背景:生理失调/同种异体负荷和老年综合征的虚弱随着年龄的增长而增加。作为一种神经生理反应系统,同种异体通过限制与应激源相关的损伤来支持生存。虚弱反映力量下降,耐力,和身体能力继发于肌肉和骨骼的损失随着年龄的增长。一个建议,基于对70岁以上人群的大型队列研究,脆弱有助于老年人的静力负荷。然而,基于社区的小型研究尚未证实这种特定的关联。
方法:为了进一步探索同种异体载荷和脆弱之间可能的关联,我们招募了211名年龄在55-91岁的大波兰居民,他们住在一个小村庄(Nekla,N=104)和大波兰的城市中心和首都(波兹南,N=107)。对于每一个,我们记录了年龄,自我报告的性别,和居住地,并估计10个生物标志物的同种异体负荷评分(ALS)和8个生物标志物的脆弱指数。我们预计以下情况:男性和农村居民的ALS和身体虚弱较高;年龄较大时,ALS的身体虚弱而不是ALS较高;ALS与性别和居住地的显着关联,但不是年龄或虚弱。通过t检验和多变量回归评估观察到的关联的显著性。
结果:ALS在男性和女性之间以及Nekla和Poznan居民之间没有显着差异。然而,女性的虚弱程度明显高于男性。Nekla男性表现出明显较高的ALS,但没有虚弱,而Nekla女性表现出非显著高于Poznan的ALS和较低的身体虚弱。在多变量分析中,无论是年龄,也不是性,居住也不与ALS相关。相反,年龄,性别,和居住,但不是ALS,与脆弱显著相关。在Nekla,年龄和性别,但在波兹南唯一的年龄,与ALS有关。在女性中,年龄和居住地,但是在男人中,与ALS无关。在任何情况下,ALS都不会与虚弱显着相关。
结论:在此示例中,与居住相关的生活方式因素,年龄,和性别影响压力相关的生理,在女性中更少,而ALS和脆弱并不共存,表明它们的潜在启动子是不同的。生理失调与虚弱的类似复杂关联,年龄,性别,和住所可能存在于许多当地环境中。了解这种变化可能有助于支持老年人的健康和医疗保健服务。
BACKGROUND: Physiological dysregulation/allostatic load and the geriatric syndrome frailty increase with age. As a neurophysiological response system, allostasis supports survival by limiting stressor-related damage. Frailty reflects decreased strength, endurance, and physical abilities secondary to losses of muscle and bone with age. One suggestion, based on large cohort studies of person\'s ages 70 + years, is that frailty contributes to allostatic load at older ages. However, small community-based research has not confirmed this specific association.
METHODS: To further explore possible associations between allostatic load and frailty, we enrolled 211 residents of Greater Poland aged 55-91 years living in a small village (Nekla, N = 104) and an urban center and capital of Greater Poland (Poznan, N = 107). For each, we recorded age, self-reported sex, and residence and estimated a 10-biomarker allostatic load score (ALS) and an 8-biomarker frailty index. We anticipated the following: higher ALS and frailty among men and rural residents; for frailty but not ALS to be higher at older ages; significant associations of ALS with sex and place of residence, but not with age or frailty. The significance of observed associations was evaluated by t-tests and multivariate regression.
RESULTS: ALS did not vary significantly between men and women nor between Nekla and Poznan residents overall. However, women showed significantly higher frailty than men. Nekla men showed significantly higher ALS but not frailty, while Nekla women showed nonsignificantly higher ALS and lower frailty than Poznan. In multivariate analyses, neither age, nor sex, nor residence was associated with ALS. Conversely, age, sex, and residence, but not ALS, are associated significantly with frailty. In Nekla, both age and sex, but in Poznan only age, are associated with ALS. Among women, both age and residence, but among men, neither associated with ALS. In no case did ALS associate significantly with frailty.
CONCLUSIONS: In this sample, lifestyle factors associated with residence, age, and sex influence stress-related physiology, less so in women, while ALS and frailty do not covary, suggesting their underlying promoters are distinct. Similar complex associations of physiological dysregulation with frailty, age, sex, and residence likely exist within many local settings. Knowledge of this variation likely will aid in supporting health and healthcare services among
seniors.