From frailty to resilience: exploring adaptive capacity and reserve in older adults-a narrative review.

Resilience, the capacity to adapt and recover from adversity, plays a critical role in the health and wellbeing of older adults. In geriatric populations, resilience encompasses physical, cognitive, and psychosocial domains and is essential for maintaining functional independence and quality of life amidst the challenges of aging. This review explores the concept of resilience within geriatric medicine across physical, cognitive, and psychosocial domains, highlights the differences from frailty and reserve, underscores importance of stressors, summarizes key biomarkers that predict resilience, and evaluates interventions designed to enhance resilience in older adults.

Musculoskeletal biomarkers in health and disease: implications for the aging spine-a review for spinal surgeons by the SRS adult spinal deformity task force on senescence.

The incidence of spine-related pathologies is expected to increase in developed countries due to ongoing fundamental demographic shifts toward an older population. These changes present significant challenges to public health, as healthcare systems worldwide must confront the burden of musculoskeletal aging and its related consequences. Here, we synthesize current knowledge on the biologic mechanisms underlying musculoskeletal aging, focusing on the implications for the aging spine.

Cardiovascular-Derived Circulating Cell-Free DNA Fragments Are Associated With Frailty and Increased Cardiovascular Events in Older Adults.

Increased cellular damage in aging tissues releases circulating cell-free genomic DNA (ccf-gDNA) into the bloodstream, and these fragments are associated with a higher risk of frailty and dementia. We hypothesized that identifying the tissue of origin for ccf-gDNA using methylation signatures can distinguish subgroups of participants with distinct clinical outcomes, biological aging rates, and energy use. Serum ccf-gDNA from 181 participants in the Religious Orders Study or Rush Memory and Aging Project (ROS-MAP) was assessed for DNA methylation at one timepoint using the Illumina MethylationEPIC array.

Characterization of Dynamic Adaptation to Stressors Using Multisystem Stimulus-Response Data: The Study of Physical Resilience in Aging Pilot.

Resilience to stressors has emerged as a major gerontological concept aiming to promote more positive outcomes for older adults. Achieving this aim relies on determining mechanisms underlying the capacity to respond resiliently. This article seeks proof of principle for the hypothesis that physical aspects of said capacity are rooted in the fitness of one's physiology governing stress response, conceptualized as a dynamical system.

Multivariate Profiling of Physical Resilience in Older Adults After Total Knee Replacement Surgery: Results From a Prospective Observational Study.

Background: As individuals age, their ability to cope with and recover from health challenges becomes vital for maintaining independence and quality of life. This study aims to develop a multivariate phenotype of physical resilience based on individual recovery dynamics before and after a physical stressor.

Methods: This prospective observational study included 104 individuals aged ≥60 who underwent elective total knee replacement (TKR) for degenerative joint disease between December 2, 2019 and January 4, 2023.

Moderate-to-Vigorous Physical Activity at any Dose Reduces All-Cause Dementia Risk Regardless of Frailty Status.

Objectives: Reaching the moderate-to-vigorous physical activity (MVPA) recommendations of 150 min/wk is difficult for older adults, particularly among those living with frailty and its associated risk of dementia. We examined the dose-response relationship between MVPA and dementia risk among at-risk persons living with and without frailty enrolled in the UK Biobank study.

Design: Survival analysis within a prospective cohort study.

Characterization of Dynamic Adaptation to Stressors using Multi-System Stimulus-Response Data: The Study of Physical Resilience in Aging Pilot.

Resilience to stressors has emerged as a major gerontological concept aiming to promote more positive outcomes for older adults. Achieving this aim relies on determining mechanisms underlying capacity to respond resiliently. This paper seeks proof of principle for the hypothesis that physical aspects of said capacity are rooted in the fitness of one's physiology governing stress response, conceptualized as a dynamical system.

Assessment of Inflammatory Biomarkers and Incident Atrial Fibrillation in Older Adults.

Background: Available evidence supports the importance of inflammation in atrial fibrillation (AF) pathogenesis, yet general anti-inflammatory therapies have failed to show benefit for prevention of the arrhythmia. Better understanding of the specific inflammatory pathways involved is necessary to advance therapeutics.

Methods And Results: We evaluated 9 circulating markers of inflammation measured by immunoassays and incidence of AF in a population-based older cohort.

Frailty integration in medical specialties: Current evidence and suggested strategies from the Clin-STAR frailty interest group.

Frailty is a syndrome that can inform clinical treatments and interventions for older adults. Although implementation of frailty across medical subspecialties has the potential to improve care for the aging population, its uptake has been heterogenous. While frailty assessment is highly integrated into certain medical subspecialties, other subspecialties have only recently begun to consider frailty in the context of patient care.

Inflammatory Indices and Their Associations With Postoperative Delirium.

Background: Although the pathogenesis of delirium is poorly understood, increasing evidence supports a role for inflammation. Previously, individual inflammatory biomarkers have been associated with delirium. Aggregating biomarkers into an index may provide more information than individual biomarkers in predicting certain health outcomes (eg, mortality); however, inflammatory indices have not yet been examined in delirium.

Body Mass Index and Diabetes Incidence Across the Adult Lifespan: The Baltimore Longitudinal Study of Aging.

