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Aging, frailty and complex networks
Abstract
When people age their mortality rate increases exponentially, following Gompertz's law. Even so, individuals do not die from old age. Instead, they accumulate age-related illnesses and conditions and so become increasingly vulnerable to death from various external and internal stressors. As a measure of such vulnerability, frailty can be quantified using the frailty index (FI). Larger values of the FI are strongly associated with mortality and other adverse health outcomes. This association, and the insensitivity of the FI to the particular health variables that are included in its construction, makes it a powerful, convenient, and increasingly popular integrative health measure. Still, little is known about why the FI works so well. Our group has recently developed a theoretical network model of health deficits to better understand how changes in health are captured by the FI. In our model, health-related variables are represented by the nodes of a complex network. The network has a scale-free shape or "topology": a few nodes have many connections with other nodes, whereas most nodes have few connections. These nodes can be in two states, either damaged or undamaged. Transitions between damaged and non-damaged states are governed by the stochastic environment of individual nodes. Changes in the degree of damage of connected nodes change the local environment and make further damage more likely. Our model shows how age-dependent acceleration of the FI and of mortality emerges…
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Other frameworks include failure models in networks of components.
“Other frameworks include failure models in networks of components65–67.”
From A damage accumulation model identifies distinct aging regimes across species (2026) · cites this paper as [67]
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Gompertz, B. (1825) · Philosophical Transactions of the Royal Society of London · doi:10.1098/rstl.1825.0026 · Cited by 3,816
Accumulation of Deficits as a Proxy Measure of Aging
Mitnitski, A. B., Mogilner, A. J., & Rockwood, K. (2001) · The Scientific World JOURNAL · doi:10.1100/tsw.2001.58 · Cited by 2,893 · cited 6×
“The FI increases characteristically with age with an upwards curvature, indicating an accelerating rate of the accumulation of deficits with age (Mitnitski et al. 2001; Kulminski et al. 2007) with a cross-sectional exponential rate of 0.”
BackgroundInfluentialSelf-citationValidity and reliability of the Edmonton Frail Scale
Rolfson, D. B., Majumdar, S. R., Tsuyuki, R. T., Tahir, A., & Rockwood, K. (2006) · Age and Ageing · doi:10.1093/ageing/afl041 · Cited by 1,643 · cited 2×
“Other scales include neuro-physiological characteristics (Rolfson et al. 2006) or psychometric measurements (Gobbens et al. 2010).”
BackgroundSelf-citationTheou, O., Brothers, T. D., Mitnitski, A., & Rockwood, K. (2013) · Journal of the American Geriatrics Society · doi:10.1111/jgs.12420 · Cited by 665 · cited 5×
“Other frailty measures can also be considered as special cases of the FI (Theou et al. 2013a) and often are specialized.”
BackgroundInfluentialSelf-citationParcellating cortical functional networks in individuals
Wang, D., Buckner, R. L., Fox, M. D., Holt, D. J., Holmes, A. J., Stoecklein, S., Langs, G., Pan, R., Qian, T., Li, K., et al. (2015) · Nature Neuroscience · doi:10.1038/nn.4164 · Cited by 527
Comparison of alternate scoring of variables on the performance of the frailty index
Peña, F. G., Theou, O., Wallace, L., Brothers, T. D., Gill, T. M., Gahbauer, E. A., Kirkland, S., Mitnitski, A., & Rockwood, K. (2014) · BMC Geriatrics · doi:10.1186/1471-2318-14-25 · Cited by 96
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Research works printed but not linked: 74
- Arbeev KG, Ukraintseva SV, Akushevich I, Kulminski AM, Arbeeva LS, Akushevich L et al (2011) Age trajectories of physiological indices in relation to healthy life course. Mech Ageing Dev 132:93–102 · DOI
- Arias E (2014) United States life tables, 2010. Natl Vital Stat Rep 63:1–63
