海南省百岁老人日常生活活动能力现状及影响因素分析

目的 了解海南省百岁老人日常生活活动能力现状及其主要影响因素。方法 2014年6月至2016年12月采用全样本横断面调查法,对海南省18个市（县）百岁老人进行入户调查,采集一般情况、日常生活活动能力（ADL）以及老年贫血和维生素D缺乏情况。对上述变量进行统计描述、单因素和多因素logistic分析。结果 共计分析804例百岁老人,其中ADL功能正常者221例（27.5%）,ADL轻度损失和失能者分别为393例（48.9%）和190例（23.6%）。主要ADL损失项目为爬楼梯（79.0%）、转移（59.1%）、平地行走50 m（44.3%）和如厕（41.3%）;多因素logistic回归表明,百岁老年人群有饮茶习惯、视力听力良好可能是ADL的保护因素,而低文化程度、维生素D缺乏可能是发生ADL损失的危险因素（P<0.05）。结论 海南省百岁老人ADL损失较高,文化程度、饮茶习惯、听力、视力和维生素D水平可能是ADL损失的主要危险因素。     

Diabetes mellitus in the extreme longevity

Epidemiological studies have revealed a progressive increase in the prevalence of diabetes mellitus in the elderly. Numerous factors are responsible for this trend, among them there are (a) the long-lasting disease due the improved therapeutic remedial (pharmacological, dietary treatments and physical activity), (b) the increased life span expectancy. The prevalence of diabetes mellitus in long living subjects is lower than in elderly people (subjects aged from 65 to 84). Senile diabetes is prevalent in long living people, and usually begins after 90 years. The incidence of neodiagnosed diabetes is higher in the oldest old than in the elderly people. Based on the results, diabetes mellitus is a negative factor for survival, and does not usually allow to achieve very old age, i.e. centenarian.     

Functional measures,inflammatory markers and endothelin-1 as predictors of 360-day survival in centenarians

Centenarians represent a rapidly growing population. To better characterize this specific age group, we have performed a cross-sectional study to observe associations between functional measures and a range of biochemical markers, including inflammatory markers and their significance as predictors of 360-day survival. Medical history and physical and functional assessment (Mini-Mental State Examination (MMSE), Katz Index (activities of daily living, ADL) and Barthel Index (Barthel Index) of Activities of Daily Living, and Lawton Instrumental Activities of Daily Living Scale (Lawton IADL)) were conducted on 86 101.9 ± 1.2-year-old (mean ± SD) subjects (70 women, 16 men). Blood tests were performed on 84 subjects of whom 43 also had extended biomarker assessment. As a reference group 30 51.8 ± 5.0-year old healthy subjects (20 women, 10 men) were recruited. The centenarians received follow-up phone calls. Fifty-two centenarians (60 %) survived ≥360 days. Longer survival was associated with higher MMSE (hazard ratio, HR = 0.934, 95 % confidence interval (CI) 0.896–0.975, P = .002), ADL (HR = 0.840, 95 % CI 0.716–0.985, P = .032), Barthel Index (HR = 0.988, 95 % CI 0.977–0.999, P = .026), and albumin level (HR .926, 95 % CI 0.870–0.986, P .016) and with lower white blood cell (WBC) (HR = 1.161, 95 % CI 1.059–1.273, P = .001), C-reactive protein (CRP) (HR = 1.032, 95 % CI 1.014–1.050, P < .001), IL-6 (HR = 1.182, 95 % CI 1.047–1.335, P = .007), and endothelin-1 (ET-1) level (HR = 3.711, 95 % CI 1.233–11.169, P = .020). Centenarians had higher 360-day survival probability with MMSE ≥13 (P < .001), ADL ≥1 (P < .001), Barthel Index ≥15 (P < .001), Lawton IADL ≥10 points (P = .009), WBC <8.3 G/L (P = .039), CRP <10 mg/L (P < .001), IL-6 <6 pg/mL (P .002), and ET-1 <1.1 pg/mL (P .007). Our results indicate that functional measures, inflammatory markers, and endothelin-1 are predictors of 360-day survival in centenarians.     

Cardiovascular risk factors in centenarians

Several studies have shown that centenarians have better cardiovascular risk profiles compared to younger old people. Some reports have revealed that cardiovascular diseases (i.e. hypertension, diabetes, angina and/or myocardial infarction) are less common in centenarians respect to 70 and 80 years old persons. In order to explain this evidence, there is a growing number of hypothesis that consider a combination of genetic factors and lifestyle aspects to elucidate the exceptional longevity of centenarians, able to overcome the most frequent mortality cause, which is a cardiovascular event. It has been suggested that a role on this better cardiovascular risk profile may be played by the increasing use of pharmacologic treatments in the elderly population (specially for hypertension and dyslipidemia), but the contribution of drug treatments to promote extreme longevity is not confirmed. Furthermore, centenarians in general have needed fewer drugs at younger ages due to a healthy lifestyle. The importance of the genetic contribution is demonstrated by the inheritance of low-risk cardiovascular profiles in centenarian offspring and lower prevalence of cardiovascular diseases in this population as compared with their spouses or with age-matched subjects without centenarian parents. Another advantage in centenarians' offspring seems to be a delay in the onset for cardiovascular diseases, respect to age- and sex-matched controls. Cardiovascular risk factors mirror the factors that contribute to longevity. Hence, it is not surprising that these risk factors are less prevalent in centenarians when compared to younger old individuals.     

