population, and there is evident age-related changes in the periodontium, severe periodontitis is not a natural consequence of ageing. The importance of identifying the risk factors that participate in the pathogenesis of periodontal disease at an early phase, both of the individual and the disease, as well as evaluating the capacity of the individual to control dental plaque will enable the implementation of an adequate preventive program, where the needs and limitations of the individual are considered to specifically tailor the oral hygiene procedures and the mouthwashes to be used.

Age-related effects of digoxin on myocardial contractility and Na-K pump in sheep

1982 ◽  
Vol 243 (4) ◽  
pp. H517-H522
Author(s):  
T. J. Hougen ◽  
W. F. Friedman
Keyword(s):  
Active Transport ◽  
Monovalent Cation ◽  
Left Ventricular ◽  
Rate Of Change ◽  
Control Group ◽  
Base Line ◽  
Experimental Conditions ◽  
Adult Sheep ◽  
Age Related ◽  
Age Dependent

The age-dependent effects of an acute nontoxic, positively inotropic dose of digoxin on myocardial monovalent cation active transport were determined in fetal, newborn, and adult sheep. Thirty-five lightly sedated, closed-chest animals were instrumented to record electrocardiogram, left ventricular (LV) pressure, and rate of change of LV pressure (LV dP/dt). Ouabain-inhibitable uptake of Rb+ (86Rb+) was measured in both right ventricular (RV) and LV slices from control animals and in animals infused with [3H]digoxin (0.04 mg/kg) sufficient to cause an increase in LV dP/dt without toxicity. Sixty minutes after digoxin, LV dP/dt increased 123% over base-line values in fetuses, 131% in newborns, and 165% in adult animals. RV and LV myocardial digoxin concentrations were similar in all groups. Rb+ active transport was significantly reduced in both RV and LV tissue from all animals 60 min after digoxin. Control animals showed no significant changes in contractility or Rb+ active transport among the control group of fetal, newborn, or adult sheep. Acute infusions of digoxin increased LV contractility in each age group and was accompanied by digoxin-induced inhibition of myocardial Rb+ active transport. No age-related differences in the extent of Rb+ active transport among control or among digoxin-treated animals were observed under these experimental conditions. These studies suggest that the differential response to the therapeutic and toxic effects of digoxin in sheep of various ages does not reside in an age-dependent response of the myocardial sodium pump to digoxin.

scholarly journals The concept of quality of life in dementia in the different stages of the disease

2005 ◽  
Vol 17 (3) ◽  
pp. 353-370 ◽  
Author(s):  
Teake P. Ettema ◽  
Rose-Marie Dröes ◽  
Jacomine de Lange ◽  
Marcel E. Ooms ◽  
Gideon J. Mellenbergh ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Population ◽  
The Elderly ◽  
Literature Study ◽  
Age Related ◽  
Multidimensional Evaluation ◽  
Specific Concept ◽  
Definition Of ◽  
The Individual

In order to conceptually define quality of life (QOL) in dementia, the literature on QOL in the elderly population, in chronic disease and in dementia was studied. Dementia is a progressive, age-related, chronic condition and to avoid omissions within the dementia-specific concept of QOL, a broad orientation was the preferred approach in this literature study. Adaptation is a major outcome in studies investigating interventions aimed at improving QOL in chronic conditions, but to date, it has not been used in the definition of QOL. It is argued that adaptation is an important indication of QOL in people with chronic diseases and therefore also in dementia. Some crucial issues in assessing dementia-related QOL that are relevant to clarify the continuing debate on whether QOL, particularly in dementia, can be measured at all, are discussed. Then the following conceptual definition is offered: dementia-specific QOL is the multidimensional evaluation of the person–environment system of the individual, in terms of adaptation to the perceived consequences of the dementia.

