Kulminski Alexander, Ukraintseva Svetlana V, Akushevich Igor, Arbeev Konstantin G, Land Kenneth, Yashin Anatoli I
Center for Population Health and Aging, Duke University Population Research Institute, Trent Drive, Box 90408, Durham, NC 27708, USA.
Exp Gerontol. 2007 Oct;42(10):963-70. doi: 10.1016/j.exger.2007.05.009. Epub 2007 May 29.
Cross-sectional analyses show that an index of aging-associated health/well-being deficits, called the "frailty index", can characterize the aging process in humans. This study provides support for such characterization from a longitudinal analysis of the frailty index properties. The data are from the National Long Term Care Survey assessed longitudinally health and functioning of the U.S. elderly in the period 1982-1999. In cross-sectional analysis, the frailty index exhibits accelerated increase with age till oldest-old ages (95+), with possible deceleration thereafter. Longitudinal analysis confirms the accelerated accumulation of deficits in aging individuals. The time-dynamics of the frailty index is affected by two sex-sensitive processes: (i) selection of robust individuals, resulting in a decline of the mean frailty index with age and (ii) accumulation of deficits associated with physiological aging and its interaction with environment, which results in an accelerated increase of individual frailty index prior to death irrespective of chronological age. Current frailty index levels in individuals are more predictive of death than the index past values. Longitudinal analysis provides strong evidence that the cumulative index of health/well-being deficits can characterize aging-associated processes in humans and predict death better than chronological age during short-term periods.
横断面分析表明,一种名为“衰弱指数”的与衰老相关的健康/幸福赤字指标可以表征人类的衰老过程。本研究通过对衰弱指数属性的纵向分析为这种表征提供了支持。数据来自1982 - 1999年期间对美国老年人健康和功能进行纵向评估的国家长期护理调查。在横断面分析中,衰弱指数随年龄增长呈加速上升,直至高龄(95岁及以上),此后可能会减速。纵向分析证实了衰老个体中赤字的加速积累。衰弱指数的时间动态受两个性别敏感过程的影响:(i)强壮个体的选择,导致平均衰弱指数随年龄下降;(ii)与生理衰老及其与环境相互作用相关的赤字积累,这导致个体衰弱指数在死亡前加速上升,而与实际年龄无关。个体当前的衰弱指数水平比该指数的过去值更能预测死亡。纵向分析提供了强有力的证据,表明健康/幸福赤字的累积指数可以表征人类与衰老相关的过程,并且在短期内比实际年龄更能预测死亡。