Centenarians: An excellent example of resilience for successful ageing

Borrás, Consuelo; Inglés, Marta; Mas-Bargues, Cristina; Dromant, Mar; Sanz-Ros, Jorge; Román-Domínguez, Aurora; Gimeno-Mallench, Lucía; Gambini, Juan; Viña, José

doi:10.1016/j.mad.2019.111199

Cited by 70 publications

(53 citation statements)

References 109 publications

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“…The discussed findings support the idea that, while a young age predisposes to mild disease 29,32 , habits and comorbidities may play a key role in predicting mortality rates in older patients with SARS-CoV-2 infection. Interestingly, when we performed the age-gender clustering for the age group of >65 years, we found that centenarians –individuals of over 100 years of age– tended to repeatedly fall in the groups with better outcomes, which is in line with the well-studied good health and low frailty scores 33 of this subpopulation. Therefore, age is a key factor to explain the dividing line between “high” and “moderate” RRs, as well as the low RR in MC11 (56%) compared to MC8 and 10 (64 and 66%), all of which share “hypertension”, “COPD” and “smoke” as only inputs, differing in mean age (76 years for MC11 versus 66-64 years for MC8 and 10).…”

Section: Discussionsupporting

confidence: 56%

Subphenotyping of COVID-19 patients at pre-admission towards anticipated severity stratification: an analysis of 778 692 Mexican patients through an age-gender unbiased meta-clustering technique

Zhou¹,

Romero²,

Martı́nez-Miranda

et al. 2021

Preprint

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Objective To describe COVID-19 subphenotypes regarding severity patterns including prognostic, ICU and morbimortality outcomes, through stratification based on gender and age groups, as described by inter-patient variability patterns in clinical phenotypes and demographic features. Materials and methods We used the COVID-19 open data from the Mexican Government including patient-level epidemiological and clinical data from 778 692 SARS-CoV-2 patients from January 13, 2020 to September 30, 2020. Inter-patient variability was analyzed by combining dimensionality reduction and hierarchical clustering methods. We produced cluster analyses for all combinations of gender and age groups (<18, 18-49, 50-64, and >64). For each group, the optimum number of clusters was selected combining a quantitative approach using the Silhouette coefficient, and a qualitative approach through a subgroup expert inspection via visual analytics. Using the features of the resultant age-gender clusters, we performed a meta-clustering analysis to provide an overall description of the population. Results We observed a total of 56 age-gender clusters, grouped in 11 clinically distinguishable meta-clusters with different outcomes. Meta-clusters 1 to 3 showed the highest recovery rates (90.27-95.22%). These clusters include: (1) healthy patients of all ages, (2) children with comorbidities who had priority in medical resources, (3) young patients with obesity and smoking habit. Meta-clusters 4 and 5 showed moderate recovery rates (81.3-82.81%): (4) patients with hypertension or diabetes of all ages, (5) typical obese patients with three highly correlated conditions, namely, pneumonia, hypertension and diabetes. Meta-clusters 6 to 11 had very low recovery rates (53.96-66.94%) which include: (6) immunosuppressed patients with the highest comorbidity rate in many diseases, (7) CKD patients with the worse survival length and recovery, (8) elderly smoker with mild COPD, (9) severe diabetic elderly with hypertension, (10, 11) oldest obese smokers with severe COPD and mild cardiovascular disease with the latter (11) showing a relatively higher age and smoke rate, severe COPD and shorter survival length, reinforcing a high correlation between smoking habit and COPD among elderly. Additionally, the source Mexican state and type of clinical institution proved to be an important factor for heterogeneity in severity. Discussion The proposed unsupervised learning approach successfully uncovered discriminative COVID-19 severity patterns for both genders and all age groups from clinical phenotypes and demographic features. A careful read of group outcomes showed consistent results regarding recent literature. Regarding the Mexican population, our results suggest that habits and comorbidities may play a key role in predicting mortality in older patients. Centenarians tended to fall in the groups with better outcomes repeatedly. Additionally, immunosuppression was not found as a relevant factor for severity alone but did when present along with chronic kidney disease. Further useful correlations could be found by evaluating the duration of unhealthy habits, demographic features, comorbidities, the time since diagnosis, recovery progress, readmission record, and the effect of source variability. Conclusion The resultant eleven meta-clusters provide bases to comprehend the classification of patients with COVID-19 based on comorbidities, habits, demographic characteristics, geographic data and type of clinical institutions, as well as revealing the correlations between the above characteristics thereby help to anticipate the possible clinical outcomes for every specifically characterized patient. These subphenotypes can establish target groups for automated stratification or triage systems to provide personalized therapies or treatments. Code available at: https://github.com/bdslab-upv/covid19-metaclustering Dynamic results visualization at: http://covid19sdetool.upv.es/?tab=mexicoGov

