Cumulative biological risk and socio-economic differences in mortality: MacArthur Studies of Successful Aging

Seeman, Teresa E.; Crimmins, Eileen M.; Huang, Mei‐Hua; Singer, Burton H.; Bucur, Alexander; Gruenewald, Tara L.; Berkman, Lisa F.; Reuben, David B.

doi:10.1016/s0277-9536(03)00402-7

Cited by 432 publications

(448 citation statements)

References 46 publications

Supporting

Mentioning

425

Contrasting

Order By: Relevance

“…There are several challenges in using longevity as a phenotype (reviewed in Karasik et al 2005 and below). A better strategy would be to investigate a broader outcome such as "successful" or "healthy" aging (Mulsant et al 1994;Seeman et al 2004). However, there is no consensus definition for the latter categories, especially for a genetic study.…”

Section: Current Progress and Problems Of Genetic Studies Of Aging Anmentioning

confidence: 99%

“…Despite growing interest surrounding the topic, data on valid predictors of active life expectancy and successful aging are relatively scarce (Jackson et al 2003;Anstey et al 1996;Nakamura and Miyao 2003;Seeman et al 2004). With aging, a discernable decline occurs in most bodily systems, including metabolic, cognitive, reproductive, and endocrine.…”

Section: Biomarkers Of Agingmentioning

confidence: 99%

“…First, biomarkers measured at a given age are merely snapshots of important regulatory systems (Seeman et al 2004); there is no information on system dynamics if each biomarker is measured only once. Having longitudinal measures should be important to approximate trajectories of change in each system.…”

Section: Biomarkers Of Agingmentioning

confidence: 99%

See 2 more Smart Citations

How pleiotropic genetics of the musculoskeletal system can inform genomics and phenomics of aging

Karasik

2010

AGE

View full text Add to dashboard Cite

Genetic study can provide insight into the biologic mechanisms underlying inter-individual differences in susceptibility to (or resistance to) organisms' aging. Recent advances in molecular genetics and genetic epidemiology provide the necessary tools to perform a study of the genetic sources of biological aging. However, to be successful, the genetic study of a complex condition requires a heritable phenotype to be developed and validated. Genome-wide association studies offer an unbiased approach to identify new candidate genes for human diseases. It is hypothesized that convergent results from multiple aging-related traits will point out the genes responsible for the general aging of the organism. This perspective focuses on the musculoskeletal aging as an example of an approach to identify a downstream common pathway that summarizes aging processes. Since the musculoskeletal traits are linked to the state of many vital functions, disability, and ultimately survival rates, we postulate that there is significance in studying musculoskeletal aging. Construction of an integrated phenotype of aging can be achieved based on shared genetics among multiple musculoskeletal biomarkers. Valid biomarkers from other systems of the organism should be similarly explored. The new composite aging score needs to be validated by determining whether it predicts all-cause mortality, incidences of major chronic diseases, and disability late in life. Comprehensive databases on biomarkers of musculoskeletal aging in multiple large cohort studies, along with information on various health outcomes, are needed to validate the proposed measure of biological aging.

show abstract

Section: Current Progress and Problems Of Genetic Studies Of Aging Anmentioning

confidence: 99%

Section: Biomarkers Of Agingmentioning

confidence: 99%

See 1 more Smart Citation

How pleiotropic genetics of the musculoskeletal system can inform genomics and phenomics of aging

Karasik

2010

AGE

View full text Add to dashboard Cite

show abstract

“…There have been many studies of individual biomarkers as predictors of mortality in older people (Seeman et al 2004;Crimmins et al 2008). A number of prognostic indices for older adults living in the community have also been developed (Yourman et al 2012); however, these indices are all based on subjects' responses to questionnaires and use of administrative datasets but do not include the wider range of information that can be easily collected in a clinical setting.…”