Towards Multimodal Mobile GIS for the Elderly

2010 ◽  
pp. 301-320 ◽  
Author(s):  
Julie Doyle ◽  
Michela Bertolotto ◽  
David Wilson
Keyword(s):  
Digital Literacy ◽  
The Elderly ◽  
Multimodal Interfaces ◽  
Full Potential ◽  
User Group ◽  
Gis Applications ◽  
Age Related ◽  
Spatial Systems ◽  
Potential Benefits ◽  
Elderly Cohort

Information technology can play an important role in helping the elderly to live full, healthy and independent lives. However, elders are often overlooked as a potential user group of many technologies. In particular, we are concerned with the lack of GIS applications which might be useful to the elderly population. The main underlying reasons which make it difficult to design usable applications for elders are threefold. The first concerns a lack of digital literacy within this cohort, the second involves physical and cognitive age-related impairments while the third involves a lack of knowledge on improving usability in interactive geovisualisation and spatial systems. As such, in this chapter we analyse existing literature in the fields of mobile multimodal interfaces with emphasis on GIS and the specific requirements of the elderly in relation to the use of such technologies. We also examine the potential benefits that the elderly could gain through using such technology, as well as the shortcomings that current systems have, with the aim to ensure full potential for this diverse, user group. In particular, we identify specific requirements for the design of multimodal GIS through a usage example of a system we have developed. Such a system produced very good evaluation results in terms of usability and effectiveness when tested by a different user group. However, a number of changes are necessary to ensure usability and acceptability by an elderly cohort. A discussion of these concludes the chapter.

The ageing heart

ESC CardioMed ◽  
2018 ◽  
pp. 150-154
Author(s):  
Magnus Bäck ◽  
Laure Joly ◽  
Nicolas Sadoul ◽  
Athanase Benetos
Keyword(s):  
Heart Disease ◽  
Cardiovascular Events ◽  
The Elderly ◽  
Left Ventricular ◽  
Cumulative Exposure ◽  
Diastolic Filling ◽  
Ischaemic Damage ◽  
Age Related ◽  
Increased Risk ◽  
Conductive System

The ageing heart is faced with age-related structural alterations of the coronary circulation, myocardium, valves, conductive system, and aorta, as well as the cumulative exposure to various cardiovascular risk factors over a lifetime. Coronary ageing in terms of atherosclerosis and coronary calcifications and the resulting ischaemic heart disease, imply specific diagnostic and therapeutic challenges in the elderly. In addition to a higher risk of ischaemic damage, the myocardial ageing per se is associated with left ventricular hypertrophy and increased stiffening, resulting in typical diastolic filling patterns with ageing. The myocardium may be further affected by the consequences of valvular ageing and an increased prevalence of either stenotic or regurgitant valvular heart disease. The conductance system also experiences age-related changes resulting in conduction abnormalities and arrhythmias. It should be emphasized that age-dependent arterial stiffening and hypertension may account for a heart–vessel coupling to further deteriorate the ageing heart. Ultimately all those factors participate in an age-related increased risk of cardiovascular events and heart failure. Finally, it is important to also consider extra-cardiac co-morbidities, frailty, and the cognitive and functional status of the older patient when evaluating the ageing heart.

Age-dependent changes in GI physiology and microbiota: time to reconsider?

Gut ◽  
2018 ◽  
Vol 67 (12) ◽  
pp. 2213-2222 ◽  
Author(s):  
Ran An ◽  
Ellen Wilms ◽  
Ad A M Masclee ◽  
Hauke Smidt ◽  
Erwin G Zoetendal ◽  
...  
Keyword(s):  
Adaptive Capacity ◽  
Intestinal Microbiota ◽  
Physiological Function ◽  
The Elderly ◽  
Population Ageing ◽  
Ageing Population ◽  
Targeted Interventions ◽  
Age Related ◽  
Age Dependent ◽  
And Function

Our life expectancy is increasing, leading to a rise in the ageing population. Ageing is associated with a decline in physiological function and adaptive capacity. Altered GI physiology can affect the amount and types of nutrients digested and absorbed as well as impact the intestinal microbiota. The intestinal microbiota is considered a key player in our health, and a variety of studies have reported that microbiota composition is changing during ageing. Since ageing is associated with a decline in GI function and adaptive capacity, it is crucial to obtain insights into this decline and how this is related to the intestinal microbiota in the elderly. Hence, in this review we focus on age-related changes in GI physiology and function, changes of the intestinal microbiota with ageing and frailty, how these are associated and how intestinal microbiota-targeted interventions may counteract these changes.

