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Quantification of biological aging has been proposed for population surveillance of age-related decline in system integrity and evaluation of geroprotective therapies. However, methods of quantifying biological aging have been little studied in geriatric populations. We analyzed three clinical-biomarker-algorithm methods to quantify biological aging. Klemera-Doubal method Biological Age and homeostatic dysregulation algorithms were parameterized from analysis of U.S. National Health and Nutrition Examination Surveys (NHANES) data (N = 36,207) based on published methods. Levine method Biological Age was adapted from published analysis of NHANES data. Algorithms were applied to biomarker data from the Duke Established Populations for Epidemiologic Studies of the Elderly (Duke-EPESE) cohort of older adults (N = 1,374, aged 71-102 years, 35% male, 52% African American). We tested associations of biological aging measures with participant reported Activities of daily living (ADL), instrumental activities of daily living (IADL) dependencies, and mortality. We evaluated the sensitivity of results to the demographic composition of reference samples and biomarker sets used to develop biological aging algorithms. African American and white Duke-EPESE participants with more advanced biological aging reported dependence in more ADLs and IADLs and were at increased risk of death over follow-up through 2017. Effect sizes were similar across algorithms, but were strongest for Levine method Biological Age (per-quintile increase in ADL incidence rate ratio = 1.25, 95% confidence interval [1.17-1.37], IADL incidence rate ratio = 1.23 [1.15-1.32], mortality hazard ratio = 1.12 [1.08-1.16]). Results were insensitive to demographic composition of reference samples, but modestly sensitive to the biomarker sets used to develop biological aging algorithms. Blood-chemistry-based quantifications of biological aging show promise for evaluating the effectiveness of interventions to extend healthy life span in older adults. [ABSTRACT FROM AUTHOR]

Background: A number of large-scale population studies have provided valuable information about physical performance in aged individuals; however, there is little information about trajectories of function and associations with age across the adult life span. We developed a mobility-focused physical performance screener designed to be appropriate for the adult life span.Methods: The physical performance battery includes measures of mobility, strength, endurance, and balance. Physical activity (PA) was assessed with accelerometry. We examined age-related trends in physical performance and PA, and the relationship between physical performance and PA across the age range (30-90+), by decade, in 775 participants enrolled in the study 2012-2014.Results: Physical performance was worse with increasing age decade. Although men performed better than women across all ages, the decrement by age group was similar between genders. Worsening physical performance was observed as early as the fifth decade for chair stands and balance and in the sixth decade for gait speed and aerobic endurance. The number and strength of significant associations between physical performance and PA increased with greater age: the greatest number of significant associations was seen in the 60-79 age groups, with fewer reported in the 30-59 and 80-90+ age groups. More PA was associated with better physical function.Conclusion: These results emphasize the importance of a life span approach to studies of function and aging. This work points to the need for a physical performance screener that spans across adulthood as a clinical tool for identifying functional decline. [ABSTRACT FROM AUTHOR]

Background: Older age and obesity are associated with metabolic dysregulation; the mechanism by which these factors impact metabolism across the lifespan is important, but relatively unknown. We evaluated a panel of amino acids (AAs) and acylcarnitines (ACs) to identify effects of age and adiposity (body mass index) on circulating small-molecule metabolites in a meta-analysis of six diverse study populations.Methods: Targeted metabolic profiling was performed in six independent studies, representing 739 subjects with a broad range of age, body mass index, health states, and ethnic origin. Principal components analysis was performed on log-normalized values for AAs and ACs separately, generating one AC factor and two AA factors for each study. A common AC factor consisted primarily of acetylcarnitine, medium-chain AC, and several long-chain AC. AA Factor 1 consisted primarily of large neutral AAs. Glycine was its own factor.Results: Metabolic profiling and factor analysis identified clusters of related metabolites of lipid and AA metabolism that were consistently associated with age and body mass in a series of studies with a broad range of age, body mass index, and health status. An inverse association of glycine with body mass index and male gender supports its role as a marker of favorable metabolic health.Conclusions: An important focus of future investigations should be to determine whether these clusters of metabolic intermediates are possible early predictors of health outcomes associated with body mass; are involved with accelerated aging; are involved in the causative pathway of aging; and how modification of these metabolic pathways impact the biology of aging. [ABSTRACT FROM AUTHOR]