Section: Introductionmentioning

confidence: 99%

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Hirani

Naganathan

Blyth

et al. 2014

AGE

View full text Add to dashboard Cite

This study aims to identify the common risk factors for mortality in community-dwelling older men. A prospective population-based study was conducted with a median of 6.7 years of follow-up. Participants included 1705 men aged ≥70 years at baseline (2005)(2006)(2007) living in the community in Sydney, Australia. Demographic information, lifestyle factors, health status, self-reported history of diseases, physical performance measures, blood pressure, height and weight, disability (activities of daily living (ADL) and instrumental ADLs, instrumental ADLs (IADLs)), cognitive status, depressive symptoms and blood analyte measures were considered. Cox regression analyses were conducted to model predictors of mortality. During follow-up, 461 men (27 %) died. Using Cox proportional hazards model, significant predictors of mortality included in the final model (p<0.05) were older age, body mass index<20 kg m 2 , high white cell count, anaemia, low albumin, current smoking, history of cancer, history of myocardial infarction, history of congestive heart failure, depressive symptoms and ADL and IADL disability and impaired chair stands. We found that overweight and obesity and/or being a lifelong nondrinker of alcohol were protective against mortality. Compared to men with less than or equal to one risk factor, the hazard ratio in men with three risk factors was 2.5; with four risk factors, it was 4.0; with five risk factors, it was 4.9; and for six or more risk factors, it AGE (2014) was 11.4, respectively. We have identified common risk factors that predict mortality that may be useful in making clinical decisions among older people living in the community. Our findings suggest that, in primary care, screening and management of multiple risk factors are important to consider for extending survival, rather than simply considering individual risk factors in isolation. Some of the "traditional" risk factors for mortality in a younger population, including high blood pressure, hypercholesterolaemia, overweight and obesity and diabetes, were not independent predictors of mortality in this population of older men.

show abstract

“…Other social conditions have been linked to later health through prolonged exposure to adversity-induced Btoxic stress.^In these cases it will be more informative to use outcomes such as biomarkers of inflammatory and stress pathways, which are known to impact downstream health and can serve as markers of future morbidity. [19][20][21] In relation to the AHC evaluation, it would be too costly to collect such data across 44 sites, but funding high-quality, local studies would markedly expand the knowledge produced by this large-scale demonstration. Stronger evidence documenting the impacts on biological markers could inform existing risk stratification tools and better target social interventions.…”

Section: Effectiveness Researchmentioning

confidence: 99%

Evaluating the Accountable Health Communities Demonstration Project

et al. 2016

View full text Add to dashboard Cite

Despite substantial evidence documenting the social patterning of disease, relatively little information is available on how the health care system can best intervene on social determinants to impact individual and population health. Announced in January 2016, the Centers for Medicare and Medicaid Innovation's (CMMI) Accountable Health Communities (AHC) initiative provides an important opportunity to improve the evidence base around integrated social and medical care delivery. To maximize learning from this largescale demonstration, comprehensive evaluation efforts should focus on effectiveness and implementation research by supporting local, regional, and national studies across a range of outcomes. Findings from this demonstration could transform how, when, and which patients' health-related social needs are addressed within the health care delivery system. Such findings would strongly complement other initiatives to address social factors outside of health care. A substantial body of evidence links social circumstances to health and longevity. 1-3 Mortality estimates associated with social factors are comparable in magnitude to those associated with myocardial infarction, cerebrovascular disease, or lung cancer. [4][5][6] At the same time, there is national concern about the expense and deficiencies of traditional health care services. 7 Together, these forces are fueling interest in addressing social determinants of health (SDH) within the health care delivery system. While recognizing that work to improve social conditions occurs outside of health care settings, 5 health professional organizations have recommended better integration of medical and social care delivery systems as one part of a comprehensive strategy to identify and address SDH. [8][9][10] Clinical delivery systems are increasingly experimenting with ways to address SDH in the clinical delivery system. 11-13 However, little research has examined whether these efforts improve individual and population health, decrease avoidable utilization, and/or improve revenue under value-based payment systems. 11,12 To respond to the disconnect between this growing interest in addressing SDH in the health care setting and gaps in effectiveness evidence, in January of 2016, the Centers for Medicare and Medicaid Services Innovation (CMMI) announced an initiative to test a new model of care that includes health-based social needs screening and resource navigation for Medicare and Medicaid beneficiaries. 14 The financial investment in the CMMI Accountable Health Communities (AHC) initiative totals $157 million over 5 years and presents an important opportunity to fill evidence gaps.In this article, we outline the CMMI AHC demonstration project and anticipated CMMI evaluation outcomes metrics. We then provide a rationale for examining a wider range of effectiveness and implementation outcomes and highlight opportunities and challenges facing this broader research agenda. This article emerged from a meeting of 25 affiliates (complete list included in the Acknowl...

show abstract

Cumulative biological risk and socio-economic differences in mortality: MacArthur Studies of Successful Aging

Cited by 432 publications

References 46 publications

How pleiotropic genetics of the musculoskeletal system can inform genomics and phenomics of aging

How pleiotropic genetics of the musculoskeletal system can inform genomics and phenomics of aging

Multiple, but not traditional risk factors predict mortality in older people: the concord health and ageing in men project

Evaluating the Accountable Health Communities Demonstration Project

Contact Info

Product

Resources

About