Fight Aging!

The many varied types of age-related condition emerge from the effects of a much smaller set of underlying processes of aging. People age at different rates, largely the result of differences in lifestyle choices and environmental factors such as exposure to persistent pathogens. If an individual manifests a greater number of age-related conditions, forms of degeneration that have grown to the degree that a clinical diagnosis of loss of function can be made, then this greater number of conditions is a reflection of a faster progression of the underlying processes of aging. One should expect that this individual to exhibit a raised risk of the emergence of other age-related conditions.

This point is demonstrated in today's open access paper, reporting on the correlation between the presence of age-related conditions and the risk of frailty. Many older individuals suffer comorbidity, the presence of multiple age-related conditions. More conditions implies a greater risk of later frailty because both the conditions and frailty emerge from the underlying burden of cell and tissue damage that causes aging and age-related disease. Frailty is characterized by chronic inflammation and immunosenescence, and it is certainly the case that those issues play a sizable role in many age-related conditions.

The impact of long-term conditions on the progression of frailty

Population ageing leads to increased demand for health and social care and associated cost pressures. By 2028, 25% of England's population will be aged 65 and over, with 8% classified as frail. Frailty increases with age and is associated with higher healthcare utilization, and its determinants are key for effective healthcare services provision. Studies have identified protective (e.g. higher wealth, increased social support) and harmful (e.g. lower wealth, educational achievement, presence of long-term conditions, being female) factors associated with frailty progression. However, there is a lack of evidence on the impact of multiple long-term conditions (LTCs) longitudinally as a separate determinant of frailty progression. LTCs are defined as "A long term condition is one that cannot currently be cured but can be controlled with the use of medication and/or other therapies."

This study aimed to explore longitudinally the impact of multiple LTCs on frailty progression separately for males and females due to behavioural, social, and biological differences. A functional frailty measure (FFM) was used to examine putative determinants of frailty progression among participants aged 65 to 90 in the English Longitudinal Study of Ageing (ELSA), across nine waves (18 years) of data collection. A multilevel growth model was fitted to measure the FFM progression over 18 years, grouped by LTC categories (zero, one, two and more).

There were 2,396 male participants at wave 1, of whom 742 (31.0%) had 1 LTC and 1147 (47.9%) had ≥2 LTCs. There were 2,965 females at wave 1 of whom 881 (29.7%) had one LTC and 1,584 (53.4%) had ≥2 LTCs. The FFM increased 4% each 10 years for the male participants with no LTCs, while it increased 6% per decade in females. The FFM increased with the number of LTCs, for males and females. The acceleration of FMM increases for males with one long-term health condition or more; however in females the acceleration of FMM increases when they have two LTCs or more. In conclusion, frailty progression accelerates in males with one LTCs and females with two LTCs or more. Health providers should be aware of planning a suitable intervention once the elderly have two or more health conditions.