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Section: Discussionsupporting

confidence: 56%

Subphenotyping of COVID-19 patients at pre-admission towards anticipated severity stratification: an analysis of 778 692 Mexican patients through an age-gender unbiased meta-clustering technique

Zhou¹,

Romero²,

Martı́nez-Miranda

et al. 2021

Preprint

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“…Aging is a natural phenomenon that affects individuals differently. While centenarians are clear examples of resilience against the detrimental effects of antigenic attrition during aging (132), some individuals present signs of aging and age-related diseases early in life. Studies on centenarians who present high levels of inflammatory mediators suggest that inflammaging is compatible with longevity (17,132).…”

Section: Genetic and Epigenetic Factors As Major Determinants Of Immumentioning

confidence: 99%

“…While centenarians are clear examples of resilience against the detrimental effects of antigenic attrition during aging (132), some individuals present signs of aging and age-related diseases early in life. Studies on centenarians who present high levels of inflammatory mediators suggest that inflammaging is compatible with longevity (17,132). These different performances of individuals facing aging and inflammaging may have strong genetic and epigenetic determinants (133,134).…”

Section: Genetic and Epigenetic Factors As Major Determinants Of Immumentioning

confidence: 99%

Inflammaging in Endemic Areas for Infectious Diseases

et al. 2020

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Immunosenescence is marked by a systemic process named inflammaging along with a series of defects in the immunological activity that results in poor responses to infectious agents and to vaccination. Inflammaging, a state of low-grade chronic inflammation, usually leads to chronic inflammatory diseases and frailty in the elderly. However, some elderly escape from frailty and reach advanced age free of the consequences of inflammaging. This process has been called immunological remodeling, and it is the hallmark of healthy aging as described in the studies of centenarians in Italy. The biological markers of healthy aging are still a matter of debate, and the studies on the topic have focused on inflammatory versus remodeling processes and molecules. The sub-clinical inflammatory status associated with aging might be a deleterious event for populations living in countries where chronic infectious diseases are not prevalent. Nevertheless, in other parts of the world where they are, two possibilities may occur. Inflammatory responses may have a protective effect against these infectious agents. At the same time, the long-term consequences of protective immune responses during chronic infections may result in accelerated immunosenescence in these individuals. Therefore, the biological markers of healthy aging can vary according to environmental, cultural, and geographical settings that reflect worldwide, and in a non-biased, non-westernized perspective, the changes that we experience regarding our contacts with microorganisms and the outcomes of such contacts.

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“…Long life is a topic of great interest in medicine and among the general public. In several countries, the increase in life expectancy has led the very old to become the fastest growing segment of the population [1][2][3][4]. Centenarians are subjects living 100 years or older.…”

Section: Introductionmentioning

confidence: 99%

“…Centenarians are subjects living 100 years or older. Most centenarians have managed to avoid, postpone, or overcome the important age-related and life-threatening diseases [3,5,6].…”

Section: Introductionmentioning

confidence: 99%

The Centenarians: An Emerging Population

Heshmati¹

2021

Update in Geriatrics

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Long life is a topic of great interest in medicine and among the general public. The “successful aging” which is a high priority for individuals and societies, is aging without any disabilities and severe diseases. In several countries, the increase in life expectancy has led the very old to become the fastest growing segment of the population. Centenarians are subjects living 100 years or older. The majority of centenarians are females (female to male ratio around 3.6/1). A very small fraction of centenarians (up to 0.5%) will live 110 years or older (supercentenarians). Most centenarians have managed to avoid, postpone, or overcome the important age-related and life-threatening diseases and disabilities (e.g., ischemic heart disease, stroke, chronic obstructive pulmonary disease, cancer, respiratory infection, type 2 diabetes, osteoporosis, and dementia). Some forecasts suggest that most babies born in developed countries since 2000 will become centenarians. In 2020, the number of centenarians in the world was approximately 573,000, mainly from the United States of America (USA). This number could reach approximately 3,676,000 by 2050. In the absence of the genetic predisposition to become centenarian, there are several ways to extend longevity (e.g., lifestyle, reduction of several life-threatening diseases and disabilities, hormonal replacement or blockade, antioxidants, maintenance of a proper autophagic activity, stem cell therapy, and gene therapy). The continuous increase of the number of centenarians has worldwide practical implications including profound impact on intergenerational interactions and significant financial challenges for any society, especially in relation to medical expenses.

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Centenarians: An excellent example of resilience for successful ageing

Cited by 70 publications

References 109 publications

Subphenotyping of COVID-19 patients at pre-admission towards anticipated severity stratification: an analysis of 778 692 Mexican patients through an age-gender unbiased meta-clustering technique

Subphenotyping of COVID-19 patients at pre-admission towards anticipated severity stratification: an analysis of 778 692 Mexican patients through an age-gender unbiased meta-clustering technique

Inflammaging in Endemic Areas for Infectious Diseases

The Centenarians: An Emerging Population

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