Hernandez Hernan, Santamaria-Garcia Hernando, Moguilner Sebastian, Farina Francesca R, Legaz Agustina, Prado Pavel, Cuadros Jhosmary, Gonzalez Liset, Gonzalez-Gomez Raul, Migeot Joaquín, Coronel-Oliveros Carlos, Tagliazucchi Enzo, Maito Marcelo Adrián, Godoy María E, Cruzat Josephine, Shaheen Ahmed, Farombi Temitope, Salazar Daniel, Da Ros Lucas Uglione, Borelli Wyllians V, Zimmer Eduardo R, Njamnshi Alfred K, Bajpai Swati, Dey A B, Mostert Cyprian, Merali Zul, Salama Mohamed, Moustafa Sara A, Fittipaldi Sol, Altschuler Florencia, Medel Vicente, Huepe David, Yaffe Kristine, Momoh Chinedu, Eyre Harris A, Swieboda Pawel, Lawlor Brian, Miranda J Jaime, Duran-Aniotz Claudia, Baez Sandra, Ibanez Agustin
Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile.
PhD Program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia.
Nat Med. 2025 Jul 14. doi: 10.1038/s41591-025-03808-2.
Protective and risk factors can drive healthy or accelerated aging, with distinct environments modulating their effects. The impact of the exposome-the combined physical and social exposures experienced throughout life-on accelerated aging remains unknown. We assessed delayed and accelerated aging in 161,981 participants from 40 countries (45.09% female; mean age, 67.06; s.d., 9.85) by measuring biobehavioral age gaps (BBAGs), defined as the difference between estimated age from protective and risk factors and chronological age, in cross-sectional and longitudinal designs. BBAGs predicted chronological age, followed by regional and exposomal factor analyses, linked to accelerated aging. Europe led in healthy aging, while Egypt and South Africa showed the greatest acceleration; Asia and Latin America fell in between (Cliff's delta (δd) = 0.15-0.52; all P < 0.0001). Accelerated aging was more evident in eastern and southern Europe; globally, it was also associated with lower income (δd = 0.48-0.56, P < 1 × 10). Exposomal factors of accelerated aging include physical (air quality), social (socioeconomic and gender inequality, migration) and sociopolitical (representation, party freedom, suffrage, elections and democracy) determinants (all Cohen's d (d) > 0.37, P < 0.0001). BBAGs predicted future functional (r (Pearson correlation) = -0.33, P < 1 × 10, d = 0.70) and cognitive declines (r = -0.22, P < 1 × 10, d = 0.44), and larger BBAGs (P < 0.0001, d = 1.55). Healthy and accelerated aging are influenced by physical, social and sociopolitical exposomes, with considerable disparities across nations.
保护因素和风险因素可推动健康衰老或加速衰老，不同的环境会调节它们的作用。一生中经历的综合物理和社会暴露——暴露组——对加速衰老的影响尚不清楚。我们通过测量生物行为年龄差距（BBAGs），即在横断面和纵向设计中，定义为保护因素和风险因素估计年龄与实际年龄之差，评估了来自40个国家的161,981名参与者（45.09%为女性；平均年龄67.06岁；标准差9.85岁）的延迟衰老和加速衰老情况。BBAGs可预测实际年龄，其次是区域和暴露组因素分析，与加速衰老相关。欧洲在健康衰老方面领先，而埃及和南非加速衰老最为明显；亚洲和拉丁美洲介于两者之间（克利夫德尔塔（δd）=0.15 - 0.52；所有P < 0.0001）。加速衰老在东欧和南欧更为明显；在全球范围内，它还与较低收入相关（δd = 0.48 - 0.56，P < 1×10）。加速衰老的暴露组因素包括物理因素（空气质量）、社会因素（社会经济和性别不平等、移民）和社会政治因素（代表性、政党自由、选举权、选举和民主）（所有科恩d值（d）> 0.37，P < 0.0001）。BBAGs可预测未来的功能衰退（r（皮尔逊相关系数）=-0.33，P < 1×10，d = 0.70）和认知衰退（r = -0.22，P < 1×10，d = 0.44），且BBAGs越大（P < 0.0001，d = 1.55）。健康衰老和加速衰老受物理、社会和社会政治暴露组的影响，各国之间存在相当大的差异。