Background: Resilience has been described in the psychosocial literature as the capacity to maintain or regain well-being during or after adversity. Physical resilience is a newer concept that is highly relevant to successful aging. Our objective was to characterize the emerging construct of resilience as it pertains to physical health in older adults, and to identify gaps and opportunities to advance research in this area.Methods: We conducted a systematic review to identify English language papers published through January 2015 that apply the term "resilience" in relation to physical health in older adults. We applied a modified framework analysis to characterize themes in implicit or explicit definitions of physical resilience.Results: Of 1,078 abstracts identified, 49 articles met criteria for inclusion. Sixteen were letters or concept papers, and only one was an intervention study. Definitions of physical resilience spanned cellular to whole-person levels, incorporated many outcome measures, and represented three conceptual themes: resilience as a trait, trajectory, or characteristic/capacity.Conclusions: Current biomedical literature lacks consensus on how to define and measure physical resilience. We propose a working definition of physical resilience at the whole person level: a characteristic which determines one's ability to resist or recover from functional decline following health stressor(s). We present a conceptual framework that encompasses the related construct of physiologic reserve. We discuss gaps and opportunities in measurement, interactions across contributors to physical resilience, and points of intervention. [ABSTRACT FROM AUTHOR]

Background: Levels of circulating progenitor cells (CPCs) are depleted with aging and chronic injury and are associated with level of physical functioning; however, little is known about the correlation of CPCs with longer-term measures of physical capabilities. We sought to determine the association of CPCs with future levels of physical function and with changes in physical function over time.Methods: CPCs were measured in 117 participants with impaired glucose tolerance in the Enhanced Fitness clinical trial based on the cell surface markers CD34 and CD133 and aldehyde dehydrogenase (ALDH) activity at baseline, 3 months, and 12 months. Physical function was assessed using usual and rapid gait speed, 6-minute walk distance, chair stand time, and SF-36 physical functioning score and reassessed at 3 and 12 months after clinical intervention.Results: Higher baseline levels of CD133(+), CD34(+), CD133(+)CD34(+), and ALDH(br) were each highly predictive of faster gait speed and longer distance walked in 6 minutes at both 3 and 12 months. These associations remained robust after adjustment for age, body mass index, baseline covariates, and inflammation and were independent of interventions to improve physical fitness. Further, higher CPC levels predicted greater improvements in usual and rapid gait speed over 1 year.Conclusions: Baseline CPC levels are associated not only with baseline mobility but also with future physical function, including changes in gait speed. These findings suggest that CPC measurement may be useful as a marker of both current and future physiologic aging and functional decline. [ABSTRACT FROM AUTHOR]

Background. Aging is marked by a decline in physical function. Although the biological underpinnings for this remain unclear, loss of regenerative capacity has been proposed as one cause of the loss of physical function that occurs over time. The quantity of circulating progenitor cells (CPCs) may be one reflection of regenerative capability. We sought to determine whether certain specific CPC subpopulations were associated with physical function. Methods. Baseline CPCs were measured in 129 randomized participants in the Enhanced Fitness clinical trial based on the cell surface markers CD34, CD133, CD146, and CD14 and aldehyde dehydrogenase (ALDH) activity. Physical function was assessed using usual and rapid gait speed, 6-minute walk distance, chair stand time, and balance time. Results. Low counts of early angiogenic CPCs identified as CD34+, CD34+CD133+, and ALDH-bright (ALDHbr) cells were associated with low usual gait speed (p < .005, p < .001, and p < .007), rapid gait speed (p < .001, p < .003, and p < .001), and 6-minute walking distance (all comparisons p < .001), and longer time required to complete five chair stands (p < .006, p < .002, and p < .004). CPC counts of mature endothelial or monocytic markers were not associated with physical function. Conclusions. The numbers of CD34+ and ALDHbr CPCs are significantly lower in patients with impaired physical function. Further studies are needed to determine the underlying causes for this association. [ABSTRACT FROM PUBLISHER]

The table of contents for the May 1, 2011 issue of the "Journal of Gerontology" is presented.

