An exposome approach to frailty in older adults

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Life-course exposure and its influence on frailty syndrome

Publication . Lage, Bruna; Costa, Solange; Teixeira, João Paulo

One area of health concern is reducing the burden of environmentally induced disease in populations that may be more susceptible to the effects of exposures to contaminants. The potential to reduce the prevalence of some major diseases is driving research to understand the totality of exposures over the course of our lifetimes. Older adults are well-recognized susceptible subpopulation. Health status in older adults is complex and multidimensional. One metric is frailty, a state of increased vulnerability to stressors, characterized by decreased physical and mental functioning and an increased risk for poor health outcomes. The European Commission has appointed Ageing one of the main priorities in the next Horizon 2020 Framework Program, the prevention of frailty in old age is one of the key actions identified. The aim of the present study is to build and apply a life-course exposure questionnaire and study the association with DNA basal damage and oxidative damage endpoints with frailty syndrome, contributing to the knowledge of the mechanistic pathways and syndrome aetiology. A total of 61 voluntary individuals aged 65 and over were involved in the study from senior recreational community associations and day care centres, located in metropolitan region of Oporto. Frailty assessment was performed using Fried’s frailty model and the individuals were classified as robust, pre-frail or frail. Life-time exposure was evaluated by a selfreported life-course exposure questionnaire and a job exposure matrix application. DNA basal damage and DNA oxidative damage endpoints were measured through comet assay in whole blood. Study population was classified as 47.5% robust, 49.2% pre-frail and 3.3% frail. A relation between the prevalence frailty with age and with gender was observed, with women and older elderly displaying higher rates of frailty. A relation between frailty status and secondhand smokers was found, since higher prevalence of exposure to tobacco smoke was found in pre-frail group (23.3%) when compared with the robust individuals (10.4%). Associations between frailty status and consumption of home-produced vegetables were found, with robust individuals consuming more home-produced vegetables (71.4%) from this source compared to pre-frail individuals (28.6%) that eat those aliments. Furthermore, associations between the consume of these vegetables and DNA damage in robust groups were found, since the robust individuals that include these aliments in their diet showing lower DNA damage than robust individuals that not consumption those aliments from particular produced sources. Regarding the effects of the variables studied, a significant influence was found on the genotoxic endpoints for gender and age within the robust group (p<0.05). Thus, significant differences were observed between the basal damage between robust females and males and between the oxidative damage between earlier age group and 75- 84 age group. Lastly, also a relation was verified between the role of current exposures and the DNA damage, regarding household-proximity to farming operation within the robust group. Thus, robust individuals that reported to live near of this activity have higher basal and oxidative damage than those robust individuals that do not live near farming operations (p<0.05). Data obtained provides preliminary information on relations between exposure, frailty syndrome and DNA damage. Further studies need to be performed in order to deepen the knowledge about frailty aetiology and the possible role of life-course exposures, helping to understand how the past may affect the future.

2017-11-24Master thesis

Open access

Exploring Early Detection of Frailty Syndrome in Older Adults: Evaluation of Oxi-Immune Markers, Clinical Parameters and Modifiable Risk Factors

Publication . Teixeira-Gomes, Armanda; Laffon, Blanca; Valdiglesias, Vanessa; Gostner, Johanna M.; Felder, Thomas; Costa, Carla; Madureira, Joana; Fuchs, Dietmar; Teixeira, João Paulo; Costa, Solange

Ageing is accompanied with a decline in several physiological systems. Frailty is an age-related syndrome correlated to the loss of homeostasis and increased vulnerability to stressors, which is associated with increase in the risk of disability, comorbidity, hospitalisation, and death in older adults. The aim of this study was to understand the relationship between frailty syndrome, immune activation, and oxidative stress. Serum concentrations of vitamins A and E were also evaluated, as well as inflammatory biomarkers (CRP and IL-6) and oxidative DNA levels. A group of Portuguese older adults (≥65 years old) was engaged in this study and classified according to Fried's frailty phenotype. Significant increases in the inflammatory mediators (CRP and IL-6), neopterin levels, kynurenine to tryptophan ratio (Kyn/Trp), and phenylalanine to tyrosine ratio (Phe/Tyr), and significant decreases in Trp and Tyr concentrations were observed in the presence of frailty. IL-6, neopterin, and Kyn/Trp showed potential as predictable biomarkers of frailty syndrome. Several clinical parameters such as nutrition, dependency scales, and polypharmacy were related to frailty and, consequently, may influence the associations observed. Results obtained show a progressive immune activation and production of pro-inflammatory molecules in the presence of frailty, agreeing with the inflammageing model. Future research should include different dimensions of frailty, including psychological, social, biological, and environmental factors.

2021-12-10Journal article

Open access

Aging, Living Environment, and Sustainability: What Should be Taken into Account?

Publication . Grazuleviciute-Vileniske, Indre; Seduikyte, Lina; Teixeira-Gomes, Armanda; Mendes, Ana; Borodinecs, Anatolijs; Buzinskaite, Deimante

he aging population presents numerous challenges and the design and management of living environments are not an exception. This literature review and analysis brings together topics related to the living environment of the aging population and the concept of sustainability. The article presents the review of the existing design concepts that are applied to planning the environment for the elderly, including (i) design for all, (ii) universal design, and (iii) inclusive design. Furthermore, this review highlights the aspects of sustainability and the peculiarities of the aging population that should be taken into account in the design and management of their living environment. Key points related to sustainable aging are highlighted, and the possibility of complementing the existing design concepts with the concept of biophilic design is proposed in order to strengthen their social, psychological, and ecological aspects.

2020-03-01Journal article

Open access

Determining the association between genomic instability and prevalence of frailty syndrome in Portuguese older adults

Publication . Costa, Solange; Gomes, Armanda Teixeira; Lage, Bruna; Esteves, Filipa; Loureiro, A.; Valdiglesias, Vanessa; Laffon, Blanca; Teixeira, João

The aim of the present study was to investigate the association between genomic instability, via DNA damage and oxidative DNA damage, and the prevalence frailty syndrome in a group of older adults community-dwellers (≥ 65 years old).

2020-09Conference object

Restricted access

Exploring the potential relation between immune biomarkers and frailty syndrome in older adults: preliminary results from the BioFrail study

Publication . teixeira-gomes, Armanda; Costa, Solange; lage, Bruna; Fuchs, Dietmar; Valdiglesias, Vanessa; Laffon, Blanca; Teixeira, João Paulo

Objectives: On this basis, the main objective of the present work was to evaluate the possible association between immunological: biomarkers and the frailty status in a group of community dwellers.

2020-03Conference object

Open access