Left atrial and ventricular function during dobutamine and glycopyrrolate stress in healthy young and elderly as evaluated by cardiac magnetic resonance

2012 ◽  
Vol 303 (12) ◽  
pp. H1469-H1473 ◽  
Author(s):  
Kiril A. Ahtarovski ◽  
Kasper K. Iversen ◽  
Jacob T. Lønborg ◽  
Per L. Madsen ◽  
Thomas Engstrøm ◽  
...  
Keyword(s):  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Maximum Size ◽  
The Elderly ◽  
Left Ventricular ◽  
Elderly Subjects ◽  
Pharmacological Stress ◽  
Volume Changes ◽  
Age Related ◽  
Atrial Contraction

The aim of this study is to describe phasic volume changes of the left atrium (LA) in healthy young and elderly subjects at rest and during pharmacological stress (PS). LA maximum size is related to cardiovascular mortality. LA has passive, active, and conduit function for left ventricular (LV) filling. We hypothesized that changes in LV compliance from normal aging are reflected in LA volume changes and that PS will augment these differences. We enrolled twenty young (20–30 yr) and twenty elderly (60–70 yr) healthy subjects and measured their LV and LA volumes by cardiac magnetic resonance imaging at rest and during dobutamine and glycopyrrolate stress. We identified LA minimum, maximum, and middiastolic volumes and the volume before atrial contraction. LA emptying volumes were calculated as LA passive and active emptying volumes and LA conduit volume. We also calculated LV peak filling rates (LVPFRs). Both at rest and during PS, LA maximum and minimum volumes were similar in the groups, whereas middiastolic volume was higher in the elderly. During PS, a marked decrease in LA passive emptying function and a corresponding increase in LA active emptying function were seen in the elderly but not in the young. At rest, LVPFR was lower in the elderly, and during PS this difference was augmented. The aging heart has reduced LVPFR, which is reflected in reduced LA passive and compensatory increased LA active volumetric contribution to LV stroke volume. These age-related differences are evident at rest and highly augmented during both dobutamine and glycopyrrolate stress.

scholarly journals Establishing a Comprehensive Anti-aging Research Center: Experiences and Challenges

2020 ◽  
Author(s):  
Xin Chen ◽  
Jianli Ge ◽  
Jiaoling Huang ◽  
Shasha Geng ◽  
Qingqing Li ◽  
...  
Keyword(s):  
Elderly Population ◽  
The Elderly ◽  
Research Center ◽  
Second Phase ◽  
Aging Research ◽  
High Risk Factors ◽  
Third Phase ◽  
Age Related ◽  
Government Websites ◽  
Elderly Cohort

Abstract Introduction: Age-related diseases have become the leading causes of morbidity and mortality worldwide. Anti-aging researches both at the population and individual levels are still urgently needed. Establishing comprehensive anti-aging research centers is crucial to advancing anti-aging researches. However, few studies have shown guidelines for establishing a comprehensive anti-aging research center. We aim to describe the establishment of a comprehensive anti-aging center, summarize the initial experiences, and discuss limitations, strengths and challenges. Methods: The establishment contains three phases (from October, 2017 to January, 2020), the first phase is assessing the need for anti-aging research by reviewing relevant literatures and investigating the elderly population. The second phase is interpreting the aging-related policies by searching and analyzing China's aging-related policies in recent years on government websites. The third phase is completing the protocol of establishing the center, raising funds for the establishment of the center and selecting the adequate equipment. Results: In phase one, we find improving strategies at the population and individual levels are still needed. Through establishing elderly cohort, we find that many elderly people are with high risk factors of aging. In phase two, we find many age-related policies have been unveiled. In phase three, we complete the protocol of establishing the center based on the results of phase one and two. We also have raised funds and selected equipment for the center. Conclusion: With limited guideline for establishing a comprehensive anti-aging research center, the experience in this paper might help other institutions to build anti-aging research center or program. KEY WORDS: anti-aging; research center; establishing; experience; challenge

