Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
J Gerontol A Biol Sci Med Sci. 2022 Aug 12;77(8):1691-1698. doi: 10.1093/gerona/glab342.
Indices of multimorbidity and deficit accumulation (ie, frailty indices) have been proposed as markers of biological aging. If true, changes in these indices over time should predict downstream changes in cognition and physical function, and mortality.
We examined associations that 8-year changes in (i) a multimorbidity index comprised of 9 chronic diseases and (ii) a frailty index (FI) based on deficit accumulation in functional, behavioral, and clinical characteristics had with subsequent measures of cognitive and physical function over 10 years. We drew data from 3 842 participants in the Action for Health in Diabetes clinical trial. They were aged 45-76 years at baseline and at risk for accelerated biological aging due to overweight/obesity and type 2 diabetes mellitus.
A total of 1 501 (39%) of the cohort had 8-year increases of 1 among the 9 diseases tracked in the multimorbidity index and 868 (23%) had increases of ≥2. Those with greatest increases in multimorbidity tended to be older individuals, males, and non-Hispanic Whites. Greater FI increases tended to occur among individuals who were older, non-Hispanic White, heavier, and who had more baseline morbidities. Changes in multimorbidity and FI were moderately correlated (r = 0.26; p < .001). Increases in both multimorbidity and FI were associated with subsequently poorer composite cognitive function and 400-m walk speed and increased risk for death (all p < .001).
Accelerated biological aging, as captured by multimorbidity and frailty indices, predicts subsequent reduced function and mortality. Whether intensive lifestyle interventions generally targeting multimorbidity and FI reduce risks for downstream outcomes remains to be seen. Clinical Trials Registration Number: NCT00017953.
多种疾病指数和缺陷积累（即虚弱指数）已被提出作为生物衰老的标志物。如果这是真的，这些指数随时间的变化应该可以预测认知和身体功能以及死亡率的后续变化。
我们研究了 8 年内（i）由 9 种慢性疾病组成的多种疾病指数和（ii）基于功能、行为和临床特征缺陷积累的虚弱指数（FI）的变化与随后 10 年内认知和身体功能的后续测量之间的关联。我们从行动促进糖尿病临床试验中的 3842 名参与者中提取数据。他们在基线时年龄为 45-76 岁，由于超重/肥胖和 2 型糖尿病，有加速生物衰老的风险。
共有 1501 名（39%）队列成员在多种疾病指数中跟踪的 9 种疾病中有 8 年的增加 1，868 名（23%）的增加≥2。多种疾病增加最多的患者往往是年龄较大的个体、男性和非西班牙裔白人。FI 增加较多的患者往往年龄较大、非西班牙裔白人、体重较重且基线疾病较多。多种疾病和 FI 的变化中度相关（r = 0.26；p <.001）。多种疾病和 FI 的增加均与随后的认知功能综合下降和 400 米步行速度下降以及死亡风险增加相关（均 p <.001）。
多种疾病和虚弱指数所捕捉到的加速生物衰老，预测了随后的功能下降和死亡风险。强化生活方式干预是否普遍针对多种疾病和 FI 降低下游结局的风险仍有待观察。临床试验注册号：NCT00017953。