A table of contents for the October 2010 issue of "Journal of Gerontology: Medical Sciences" is presented.

Background. To ascertain accuracy of self-reported height, weight (and hence body mass index) in African American and white women and men older than 70 years of age. Method. The sample consisted of cognitively intact participants at the third in-person wave (1992-1993) of the Duke Established Populations for Epidemiologic Studies of the Elderly (age 71 and older, N = 1761; residents of five adjacent counties, one urban, four rural). During in-person, in-home interviews using trained interviewers, height and weight were self-reported (and measured later in the same visit using a standardized protocol), and information were obtained on race, sex, and age. Results. Accuracy of self-reported height and weight was high (intraclass correlation coefficient 0.85 and 0.97, respectively) but differed as a function of race and age. On average, all groups overestimated their height; whereas (non-Hispanic) white men and women underestimated their weight, African Americans overestimated their weight. Overestimation of height and weight was more marked in persons 85 years and older. Specificity for overweight (body mass index [kg/ m 2 ] ≥ 25) and obesity (body mass index ≥ 30) ranged from 0.90 to 0.99 for African Americans and whites, but sensitivity was better for African Americans (overweight: 0.81, obesity: 0.89), than for whites (0.66 and 0.57, respectively). Conclusions. Height and weight self-reported by African Americans and whites over the age of 70 can be used in epidemiological studies, with greater caution needed for self-reports of whites, and of persons 85 years of age or older. [ABSTRACT FROM PUBLISHER]

Background. It is unclear if physical activity (PA) can prevent or reverse frailty. We examined different doses and types of PA and their association with the onset and severity of frailty. Methods. Health, Aging and Body Composition (Health ABC) study participants (N = 2,964) were followed for 5 years, with frailty defined as a gait speed of less than 0.60 m/s and/or inability to rise from a chair without using one's arms. Individuals with one impairment were considered moderately frail and those with both severely frail. We examined PA doses of volume and intensity, activity types (eg, lifestyle vs exercise activities), and their associations with incident frailty and transition to severe frailty in those who became frail. Results. Adjusted models indicated that sedentary individuals had significantly increased odds of developing frailty com- pared with the exercise active group (adjusted odds ratio [OR] = 1.45; 95% confidence interval [Cl]: 1.04-2.01), whereas the lifestyle active did not. Number of diagnoses was the strongest predictor of incident frailty. In those who became frail during follow-up (a = 410), there was evidence that the sedentary (adjusted OR = 2.80; 95% Cl: 0.98-8.02) and lifestyle active (adjusted OR = 2.81; 95% CI: I .22-6.43) groups were more likely to have worsening frailty over time. Conclusions. Despite the strong relationship seen between comorbid conditions and onset of frailty, this observational study suggests that participation in self-selected exercise activities is independently associated with delaying the onset and the progression of frailty. Regular exercise should be further examined as a potential factor in frailty prevention for older adults. [ABSTRACT FROM AUTHOR]

THE National Institute on Aging (NIA) Geriatrics and Clinical Gerontology (GCG) Program convened an interdisciplinary Task Force on Comorbidity to foster the development of a research agenda on the multiple concurrent health problems that often occur in older persons. This report summarizes Task Force discussions held in Bethesda, Maryland (October 21-22, 2003; July 20-21, 2004) and serves as an introduction to the following three articles that address specific issues such as the nosological classification of impairment for the construction of comorbidity measures, staging and classification of disease severity, and methodological and analytical issues. The risk of developing concomitant chronic illnesses and physiological limitations escalates with aging. Diabetes, respiratory diseases, cancer, cardiovascular problems, arthritis, hypertension, and certain other chronic conditions are more common in older than in younger persons. As a consequence, a new diagnosis of any common chronic health condition is likely to be made in the context of preexisting health problems. [ABSTRACT FROM AUTHOR]