Increased risk of immune-related hepatitis among adolescent and young adults (AYAs) with melanoma during immunotherapy with checkpoint inhibitors (ICIs).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9584-9584
Author(s):  
Alicia Darwin ◽  
Damon R. Reed ◽  
Tawee Tanvetyanon
Keyword(s):  
Adverse Events ◽  
Checkpoint Inhibitors ◽  
Age Groups ◽  
The Elderly ◽  
Age Related ◽  
Increased Risk ◽  
Melanoma Patients ◽  
Grade 3 ◽  
Elderly Cohort ◽  
Investigational Agents

9584 Background: Melanoma is the second most common malignancy affecting AYA patients after lymphoma. Nevertheless, AYA melanoma does constitute a minority of all melanoma cases. Additionally, the AYA population is not well represented in prospective clinical trials, including immunotherapy trials. While previous research has demonstrated the efficacy of ICIs across age groups, it remains unclear if toxicity profiles will be similar. In the general population, age-related changes in the immune milieu result in differential incidences of autoimmune diseases by age. This study aims to compare the toxicity profile between a cohort of AYA melanoma versus elderly melanoma patients receiving ICI therapy. Methods: In this single NCCN institutional study, electronic medical records of melanoma patients treated with ICIs between 01/2007-01/2019 were reviewed. Subjects receiving concurrent investigational agents or chemotherapy were excluded. The AYA cohort included those aged 15-40 years. The elderly cohort included those aged ≥65 years. Adverse events were coded according to CTC-AE version 5.0. Multivariable logistic regression analyses were performed. Results: Analyses included 184 treatment courses. In the AYA cohort (N = 57), median age at ICI initiation was 28.8 years (range: 17.9-39.3). In the Elderly cohort (N = 127), median age at ICI initiation was 72.3 years. More AYA patients (28.1% AYA vs. 7.9% Elderly) received ICI combination regimens. The most common adverse events amongst both cohorts were transaminitis (23.4%), rashes (49.5%), and diarrhea/colitis (20%). Incidences of pneumonitis, colitis, hypothyroidism, and hypophysitis did not differ significantly between cohorts. However, the AYA cohort experienced a higher incidence of transaminitis (38.6% AYA vs. 16.5% Elderly, p =0.001 ) and increased occurrence of treatment related hospitalization (26.3% AYA vs. 7.1% Elderly, p <0.001 ). Moreover, a higher proportion of severe grade ≥3 transaminitis occurred in the AYA group (27.3% AYA vs. 9.5% Elderly, p =0.004). While occurrence of transaminitis was significantly associated with combination ICIs, the association between AYA status and transaminitis remained significant after adjusting for ICI regimen (OR 2.75, 95% CI: 1.3-5.8). There was a trend toward shorter time to transaminitis onset among the AYA than Elderly cohort (median 53.0 vs. 74.5 days [non-parametric p= 0.28]). To date, median survival has not been reached in both groups ( p= 0.09). Conclusions: In this large cohort of AYA melanoma patients treated with ICI, we found a significantly higher incidence of immune-related transaminitis than in the Elderly cohort. Other immune-related AEs were comparable between cohorts. This finding was independent of ICI regimen. Further investigation will be needed to understand these differences between the AYA and Elderly cohorts.

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