Context: Body composition and glucose metabolism change with aging. Whether different levels of body-mass-index (BMI) are needed to define diabetes risk across the adult lifespan is unknown.

Objective: This work aimed to investigate whether BMI similarly reflects relative fat mass (FM) and diabetes risk across age groups.

Co-Delivery of Valsartan and Metformin from a Thermosensitive Hydrogel-Nanoparticle System Promotes Collagen Production in Proliferating and Senescent Primary Human Dermal Fibroblasts.

Aging negatively impacts skin health, notably through the senescent cell phenotype, which reduces collagen production and leads to thinner, more fragile skin prone to injuries and chronic wounds. We designed a drug delivery system that addresses these age-related issues using a hybrid hydrogel-nanoparticle system that utilizes a poly(δ-valerolactone--lactide)--poly(ethylene-glycol)--poly(δ-valerolactone--lactide) (PVLA-PEG-PVLA) hydrogel. This hydrogel allows for the local, extended release of therapeutics targeting both proliferating and senescent cells.

qMAP enabled microanatomical mapping of human skin aging.

Aging is a major driver of diseases in humans. Identifying features associated with aging is essential for designing robust intervention strategies and discovering novel biomarkers of aging. Extensive studies at both the molecular and organ/whole-body physiological scales have helped determined features associated with aging.

Enhancing Care for Older Adults and Dementia Patients With Large Language Models: Proceedings of the National Institute on Aging-Artificial Intelligence & Technology Collaboratory for Aging Research Symposium.

Large Language Models (LLMs) stand on the brink of reshaping the field of aging and dementia care, challenging the one-size-fits-all paradigm with their capacity for precision medicine and individualized treatment strategies. The "Large Pre-Trained Models with a Focus on AD/ADRD and Healthy Aging" symposium, organized by the National Institute on Aging and the Johns Hopkins Artificial Intelligence & Technology Collaboratory for Aging Research, served as a platform for exploring this potential. The symposium brought together diverse experts to discuss the integration of LLMs in aging and dementia care.

Recipient clonal hematopoiesis in allogeneic bone marrow transplantation for lymphoid malignancies.

Allogeneic blood and marrow transplantation (alloBMT) is increasingly being used in older patients with blood cancer. Aging is associated with an increasing incidence of clonal hematopoiesis (CH). Although the effects of donor CH on alloBMT has been reported, the impact of recipient CH on alloBMT outcomes is unknown.

Dual treatment with kynurenine pathway inhibitors and NAD precursors synergistically extends life span in Drosophila.

Tryptophan catabolism is highly conserved and generates important bioactive metabolites, including kynurenines, and in some animals, NAD. Aging and inflammation are associated with increased levels of kynurenine pathway (KP) metabolites and depleted NAD, factors which are implicated as contributors to frailty and morbidity. Contrastingly, KP suppression and NAD supplementation are associated with increased life span in some animals.

Metabolic dysfunction and the development of physical frailty: an aging war of attrition.

The World Health Organization recently declared 2021-2030 the decade of healthy aging. Such emphasis on healthy aging requires an understanding of the biologic challenges aging populations face. Physical frailty is a syndrome of vulnerability that puts a subset of older adults at high risk for adverse health outcomes including functional and cognitive decline, falls, hospitalization, and mortality.

Artificial Intelligence and Technology Collaboratories: Innovating aging research and Alzheimer's care.

This perspective outlines the Artificial Intelligence and Technology Collaboratories (AITC) at Johns Hopkins University, University of Pennsylvania, and University of Massachusetts, highlighting their roles in developing AI-based technologies for older adult care, particularly targeting Alzheimer's disease (AD). These National Institute on Aging (NIA) centers foster collaboration among clinicians, gerontologists, ethicists, business professionals, and engineers to create AI solutions. Key activities include identifying technology needs, stakeholder engagement, training, mentoring, data integration, and navigating ethical challenges.

Prevalence and risk factors for dysphagia in older adults after thyroid and parathyroid surgery.

Background: We aimed to determine the prevalence and risk factors for dysphagia in adults 65 years and older before and after thyroidectomy or parathyroidectomy.

Methods: We performed a longitudinal prospective cohort study of older adults undergoing initial thyroidectomy or parathyroidectomy. We administered the Dysphagia Handicap Index questionnaire preoperatively and 1, 3, and 6 months postoperatively.

Native lamin A/C proteomes and novel partners from heart and skeletal muscle in a mouse chronic inflammation model of human frailty.

Clinical frailty affects ∼10% of people over age 65 and is studied in a chronically inflamed (Interleukin-10 knockout; "IL10-KO") mouse model. Frailty phenotypes overlap the spectrum of diseases ("laminopathies") caused by mutations in . encodes nuclear intermediate filament proteins lamin A and lamin C ("lamin A/C"), important for tissue-specific signaling, metabolism and chromatin regulation.

Navigating and diagnosing cognitive frailty in research and clinical domains.

While physical frailty has been recognized as a clinical entity for some time, the concept of cognitive frailty (CF) is now gaining increasing attention in the geriatrics research community. CF refers to the co-occurrence of physical frailty and cognitive impairment in older adults, which has been suggested as a potential precursor to both dementia and adverse physical outcomes. However, this condition represents a challenge for researchers and clinicians, as there remains a lack of consensus regarding the definition and diagnostic criteria for CF, which has limited its utility.