Background: Dysregulation of immunologic and coagulation systems is common in elderly persons and is associated with many diseases of aging. Thrombotic events are a major cause of morbidity and mortality in the elderly population. This study assesses whether D-dimer, a marker of fibrinolytic activity, varies systematically by demographic, health, and functional measures, and derives a prediction model for factors related to D-dimer in a sample of community-dwelling elderly persons.Methods: D-dimer levels were assessed in a random sample of 1,727 community-dwelling elderly persons from five rural and urban counties in North Carolina in 1992, as part of the Established Populations for the Epidemiologic Studies of the Elderly (Duke University). All subjects were 72 years or older at the time of the blood draw. In addition, all subjects were surveyed yearly by telephone or in person each year from 1986 to 1992 for a variety of health, functional, and social factors. Levels of D-dimer in 1992 were related cross-sectionally to demographics (age, race, education, income, gender, smoking), function (Nagi, Rosow-Breslau, Katz, Older Americans Resources and Services procedures instrumental activities of daily living), life satisfaction and self-rated health, self-reported diseases (heart attack, cancer, stroke, diabetes, and hypertension), and weight change from 1986 to 1992.Results: D-dimer levels increased with increasing age and functional disability. Among the health variables, only high blood pressure was predictive of D-dimer level. D-dimer levels were dramatically higher in blacks. Blacks were nearly four times more likely to have an extreme value of D-dimer (>600 microg/l) than whites when high D-dimer (yes/no) was analyzed, and blacks had an average level that was nearly 40% higher than whites in analyses of the continuous version of the outcome. This racial effect was not substantively affected in multivariable analyses with demographic and socioeconomic variables controlled. Race, age, functional status, current smoking, high blood pressure, and weight loss were related to level of D-dimer, and race, age, and functional status were related to the presence of a high D-dimer level (in the top 10% of the sample).Conclusions: Black, older, and functionally impaired persons had significantly higher levels of D-dimer in this sample of community-dwelling elderly persons. The findings for race were particularly striking and persisted even after controlling for smoking and other factors known to be related to thrombosis and were not mediated by social factors. This result may contribute to our understanding of the increased levels of thrombotic events found in these groups. [ABSTRACT FROM AUTHOR]

The article discusses physiologic frailty and full-blown functional frailty in older people. Both concepts refer to a state of multifactorial vulnerability that is associated with functional limitations and comorbidities. It indicates that full-blown functional frailty or F-frailty may develop in the absence of any physical weakness or underlying physiologic conditions. It emphasizes the importance of frailty phenotypes as tools in the study of such vulnerability.

The article discusses the use of physical robustness and resilience as key components of measuring the ability of older people to resist or recover from functional decline following health stressors. Topics addressed include the difference between the terms resistance to and recovery from, the use of the term 'robustness' in the ability to resist the deviation from baseline and in a low risk of developing a particular disease, and the distinction between disease development and symptoms.

A response from the author of the article regarding the biological resilience and recovery of older patients who are hospitalized with acute illnesses, is presented.

The article presents the editorial board of the "Journal of Gerontology: Medical Sciences" as of February 2015, including Stephen Kritchevsky as editor, James Goodwin as deputy editor and Mark Espeland as statistical editor.

A list of the journal's editorial staff is presented including James Goodwin, Ali Ahmed and Dawn Alley.

The article offers information on the editorial board of the periodical.

A list of editors and members of the editorial board of the medical sciences section of the "Journal of Gerontology" is presented which includes Ali Ahmed, Dawn Alley and Stephen Kritchevsky.

A list of editors, members of the editorial board and members of the publications committee of the medical sciences segment of the "Journal of Gerontology" is presented which includes Ali Ahmed, James Goodwin and Abraham Brody.

A list of editors, members of the editorial board and members of the publication committee of the "Journal of Gerontology" is presented which includes Dan Blazer, Kristine Yaffe and Abraham Brody.

A list of associate editors, members of the editorial board and members of the publications committee of the "Journal of Gerontology" is presented which includes Neil B. Alexander, Dawn Alley and Robin Conwit.

A list of associate editors, members of the editorial board and members of the publication committee of the "Journal of Gerontology" is presented which includes Dawn Alley, Roger Fielding and Anthony Marsh.

A list of associate editors, members of the editorial board and members of the publications committee of the "Journal of Gerontology", Series A: Medical Sciences is presented which includes Ali Ahmed, Dan Blazer and Matteo Cesari.