湖北省钟祥市百岁老人健康状况评估与慢性病调查

目的：对我国长寿之乡———湖北钟祥百岁老人进行健康状况评估与慢性病调查,探讨百岁老人长寿的影响因素。方法于2013年1月—2014年1月对湖北省钟祥市百岁老人进行走访、健康体检和问卷调查,问卷调查表依据《中国健康老年人标准(2013)》设计拟定,包括认知功能(MMSE)、心理状况(GDS)和生活自理能力(ADL)评分。同时进行健康体检和采集血样标本,进行血液常规、肝肾功能、血脂及血糖检查。随机走访了4个乡镇的百岁老人,完成有效问卷调查共10人,对问卷结果、体检和各项血液生化检查进行综合评估及疾病谱分析。结果10位百岁老人年龄100~110岁,平均年龄103岁,男性4人,女性6人。农民9人,退休教师1人。营养评定显示,营养状况中等8人、良好与较差各1人。简易智能量表(MMSE)评分：认知功能正常4人,不同程度的认知功能障碍6人,无痴呆老人。老年抑郁量表(GDS)评分：10人均<15分,无老年抑郁表现。日常生活活动量表(ADL)评分：最低36,最高87分,平均72分,显示10位百岁老人日常生活活动能力均不同程度下降的差异较大。主要疾病为：高脂血症80%;高血压60%;支气管炎30%;白内障20%;冠心病、支气管哮喘、肝功能异常、肾功能不全、帕金森病、血小板减少症和颈部包块各10%。普遍存在不同程度的耳聋、视力下降和缺齿。结论10位百岁老人大多生活在乡村,生活条件简陋,文化程度低,但生活规律,主观幸福感较强。重要脏器的增龄性改变未导致功能异常,无痴呆老人,未发现心脑血管重大疾病致残者。罹患慢性病1~3种∕人,均带病长寿,生活质量尚佳。     

Remodelling of biological parameters during human ageing: evidence for complex regulation in longevity and in type 2 diabetes

Factor structure analyses have revealed the presence of specific biological system markers in healthy humans and diseases. However, this type of approach in very old persons and in type 2 diabetes (T2DM) is lacking. A total sample of 2,137 Italians consisted of two groups: 1,604 healthy and 533 with T2DM. Age (years) was categorized as adults (≤65), old (66–85), oldest old (>85–98) and centenarians (≥99). Specific biomarkers of routine haematological and biochemical testing were tested across each age group. Exploratory factorial analysis (EFA) by principal component method with Varimax rotation was used to identify factors including related variables. Structural equation modelling (SEM) was applied to confirm factor solutions for each age group. EFA and SEM identified specific factor structures according to age in both groups. An age-associated reduction of factor structure was observed from adults to oldest old in the healthy group (explained variance 60.4% vs 50.3%) and from adults to old in the T2DM group (explained variance 57.4% vs 44.2%). Centenarians showed three-factor structure similar to those of adults (explained variance 58.4%). The inflammatory component became the major factor in old group and was the first one in T2DM. SEM analysis in healthy subjects suggested that the glucose levels had an important role in the oldest old. Factorial structure change during healthy ageing was associated with a decrease in complexity but showed an increase in variability and inflammation. Structural relationship changes observed in healthy subjects appeared earlier in diabetic patients and later in centenarians.     

In vitro IL-6 production by EBV-immortalized B lymphocytes from young and elderly people genotyped for -174 C/G polymorphism in IL-6 gene: a model to study the genetic basis of inflamm-aging

In the present investigation we analysed Interleukin 6 (IL-6) in vitro production by Epstein-Barr virus (EBV)-immortalized B lymphocytes established from 43 subjects, 15 young people and 28 elderly people, including 18 centenarians, after 3, 6, 9, 24, 48 and 72 h of culture. The subjects were genotypized for the C to G transition at nucleotide -174 of IL-6 gene promoter (-174 C/G) and were classified as C allele carriers (C+) and non-carriers (C-). We found that: (i) the interindividual difference in in vitro IL-6 production was wider in elderly individuals in respect to young individuals, leading to different coefficient of variation in the two groups; (ii) the -174 C/G polymorphism had an age-related effect on IL-6 in vitro production. Only among C- people, cells from elderly subjects produced significant higher level of IL-6 than cells from young subjects. These data are consistent with our previous results regarding the IL-6 serum levels in a large group of people of different age, including centenarians. Thus, the EBV-immortalized B lymphocytes can be considered a useful in vitro model for studying the genetic control of IL-6 production and its changes with age.