Respiratory muscle senescence in ageing and chronic lung diseases

Associations between physical activity and the incidence of restrictive spirometry patterns: A cohort study

BACKGROUNDS

Restrictive spirometry patterns (RSP) are associated with adverse health outcomes, but the association between physical activity (PA) levels and RSP risk, as well as the influence of factors like age, sex, and smoking status, is not well understood.

METHODS

This study included 212,023 participants (mean age: 38 years, 40.7 % women). PA levels were classified into four groups, and RSP incidence was assessed. RSP was defined using Global Lung Initiative criteria as FEV1/FVC z-score ≥ -1.64 and FVC z-score < -1.64. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs) for RSP incidence. Subgroup analyses were conducted to evaluate the potential influence of age, sex, and smoking status on the association between PA and RSP risk.

RESULTS

Engaging in any level of PA was associated with a reduced risk of RSP compared with complete inactivity. Subgroup analyses revealed that older adults (≥45 years) exhibited a significantly lower risk of RSP (HR: 0.81, 95 % CI: 0.73-0.90) compared to younger adults. Men had a lower risk than women (HR: 0.87, 95 % CI: 0.83-0.92), and current smokers showed a reduced risk compared to non-smokers (HR: 0.86, 95 % CI: 0.80-0.93). These findings indicate that the protective effect of PA on RSP may vary across population subgroups.

CONCLUSIONS

Even minimal PA is associated with a lower RSP risk. Subgroup differences highlight the need for tailored PA interventions in diverse populations.

A tale as old as time - the importance of accelerated lung aging in chronic obstructive pulmonary disease

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is progressive in nature and predominantly affects older individuals. Lung function decline is a typical part of the aging process, characterized by gradual loss of lung mechanics, airway remodeling, persistent low-grade inflammation of the airways, compromised epithelial barrier function, and impaired immune responses over time.

AREAS COVERED

The pathology of the senile lung is advanced in patients with COPD, whereby genomic damages contribute to structural defects and cellular dysfunction. Primary, antagonistic, and integrative hallmarks of aging are accelerated in COPD, potentiated by cumulative injury sustained from repeated environmental exposures and the interaction with comorbidities. Identification of epigenetic profiles in COPD indicates how cellular processes contribute to the advancement of biological age. Epigenetic abnormalities unique to COPD subpopulations occur in individuals who are immunodeficient, and often experience early onset and increased severity of COPD.

EXPERT OPINION

Accelerated aging processes indicated by epigenetic and other biomarkers may be a promising avenue for early detection, prevention, and subsequent management of COPD. Understanding risk factors contributing to progressive lung function decline and implementation of mitigation strategies such as cessation of smoking, repurposing existing pharmacotherapeutics and development of novel therapies may slow age-related pathologies in COPD. [Figure: see text].

Effect of Tai Chi Softball on Health-Related Outcomes in Elderly Men

This study aimed to investigate the effects of Tai Chi Softball (TCSB) training on the physical health of older men, with a focus on improvements in muscle strength, flexibility, balance, and blood lipid profiles. A 12-week randomized controlled trial was conducted, recruiting 140 men aged 55-65 years. Participants were randomly assigned to either a Tai Chi Softball group (TCSBG, N = 70) or a control group (CG, N = 70). The TCSBG engaged in TCSB training sessions 4 to 5 times per week, with each session lasting 70 to 90 min, while the CG maintained their usual daily routines without any additional interventions. Measurements were taken before and after the intervention and included waist-to-hip ratio (WHR), handgrip strength (HS), sit-and-reach (SAR), single-leg stance (SLS), vital capacity (VC), heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol. The results revealed that after 12 weeks of TCSB training, participants in the TCSBG showed significant improvements (p < .05) in HS, SAR, and SLS, indicating enhanced muscle strength, flexibility, and balance, respectively. The VC also increased significantly, while both SBP and DBP decreased notably (p < .05). Moreover, significant reductions were observed in TC, TG, and LDL-C levels p < .05). In conclusion, TCSB training demonstrated efficacy in improving muscle strength, flexibility, balance, cardiorespiratory fitness, and blood lipid profiles in older men. These findings suggest that TCSB training can mitigate age-related declines in physical function and reduce cardiovascular risk in older men.

An 18-month multimodal intervention trial for preventing dementia: J-MINT PRIME Tamba

BACKGROUND

The number of people with dementia is increasing in Japan, and establishing evidence for preventing dementia is necessary.