- Avraam D, de Magalhaes JP, Vasiev B (2013) A mathematical model of mortality dynamics across the lifespan combining heterogeneity and stochastic effects. Exp Gerontol 48:801–811 · DOI
- Barabasi AL, Albert R (1999) Emergence of scaling in random networks. Science 286:509–512 · DOI · Paper page
- Bennett S, Song X, Mitnitski A, Rockwood K (2013) A limit to frailty in very old, community-dwelling people: a secondary analysis of the Chinese longitudinal health and longevity study. Age Ageing 42:372–377 · DOI
- Blokh D, Stambler I (2016) The application of information theory for the research of aging and aging-related diseases. Prog Neurobiol. doi: 10.1016/j.pneurobio.2016.03.005 · DOI
- Budovsky A, Abramovich A, Cohen R, Chalifa-Caspi V, Fraifeld V (2007) Longevity network: construction and implications. Mech Ageing Dev 128:117–124 · DOI
- Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K (2013) Frailty in elderly people. Lancet 381:752–762 · DOI · Paper page
- Clegg A, Bates C, Young J, Ryan R, Nichols L, Ann Teale E et al (2016) Development and validation of an electronic frailty index using routine primary care electronic health record data. Age Ageing 45:353–360 · DOI
- Farrell S, Mitnitski AB, Rockwood K, Rutenberg A (2016) Network model of human aging: frailty limits and information measures. Phys Rev E 94:052409 · DOI
- Fried LP, Tangen CM, Walston J et al (2001) Frailty in older adults: evidence for a phenotype. J Gerontol A 56:M146–M156 · DOI · Paper page
- Fulop T, Larbi A, Witkowski JM, McElhaney J, Loeb M, Mitnitski A et al (2010) Aging, frailty and age-related diseases. Biogerontology 11:547–563 · DOI
- Gavrilov LA, Gavrilova NS (2001) The reliability theory of aging and longevity. J Theor Biol 213:527–545 · DOI · Paper page
- Gavrilov LA, Gavrilova NS (2002) Evolutionary theories of aging and longevity. Sci World J 2:339–356 · DOI
- Gavrilov LA, Gavrilova NS (2006) Reliability theory of aging and longevity. In: Masoro EJ, Austad SN (eds) Handbook of the Biology of Aging, 6th edn. Elsevier Academic Press, Cambridge
- Ghiassian SD, Menche J, Chasman DI, Giulianini F, Wang R, Ricchiuto P et al (2016) Endophenotype network models: common core of complex diseases. Sci Rep 6:27414 · DOI
- Gobbens RJ, van Assen MA, Luijkx KG, Wijnen-Sponselee MT, Schols JM (2010) The Tilburg Frailty Indicator: psychometric properties. J Am Med Dir Assoc 11:344–355 · DOI
- Gu D, Dupre ME, Sautter J, Zhu H, Liu Y, Yi Z (2009) Frailty and mortality among Chinese at advanced ages. J Gerontol B 64:279–289 · DOI
- Guaraldi G, Brothers TD, Zona S, Stentarelli C, Carli F, Malagoli A et al (2015) A frailty index predicts survival and incident multimorbidity independent of markers of HIV disease severity. AIDS 29:1633–1641 · DOI
- Hajizadeh M, Mitnitski A, Rockwood K (2016) Socioeconomic gradient in health in Canada: is the gap widening or narrowing? Health Policy 120:1040–1050 · DOI
- Hidalgo CA, Blumm N, Barabási AL, Christakis NA (2009) A dynamic network approach for the study of human phenotypes. PLoS Comput Biol 5:e1000353 · DOI
- Howlett SE, Rockwood MR, Mitnitski A, Rockwood K (2014) Standard laboratory tests to identify older adults at increased risk of death. BMC Med 12:171 · DOI
- Hubbard RE, Peel NM, Smith M, Dawson B, Lambat Z, Bak M et al (2015) Feasibility and construct validity of a Frailty index for patients with chronic kidney disease. Australas J Ageing 34:E9–E12 · DOI
- Kirkwood TB (2015) Deciphering death: a commentary on Gompertz (1825) ‘on the nature of the function expressive of the law of human mortality, and on a new mode of determining the value of life contingencies’. Philos Trans R Soc Lond B 370:20140379 · DOI
- Kowald A, Kirkwood TB (2016) Can aging be programmed? A critical literature review. Aging Cell. 15:986–998 · DOI
- Kulminski A, Ukraintseva SV, Akushevich I, Arbeev KG, Land K, Yashin AI (2007) Accelerated accumulation of health deficits as a characteristic of aging. Exp Gerontol 42:963–970 · DOI
- Kulminski AM, Kernogitski Y, Culminskaya I, Loika Y, Arbeev KG, Bagley O et al (2016) Uncoupling associations of risk alleles with endophenotypes and phenotypes: insights from the ApoB locus and heart-related traits. Aging Cell. 16:61–72 · DOI
