BACKGROUND:

The brain natriuretic peptides (BNP, NT-proBNP ) are useful diagnostic markers of heart failure (HF), as exemplified by the ESC Heart Failure guidelines. The PolSenior project was an epidemiological study carried out to examine medical, psychological and socioeconomic aspects of aging in Poland. The aim of this study is an epidemiological description of HF based on elderly population from the PolSenior Study, stratified by NT-pro-BNP concentration values.

MATERIAL AND METHODS:

The research sample included 4979 respondents (2567 males and 2412 females) split into six equally sized age groups of elderly individuals. The study consisted of three visits performed by trained nurses and included a questionnaire survey, comprehensive geriatric assessment and blood and urine sampling with more than 50 biochemical parameters measured. Serum NT-pro- BNP was measured by electrochemiluminescence method (ECLIA).

RESULTS:

The prevalence of chronic kidney disease (CKD) (77.8%) and atrial fibrilattion (39.5%), number of hospitalizations (23.7%) and number of patients treated with HF drugs were highest in NTproBNP>2000 pg/ml group and least frequent in NT-proBNP <400 pg/ml group. Obese patients had significantly more frequently NT-proBNP values <400pg/ml (73.0%) and less frequently NT-proBNP values >2000 pg/ml (2.8%). Age over 70 years and male gender were associated with the increased NT-pro-BNP (>400 pg/ml) (OR 1.41; CI 1.20-1.65 for male gender).

CONCLUSIONS:

We conclude that CKD and atrial fibrillation are associated with the occurrence of increased NT-pro-BNP, the surrogate for HF in elderly population. On contrary, overweight or obesity are associated with lower prevalence of HF in elderly.

The lifespan of each individual, even in an isogenic cohort and a uniform environment, is quite different. The genetic factors influencing the lifespan in humans as well as animal models are few. The balance is attributed to "chance" variations. In this study, we focus on a third factor, noise or chance variations, as well as on genetic and environmental factors and examine how biodemographic aging is related to stochastic fluctuations, or noise. To elucidate the third factor in relation to aging and lifespan, we employed the nematode Caenorhabditis elegans, which can provide an ideal system for analyzing the mathematical and biophysical models. An amplification of ATP noise was clearly evident from around the onset of biodemographic aging (t0) as if the t0 was synchronized with or derived from the amplification of noise. Furthermore, the expression noise of the unc-54 gene, which encodes the myosin heavy chain, increased from around the t0. In contrast, the noise of genes related to the mitochondrial respiratory chain was almost constant with aging. There is a high energy barrier between life and death. Here we propose that the transition from living to dying may be facilitated by noise amplification. The finite value (or non-zero) of t0 is essential to the lifespan equation derived from the diffusion model.

Oxidative stress and chronic inflammation have been implicated in the testicular aging process. Different types and moderate-intensity of regular exercise may reduce age-related physiological dysfunction associated with inflammation and oxidative stress, but such effects of moderate-intensity of exercise over different phases of life in testes have not been reported. In this study, male SAMP8 mice, a senescence-accelerated strain, were maintained as sedentary (sed) or subjected to daily 15-min periods of swimming exercise between ages of 2-7months (lifelong), 2-4months (earlier) or 5-7months (late). Age-related changes, including serum testosterone levels and biomarkers of inflammation and oxidative stress were analyzed at the end of the experiment. All exercise groups showed significantly greater serum testosterone levels and decreased age-related inflammation and oxidative stress compared with the sedentary group. Exercise also increased expression and activity of the nuclear factor erythroid 2-related factor (Nrf2), a transcriptional regulator of the cellular anti-oxidant system, and decreased expression and activity of nuclear factor kappa beta (NF-κB), a mediator of inflammatory molecules, in the nucleus of testicular cells. However, lifelong and earlier groups generally showed significantly better protective effects than the late group against age-related physiological dysfunction in testes. Thus, lifelong exercise and earlier phase exercise were most effective in counteracting oxidative stress and inflammation and in preserving testes function through regulation of Nrf2 and NF-κB. These results advocate the benefits of lifelong exercise and emphasize a greater protection against male aging by instituting exercise earlier rather than late in life.

