The Baltimore Longitudinal Study of Aging

巴尔的摩老龄化纵向研究

• 批准号: 10691054
• 负责人: ELEANOR Marie SIMONSICK
• 金额: $ 800.53万
• 依托单位: NATIONAL INSTITUTE ON AGING
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10691054
• 关键词: Address; Affect; Age; Aging; Anatomy; Ancillary Study; Antioxidants; Autonomic nervous system; Baltimore; Biological; Blood Pressure; Body Weight; COVID-19; Cardiovascular Physiology; Cells; Central Nervous System; Characteristics; Classification; Clinic; Clinical; Clinical Medicine; Clinical Research; Cognitive; Cohort Studies; Collection; DNA; Data; Dementia; Development; Diagnosis; Disabled Persons; Disease; Documentation; Elderly; Enrollment; Environment; Equilibrium; Equipment and supply inventories; Erythrocytes; Feedback; Feeling; Functional disorder; Future; General Population; Genetic; Genome Scan; Genotype; Gerontology; Goals; Gold; Health; Health Status; Health behavior; Home visitation; Homeostasis; Hormones; Hospitals; Human; Impaired cognition; Individual; Intake; Intramural Research Program; Joints; Laboratories; Life; Life Cycle Stages; Lipids; Longevity; Longitudinal Studies; Maintenance; Malignant neoplasm of prostate; Measurement; Measures; Muscle; Names; Nutritional; Organ; Outcome; Outcome Measure; Oxidative Stress; Participant; Pathologic Processes; Peripheral Nervous System; Personal Financing; Persons; Phenotype; Physical Function; Physical activity; Physiological; Physiology; Plasma; Process; Production; Prognosis; Publishing; Quality Control; Quality of life; Reference Standards; Reporting; Research; Research Personnel; Resources; SARS-CoV-2 exposure; Scientist; Serum; Social Interaction; Societies; Specimen; Structure; Surveys; Symptoms; System; Technology Assessment; Telephone; Time; Tissues; Uric Acid; Urine; Vaccination; Visit; Work; age effect; age related; base; bone; cognitive function; cognitive performance; cohort; data cleaning; design; disability; experience; follow-up; frailty; functional status; gene environment interaction; glucose metabolism; high risk; human old age (65+); immune function; improved; inflammatory marker; insight; interdisciplinary approach; mortality; muscle strength; pandemic disease; pathological aging; programs; prospective; prostate cancer risk; recruit; sensory system; study population; trait; trend; volunteer

The Baltimore Longitudinal Study of Aging (BLSA), the major research program on human aging supported by the Intramural Research Program of the NIA, was established in 1958 and conducted at the Gerontology Research Center through 2003. Beginning in 2003 a new research unit was established at Harbor Hospital (Baltimore). The study continues to represent a consortium of scientists who work collaboratively to characterize normal, exceptional and pathological aging. The current team of researchers directing the BLSA has implemented major changes in its design and assessment technology. The primary scientific goals remain consistent with the original BLSA legacy to: 1) identify age-associated differences among individuals that are not explained by diseases and 2) characterize factors that affect transitions from normal to pathological aging. New measures have and continue to be implemented aimed at gaining a better understanding of the effect of age and diseases on the process that leads to mobility disability, cognitive impairment, dementia and poor quality of life in many older adults. Using an integrative and multidisciplinary approach, the study aims to identify and delineate the compensatory mechanisms that occur at multiple levels (cells, tissues, organs, whole body, society) that allow many older persons to maintain a high level of mobility and cognitive performance, in spite of multiple pathological processes. The study population consists of a cohort of volunteers followed for life over multiple follow-up visits. Many participants have been enrolled in the study for over 20 years, and some for as long as 60 years. The study recently completed targeted enrollment of individuals 80 years and older who are extremely well-functioning and have exceptional health. This new aspect of the BLSA has been named "The IDEAL (Insight into the Determinants of Exceptional Aging and Longevity) Study". New enrollment now targets healthy individuals under age 60. Historically, the BLSA has been the gold-standard reference for aging-related changes in multiple systems. Important findings in cardiovascular function over the life course, factors affecting risk of prostate cancer, age-associated decline in cognitive function, glucose