No winners or losers: clinical chemistry-based biological aging metrics perform similarly across cohorts and health outcomes

The Journals of Gerontology Series A · 2025-08-12 · 1 citations

Aging is the leading risk factor for most chronic disease. However, disease risk varies substantially between individuals of the same age. Biological aging measures attempt to quantify this difference using biomarkers; such measures have amassed substantial evidence as reliable correlates of morbidity and mortality. Although many have been developed throughout the years, there is no clear consensus as to which one is the best, if any. This study evaluates four methods for measuring biological aging: Klemera and Doubal's method for biological age (KDM BA), phenotypic age (PA), homeostatic dysregulation (DM), and Pace of Aging (Pace). Using five cohort studies from four different countries (InCHIANTI from Italy, WHAS I and II from the United States, NuAge from Canada, and the UK Biobank), we assessed the relationship of these metrics with six health outcomes. The metrics were calculated using a consistent set of biomarkers to facilitate comparison. The biological aging measures correlated only weakly with each other (r > .5 for six of 21 correlations). The meta-analyses performed on the results from each dataset revealed that all biological age measures were significantly associated with at least one health outcome; however, no single metric consistently outperformed the others, with strength of association strikingly similar across metrics. This study is the first to combine an international multicohort analysis using a consistent set of biomarkers across biological age metrics. While there are no net winners or losers, effect sizes are heterogeneous across cohorts, highlighting the importance of replicating findings in different contexts and with different metrics.

Relation of income to trends in well-being by age: implications for the future older “forgotten” lower middle class

Health Affairs Scholar · 2025-01-09

Abstract The structure of social welfare policy has neglected a growing and increasingly economically marginalized segment of the American population—the lower middle class, a large group who are ineligible for many need-based social services. We examined 20-year time trends in physical well-being, mental well-being, and functional well-being by levels of household income. Our descriptive study used data from the Behavioral Risk Factor Surveillance System and is representative of the population of the United States, ages 40 to 74, from 2003 to 2022 (n = 5 308 256). We found dramatic and consistent differences in trends in well-being by income category. While well-being generally got worse over the 20-year period for all ages, the declines were most pronounced for lower-middle-income households for individuals age 50 to 59. These differential trends by income were similar for all 3 of the measures of well-being we examined, but were most different by income level for physical well-being and functional well-being. No major trends or levels were explained by race, body mass index, or smoking. If the observed trends persist, the current age 50–59-year-old lower-middle-income population will enter retirement ages with substantially worse well-being than previous generations.

The 100-Year-Old American and Our Health System

Cambridge University Press eBooks · 2025-05-13

Carta of Florence Against Ageism; No Place for Ageism in Health Care

The Gerontologist · 2024-02-29 · 4 citations

International audience

A global analysis of adaptation to societal aging across low-, middle- and high-income countries using the Global Aging Society Index

Nature Aging · 2024-12-27 · 33 citations

We have previously presented a multidimensional Aging Society Index, a weighted summation of five domains central to successful adaptation to societal aging: well-being, productivity and engagement, equity, cohesion and security, as a tool to assess countries' adaptation to demographic transformation. As the index was based on data from developed countries and some of the individual metrics or weightings may not be well suited for application to low- and middle-income countries, we here present the scores on a modified index (Global Aging Society Index) on 143 countries distributed across the span of economic development. Only 5 out of 143 (3.5%) countries had higher scores for women than men. Countries with the most notable gender differences were primarily low-income countries. The multidimensional index permits cross-national comparisons and may facilitate the identification of targets for developing policies and programs to enhance the likelihood that older persons will age successfully.

Intrinsic Health as a Foundation for a Science of Health

2024-10-30 · 1 citations

The health sciences largely focus on disease. However, the interconnected determinants of diseases suggest that we need a Science of Health, a framework to examine the biology of homeodynamics in a changing environment and how this impacts the health we value. We build on first principles and recent discoveries on biological system dynamics to develop the concept of intrinsic health, a field-like state emerging from the dynamic interplay of energy, communication, and structure within the organism, giving rise to robustness/resilience, plasticity, performance, and sustainability. Intrinsic health is a quantifiable property of individuals that declines with age and interacts with context. We propose a measurement framework and describe how it will contribute to achieve the shared goals of medicine and public health.

Defining Roles and Responsibilities of the Health Workforce to Respond to the Climate Crisis

JAMA Network Open · 2024-03-22 · 34 citations

Importance: The adverse effects of climate change are now apparent, disproportionately affecting marginalized and vulnerable populations and resulting in urgent worldwide calls to action. Health professionals occupy a critical position in the response to climate change, including in climate mitigation and adaptation, and their professional expertise and roles as health messengers are currently underused in the society-wide response to this crisis. Observations: Clinical and public health professionals have important roles and responsibilities, some of which are shared, that they must fill for society to successfully mitigate the root causes of climate change and build a health system that can reduce morbidity and mortality impacts from climate-related hazards. When viewed through a preventive framework, the unique and synergizing roles and responsibilities provide a blueprint for investment in climate change-related prevention (primary, secondary, and tertiary), capacity building, education, and training of the health workforce. Substantial investment in increasing the competence and collaboration of health professionals is required, which must be undertaken in an urgent, coordinated, and deliberate manner. Conclusions and Relevance: Exceptional collaboration, knowledge sharing, and workforce capacity building are essential to tackle the complex ways in which climate change threatens health. This framework serves as a guide for health system leaders, education institutions, policy planners, and others seeking to create a more resilient and just health system.

Carta of Florence Against Ageism: No Place for Ageism in Health Care

The Journals of Gerontology Series B · 2024-02-29 · 2 citations

International audience

Carta of Florence against ageism. No place for ageism in health care

European Geriatric Medicine · 2024-02-29 · 13 citations

International audience

Carta of Florence Against Ageism; No Place for Ageism in Healthcare

Innovation in Aging · 2024-02-01 · 5 citations

International audience