Emeritus Professor of Medical Gerontology, King's College London and Emeritus Consultant Geriatrician, Guy's and St Thomas NHS Foundation Trust, London, UK.
Associate Professor in Medical Gerontology, Trinity College Dublin and Consultant Physician, St James's Hospital, Dublin.
Age Ageing. 2019 Jul 1;48(4):481-485. doi: 10.1093/ageing/afz028.
'Time is the best diagnostician': who has not thought this? In clinical practice, presentations are often subtle and decisions made in the face of a 'snapshot.' Crystal balls do not exist; yet, insights from longitudinal studies can help to recognise emerging pictures and anticipate typical trajectories. In the multifactorial, biopsychosocial world of geriatrics, the determinants of those trajectories, and hence opportunities to modify them, can be better understood through careful longitudinal disentangling of the wider determinants of health, and this can be done at multiple levels of analysis, from molecules to society. With this collection and commentary, we highlight the approaches, scope and impacts of a selection of longitudinal studies of ageing published in Age and Ageing within the past 10 years. Longitudinal studies can illuminate disease mechanisms, how declines in multiple domains of intrinsic capacity interact, how losses in one domain may influence the path of another, and in turn, how these changes translate to functional disability, or not. Observing trajectories of geriatric syndromes can suggest opportunities for optimisation and prevention in clinical practice and policy. With global opportunities for harmonising data, longitudinal studies are already offering the opportunity for cross-national comparisons and for developing hypotheses about the relative contributions of time, place and society in the trajectories of frailty, disability and quality of life. We also include studies which show how research-based longitudinal data can be synthesised or be linked to administrative datasets. We hope you find this collection as interesting and encouraging as we have.
“时间是最好的诊断医生”：谁没有这样想过呢？在临床实践中，表现往往很微妙，需要在面对“快照”的情况下做出决策。虽然没有水晶球，但纵向研究的结果可以帮助我们识别新出现的情况并预测典型的发展轨迹。在多因素、生物心理社会的老年医学领域，通过仔细的纵向分析健康的更广泛决定因素，可以更好地理解这些轨迹的决定因素，以及改变这些轨迹的机会，这可以在从分子到社会的多个分析层次上进行。通过这篇论文集和评论，我们强调了在过去 10 年中，《Age and Ageing》杂志上发表的一系列关于衰老的纵向研究的方法、范围和影响。纵向研究可以阐明疾病机制，多个内在能力领域的衰退如何相互作用，一个领域的损失如何影响另一个领域的发展轨迹，以及这些变化如何转化为功能障碍或不转化为功能障碍。观察老年综合征的发展轨迹可以为临床实践和政策中的优化和预防提供机会。随着全球数据协调机会的出现，纵向研究已经为跨国比较以及关于时间、地点和社会在脆弱性、残疾和生活质量轨迹中的相对贡献的假设提供了机会。我们还包括了一些研究，这些研究表明如何综合基于研究的纵向数据，或者将其与行政数据集联系起来。我们希望您像我们一样对这篇论文集感到有趣和鼓舞。