- Louwers L, Schnickel G, Rubinfeld I (2016) Use of a simplified frailty index to predict Clavien 4 complications and mortality after hepatectomy: analysis of the National Surgical Quality Improvement Project database. Am J Surg 211:1071–1076 · DOI
- Manton KG, Stallard E, Woodbury MA, Dowd JE (1994) Time-varying covariates in models of human mortality and aging: multidimensional generalizations of the Gompertz. J Gerontol 49:B169–B190 · DOI
- Mercer TR, Gerhardt DJ, Dinger ME, Crawford J, Trapnell C, Jeddeloh JA et al (2011) Targeted RNA sequencing reveals the deep complexity of the human transcriptome. Nat Biotechnol 30:99–104 · DOI
- Milne EM (2008) The natural distribution of survival. J Theor Biol 255:223–236 · DOI
- Mitnitski A, Rockwood K (2015) Aging as a process of deficit accumulation: its utility and origin. Interdiscip Top Gerontol 40:85–98 · DOI · Paper page
- Mitnitski A, Rockwood K (2016) The rate of aging: the rate of deficit accumulation does not change over the adult life span. Biogerontology 17:199–204 · DOI · Paper page
- Mitnitski A, Bao L, Rockwood K (2006) Going from bad to worse: a stochastic model of transitions in deficit accumulation, in relation to mortality. Mech Ageing Dev 127:490–493 · DOI
- Mitnitski A, Song X, Rockwood K (2012) Trajectories of changes over twelve years in the health status of Canadians from late middle age. Exp Gerontol 47:893–899 · DOI
- Mitnitski A, Song X, Rockwood K (2013) Assessing biological aging: the origin of deficit accumulation. Biogerontology 14:709–717 · DOI · Paper page
- Mitnitski A, Collerton J, Martin-Ruiz C, Jagger C, von Zglinicki T, Rockwood K et al (2015) Age-related frailty and its association with biological markers of ageing. BMC Med 13:161 · DOI
- Mitnitski A, Howlett SE, Rockwood K (2016) Heterogeneity of human aging and its assessment. J Gerontol A. doi: 10.1093/gerona/glw089 · DOI
- Moghtadaei M, Jansen HJ, Mackasey M, Rafferty SA, Bogachev O, Sapp JL et al (2016) The impacts of age and frailty on heart rate and sinoatrial node function. J Physiol 594:7105–7126 · DOI
- Pan Q, Shai O, Lee LJ, Frey BJ, Blencowe BJ (2008) Deep surveying of alternative splicing complexity in the human transcriptome by high-throughput sequencing. Nat Genet 40:1413–1415 · DOI · Paper page
- Parks RJ, Fares E, Macdonald JK, Ernst MC, Sinal CJ, Rockwood K et al (2012) A procedure for creating a frailty index based on deficit accumulation in aging mice. J Gerontol A 67:217–227 · DOI
- Promislow DE (2004) Protein networks, pleiotropy and the evolution of senescence. Proc Biol Sci 271:1225–1234 · DOI
- Rattan SI (2013) Healthy ageing, but what is health? Biogerontology 14:673–677 · DOI
- Rockwood K, Mitnitski A (2006) Limits to deficit accumulation in elderly people. Mech Ageing Dev 127:494–496 · DOI
- Rockwood K, Mitnitski A (2007) Frailty in relation to the accumulation of deficits. J Gerontol A 62:722–727 · DOI · Paper page
- Rockwood K, Mogilner A, Mitnitski A (2004) Changes with age in the distribution of a frailty index. Mech Ageing Dev 125:517–519 · DOI
- Rockwood K, Mitnitski A, Song X, Steen B, Skoog I (2006) Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. J Am Geriatr Soc 54:975–979 · DOI · Paper page
- Rockwood K, Andrew M, Mitnitski A (2007) A comparison of two approaches to measuring frailty in elderly people. J Gerontol A 62:738–743 · DOI · Paper page
- Rockwood K, Song X, Mitnitski A (2011) Changes in relative fitness and frailty across the adult lifespan: evidence from the Canadian National Population Health Survey. CMAJ 183:E487–E494 · DOI
- Rockwood MR, MacDonald E, Sutton E, Rockwood K, Baron M, Canadian Scleroderma Research Group (2014) Frailty index to measure health status in people with systemic sclerosis. J Rheumatol 41:698–705 · DOI
- Schoufour JD, Mitnitski A, Rockwood K, Hilgenkamp TI, Evenhuis HM, Echteld MA (2014) Predicting disabilities in daily functioning in older people with intellectual disabilities using a frailty index. Res Dev Disabil 35:2267–2277 · DOI
- Searle SD, Mitnitski A, Gahbauer EA, Gill TM, Rockwood K (2008) A standard procedure for creating a frailty index. BMC Geriatr 8:24 · DOI · Paper page
- Shannon CE (1948) A mathematical theory of communication. Bell Syst Tech J 27:379–423 · DOI · Paper page
