The Aging Process of WTC Responders: Assessment and Consequences of Frailty

世贸中心响应者的衰老过程：虚弱的评估和后果

• 批准号: 10064817
• 负责人: Roberto G Lucchini
• 金额: $ 49.83万
• 依托单位: ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10064817
• 关键词: Aging; Process; WTC; Responders; Assessment

Project Summary/Abstract Although the WTC general responders cohort is aging (average age=56), the WTC Health Program (WTCHP) does not routinely collect data on aging-related syndromes. In particular, frailty is a syndrome characterized by increased vulnerability to adverse events including mortality, morbidity, disability, and hospitalizations. Our preliminary data indicate that almost one-third of the General Responders WTC cohort meets criteria for frailty, an association that increases with age, WTC exposure, and by occupation type (e.g. higher risk among construction worker). These findings underscore the need for routine systematic assessments of structured age-related indicators in the cohort. Therefore the overarching aim of this study is to assess whether previous WTC exposure leads to premature age-related deterioration in physiological function. We will develop a WTC- specific clinical frailty index based on clinically observable signs and symptoms of aging regularly examined within WTCHP surveillance. We will carry out analyses using the repository of WTC general responders cohort health monitoring data that has been collected at the Mount Sinai Clinical Center of Excellence (CCE) since 2002. Additionally, we will recruit 500 individuals from the WTC general responders cohort who are followed at the Mount Sinai Clinical CCE to collect new measures of cognitive function, grip strength, weight loss, physical activity, exhaustion and walking speed, which will improve the accuracy of the WTC clinical frailty index. We will first establish a validated frailty cutoff for a WTC-specific Clinical-FI using newly collected measures of cognition, grip strength, walking speed, unintentional weight loss, physical activity, and exhaustion (Aim 1) .We will assess the influence of WTC exposure severity on the development of frailty in WTC responders (Aim 2) and the association of WTC exposure (and other potential risk factors) with frailty trajectories (Aim 3). In an exploratory Aim we will assess the influence of frailty on other age-related syndromes (functional decline and falls) and key consequences (hospitalizations). Identifying modifiable risk factors for premature aging has the potential to impact the entire WTCHP, which is an aging cohort and at higher risk for negative consequences. Our broader focus on aging and frailty serves as a paradigm shift in the WTCHP from exposure and trauma- related injury. Results of this study will be instrumental in improving the capacity of the WTCHP to monitor and care for aging responders through partnership with Geriatrics and Palliative Care programs, including the development of future intervention research on the effectiveness of specific multifactorial preventive programs.

项目摘要/摘要 尽管WTC总响应者队列正在老化（平均年龄= 56），但WTC健康计划（WTCHP） 不常规收集有关衰老相关综合征的数据。特别是，脆弱是一种综合症 增加了对不良事件的脆弱性，包括死亡率，发病率，残疾和住院。我们的 初步数据表明，几乎三分之一的一般响应者WTC队列符合脆弱的标准， 随着年龄的增长，WTC暴露和占领类型的增加的关联（例如 建筑工人）。这些发现强调了对结构化的常规系统评估的需求 队列中与年龄有关的指标。因此，这项研究的总体目的是评估以前的 WTC暴露会导致生理功能过早与年龄相关的恶化。我们将开发一个WTC- 基于临床上可观察到的症状和经常检查的症状的特定临床脆弱指数 在WTCHP监视中。我们将使用WTC总响应者队列的存储库进行分析 自从西奈山临床卓越中心（CCE）收集的健康监测数据以来 2002年。此外，我们将从WTC总响应者队列中招募500个人 西奈山临床CCE收集认知功能，抓地力，体重减轻，身体的新措施 活动，疲惫和步行速度将提高WTC临床脆弱指数的准确性。 我们将首先使用新收集的措施来为WTC特定的临床网络建立经过验证的脆弱截止 认知，抓地力，步行速度，无意减肥，体育锻炼和疲惫（AIM 1）。 将评估WTC暴露严重程度对WTC响应者脆弱发展的影响（AIM 2） 以及WTC暴露（以及其他潜在危险因素）与脆弱轨迹的关联（AIM 3）。在 探索目的我们将评估脆弱对其他年龄相关综合症的影响（功能下降和 跌倒）和关键后果（住院）。确定过早衰老的可修改风险因素具有 影响整个WTCHP的潜力，这是老化的队列，负面后果的风险更高。 我们对衰老和脆弱的广泛关注是WTCHP的范式转移，从暴露和创伤中转变 相关伤害。这项研究的结果将有助于提高WTCHP监测和 通过与老年医学和姑息治疗计划的伙伴关系，包括 开发对特定多因素预防计划有效性的未来干预研究。

项目成果

Development and Validation of a Clinical Frailty Index for the World Trade Center General Responder Cohort.

• DOI: 10.1177/0898264321997675
• 发表时间: 2021-08
• 期刊: Journal of aging and health
• 影响因子: 2.8
• 作者: Bello GA;Ornstein KA;Lucchini RG;Hung WW;Ko FC;Colicino E;Taioli E;Crane MA;Todd AC
• 通讯作者: Todd AC