The Association of Healthy Aging with Multimorbidity: IKARIA Study

Foscolou, Alexandra; Chrysochoou, Christina; Dimitriadis, Kyriakos; Masoura, Konstantina; Vogiatzi, Georgia; Gkotzamanis, Viktor; Lazaros, George; Tsioufis, Costas; Stefanadis, Christodoulos

doi:10.3390/nu13041386

Cited by 16 publications

(11 citation statements)

References 33 publications

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“…However, this trend is more pronounced in men than in women, as indicated by our results. Notably, in the population aged 80 and older, a decrease in average comorbidities is observed, which contradicts the prevailing literature on multimorbidity phenomena ( 37 , 39 , 38 ).…”

Section: Discussioncontrasting

confidence: 70%

Comorbidity patterns in cardiovascular diseases: the role of life-stage and socioeconomic status

Cruz-Ávila,

Ramírez-Alatriste,

Martínez-García

et al. 2024

Front. Cardiovasc. Med.

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Cardiovascular diseases stand as a prominent global cause of mortality, their intricate origins often entwined with comorbidities and multimorbid conditions. Acknowledging the pivotal roles of age, sex, and social determinants of health in shaping the onset and progression of these diseases, our study delves into the nuanced interplay between life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Leveraging data from a cross-sectional survey encompassing Mexican adults, we unearth a robust association between these variables and the prevalence of comorbidities linked to cardiovascular conditions. To foster a comprehensive understanding of multimorbidity patterns across diverse life-stages, we scrutinize an extensive dataset comprising 47,377 cases diagnosed with cardiovascular ailments at Mexico’s national reference hospital. Extracting sociodemographic details, primary diagnoses prompting hospitalization, and additional conditions identified through ICD-10 codes, we unveil subtle yet significant associations and discuss pertinent specific cases. Our results underscore a noteworthy trend: younger patients of lower socioeconomic status exhibit a heightened likelihood of cardiovascular comorbidities compared to their older counterparts with a higher socioeconomic status. By empowering clinicians to discern non-evident comorbidities, our study aims to refine therapeutic designs. These findings offer profound insights into the intricate interplay among life-stage, socioeconomic status, and comorbidity patterns within cardiovascular diseases. Armed with data-supported approaches that account for these factors, clinical practices stand to be enhanced, and public health policies informed, ultimately advancing the prevention and management of cardiovascular disease in Mexico.

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Section: Discussioncontrasting

confidence: 70%

Comorbidity patterns in cardiovascular diseases: the role of life-stage and socioeconomic status

Cruz-Ávila,

Ramírez-Alatriste,

Martínez-García

et al. 2024

Front. Cardiovasc. Med.

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“…A subset of participants from two separate studies, one in the Ikaria Blue Zone in Greece and one in the Sardinia Blue Zone in Italy, were selected for DNAm analysis ( Pes et al, 2020 ; Foscolou et al, 2021 ) ( Table 1 ). Given that these regions are in relatively close proximity geographically when compared to the other Blue Zones in Costa Rica and Japan, have relatively similar climates, diets, and cultures, and the same male survival phenomenon is observed, we combined the Sardinian and Ikarian Blue Zone residents into one cohort to represent the Mediterranean Blue Zones ( Poulain et al, 2021 ; Pes et al, 2022 ).…”