The article presents a list of editors and editorial boards for the "Journal of Gerontology: Medical Sciences," including Dr. Stephen Kritchevsky, Dr. Tamara Harris, and Dr. Joanne Murabito.

The article presents a list of editors and editorial board members for the "Journal of Gerontology: Medical Sciences" including editor Dr. Stephen Kritchevsky and editorial board members Dr. Dawn Alley and Dr. Caterina Rosano.

The article presents a list of editors and editorial board members for the "Journal of Gerontology: Medical Sciences," including Dr. Stephen Kritchevsky, Dr. Caterina Rosano, and Dr. Dan Blazer.

A list of editors and members of the editorial board of the "Journal of Gerontology" is presented which includes Ali Ahmed, Dawn Alley and Thomas M. Gill.

The article presents a list of editors, editorial board members, and publications committee members, including Dr. Jennifer S. Brach, Dr. Xinqi Dong, and Dr. Taina Rantanen.

Information is presented about the editorial staff of the periodical "Journal of Gerontology: Medical Sciences," including editor Stephen Kritchevsky, associate editor Ali Ahmed, and editorial board member Dawn Alley.

The table of contents is presented for the December 2013 issue of "Journal of Gerontology: Medical Sciences."

The article offers information about the editorial staff of the periodical "Journal of Gerontology: Medical Sciences," including editor Stephen Kritchevsky, associate editor Susan E. Hardy, and editorial board member Caterina Rosano.

A list of editors, members of the editorial board and publications committee of the "Journal of Gerontology: Medical Sciences" is presented which includes Ali Ahmed, Dawn Alley and Tamara Harris.

The article presents a list of associate editors, editorial board members, and members of the publications committee, including Dr. Timothy M. Frayling, Laurence Z. Rubentein, and Kathleen Jackson.

The article presents issue information for the August 2013 publication of periodical "Journal of Gerontology: Medical Sciences," including details on aging research and scope of published content, editorial board membership, and instructions for authors.

The article presents issue information for the July 2013 publication of periodical "Journal of Gerontology: Medical Sciences," including details on aging research and scope of published content, editorial board membership, and instructions for authors.

A list of the editors, members of the editorial board and publications committee of the "Journal of Gerontology: Medical Sciences" is presented which includes Ali Ahmed, Jill Crandall and Dan Blazer.

The article presents issue information for the May 2013 publication of periodical "Journal of Gerontology: Medical Sciences," including details on aging research and scope of published content, editorial board membership, and instructions for authors.

A list of associate editors and members of the editorial board and publications committee of the "Journal of Gerontology: Medical Sciences" is presented which includes Marco Pahor, Thomas M. Gill and Judy Howe.

The article presents issue information for the March 2013 publication of periodical "Journal of Gerontology: Medical Sciences," including details on aging research and scope of published content, editorial board membership, and instructions for authors.

The article presents issue information for the February 2013 publication of periodical "Journal of Gerontology: Medical Sciences," including details on aging research and scope of published content, editorial board membership, and instructions for authors.

The article presents the editorial staff for the January 1, 2013 issue of "Journals of Gerontology Series A: Medical Sciences" and includes Stephen Kritchevsky as chief editor, Stephanie Studenski as associate editor, and Gregory Hicks on the editorial board.

The cover page of the journal "The Journals of Gerontology: Series A: Biological Sciences and Medical Sciences" is presented.

The article presents a list of editors for the journal, including Dr. Stephen Kritchevsky, Dr. Dawn Alley, and Dr. Robert L. Kane.

The article presents issue information for the November 2012 publication of periodical "Journal of Gerontology: Medical Sciences," including details on aging research and scope of published content, editorial board membership, and instructions for authors.

A list of the members of the editorial board of the "Journal of Gerontology: Medical Sciences" is presented, including Stephen Kritchevsky, James Goodwin and Kathleen Jackson.

A list of the members of the editorial board of the "Journal of Gerontology, Series A: Medical Sciences" is presented, including Stephen Kritchevsky, James Goodwin and Kathleen Jackson.