Laboratory parameters in centenarians of Italian ancestry

Studies aimed at collecting reference parameters for haematochemical analysis in the elderly are scarce and for the oldest old subjects even more rare. In order to establish the reference values for the most common laboratory text in long living individuals, we measured haematochemical parameters in >100 years old subjects and in aged subjects as control. Six hundred and two centenarians accepted to be enrolled in the study. A case history containing the complete anamnesis, clinical examinations, evaluation of the clinical cognitive and functional tests, was prepared for each centenarian. Blood samples from 120>100 years old subjects free of chronic or acute Illness (i.e. Alzheimer's disease, metabolic diseases, cardiovascular disease, stroke, neoplastic and infectious diseases) were analysed. A population of 381 healthy old subjects (age range 65-85 years old), recruited in the same geographic areas and with the same clinical characteristic of the health centenarians, was utilized as control. Significant differences were observed for blood glucose, ALT, cholesterol and platelet levels, reduced in centenarians respect to the old subjects, whereas blood urea nitrogen levels were found significantly increased in centenarians. In conclusion, reference values of the healthy adults can generally been utilized also for the healthy oldest old group, with the notable exception of the above mentioned laboratory parameters that appear to be modified in long living subjects.     

Polish Centenarians Programme. Multidisciplinary studies of successful ageing: aims, methods, and preliminary results

Studies of centenarians as a model of successful ageing may help identify various environmental, social, psychological, and genetic factors supporting longevity. The scientific aims of the programme were to assess health status and environmental determinants of ageing of Polish centenarians, and to collect biological material for studying selected aspects of longevity, including genetic factors. The social aim of the project was to bring public attention to ageing of the population, as well as living conditions of elderly individuals. The intention of the authors of this paper is to present aims, scope, methods and preliminary results of the Polish Centenarians Programme, as well as to provide potential new partners for studying various aspects of longevity and ageing with the information about available materials collected during the programme. In this study, 346 subjects aged 100+ were visited, biological material was collected from 285 subjects, and 153 lymphocyte cell lines were immortalized.     

上海地区20例百岁老人健康与生活状况的调查

目的调查上海地区百岁老人的健康与生活状况,为社区老年人的医疗保健工作和健康长寿研究提供依据。方法在上海市范围内的各区县随机抽取20名百岁老人,由专职医师人户对百岁老人进行体格检查和面对面问卷调查。调查内容含健康状况和生活状况两个方面,健康状况的调查包括询问所患慢性病史、性格特点和体格检查;生活状况的调查包括月收入、居住方式、烟酒、运动能力、睡眠、日常生活自理能力及饮食。结果健康状况：（1）患病情况以心血管系统疾病最多,有8人,也有6人没有明确器质性病变;（2）性格特点：以外向型（开朗、语言丰富）居多;（3）体格检查：多数人日常血压控制稳定,神志清楚,保持准确的计算能力,视力尚佳,心、肺、腹部、肢体活动如常;但听力大部分人减退。生活状况：（1）大部分百岁老人有固定收入;与子女或老伴直系亲属共同居住为多,选择养老院模式少;每天能坚持（或在他人帮助下）慢步行走至少10min;16例有午睡习惯且时间≥1h;晚上睡眠时间充足,15例≥7h。另外有3人吸烟,7人喜饮酒;（2）生活自理能力方面,大部分百岁老人能自理完成穿衣、进食、行走、大小便,少部分需在他人帮助下完成行走、大小便;大部分百岁老人在打电话（手机）方面不能自理或需他人帮助完成;（3）饮食调查,百岁老人膳食营养显示主要是低热量、高纤维素、丰富的矿物质饮食。结论本组百岁老人得以健康长寿的主要因素是居家养老,无病则防,有病早治,坚持活动,充足睡眠,合理膳食,适量运动及不吸烟、少饮酒。     

我国长寿地区百岁老人慢性肾脏病的流行病学调查

目的 探讨我国长寿地区百岁老人慢性肾脏病(CKD)的患病情况及相关危险因素.方法 选取7个中国长寿之乡的所有百岁老人,以及在该地区按百岁老人编码尾数随机选取的40～、60～、80～和90～岁人群为研究对象,进行CKD及相关危险因素的问卷调查、体格检查和血尿检测,采用非条件Logistic回归分析CKD的影响因素.结果 在资料完整的363名百岁老人中,CKD患病率为50.41%(95%CI 45.27%～55.56%),女性患病率高于男性;各年龄组间比较,女性CKD患病率都随年龄增加而升高,而男性的CKD患病率随年龄增加先升高后下降.多因素Logistics回归提示高尿酸血症、高TG、女性、贫血、增龄和高血压为CKD的危险因素.结论 我国长寿地区百岁老人CKD患病率为50.41%,CKD的危险因素为高尿酸血症、高TG、女性、贫血、增年和高血压.     

