RU2617313C1 - Method for biological age determination for men - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: clinical and functional indices are measured: hearing acuity, accommodation, vital capacity, arterial systolic, diastolic and pulse pressure, arterial systolic, diastolic and pulse pressure, statistical balancing on one leg, symbol-to-digital Wechsler attention test, body weight, subjective health assessment, Q-T electrocardiographic interval. Regression analysis is performed based on "derivative indicators". The biological age is calculated by the stated formula.

EFFECT: method allows to accurately determine the biological age, to estimate the rate of aging due to comprehensive assessment of the most significant indicators.

6 ex

Description

The invention relates to medicine, namely to functional diagnostics and geriatrics, and can be used to assess the rate of aging of a person and the presence of severity of senile asthenia.

It is known that calendar age (KB), as a natural measure of aging, often does not coincide with the biological age (BV), which objectively reflects the functional capabilities of the body.

There are various ways to establish the biological age of a person, based on determining the severity of metabolic, structural and functional changes.

A known method for determining the biological age of a person (Abramovich S.G. Method for determining the biological age and rate of aging of a person / S.G. Abramovich, I.M. Mikhalevich, A.V. Shcherbakova, N.A. Kholmogorov, E.M. Larionova , E.O. Korovina, E.V. Barkhatova // Clinical Medicine No. 9, 2008, pp. 54-56; (Patent RU No. 2294692, IPC 5/107, 5/02, 5/08, 5/01, 5/16, 10/00, published March 10, 2007 Bull. No. 7), based on the use of indicators such as skin and hair aging coefficient, eye age, dental index, and waist size.The calculation of BV is carried out according to the following formulas (set equations Twain linear regression):

_Men BV = 14.074 + 2.306 ⋅ KSKV + 0.154 ⋅ VG + 0.618 ⋅ IMT + 0.2 ⋅ ADS + 3.621 В PVChPS-0.086 ⋅ ZI-0.019 ⋅ PFM-0.147 ⋅ IRS,

where KSKV - coefficient of aging of the skin and hair, score;

VG - eye age, cm;

BMI - body mass index, kg / m ² ;

ADS - systolic blood pressure, mm Hg;

PVChPS - the threshold of taste sensitivity to table salt,%;

ZI - dental index,%;

PFM - pink flowmetry, l / min;

IRS - index of the work of the heart, rel.

These digital indicators are constants of the regression equation.

However, the use of indicators that are not used in ordinary practice, such as skin aging coefficient, eye age, dental index, and taste threshold for table salt, severely limits the use of this method. Also noteworthy is the use by the authors of such an indicator as proper bio-age (DBA), with which (and not with the calendar age), the authors further compare the calculated BV of the patient. Refusal to compare with the calendar age may be a reason for doubt in the high statistical results indicated by the authors.

A classic is a method for determining BV, including measuring clinical and functional health indicators, conducting a regression analysis and establishing the biological age for men and women using the formulas (Methodological recommendations “Using the methodology for determining the biological age of a person in prenosological diagnosis”, Ministry of Health of the Ukrainian SSR, Kiev, 1990 ., p. 3-8, first option).

This method is based on the determination of age-dependent indicators characterizing the functional state of the cardiovascular, nervous and respiratory systems; indicators of body weight, the subject’s ability to maintain balance and questionnaire data, in which the subject subjectively characterizes the state of his own health. The determination of BV for men is carried out according to the following formula (multiple linear regression equation):

BV of _men = 58.873 + 0.180 ⋅ ADS-0.073 ⋅ ADD-0.141 Д ADP-0.262 ⋅ Se + 0.546 ⋅ Sm1-0.001 ЕЛ VEL + 0.005 ⋅ Zd-1.881 1,8 A + 0.189 ⋅ O-0.026 ⋅ SB-0.107 ⋅ MT + 0 32⋅COZ-0.327TV,

Where BV _men - the biological age of men, (year);

ADS - systolic blood pressure, mm Hg;

ADD - diastolic blood pressure, mm Hg;

ADP - arterial pulse pressure, (ADP = ADS-ADD), mm Hg;

Се - pulse wave propagation speed through the elastic type arteries in the section of the carotid artery - femoral artery, m / s;

Cm ₁ - the propagation velocity of the pulse wave of the muscle type in the section of the carotid artery - radial artery, m / s;

JELL - vital lung capacity, ml;

ZDvyd - breath holding time on exhalation, s;

A - accommodation, diopters;

OS - hearing acuity, dB;

SB - static balancing on the left leg, s;

MT - body weight, kg;

POPs - subjective assessment of health, score;

TV - a symbol-digital test of Wexler, score.