METHODS

This study was a randomized controlled trial in cognitively normal community-dwelling older adults aged 65 to 85 with diabetes and/or hypertension. Participants were randomly assigned in a 1:1 ratio. The intervention group underwent 90 min of group-based weekly physical exercise, cognitive training, nutritional counseling, and vascular risk management for 18 months. The primary endpoint was the change in a cognitive composite score calculated by averaging the z-scores of seven neuropsychological tests from baseline to 18 months.

RESULTS

We randomly assigned 203 participants to two groups, and 178 (87.7%) completed the 18-month follow-up. There was a significant group difference in the cognitive composite score change at 18 months (mean difference 0.16, 95% confidence interval: 0.04 to 0.27; p = 0.009).

DISCUSSION

An 18-month multimodal intervention for older adults at risk of dementia could improve their cognitive function. The trial was registered in the Clinical Trial Registration System (UMIN000041938).

HIGHLIGHTS

Japan-Multimodal Intervention Trial for Prevention of Dementia (J-MINT) PRIME Tamba was a randomized controlled trial to prevent dementia. We provided a multifactorial intervention based on the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial methodology. The primary outcome, the cognitive composite score, improved with our intervention. Executive function/processing speed and memory improved in the intervention group. Intervention adherence was high, and no serious adverse events occurred.

Lung function and the risk of frailty in the European population: a mendelian randomization study

BACKGROUND

Epidemiological evidence has suggested a relationship between lung function and frailty, but the precise nature of the causality remains unclear. In this study, we applied a two-sample Mendelian randomization (MR) analysis to determine the causal effects of lung function on frailty.

METHODS

Single nucleotide polymorphisms (SNPs) independently related (P ≤ 5E-08) to lung function, as identified by genome-wide association study (GWAS), were applied as instrumental variables (IV). The association with frailty index (FI) was investigated using summary-level data from the latest GWAS on FI (n = 175,226). Different statistical methods were employed to evaluate the causal estimates between lung function and FI. The pleiotropy, heterogeneity, and leave-one-out analysis were applied to confirm the stability of the MR estimates.

RESULTS

Using the random-effect inverse-variance weighted approach, genetically proxied forced expiratory volume in the first second (FEV1), ratio of FEV1 on forced vital capacity (FVC) [FEV1/FVC], and peak expiratory flow (PEF) were significantly and inversely associated with FI (FEV1, β = -0.08, P = 2.03E-05; FEV1/FVC, β = -0.06, P = 9.51E-06; PEF, β = -0.07, P = 4.09E-04) with good statistical power (99.7-100%). However, no significant association was observed between FVC and FI (β = -0.01, P = 0.681). Leave-one-out analysis showed that there was no single SNP driving the bias of the estimates. There was potential heterogeneity, but no obvious pleiotropy was founded in this MR study.

CONCLUSIONS

Our findings indicate that impaired pulmonary function is closely related to the risk of frailty. Enhancing lung function in the elderly population may contribute to the prevention of frailty to a certain extent.

Maximal Respiratory Pressure Reference Equations in Healthy Adults and Cut-off Points for Defining Respiratory Muscle Weakness

INTRODUCTION

Maximal inspiratory and expiratory pressures (PImax/PEmax) reference equations obtained in healthy people are needed to correctly interpret respiratory muscle strength. Currently, no clear cut-off points defining respiratory muscle weakness are available. We aimed to establish sex-specific reference equations for PImax/PEmax in a large sample of healthy adults and to objectively determine cut-off points for respiratory muscle weakness.

METHODS

A multicentre cross-sectional study was conducted across 14 Spanish centres. Healthy non-smoking volunteers aged 18-80 years stratified by sex and age were recruited. PImax/PEmax were assessed using uniform methodology according to international standards. Multiple linear regressions were used to obtain reference equations. Cut-off points for respiratory muscle weakness were established by using T-scores.

RESULTS

The final sample consisted of 610 subjects (314 females; 48 [standard deviation, SD: 17] years). Reference equations for PImax/PEmax included body mass index and a squared term of the age as independent variables for both sexes (p<0.01). Cut-off points for respiratory muscle weakness based on T-scores ≥2.5 SD below the peak mean value achieved at a young age were: 62 and 83cmH2O for PImax and 81 and 109cmH2O for PEmax in females and males, respectively.

CONCLUSION

These reference values, based on the largest dataset collected in a European population to date using uniform methodology, help identify cut-off points for respiratory muscle weakness in females and males. These data will help to better identify the presence of respiratory muscle weakness and to determine indications for interventions to improve respiratory muscle function.