上海地区34例百岁老人中医体质类型调查

目的了解上海地区百岁老人中医体质的分布情况。方法从上海市各区县随机抽取34例百岁老人。由专职医师经系统培训后统一入户,采用《中医体质分类与判定表》进行问卷调查,判定中医体质类型。结果34例百岁老人,男性18例,年龄101～110岁,平均（103．5±2．5）岁;女性16例,年龄101～113岁,平均（106．1±3．4）岁,2例由于精神原因失访。男性以阳虚质最多9例占34．6％,其次为平和质8例（30．8％）、气虚质6例（23．1％）、痰湿质1例（3．8％）、血瘀质1例（3．8％）、特禀质1例（3．8％）。女性以平和质最多10例占52．6％,其次为气虚质6例（31．6％）、阳虚质2例（10．5％）、血瘀质1例（5．3％）。没有百岁老人表现出阴虚质、湿热质和气郁质。20例舌质淡红,9例舌质淡白,3例舌质黯。13例苔质薄,15例苔质腻,4例少苔。27例苔色白,5例苔色黄。20例细脉,9例弱脉,16例弦脉,2例滑脉,1例沉脉,3例结脉。结论本组百岁老人平和质最多,与“阴平阳秘,精神乃治”的中医理论相符,大多数老人善于保存体内的阴气,脏腑机能正常,气血津液充盈,胃气旺盛,但在脉象上却难掩衰老之势。     

Association between lifetime risk of atrial fibrillation and mortality in the oldest old

Background

Age is the strongest predictor of atrial fibrillation (AF), yet little is known about AF incidence in the oldest old.

Hypothesis

AF incidence declines after age 90 years, and morbidity is compressed into a brief period at the end of life.

Methods

In this retrospective, longitudinal cohort study of patients (born 1905–1935), we examined cumulative lifetime incidence of AF and its impact on mortality. Data included records from 1 062 610 octogenarians, 317 161 nonagenarians, and 3572 centenarians. Kaplan–Meier curves were used to estimate cumulative incidence of AF by age group, incidence rates were compared using log‐rank tests, and Cox proportional hazards model was used to estimate unadjusted hazard ratios. The primary outcome was AF incidence at age > 80 years; the secondary outcome was mortality.

Results

The cumulative AF incidence rate was 5.0% in octogenarians, 5.4% in nonagenarians, and 2.3% in centenarians. Octogenarians and nonagenarians had a higher risk of AF incidence compared to centenarians (adjusted hazard ratio 8.74, 95% confidence interval [CI]: 6.31–12.04; and 2.98, 95% CI: 2.17–4.1, respectively). The lowest hazard ratio for mortality in patients with AF compared to those without was 2.3 (95% CI: 2.3–2.4) in patients who were on antiplatelet and anticoagulant medication and had a score of 0 on the Elixhauser comorbidity index score.

Conclusions

Although AF incidence increased with age, being a centenarian was associated with reduced incidence and compression of morbidity. Patients with AF had a higher adjusted mortality rate. However, data suggest that a regimen of anticoagulants and antiplatelets may reduce risk of mortality in patients over 80 with an AF diagnosis.     

基于关键词共词分析的长寿老人健康状况研究现状

目的 探讨国内长寿老人健康状况研究现状及发展趋势。方法 运用CNKI、维普、万方三大中文数据库进行主题检索,导出相关题录,并借助Note Express3.2、SATI3.2、Ucinet6.0及SPSS19.0等软件,对其进行共词分析和社会网络分析。结果 20世纪 80年代以来,该领域研究总体呈上升趋势,但地域分布不均;研究主题大致可分为健康状况、生活质量、长寿因素、饮食状况及唾液与健康状况五大类。结论 相关研究总体上处于不断上升的过程中,但绝对数量上仍不高,可以考虑针对长寿老人健康状况相关的诸多方向进行进一步的科学研究。     

Quantitative immunohistochemical analysis of the distribution of neurofibrillary tangles and senile plaques in the cerebral cortex of nonagenarians and centenarians

Summary To investigate the neuropathological differences between normal aging and senile dementia of the Alzheimer type (SDAT) in very old people and to see how they compare with a younger population of demented elderly people, we performed an immunohistochemical quantitative analysis of the topography of senile plaques and neurofibrillary tangles in a series of 31 elderly patients aged from 96 to 102 years. According to the medical records, two groups were considered: 7 patients presenting with clinically documented SDAT and 24 patients with no or very mild cognitive impairment. The densities of senile plaques were comparable in both groups. Extensive neurofibrillary tangle formation was restricted to the CA1 hippocampal field of demented subjects, whereas the superior frontal cortex showed rare neurofibrillary tangles, independently of the clinical diagnosis. These results indicate an absence of direct correlation between the number of senile plaques and the clinical manifestation of SDAT. Furthermore, they suggest that the dementing process may involve different cortical structures in nonagenarians and centenarians than in younger demented individuals where a widespread cortical involvement is generally observed. Thus, the neurofibrillary tangle density in the CA1 field may be critical for the neuropathological diagnosis of SDAT in this particular group of very old patients.Supported by grants from the American Health Assistance Foundation and the Brookdale Foundation (to P.R.H.)