Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), 31000 Toulouse, France.
Maintain Aging Research Team, Centre d'Epidémiologie et de Recherche en santé des POPulations (CERPOP), Inserm, Université Paul Sabatier, Toulouse, France.
Age Ageing. 2023 Jul 1;52(7). doi: 10.1093/ageing/afad133.
Vitality is conceptually considered as the underlying capacity influencing other intrinsic capacity (IC) domains and being related to nutrition, physiological reserve and biological ageing. However, there is no consensus on its operationalisation.
To investigate the structure and magnitude of the association of vitality with other IC domains and functional difficulties using three operational definitions of vitality.
We included 1,389 older adults from the Multidomain Alzheimer Preventive Trial with data on Mini Nutritional Assessment (MNA), handgrip strength and plasma biomarkers (comprising inflammatory and mitochondrial markers). Using path analysis, we examined the effects of vitality on difficulties in basic and instrumental activities of daily living (ADL and IADL) exerted directly and indirectly through the mediation of other IC domains: cognition, locomotion, psychological, vision and hearing. We further explored the longitudinal association of vitality with IC domains, ADL and IADL over 4 years using linear mixed-effect regression.
We observed significant indirect effects of vitality on IADL, mainly through cognitive, locomotor and psychological domains, regardless of the vitality measurement. Participants with higher vitality had fewer IADL difficulties at follow-up (MNA score: β [95% CI] = -0.020 [-0.037, -0.003]; handgrip strength: -0.011 [-0.023, 0.000]; plasma biomarker-based index: -0.015 [-0.028, -0.002]). Vitality assessed with the plasma biomarker-based index predicted improved locomotion over time.
Vitality was associated with disability primarily through the mediation of other IC domains. The three indicators examined are acceptable measurements of vitality; biomarkers might be more suitable for the early detection of locomotion decline.
活力被概念化为影响其他内在能力（IC）领域的潜在能力，并与营养、生理储备和生物衰老有关。然而，其操作性定义尚未达成共识。
使用活力的三种操作定义，研究活力与其他 IC 领域和功能障碍的结构和关联程度。
我们纳入了多领域阿尔茨海默病预防试验中的 1389 名老年人，这些老年人的数据包括微型营养评估（MNA）、握力和血浆生物标志物（包括炎症和线粒体标志物）。我们通过路径分析，考察了活力对基本和工具性日常生活活动（ADL 和 IADL）困难的直接和间接影响，这种影响是通过其他 IC 领域（认知、运动、心理、视觉和听觉）的中介作用产生的。我们进一步使用线性混合效应回归，在 4 年内探索了活力与 IC 领域、ADL 和 IADL 的纵向关联。
我们观察到，无论采用哪种活力测量方法，活力对 IADL 的间接影响都具有统计学意义，主要通过认知、运动和心理领域产生。活力较高的参与者在随访时的 IADL 困难较少（MNA 评分：β[95%CI] = -0.020[-0.037，-0.003]；握力：-0.011[-0.023，0.000]；基于血浆生物标志物的指数：-0.015[-0.028，-0.002]）。基于血浆生物标志物的指数评估的活力与随时间推移的运动能力改善相关。
活力主要通过其他 IC 领域的中介作用与残疾相关。本研究中检验的三种指标均为可接受的活力测量指标；生物标志物可能更适合早期检测运动能力下降。
