Những vai trò mới nổi của tình trạng suy yếu và viêm mãn tính trong đánh giá rủi ro của các bệnh mãn tính liên quan đến tuổi tác ở người cao tuổi: giao điểm giữa sinh học lão hóa và y học cá thể hóa

BioMedicine - Tập 5 - Trang 1-10 - 2015
I-Chien Wu1,2, Cheng-Chieh Lin2,3, Chao A. Hsiung1,2
1Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
2Program for Ageing, College of Medicine, China Medical University, Taichung, Taiwan
3Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan

Tóm tắt

Bệnh mãn tính ở người cao tuổi thường có diễn biến không thể đoán trước hơn so với ở những người trẻ tuổi. Những biến đổi không giải thích được về tỷ lệ mắc bệnh, tiên lượng, phản ứng điều trị và độc tính thường được quan sát thấy ở người cao tuổi. Tính đa dạng này tạo ra những thách thức lớn cho các hệ thống chăm sóc sức khỏe hiện tại, vốn áp dụng phương pháp một kích cỡ cho tất cả, và yêu cầu phải có những phương pháp quản lý cá thể hóa hơn cho các bệnh mãn tính ở người cao tuổi. Lão hóa được đặc trưng bởi sự suy giảm dần dần của các chức năng cơ thể với nguy cơ gia tăng xảy ra theo thời gian. Toàn bộ quá trình này được tổ chức theo thứ bậc, và tiến triển từ các sự kiện trong tế bào đến các thay đổi ở mức toàn bộ hệ thống và cuối cùng là mức sinh vật, với tốc độ khác nhau ở từng cá nhân. Sinh học lão hóa có ảnh hưởng lớn đến sự phát triển và tiến triển của hầu hết các bệnh mãn tính liên quan đến tuổi. Do đó, sinh học lão hóa có thể góp phần vào độ phức tạp của các bệnh tật gia tăng theo tuổi tác, và các dấu ấn sinh học về lão hóa có tiềm năng lớn để cho phép đánh giá rủi ro sức khỏe cá thể hóa và chăm sóc sức khỏe. Chúng tôi xem xét các bằng chứng hỗ trợ vai trò của các dấu ấn sinh học tuổi tác trong đánh giá rủi ro của các bệnh liên quan đến độ tuổi đang phổ biến. Phân loại suy yếu là một chỉ số được đo khách quan của lão hóa giai đoạn tiến triển, được đặc trưng bởi sự suy giảm chức năng ở mức sinh vật. Ngược lại, mức độ biến đổi của các dấu hiệu viêm cho thấy một giai đoạn sớm hơn giữa những bất thường tế bào và sự suy giảm hệ thống. Kết quả từ các nghiên cứu quan sát ở người và các thử nghiệm ngẫu nhiên có đối chứng cho thấy rằng những chỉ số này, mặc dù đơn giản, hỗ trợ lớn cho việc phân loại bệnh nhân cao tuổi mắc ung thư, bệnh thận mãn tính, bệnh tim mạch và bệnh tiểu đường type 2 thành các nhóm khác nhau về tỷ lệ mắc bệnh, tiên lượng và phản ứng điều trị/độc tính. Khi các cơ chế chi tiết của quá trình sinh học lão hóa phức tạp được phát hiện trong tương lai, một loạt các dấu ấn sinh học tương quan với lão hóa sinh học ở các giai đoạn khác nhau sẽ được khám phá. Theo khuôn khổ nghiên cứu chuyển giao được mô tả trong bài báo này, những nỗ lực nghiên cứu này sẽ dẫn đến những đổi mới trong phòng ngừa và quản lý bệnh để đáp ứng những nhu cầu sức khỏe còn chưa được thực hiện lớn của các cộng đồng lão hóa.

Từ khóa

#lão hóa #bệnh mãn tính #dấu ấn sinh học #sức khỏe cá thể hóa #suy yếu #viêm mãn tính

Tài liệu tham khảo

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