Aging is associated with a loss in muscle known as sarcopenia that is partially attributed to apoptosis. In aging rodents, caloric restriction (CR) increases health and longevity by improving mitochondrial function and the polyphenol resveratrol (RSV) has been reported to have similar benefits. In the present study, we investigated the potential efficacy of using short-term (6weeks) CR (20%), RSV (50mg/kg/day), or combined CR+RSV (20% CR and 50mg/kg/day RSV), initiated at late-life (27months) to protect muscle against sarcopenia by altering mitochondrial function, biogenesis, content, and apoptotic signaling in both glycolytic white and oxidative red gastrocnemius muscle (WG and RG, respectively) of male Fischer 344×Brown Norway rats. CR but not RSV attenuated the age-associated loss of muscle mass in both mixed gastrocnemius and soleus muscle, while combined treatment (CR+RSV) paradigms showed a protective effect in the soleus and plantaris muscle (P<0.05). Sirt1 protein content was increased by 2.6-fold (P<0.05) in WG but not RG muscle with RSV treatment, while CR or CR+RSV had no effect. PGC-1α levels were higher (2-fold) in the WG from CR-treated animals (P<0.05) when compared to ad-libitum (AL) animals but no differences were observed in the RG with any treatment. Levels of the anti-apoptotic protein Bcl-2 were significantly higher (1.6-fold) in the WG muscle of RSV and CR+RSV groups compared to AL (P<0.05) but tended to occur coincident with elevations in the pro-apoptotic protein Bax so that the apoptotic susceptibility as indicated by the Bax to Bcl-2 ratio was unchanged. There were no alterations in DNA fragmentation with any treatment in muscle from older animals. Additionally, mitochondrial respiration measured in permeabilized muscle fibers was unchanged in any treatment group and this paralleled the lack of change in cytochrome c oxidase (COX) activity. These data suggest that short-term moderate CR, RSV, or CR+RSV tended to modestly alter key mitochondrial regulatory and apoptotic signaling pathways in glycolytic muscle and this might contribute to the moderate protective effects against aging-induced muscle loss observed in this study.

OBJECTIVE:

The aim of this study was to investigate the metabolic risk factors for fatty liver disease in the elderly, and determine the prevalence of fatty liver disease in the elderly in Wuhan, central China.

METHODS:

The study was a case-control study based on all 4226 adults above 60years of age from a cohort investigated in 2010-11 at the medical examination center of Zhongnan hospital, using 3145 randomly selected adults under 60years of age from the same cohort as controls. Fatty liver disease (FLD) was identified with ultrasound imaging. The risk factors measured were body mass index (BMI), and plasma concentrations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), low density lipoprotein (LDL) and serum uric acid (SUA). The probability of steatohepatitis with advanced fibrosis was predicted using a score based on BMI, age, ALT, and TG (BAAT),and using AST/ALT ratio (AAR).

RESULTS:

FLD was higher in the elderly (26.7%) than in the non-elderly (22.8%) and similar in the elderly between men and women (26.6% vs 27.0%, p>0.05). BMI, TC, TG, LDL, SUA, AST and ALT were all significantly higher in FLD, whereas the level of HDL was markedly lower. Multiple regression analyses showed that obesity, high TC, TG, SUA, low HDL, and elevated ALT, AAR<1 were closely related to the elderly FLD, while male sex, obesity, high TC, TG, low HDL, elevated ALT, AST and AAR<1 were closely related to the non-elderly FLD. The prevalence of steatohepatitis with advanced fibrosis estimated as BAAT index≥3 was 2.4% in all subjects, and was higher in the elderly FLD patients than in the non-elderly FLD patients.

CONCLUSION:

The prevalence of FLD is higher in the elderly, and is broadly related to the same metabolic risk factors as in the non-elderly. However, female-sex is no longer protective with increasing age, and the prevalence of steatohepatitis with advanced fibrosis is estimated to be considerably higher in the elderly FLD patients than in the non-elderly FLD controls.

This response letter addresses two points raised by le Bourg when discussing our previous paper entitled "Exploring the impact of climate on human longevity". First, the arguments explaining the accuracy of the numbers of centenarian in Okinawa are developed, and second the composition and healthfulness of the traditional Okinawan diet are described as well as the changes in dietary pattern and their impact on longevity.