- Song X, Mitnitski A, Rockwood K (2014) Age-related deficit accumulation and the risk of late-life dementia. Alzheimers Res Ther 6:54 · DOI
- Steinsaltz D, Mohan G, Kolb M (2012) Markov models of aging: theory and practice. Exp Gerontol 47:792–802 · DOI
- Strehler BL, Mildvan AS (1960) General theory of mortality and aging. Science 132:14–21 · DOI · Paper page
- Tacutu R, Budovsky A, Fraifeld VE (2010) The NetAge database: a compendium of networks for longevity, age-related diseases and associated processes. Biogerontology 11:513–522 · DOI
- Taneja S, Mitnitski AB, Rockwood K, Rutenberg AD (2016) Dynamical network model for age-related health deficits and mortality. Phys Rev E 93:022309 · DOI
- Theou O, Brothers TD, Rockwood MR, Haardt D, Mitnitski A, Rockwood K (2013b) Exploring the relationship between national economic indicators and relative fitness and frailty in middle-aged and older Europeans. Age Ageing 42:614–619 · DOI
- Theou O, Brothers TD, Peña FG, Mitnitski A, Rockwood K (2014) Identifying common characteristics of frailty across seven scales. J Am Geriatr Soc 62:901–906 · DOI · Paper page
- Ukraintseva S, Yashin AI, Arbeev KG (2016) Resilience versus robustness in aging. J Gerontol A 71:1533–1534 · DOI
- Vaupel JW, Manton KG, Stallard E (1979) The impact of heterogeneity in individual frailty on the dynamics of mortality. Demography 16:439–454 · DOI · Paper page
- Vaupel JW, Carey JR, Christensen K, Johnson TE, Yashin AI, Holm NV et al (1998) Biodemographic trajectories of longevity. Science 280:855–860 · DOI · Paper page
- Velanovich V, Antoine H, Swartz A, Peters D, Rubinfeld I (2013) Accumulating deficits model of frailty and postoperative mortality and morbidity: its application to a national database. J Surg Res 183:104–110 · DOI
- Vural DC, Morrison G, Mahadevan L (2014) Aging in complex interdependency networks. Phys Rev E 89:022811 · DOI
- Vural DC, Isakov A, Mahadevan L (2015) The organization and control of an evolving interdependent population. J R Soc Interface 12:20150044 · DOI
- Watts DJ, Strogatz SH (1998) Collective dynamics of ‘small-world’ networks. Nature 393:440–442 · DOI · Paper page
- Whitehead JC, Hildebrand BA, Sun M, Rockwood MR, Rose RA, Rockwood K et al (2014) A clinical frailty index in aging mice: comparisons with frailty index data in humans. J Gerontol A 69:621–632 · DOI
- Wolfson M, Budovsky A, Tacutu R, Fraifeld V (2009) The signaling hubs at the crossroad of longevity and age-related disease networks. Int J Biochem Cell Biol 41:516–520 · DOI
- Yanai H, Budovsky A, Tacutu R, Barzilay T, Abramovich A, Ziesche R et al (2016) Tissue repair genes: the TiRe database and its implication for skin wound healing. Oncotarget 7:21145–21155 · DOI
- Yashin AI, Manton KG, Vaupel JW (1985) Mortality and aging in a heterogeneous population: a stochastic process model with observed and unobserved variables. Theor Popul Biol 27:154–175 · DOI
- Yashin AI, Arbeev KG, Akushevich I, Kulminski A, Ukraintseva SV, Stallard E et al (2012) The quadratic hazard model for analyzing longitudinal data on aging, health, and the life span. Phys Life Rev 9:177–188 · DOI
- Young AC, Glaser K, Spector TD, Steves CJ (2016) The identification of hereditary and environmental determinants of frailty in a cohort of UK twins. Twin Res Hum Genet 19:600–609 · DOI
- Zeng A, Song X, Dong J, Mitnitski A, Liu J, Guo Z et al (2015) Mortality in relation to frailty in patients admitted to a specialized geriatric intensive care unit. J Gerontol A 70:1586–1594 · DOI · Paper page
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A damage accumulation model identifies distinct aging regimes across species
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Metadata
- Authors
- Mitnitski, A. B., Rutenberg, A. D., Farrell, S., & Rockwood, K.
- Venue
- Biogerontology
- Published
- 2017-03-02
- Volume
- 18
- Issue
- 4
- Pages
- 433-446
- ISSN
- 1389-5729
- 1573-6768
- Cited by
- 118
- References
- 6
- Language
- en
- Funders
- Nova Scotia Health Authority Research Fund
- Natural Science and Engineering Research Council of Canada (RGPIN-2014-06245)
- CGSM Fellowship
- Dalhousie Medical Research Foundation (CA)
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