metabolism, muscle strength and bone integrity continue to be published in the present day. Some research goals will be pursued by conducting, in parallel, ancillary studies limited to defined subsets of participants and designed to address pre-formulated hypotheses with the objective of providing information more directly applicable to clinical medicine. The structure of the current BLSA design is based on three levels of measurement: 1. The reference outcome measures are physical and cognitive function. All other measures, directly or indirectly, are aimed at understanding the mechanisms by which old age is associated with high risk of developing mobility disability and impaired cognitive function. Accordingly, the BLSA collects an extensive set of measures on many different aspects of physical and cognitive function; 2. The intermediate level includes measures of anatomical integrity and functionality of the physiological systems important for mobility: central nervous system, peripheral nervous system, muscle, bone and joints, delivery of substances important for energy production, sensory systems that provide feedback from the environment; 3. The third level includes the physiological systems important for maintaining a stable biological homeostasis and include measures of immune function, hormones, oxidative stress/antioxidants, autonomic nervous system, nutritional intake, and physical activity. The overarching hypothesis is that dysfunction of the systems that maintain biological homeostasis is the primary cause of age-associated decline in physical function and development of frailty. Considerable resources have been dedicated to restructuring, documentation and cleaning the data collected over the last 62 years. This project is already in an advanced stage of development and producing important results concerning clinical features for the diagnosis and prognosis of prostate cancer, secular trends in WBC, body weight, muscular strength and their relationship with mortality over the last half of the century and genetic traits associated with accelerated decline in physical function. An essential part of this plan is the inventory, classification and quality control of the entire collection of biological specimens (urine, blood, serum, plasma, red blood cells, etc) collected in BLSA participants during the entire course of the study. In addition, a wide genome scan (Illumina 550K) has been performed in over 1450 participants with available DNA. Using the rich collection of phenotypes collected over many years and the Illumina genotypes, the BLSA has contributed data to several genetic consortia examining the contribution of genetic variability to different human phenotypes, such as blood pressure, circulating lipids, uric acid, pro-inflammatory markers and many others. In addition, we are starting new work on gene-environment interactions. An important sub-project consists of a newly recruited cohort of exceptionally healthy older persons (IDEAL), examining the cross-sectional characteristics of this group compared to the general population, and measuring several physiological parameters that may be directly or indirectly connected with physical and cognitive function. From this prospective, the future plan for the BLSA is to become a permanent laboratory of physiology that studies the different physiological changes that occur over the aging process, with the final aim of understanding their inter-relationships and describing the mechanisms by which they contribute to maintenance of homeostatic equilibrium. Since many BLSA participants who become sick and disabled were often unable to come to the Baltimore clinic for a traditional visit in the clinic creating a severe ascertainment bias informative censoring) in the study of age-related outcome the BLSA has retained a "home visit" project aimed at collecting information from individuals that are no longer able to come to the Clinical Research Unit for their traditional visit. This portion of the project is described in another report. In May 2020, an interim survey was developed and administered over the phone or sent by mail to collect data related to COVID-19 exposure and symptoms and impact of the pandemic and its consequences on daily life, feelings of isolation, health-related behaviors, social interaction, personal finances and the like. In January 2021, a follow-up to the May 2020 COVID-19 survey was developed and administered to all persons enrolled the BLSA to tract their experience with COVID-19 including vaccination status.

