Azad Tej D, Li Marvin W, Ping-Yeh Chiu, Jones Kristen E, Lord Elizabeth L, Molina Camilo A, Walker Corey T, Osorio Joseph A, Pizones Javier, Theologis Alekos, van Hooff Miranda, Yagi Mitsuru, Kelly Michael P, de Kleuver Marinus, Hu Serena S, Shah Suken A, Pellisé Ferran, Walston Jeremy D, Eastlack Robert K, Ames Christopher P
Department of Neurosurgery, Johns Hopkins Hospital, Baltimore, MD, USA.
Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA.
Spine Deform. 2025 Jun 4. doi: 10.1007/s43390-025-01124-w.
The incidence of spine-related pathologies is expected to increase in developed countries due to ongoing fundamental demographic shifts toward an older population. These changes present significant challenges to public health, as healthcare systems worldwide must confront the burden of musculoskeletal aging and its related consequences. Here, we synthesize current knowledge on the biologic mechanisms underlying musculoskeletal aging, focusing on the implications for the aging spine. The complexity of the aging process, characterized by a convoluted interplay between genetic, environmental, and lifestyle factors, necessitates a comprehensive understanding of the biologic processes and reliable methods of surveying biologic states to inform effective diagnostic, predictive, and prognostic strategies. Biomarkers emerge as invaluable tools in this domain, offering insights into the early detection, risk assessment, and targeted intervention for age-related musculoskeletal decline. This review highlights various biomarker types including diagnostic, predictive, and prognostic, and explores their distinct roles in enhancing our understanding of musculoskeletal aging. Navigating the interconnected landscape of cellular senescence, sarcopenia, osteoporosis, and frailty, this review underscores the critical importance of developing personalized care approaches for the aging population. By identifying and integrating functional biomarkers, researchers and clinicians can elucidate the underlying mechanisms and devise tailored strategies to alleviate the musculoskeletal decline associated with the aging process. We envision an "active surveillance" future where biomarkers of musculoskeletal aging are integrated into clinical practice, empowering clinicians to make proactive, data-driven decisions that improve spine health for older adults.
由于发达国家人口持续向老龄化这一基本人口结构转变，脊柱相关疾病的发病率预计将会上升。这些变化给公共卫生带来了重大挑战，因为全球医疗保健系统必须应对肌肉骨骼老化及其相关后果带来的负担。在此，我们综合了关于肌肉骨骼老化潜在生物学机制的现有知识，重点关注其对脊柱老化的影响。老化过程十分复杂，其特点是遗传、环境和生活方式因素之间存在错综复杂的相互作用，因此有必要全面了解生物学过程以及测量生物学状态的可靠方法，以便制定有效的诊断、预测和预后策略。生物标志物在这一领域成为了非常有价值的工具，为与年龄相关的肌肉骨骼衰退的早期检测、风险评估和靶向干预提供了见解。本综述重点介绍了各种类型的生物标志物，包括诊断性、预测性和预后性生物标志物，并探讨了它们在增进我们对肌肉骨骼老化理解方面的独特作用。在细胞衰老、肌肉减少症、骨质疏松症和虚弱等相互关联的领域中，本综述强调了为老年人群制定个性化护理方法的至关重要性。通过识别和整合功能性生物标志物，研究人员和临床医生能够阐明潜在机制，并制定针对性策略，以减轻与衰老过程相关的肌肉骨骼衰退。我们设想了一个“主动监测”的未来，届时肌肉骨骼老化的生物标志物将被整合到临床实践中，使临床医生能够做出积极主动、基于数据的决策，从而改善老年人的脊柱健康。
