The association of health behaviors prior to cancer diagnosis and functional aging trajectories after diagnosis: Longitudinal cohort study of middle-aged and older US cancer survivors

We aimed to determine the influence of modifiable health behaviors prior to a cancer diagnosis on functional aging trajectories after diagnosis among middle-aged and older cancer survivors in the United States. Data were from biennial interviews with 2,717 survivors of a first incident cancer diagnosis after age 50 in the population-based US Health and Retirement Study from 1998 to 2016. Smoking status, alcohol use, and vigorous physical activity frequency were assessed at the interview prior to cancer diagnosis. Confounder-adjusted multinomial logistic regression was used to determine the associations between each pre-diagnosis health behavior and post-diagnosis trajectories of memory function and limitations to activities of daily living (ADLs), which were identified using group-based trajectory modeling. Overall, 20.7 % of cancer survivors were current smokers, 30.6 % drank alcohol, and 27.1 % engaged in vigorous physical activity >=once a week prior to their diagnosis. In the years following diagnosis, those who had engaged in vigorous physical activity > once a week were less likely to have a medium-high (OR: 0.5; 95 % CI: 0.2-0.9) or medium-low memory loss trajectories (OR: 0.6; 95 % CI: 0.3-1.0) versus very low memory loss trajectory, and were less likely to have a high, increasing ADL limitation trajectory (OR: 0.3; 95 % CI: 0.2, 0.6) versus no ADL limitation trajectory. Vigorous physical activity, but not smoking or alcohol use, was associated with better post-diagnosis functional aging trajectories after a first incident cancer diagnosis in mid-to-later life in this population-based study. Identification of modifiable risk factors can inform targeted interventions to promote healthy aging among cancer survivors.

Sex-specific aging in bite force in a wild vertebrate

The manifold differences between the sexes provide wide scope for sex differences in senescence. However, detecting physiological decline in old age and evaluating any sex difference in aging in a wild population can be challenging. This applies especially to long-lived species that require marking around birth in order to recognize elderly individuals, perhaps decades later. Here, we used bite force of known-age, long-lived Nazca boobies (Sula granti, a seabird) as a functional measure of muscle strength; surprisingly, only a single study has evaluated the possibility of senescent decline in muscle strength in a wild vertebrate. The male-biased adult sex ratio of this population constrains breeding opportunities across the lifespan for males, so we predicted that slower accumulation of reproductive costs would delay senescent decline in bite force in males compared to females, matching observed patterns in some non-muscle traits in this species. Data were collected from 349 adults using a force transducer at the start of the breeding season in November 2017 on Isla Española, Galápagos. Both sexes achieved less bite force in late life. The decline began at a later age in males, providing evidence of sex-specific schedules of decline in muscle function in a wild vertebrate.

Atg2, Atg9 and Atg18 in mitochondrial integrity, cardiac function and healthspan in Drosophila

In yeast, the Atg2-Atg18 complex regulates Atg9 recycling from phagophore assembly site during autophagy; their function in higher eukaryotes remains largely unknown. In a targeted screening in Drosophila melanogaster, we show that Mef2-GAL4-RNAi-mediated knockdown of Atg2, Atg9 or Atg18 in the heart and indirect flight muscles led to shortened healthspan (declined locomotive function) and lifespan. These flies displayed an accelerated age-dependent loss of cardiac function along with cardiac hypertrophy (increased heart tube wall thickness) and structural abnormality (distortion of the lumen surface). Using the Mef2-GAL4-MitoTimer mitochondrial reporter system and transmission electron microscopy, we observed significant elongation of mitochondria and reduced number of lysosome-targeted autophagosomes containing mitochondria in the heart tube but exaggerated mitochondrial fragmentation and reduced mitochondrial density in indirect flight muscles. These findings provide the first direct evidence of the importance of Atg2-Atg18/Atg9 autophagy complex in the maintenance of mitochondrial integrity and, regulation of heart and muscle functions in Drosophila, raising the possibility of augmenting Atg2-Atg18/Atg9 activity in promoting mitochondrial health and, muscle and heart function.

Association of midlife value priorities with health-related quality of life, frailty and mortality among older men: a 26-year follow-up of the Helsinki Businessmen Study (HBS)

PURPOSE

Personal values influence behavior and decision making, but their long-term associations with health-related quality of life (HRQoL), frailty, and mortality are less clear. We studied these associations from midlife to old age in a 26-year follow-up of the Helsinki Businessmen Study (HBS) cohort.

METHODS

In 1974, 1320 clinically healthy men (born 1919-1934) reported in a 12-item questionnaire their personal values. In 2000, a mailed questionnaire, including assessment of HRQoL with RAND-36 (SF-36) instrument, was sent to survivors, and 1025 men responded. In 2000, the presence of phenotypic frailty was assessed using modified Fried criteria including indicators of shrinking, physical weakness, exhaustion, and physical inactivity. Mortality through December 31, 2000 was verified from national registries.

RESULTS

Using a factor analysis, the data of the 12-item questionnaire of personal values were loaded in 3 factors: valuing health ("Health"), enjoyable and varying life ("Enjoyment"), and comfort and work-oriented life ("Work-life-balance"). Adjusted for age, we found a significant positive association between valuing "Health" in midlife and RAND-36 domains of Physical functioning (p = .032) and Vitality (p = .005) in old age. "Health" also predicted less frailty (p = .008), and "Enjoyment" was associated with higher mortality (p = .017).

CONCLUSIONS

Value priorities of men assessed in midlife had long-term associations with HRQoL and frailty in old age, and they may also predict mortality.