Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Neurobiology and Therapeutics of Aging Division, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York, New York, USA.
J Gerontol A Biol Sci Med Sci. 2023 Oct 28;78(11):2152-2161. doi: 10.1093/gerona/glad174.
Older adults with discordant biological and chronological ages (BA and CA) may vary in cognitive and physical function from those with concordant BA and CA.
To make our approach clinically accessible, we created easy-to-interpret participant groups in the Health, Aging, and Body Composition Study (N = 2 458, 52% female participants, 65% White participants, age: 73.5 ± 2.8) based on medians of CA, and a previously validated BA index comprised of readily available clinical tests. Joint models estimated associations of BA-CA group with cognition (Modified Mini-Mental State Examination [3MS] and Digit Symbol Substitution Test [DSST]) and frailty over 10 years.
The sample included the following: 32%, Young group (BA and CA < median); 21%, Prematurely Aging group (BA ≥ median, CA < median), 27%, Old group (BA and CA ≥ median), and 20%, Resilient group (BA < median, CA ≥ median). In education-adjusted models of cognition, among those with CA < median, the Prematurely Aging group performed worse than the Young at baseline (3MS and DSST p < .0001), but among those with CA ≥ median, the Resilient group did not outperform the Old group (3MS p = .31; DSST p = .25). For frailty, the Prematurely Aging group performed worse than the Young group at baseline (p = .0001), and the Resilient group outperformed the Old group (p = .003). For all outcomes, groups did not differ on change over time based on the same pairwise comparisons (p ≥ .40).
Discordant BA and CA identify groups who have greater cognitive and physical functional decline or are more protected than their CA would suggest. This information can be used for risk stratification.
生物年龄（BA）和实际年龄（CA）不一致的老年人与 BA 和 CA 一致的老年人在认知和身体功能方面可能存在差异。
为了使我们的方法具有临床可操作性，我们根据 CA 的中位数以及之前验证的由易于获得的临床测试组成的 BA 指数，在健康、衰老和身体成分研究（N=2458 名参与者，52%为女性参与者，65%为白人参与者，年龄：73.5±2.8）中创建了易于解释的参与者组。联合模型估计了 BA-CA 组与认知（改良的迷你精神状态检查[3MS]和数字符号替代测试[DSST]）和 10 年内衰弱的关联。
该样本包括以下内容：32%，年轻组（BA 和 CA<中位数）；21%，过早衰老组（BA≥中位数，CA<中位数），27%，年老组（BA 和 CA≥中位数）和 20%，有弹性组（BA<中位数，CA≥中位数）。在认知的教育调整模型中，在 CA<中位数的人群中，过早衰老组在基线时的表现不如年轻组（3MS 和 DSST p<0.0001），但在 CA≥中位数的人群中，有弹性组与老年组没有差异（3MS p=0.31；DSST p=0.25）。对于虚弱，过早衰老组在基线时的表现不如年轻组（p=0.0001），而有弹性组的表现优于老年组（p=0.003）。对于所有结果，基于相同的两两比较，组间在随时间的变化上没有差异（p≥0.40）。
BA 和 CA 不一致可识别出认知和身体功能下降程度较大或比 CA 所提示的更具保护作用的人群。这些信息可用于风险分层。
