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内在能力下降的多轨迹及其对与年龄相关结局的影响:一项 20 年的全国纵向队列研究。

Multi-Trajectories of Intrinsic Capacity Decline and Their Impact on Age-Related Outcomes: A 20-Year National Longitudinal Cohort Study.

机构信息

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.

Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France.

出版信息

Aging Dis. 2023 Nov 21;15(6):2697-2709. doi: 10.14336/AD.2023.1115-1.


DOI:10.14336/AD.2023.1115-1
PMID:38029399
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11567246/
Abstract

The existence of intrinsic capacity (IC) subtypes and their distinct impacts on age-related outcomes remain unexplored. This study sought to investigate IC impairment trajectories across domains and their associations with the risk of age-related outcomes, including falls, functional limitations, reduced quality of life (QoL) and mortality at 4- and 8-year follow-ups. The study sample comprised 1,782 older adults residing in the community from the Taiwan Longitudinal Study on Ageing (TLSA). Utilizing group-based multitrajectory modeling, distinct subtypes of IC decline trajectories across various domains were identified. Cox proportional hazard models and multivariable logistic regression analyses were employed to assess the associations between the identified subtypes and age-related outcomes. We identified four subtypes of IC decline: robust with mild decline (n=902), hearing loss with cognitive decline (n=197), physio-cognitive decline (PCD) with depression (n=373), and severe IC decline (n=310). Over the 4-year study period, compared to the robust with mild decline group, hearing loss with cognitive decline group exhibited a significantly higher risk of diminished QoL (OR=2.53 [1.66-3.86], p<0.01), whereas those in the PCD with depression group experienced an elevated risk of falls (OR=1.62 [1.18-2.23], p<0.01), as well as functional limitation (OR=2.61 [1.81-3.75], p<.01). Individuals in the severe IC decline group faced a substantially increased risk of all outcomes of interest. Distinct subtypes of IC decline across different domains have varying impacts on age-related outcomes, highlighting the need for a personalized approach to promote healthy ageing at the population level, while further investigation into specific pathophysiological mechanisms is warranted as well.

摘要

内在能力 (IC) 亚型的存在及其对与年龄相关结局的不同影响仍未得到探索。本研究旨在调查跨领域的 IC 损伤轨迹及其与与年龄相关结局(包括跌倒、功能限制、生活质量降低和 4 年和 8 年随访时的死亡率)的风险之间的关联。研究样本包括来自台湾老龄化纵向研究(TLSA)的 1782 名居住在社区的老年人。利用基于群组的多轨迹建模,确定了不同领域的 IC 下降轨迹的不同亚型。使用 Cox 比例风险模型和多变量逻辑回归分析来评估鉴定出的亚型与与年龄相关结局之间的关联。我们确定了 IC 下降的四种亚型:具有轻度下降的稳健型(n=902)、听力损失伴认知下降型(n=197)、生理认知下降伴抑郁型(PCD 型,n=373)和严重 IC 下降型(n=310)。在 4 年的研究期间,与具有轻度下降的稳健型相比,听力损失伴认知下降组的 QoL 降低风险显著更高(OR=2.53 [1.66-3.86],p<0.01),而 PCD 伴抑郁组的跌倒风险增加(OR=1.62 [1.18-2.23],p<0.01),以及功能受限(OR=2.61 [1.81-3.75],p<.01)。严重 IC 下降组的个体面临所有感兴趣结局的风险显著增加。不同领域的 IC 下降的不同亚型对与年龄相关结局有不同的影响,这凸显了在人群层面上需要采取个性化的方法来促进健康老龄化,同时也需要进一步研究特定的病理生理机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f6/11567246/15c148ecd9c9/AD-15-6-2697-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f6/11567246/fadcab027937/AD-15-6-2697-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f6/11567246/3f3866baf62c/AD-15-6-2697-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f6/11567246/15c148ecd9c9/AD-15-6-2697-g3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f6/11567246/fadcab027937/AD-15-6-2697-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f6/11567246/3f3866baf62c/AD-15-6-2697-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f6/11567246/15c148ecd9c9/AD-15-6-2697-g3.jpg

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[7]
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本文引用的文献

[1]
Validating intrinsic capacity to measure healthy aging in an upper middle-income country: Findings from the ELSI-Brazil.

Lancet Reg Health Am. 2022-5-27

[2]
Plasma inflammation-related biomarkers are associated with intrinsic capacity in community-dwelling older adults.

J Cachexia Sarcopenia Muscle. 2023-4

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BMC Geriatr. 2022-11-25

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Intrinsic Capacity Impairment Patterns and their Associations with Unfavorable Medication Utilization: A Nationwide Population-Based Study of 37,993 Community-Dwelling Older Adults.

J Nutr Health Aging. 2022

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J Nutr Health Aging. 2022

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Exp Gerontol. 2022-10-15

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Longitudinal trajectories of intrinsic capacity and their association with quality of life and disability.

Maturitas. 2022-7

[9]
Novel Cerebello-Amygdala Connections Provide Missing Link Between Cerebellum and Limbic System.

Front Syst Neurosci. 2022-5-13

[10]
Approaching person-centered long-term care: The trajectories of intrinsic capacity and functional decline in Taiwan.

Geriatr Gerontol Int. 2022-7

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