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朝向在生活方式为基础的介入研究中健康老化表型的测量。

Towards measurement of the Healthy Ageing Phenotype in lifestyle-based intervention studies.

机构信息

Human Nutrition Research Centre, Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, UK.

出版信息

Maturitas. 2013 Oct;76(2):189-99. doi: 10.1016/j.maturitas.2013.07.007. Epub 2013 Aug 7.

Abstract

INTRODUCTION

Given the biological complexity of the ageing process, there is no single, simple and reliable measure of how healthily someone is ageing. Intervention studies need a panel of measures which capture key features of healthy ageing. To help guide our research in this area, we have adopted the concept of the "Healthy Ageing Phenotype" (HAP) and this study aimed to (i) identify the most important features of the HAP and (ii) identify/develop tools for measurement of those features.

METHODS

After a comprehensive assessment of the literature we selected the following domains: physiological and metabolic health, physical capability, cognitive function, social wellbeing, and psychological wellbeing which we hoped would provide a reasonably holistic characterisation of the HAP. We reviewed the literature and identified systematic reviews and/or meta-analysis of cohort studies, and clinical guidelines on outcome measures of these domains relevant to the HAP. Selection criteria for these measures included: frequent use in longitudinal studies of ageing; expected to change with age; evidence for strong association with/prediction of ageing-related phenotypes such as morbidity, mortality and lifespan; whenever possible, focus on studies measuring these outcomes in populations rather than on individuals selected on the basis of a particular disease; (bio)markers that respond to (lifestyle-based) intervention. Proposed markers were exposed to critique in a Workshop held in Newcastle, UK in October 2012.

RESULTS

We have selected a tentative panel of (bio)markers of physiological and metabolic health, physical capability, cognitive function, social wellbeing, and psychological wellbeing which we propose may be useful in characterising the HAP and which may have utility as outcome measures in intervention studies. In addition, we have identified a number of tools which could be applied in community-based intervention studies designed to enhance healthy ageing.

CONCLUSIONS

We have proposed, tentatively, a panel of outcome measures which could be deployed in community-based, lifestyle intervention studies. The evidence base for selection of measurement domains is less well developed in some areas e.g. social wellbeing (where the definition of the concept itself remains elusive) and this has implications for the identification of appropriate tools. Although we have developed this panel as potential outcomes for intervention studies, we recognise that broader agreement on the concept of the HAP and on tools for its measurement could have wider utility and e.g. could facilitate comparisons of healthy ageing across diverse study designs and populations.

摘要

简介

鉴于衰老过程的生物学复杂性,目前还没有单一、简单和可靠的方法来衡量一个人衰老的健康程度。干预研究需要一组能捕捉健康衰老关键特征的指标。为了帮助指导我们在这一领域的研究,我们采用了“健康衰老表型”(HAP)的概念,本研究旨在:(i)确定 HAP 的最重要特征;(ii)确定/开发测量这些特征的工具。

方法

在对文献进行全面评估后,我们选择了以下领域:生理和代谢健康、身体能力、认知功能、社会幸福感和心理健康,我们希望这些领域能为 HAP 提供一个相当全面的特征描述。我们回顾了文献,确定了与 HAP 相关的这些领域的队列研究的系统评价和/或荟萃分析,以及临床指南。这些指标的选择标准包括:在衰老的纵向研究中经常使用;预期随年龄变化;有强有力的证据表明与衰老相关表型(如发病率、死亡率和寿命)相关或可预测;只要可能,侧重于在人群中测量这些结果的研究,而不是基于特定疾病选择个体的研究;(生物)标志物对(基于生活方式的)干预有反应。在 2012 年 10 月于英国纽卡斯尔举行的一次研讨会上,对提出的标志物进行了批判性评估。

结果

我们选择了一组暂定的生理和代谢健康、身体能力、认知功能、社会幸福感和心理健康的(生物)标志物,我们建议这些标志物可能有助于描述 HAP,并可能作为干预研究中的结果测量指标。此外,我们还确定了一些可用于社区为基础的干预研究的工具,旨在促进健康衰老。

结论

我们暂定提出了一组可用于社区为基础的生活方式干预研究的结果测量指标。在某些领域,如社会幸福感(概念本身的定义仍难以捉摸),选择测量领域的证据基础不够完善,这对选择适当的工具产生了影响。虽然我们已经将这个小组作为干预研究的潜在结果,但我们认识到,对 HAP 概念和其测量工具的更广泛认同可能具有更广泛的效用,例如,可以促进不同研究设计和人群之间的健康衰老比较。

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