Inclusion of Older Adults in Research: Ensuring Relevance, Feasibility, and Rigor

Kuchel, George A.

doi:10.1111/jgs.15802

Cited by 34 publications

(35 citation statements)

References 17 publications

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“…Taken together, these findings indicate that sex plays a critical role in human immune system aging and should be taken into consideration while searching for molecular targets and time frames for interventions/therapies to target aging and age-related diseases. 39 , increasing the generalizability of our studies and the likelihood that these findings can be translated to the general population 40 . Subjects were carefully screened in order to exclude potentially confounding diseases and medications, as well as frailty.…”

Section: Discussionmentioning

confidence: 89%

Sexual-dimorphism in human immune system aging

et al. 2020

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Differences in immune function and responses contribute to health-and lifespan disparities between sexes. However, the role of sex in immune system aging is not well understood. Here, we characterize peripheral blood mononuclear cells from 172 healthy adults 22-93 years of age using ATAC-seq, RNA-seq, and flow cytometry. These data reveal a shared epigenomic signature of aging including declining naïve T cell and increasing monocyte and cytotoxic cell functions. These changes are greater in magnitude in men and accompanied by a male-specific decline in B-cell specific loci. Age-related epigenomic changes first spike around late-thirties with similar timing and magnitude between sexes, whereas the second spike is earlier and stronger in men. Unexpectedly, genomic differences between sexes increase after age 65, with men having higher innate and pro-inflammatory activity and lower adaptive activity. Impact of age and sex on immune phenotypes can be visualized at https:// immune-aging.jax.org to provide insights into future studies.

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Section: Discussionmentioning

confidence: 89%

Sexual-dimorphism in human immune system aging

et al. 2020

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“…Particularly, systems-level approaches can be effective in i) assessing risk at the individual level and dissecting how different factors contribute to this risk (age, sex, BMI); and ii) understanding genomic or cellular predictors of responsiveness to potential therapies. Furthermore, integrating these single cell genomic technologies with genotypes of individuals can bring further resolution related to the role genetics play in disease risk and in selecting appropriate therapies tailored for individual patients [82,83].…”

Section: Systems and Predictive Immunology To Study Covid-19mentioning

confidence: 99%

The lethal sex gap: COVID-19

et al. 2020

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While Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is disrupting lives across the globe for everyone, it has a more devastating impact on the health of older adults, especially that of older men. This pandemic has highlighted the crucial importance of considering an individual's age and biological sex in the clinic in addition to other confounding diseases (

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“…Finally, SPRINT recruited many community-dwelling older people with multiple comorbidities and reduced health-related quality of life. Yet older people with multiple comorbidities are often underrepresented in clinical trials, 24 and the SPRINT results may then not apply to many of the frailest individuals seen in geriatrics practice. 25 SPRINT has added significant new information about concern about falling in older hypertension patients.…”

Section: Discussionmentioning

confidence: 99%

Impact of Intensive Blood Pressure Therapy on Concern about Falling: Longitudinal Results from the Systolic Blood Pressure Intervention Trial (SPRINT)

Berlowitz

Foy

Conroy

et al. 2019

J American Geriatrics Society

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OBJECTIVES Concern about falling is common among older hypertension patients and could impact decisions to intensify blood pressure therapy. Our aim was to determine whether intensive therapy targeting a systolic blood pressure (SBP) of 120 mm Hg is associated with greater changes in concern about falling when compared with standard therapy targeting an SBP of 140 mm Hg. DESIGN Subsample analysis of participants randomized to either intensive or standard therapy in the Systolic Blood Pressure Intervention Trial (SPRINT). SETTING Approximately 100 outpatient sites. PARTICIPANTS A total of 2313 enrollees in SPRINT; participants were all age 50 or older (mean = 69 y) and diagnosed with hypertension. MEASUREMENTS Concern about falling was described by the shortened version of the Falls Efficacy Scale International as measured at baseline, 6 months, 1 year, and annually thereafter. RESULTS Concern about falling showed a small but significant increase over time among all hypertension patients. No differences were noted, however, among those randomized to intensive vs standard therapy (P = .95). Among participants younger than 75 years, no increase in concern about falling over time was noted, but among participants aged 75 years and older, the mean falls self‐efficacy score increased by .3 points per year (P < .0001). No differences were observed between the intensive and standard treatment groups when stratified by age (P = .55). CONCLUSION Intensive blood pressure therapy is not associated with increased concern about falling among older hypertension patients healthy enough to participate in SPRINT. J Am Geriatr Soc 68:614–618, 2020

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Inclusion of Older Adults in Research: Ensuring Relevance, Feasibility, and Rigor

Abstract: This Editorial comments on the articles by https://doi.org/10.1111/jgs.15784, https://doi.org/10.1111/jgs.15785, and https://doi.org/10.1111/jgs.15786. in this issue.

Cited by 34 publications

References 17 publications

Sexual-dimorphism in human immune system aging

Sexual-dimorphism in human immune system aging

The lethal sex gap: COVID-19

Impact of Intensive Blood Pressure Therapy on Concern about Falling: Longitudinal Results from the Systolic Blood Pressure Intervention Trial (SPRINT)

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