Arterial stiffness, an independent predictor of cardiovascular disease, is increased in aging, but the underlying mechanisms are not completely understood. Mineralocorticoid receptors (MR) may contribute to oxidative stress and arterial stiffness in healthy older adults. To test the hypothesis that short-term MR blockade may reduce oxidative stress and improve arterial stiffness, we conducted a randomized, double blind, crossover study using the selective MR blocker Eplerenone or placebo in 23 older adults (age, 64±1years; mean±SE) free from overt cardiovascular and other clinical disease (e.g, diabetes, renal and liver disease). In response to MR blockade, brachial and carotid blood pressure decreased (P≤0.01). However, MR blockade had no effect on oxidative stress (oxidized LDL, 61.2±6.8 vs. 62.4±7.4U/L, P=0.9; placebo vs. Eplerenone) and arterial stiffness (aortic pulse wave velocity (PWV), 9.17±1.19 vs. 8.92±1.19m/s, P=0.5; leg PWV, 13.45±0.45 vs. 12.81±0.47m/s, P=0.3; arm PWV, 11.43±0.62 vs. 11.73±0.68m/s, P=0.7; carotid artery compliance, 0.150±0.013 vs. 0.149±0.014mm(2)/mmHg, P=0.8; distensibility, 23.1±1.8 vs. 23.3±1.7 10(-3)/kPa, P=0.8; β stiffness index, 3.5±0.3 vs. 3.6±0.3, P=0.6; and augmentation index, 16.0±2.2 vs. 15.6±2.8%, P=0.8). These results provide the first evidence that MR do not appear to contribute to oxidative stress in human aging and that short-term MR blockade does not result in reduced oxidative stress and improved arterial stiffness.

OBJECTIVES:

Considering disease incidence to be a main contributor to healthy lifespan of the US elderly population may lead to erroneous conclusions when recovery/long-term remission factors are underestimated. Using two Medicare-based population datasets, we investigated the properties of recovery from eleven age-related diseases.

METHODS:

Cohorts of patients who stopped visiting doctors during a five-year follow-up since disease onset were analyzed non-parametrically and using the Cox proportional hazard model resulted in estimated recovery and survival rates and evaluated the health state of recovered individuals by comparing their survival with non-recovered patients and the general population.

RESULTS:

Recovered individuals had lower death rates than non-recovered patients, therefore, patients who stopped visiting doctors are a healthier subcohort. However, they had higher death rates than in general population for all considered diseases, therefore the complete recovery does not occur.

CONCLUSION:

Properties of recovery/long-term remission among the US population of older adults with chronic diseases were uncovered and evaluated. The results allow for a better quantifiable contribution of age-related diseases to healthy life expectancy and improving forecasts of health and mortality.

The mortality patterns in human populations reflect biological, social and medical factors affecting our lives, and mathematical modelling is an important tool for the analysis of these patterns. It is known that the mortality rate in all human populations increases with age after sexual maturity. This increase is predominantly exponential and satisfies the Gompertz equation. Although the exponential growth of mortality rates is observed over a wide range of ages, it excludes early- and late-life intervals. In this work we accept the fact that the mortality rate is an exponential function of age and analyse possible mechanisms underlying the deviations from the exponential law across the human lifespan. We consider the effect of heterogeneity as well as stochastic factors in altering the exponential law and compare our results to publicly available age-dependent mortality data for Swedish and US populations. In a model of heterogeneous populations we study how differences in parameters of the Gompertz equation describing different subpopulations account for mortality dynamics at different ages. Particularly, we show that the mortality data on Swedish populations can be reproduced fairly well by a model comprising four subpopulations. We then analyse the influence of stochastic effects on the mortality dynamics to show that they play a role only at early and late ages, when only a few individuals contribute to mortality. We conclude that the deviations from exponential law at young ages can be explained by heterogeneity, namely by the presence of a subpopulation with high initial mortality rate presumably due to congenital defects, while those for old ages can be viewed as fluctuations and explained by stochastic effects.