巴尔的摩衰老纵向研究（BLSA）是NIA壁内研究计划支持的主要人类衰老研究计划，成立于1958年，并于2003年在老年学研究中心进行。从2003年开始，在2003年开始，在2003年建立了一个新的研究单位。该研究继续代表一个科学家的联盟，他们在表征正常，特殊和病理老龄化的合作工作。当前指挥BLSA的研究人员团队在设计和评估技术方面实施了重大变化。主要的科学目标与原始的BLSA遗产保持一致：1）确定不通过疾病来解释的个体之间与年龄相关的差异； 2）表征影响从正常情况到病理老龄化过渡的因素。新的措施已经并且继续实施，旨在更好地了解年龄和疾病对许多老年人的流动性残疾，认知障碍，痴呆和生活质量差的过程的影响。该研究使用综合和多学科的方法，旨在识别和描述在多种病理学过程中，以多种层次（细胞，组织，器官，整个身体，社会）的多种级别（细胞，组织，器官，整个身体，社会）进行的补偿机制。 该研究人群由一群志愿者组成，随后进行了多次后续访问。许多参与者已入学了20多年，有些参与者长达60年。该研究最近完成了80岁及以上的人的目标入学，这些人功能齐全，健康状况良好。 BLSA的这一新方面被命名为“理想（对特殊衰老和寿命的决定因素）研究”。 现在，新的入学率针对60岁以下的健康个体。 从历史上看，BLSA一直是多个系统中与衰老相关的变化的金标准参考。在整个生命过程中，心血管功能的重要发现，影响前列腺癌风险，认知功能下降，葡萄糖代谢，肌肉力量和骨骼完整性的因素继续发表。将通过并行进行辅助研究来实现一些研究目标，仅限于参与者的定义子集，并旨在解决预先制定的假设，目的是提供更直接适用于临床医学的信息。 当前BLSA设计的结构基于三个级别的测量： 1。参考结果指标是物理和认知功能。 直接或间接的所有其他措施旨在了解老年与发展流动性残疾和认知功能受损的高风险有关的机制。因此，BLSA在身体和认知功能的许多不同方面收集了一系列措施。 2。中级水平包括对迁移率重要的生理系统的解剖完整性和功能的度量：中枢神经系统，周围神经系统，肌肉，骨骼和关节，对能量生产重要的物质的传递，提供来自环境反馈的感觉系统； 3。第三级包括对维持稳定的生物稳态重要的生理系统，包括免疫功能，激素，氧化应激/抗氧化剂，自主神经系统，营养摄入和体育活动的度量。 总体假设是，维持生物稳态的系统的功能障碍是与年龄相关的身体机能和脆弱性发展下降的主要原因。 在过去62年中，大量资源致力于重组，文档和清洁收集的数据。该项目已经处于发展的高级阶段，并产生了有关前列腺癌诊断和预后，WBC的世俗趋势，体重，肌肉力量的世俗趋势及其与死亡率的关系的重要结果，以及与物理功能加速下降相关的遗传性状。该计划的重要组成部分是在整个研究过程中收集的BLSA参与者收集的整个生物标本（尿，血液，血清，血浆，红细胞等）的库存，分类和质量控制。此外，已经在1450多名参与者中进行了广泛的基因组扫描（Illumina 550k）。 使用多年来收集的表型和Illumina基因型的丰富收集，BLSA为几个遗传联盟提供了数据，研究了遗传变异性对不同人类表型的贡献，例如血压，循环脂质，尿酸，尿酸，促炎性标记和许多其他。此外，我们正在开始有关基因环境相互作用的新工作。 一个重要的子项目由新招募的异常健康的老年人（理想）组成，研究了该组的横截面特征与一般人群相比，并测量了几种可能直接或间接与身体和认知功能联系起来的生理参数。从这一前瞻性中，BLSA的未来计划是成为生理的永久实验室，研究在衰老过程中发生的不同生理变化，最终目的是了解其相互关系，并描述它们有助于维持稳态平衡的机制。 由于许多生病和残疾的BLSA参与者经常无法来巴尔的摩诊所进行传统访问，从而在诊所进行了严重的确定性偏见的审查，这是在研究与年龄相关的研究中，BLSA保留了一个“家庭访问”项目，该项目旨在从不再能够收集临床研究单位的个人中收集信息。该项目的这一部分在另一个报告中描述。 2020年5月，通过电话进行了临时调查，或者通过邮件发送，以收集与COVID-19的暴露和症状以及大流行有关的数据及其对日常生活的影响及其对日常生活的影响，孤立感，与健康相关的行为，社交互动，社交互动，个人财务，个人财务等。 2021年1月，开发了2020年5月Covid-19的随访，并向所有招募BLSA的人进行管理，以探讨他们在Covid-19的经验，包括疫苗接种状态。