Section: Methodsmentioning

confidence: 99%

Sex differences in epigenetic age in Mediterranean high longevity regions

et al. 2022

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Sex differences in aging manifest in disparities in disease prevalence, physical health, and lifespan, where women tend to have greater longevity relative to men. However, in the Mediterranean Blue Zones of Sardinia (Italy) and Ikaria (Greece) are regions of centenarian abundance, male-female centenarian ratios are approximately one, diverging from the typical trend and making these useful regions in which to study sex differences of the oldest old. Additionally, these regions can be investigated as examples of healthy aging relative to other populations. DNA methylation (DNAm)-based predictors have been developed to assess various health biomarkers, including biological age, Pace of Aging, serum interleukin-6 (IL-6), and telomere length. Epigenetic clocks are biological age predictors whose deviation from chronological age has been indicative of relative health differences between individuals, making these useful tools for interrogating these differences in aging. We assessed sex differences between the Horvath, Hannum, GrimAge, PhenoAge, Skin and Blood, and Pace of Aging predictors from individuals in two Mediterranean Blue Zones and found that men displayed positive epigenetic age acceleration (EAA) compared to women according to all clocks, with significantly greater rates according to GrimAge (β = 3.55; p = 1.22 × 10−12), Horvath (β = 1.07; p = 0.00378) and the Pace of Aging (β = 0.0344; p = 1.77 × 10−08). Other DNAm-based biomarkers findings indicated that men had lower DNAm-predicted serum IL-6 scores (β = -0.00301, p = 2.84 × 10−12), while women displayed higher DNAm-predicted proportions of regulatory T cells than men from the Blue Zone (p = 0.0150, 95% Confidence Interval [0.00131, 0.0117], Cohen’s d = 0.517). All clocks showed better correlations with chronological age in women from the Blue Zones than men, but all clocks showed large mean absolute errors (MAE >30 years) in both sexes, except for PhenoAge (MAE <5 years). Thus, despite their equal survival to older ages in these Mediterranean Blue Zones, men in these regions remain biologically older by most measured DNAm-derived metrics than women, with the exception of the IL-6 score and proportion of regulatory T cells.

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“…The issue of multimorbidity is partly driven by the aging of the global population, including having social care implications on account of the risk of function decline and loss of independence with older age ( 9 ). Aging is usually accompanied by chronic disease ( 10 ), and it developed multimorbidity ( 11 , 12 ) eventually. China, as the largest middle-income country, went through a rapid economic development as the reform and opening up in the past 20 years.…”

Section: Introductionmentioning

confidence: 99%

Spatiotemporal Analysis of the Prevalence and Pattern of Multimorbidity in Older Chinese Adults

et al. 2022

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BackgroundMultimorbidity presents an enormous problem to societal and healthcare utilization under the context of aging population in low- and middle-income countries (LMICs). Currently, systematic studies on the profile of multimorbidity and its characteristics among Chinese elderly are lacking. We described the temporal and spatial trends in the prevalence of multimorbidity and explored chronological changes of comorbidity patterns in a large elderly population survey.MethodsData were extracted from the Chinese Longitudinal Healthy Longevity Study (CLHLS) conducted between 1998 and 2018 in a random selection of half of the counties and city districts. All the elderly aged 65 and older were included in the survey of eight waves. We used 13 investigated chronic diseases to measure the prevalence of multimorbidity by means of geography, subpopulation, and chronological changes. The patterns of multimorbidity were assessed by computing the value of relative risk (RR indicates the likelihood of certain diseases to be associated with multimorbidity) and the observed-to-expected ratio (O/E indicates the likelihood of the coexistence of a multimorbidity combination).ResultsFrom 1998 to 2018, the prevalence of multimorbidity went from 15.60 to 30.76%, increasing in the fluctuation across the survey of eight waves (pfor trend = 0.020). Increasing trends were observed similarly in a different gender group (pmale = 0.009; pfemale = 0.004) and age groups among female participants (p~80 = 0.009; p81−90 = 0.004; p91−100 = 0.035; p101~ = 0.018). The gap in the prevalence of multimorbidity between the north and the south was getting narrow across the survey of eight waves. Hypertension was the highest prevalent chronic condition while diabetes was most likely to coexist with other chronic conditions in the CLHLS survey. The most frequently occurring clusters were hypertension and heart disease, hypertension and cataract, and hypertension and chronic lung disease. And, the cancer, TB, and Parkinson's disease cluster took the domination of O/E rankings over time, which had a higher probability of coexistence in all the multimorbidity combinations.ConclusionsThe prevalence of multimorbidity has been increasing nationwide, and more attention should be paid to a rapid growth in the southern part of China. It demands the effective diagnosis and treatment adopted to the highly prevalent comorbidities, and strategies and measures were adjusted to strongly relevant clusters.

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The Association of Healthy Aging with Multimorbidity: IKARIA Study

Cited by 16 publications

References 33 publications

Comorbidity patterns in cardiovascular diseases: the role of life-stage and socioeconomic status

Comorbidity patterns in cardiovascular diseases: the role of life-stage and socioeconomic status

Sex differences in epigenetic age in Mediterranean high longevity regions

Spatiotemporal Analysis of the Prevalence and Pattern of Multimorbidity in Older Chinese Adults

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