Respiratory Muscle Function in Older Adults with Chronic Respiratory Diseases after Pulmonary Rehabilitation in Subterranean Salt Chambers

Training the respiratory muscles is a crucial aspect of pulmonary rehabilitation. The purpose of this study was to assess the function of respiratory muscles in older adults both before and after a period of pulmonary rehabilitation and treatment stay within the underground chambers of a salt mine. A total of 50 patients aged 65 years and older with chronic respiratory conditions was enrolled in the study. These participants underwent a 3-week subterranean pulmonary rehabilitation (PR) program in the "Wieliczka" Salt Mine. Levels of sniff nasal inspiratory pressure (SNIP), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) were measured using the MicroRPM both before and after the outpatient PR program conducted 135 m underground. A total of 44 patients with a mean age of 68.8 ± 2.9 years who completed the PR program and tests were included in the analysis. The average changes in the parameters of pulmonary function before and after the PR were: MIP 8.8 cmH2O, MEP 7.1 cmH2O, and SNIP 11.2 cmH2O (for p < 0.05). For patients older than 70 years, beneficial changes were only observed for MEP, which increased by 9.3 cmH2O (for p < 0.05). Speleotherapy combined with pulmonary rehabilitation improves respiratory muscle function in older adults with chronic respiratory diseases, mainly in terms of MEP. Therefore, a greater emphasis on inspiratory muscle training in the rehabilitation program should be considered.

Mapping Genetics and Epigenetics to Explore the Pathways beyond the Correlated Ageing Phenotype

Ageing is defined by the decline in the biological and physiological functions over time, which leads to health problems and increases risks of diseases. The modern societies are characterised by an ageing population, which represents challenges for the healthcare system. Within this context, there is a need to better understand the biological mechanisms beyond ageing in order to optimise geriatric therapies and medical approaches. Herein, we suggest exploring the genetic and epigenetic patterns related to ageing and correlate them with the ageing-related phenotype of the biological entities in order to establish mechanistic links and map the molecular pathways. Such links would have diverse implications in basic research, in clinics, as well as for therapeutic studies.

New insights of epigenetics in vascular and cellular senescence

Vascular senescence plays a vital role in cardiovascular diseases and it is closely related to cellular senescence. At the molecular level, aging begins with a single cell, and it is characterized by telomere shortening, mitochondrial dysfunction, stem cell exhaustion, epigenetic changes, and so on. Epigenetics is an independent discipline that modifies DNA activity without altering the DNA sequence. The application of epigenetics helps to alleviate the occurrence of human diseases, inhibit senescence, and even inhibit tumor occurrence. Epigenetics mainly includes the modification of DNA, histone, and noncoding RNA. Herein, the application of epigenetics in vascular senescence and aging has been reviewed to provide the prospects and innovative inspirations for future research.

Dynamic Aging: Channeled Through Microenvironment

Aging process is a complicated process that involves deteriorated performance at multiple levels from cellular dysfunction to organ degeneration. For many years research has been focused on how aging changes things within cell. However, new findings suggest that microenvironments, circulating factors or inter-tissue communications could also play important roles in the dynamic progression of aging. These out-of-cell mechanisms pass on the signals from the damaged aging cells to other healthy cells or tissues to promote systematic aging phenotypes. This review discusses the mechanisms of how senescence and their secretome, NAD⁺ metabolism or circulating factors change microenvironments to regulate systematic aging, as well as the potential therapeutic strategies based on these findings for anti-aging interventions.

CTCF Mediates Replicative Senescence Through POLD1

POLD1, the catalytic subunit of DNA polymerase δ, plays a critical role in DNA synthesis and DNA repair processes. Moreover, POLD1 is downregulated in replicative senescence to mediate aging. In any case, the components of age-related downregulation of POLD1 expression have not been fully explained. In this article, we elucidate the mechanism of the regulation of POLD1 at the transcription level and found that the transcription factor CCCTC-binding factor (CTCF) was bound to the POLD1 promoter area in two sites. The binding level of CTCF for the POLD1 promoter appeared to be related to aging and was confirmed to be positively controlled by the CTCF level. Additionally, cell senescence characteristics were detected within the cells transfected with short hairpin RNA (shRNA)-CTCF, pLenti-CMV-CTCF, shRNA-POLD1, and pLenti-CMV-POLD1, and the results showed that the CTCF may contribute to the altered expression of POLD1 in aging. In conclusion, the binding level of CTCF for the POLD1 promoter intervened by an age-related decrease in CTCF and downregulated the POLD1 expression in aging. Moreover, the decrease in CTCF-mediated POLD1 transcription accelerates the progression of cell aging.