This method is used in the clinic, but its disadvantages include a low coefficient of determination - 0.63 (or 0.78 correlation with the calendar age), which is insufficient accuracy in determining the biological age.

The objective of the invention is the development of an objective and affordable way to determine the biological age in men based on indicators used in the clinic.

The technical result of the proposed method is to increase the accuracy of determining the biological age of patients, which allows to determine the health status of patients, the presence and severity of their pathology, their likely life expectancy and evaluate the effectiveness of treatment of existing pathologies.

The technical result is achieved by the fact that the method for determining the biological age in men is carried out by measuring the clinical and functional health indicators: hearing acuity; accommodation; lung capacity arterial systolic and diastolic pressure, arterial pulse pressure as the difference between them; statistical balancing on the left leg; Wexler’s digital test for attention; body weight and subjective health assessment; additional measurement of the electrocardiographic interval Q-T, then perform a regression analysis based on "derived indicators", and the calculation of biological age is carried out according to the following formula:

BV _(men) = 59.618948 + 0.757013⋅OC⋅QT-0.000017⋅А⋅ЖЕЛ-0.01013232АДП / СБ-0.004649⋅ОС⋅СБ-0.006269⋅ТВ⋅СОЗ-0 , 001478 ⋅ YEL / QT-0.145022 ⋅ A / QT + 0.063113 ⋅ ADP / QT + 2.150934 ⋅ A / SB + 0.000058 ⋅ YEL ⋅ SB-0.004890 ⋅ SB ⋅ ADP-0.001936 ⋅ОС ² + 14.663394 ⋅ОС / АДД-100,9615⋅А / АДД-90,670651⋅МТ / ЖЕЛ + 0,001568⋅ ЖЕЛ / ОС,

where BV _(men) is the biological age of men;

OS - hearing acuity, dB;

QT - electrocardiographic interval Q - T, s;

A - accommodation, diopters;

JELL - vital lung capacity, ml;

ADS - arterial systolic pressure, mm RT. st .;

ADD - arterial diastolic pressure, mm RT. st .;

ADP - arterial pulse pressure (ADD = ADS-ADD), mm RT. st .;

SB - statistical balancing on the left leg, s;

TV - a symbol-digital test of Wexler's attention, score;

POPs - subjective assessment of health, score;

MT - body weight, kg.

From an analysis of the scientific, technical and patent literature of the claimed combination of features using "derived indicators", leading to high accuracy in determining the biological age and allowing to assess the health status of patients, the presence and severity of their pathology, their likely life expectancy, and the effectiveness of the treatment of existing pathologies , we have not revealed that meets the criteria of the invention of "novelty" and "inventive step".

The method is simple, does not require expensive equipment, is accessible and can be used in the practice of gerontological centers, hospitals for war veterans, rehabilitation departments of the sanatorium-resort profile for geriatric patients, as well as in ordinary medical and preventive institutions to determine the degree of recovery of patients. Therefore, this method meets the criteria of the invention of "industrial applicability".

The essence of the invention is to use in the calculation of the multiple regression equation "derived indicators", which are the result of dividing or multiplying pairwise individual clinical and functional indicators of the patient. "Derived indicators" have a greater correlation with calendar age (KB) than the initial indicators of the patient.

The coefficients used in the multiple linear regression equation are obtained experimentally based on the above indicators of 2367 males with a calendar age of 18 to 91 years.

The proposed method is as follows. To determine the BV in patients, the following health indicators were taken into account (taking into account the equipment that was used):

1. Arterial systolic pressure (ADS) and diastolic pressure (ADD) were measured using a semi-automatic blood pressure monitor firm AND (Japan) in mm Hg on the right hand in a sitting position, three times, with an interval of 5 minutes. Take into account the results of the measurement at which the blood pressure was the lowest. Arterial pulse pressure (ADP) was calculated as the difference between blood pressure and blood pressure.

2. Vital lung capacity (VC) was measured in ml while sitting on an open type spirograph SPIRO 2-25 (TU 64-1-94-79) three times with an interval of 3-5 minutes no earlier than 2 hours after eating. The largest of the three results was taken into account.

3. The mass of the body (MT) in light clothing, without shoes, on an empty stomach was determined in kg using a medical balance RP-150 MG (PO Pribor-detal, Orekhovo-Zuevo).

4. Accommodation (A) was determined in diopters for the leading eye by finding the nearest point of clear vision when reading the font from the Sivtsev tables under conditions of correction of ametropia.

5. Hearing acuity (OS) was measured in decibels at a sound frequency of 4000 Hz on a Starkey SA-10 audiometer (AMBCO)

6. Static balancing (SB) was determined in seconds when the test subject was standing on his left leg, without shoes, with his eyes closed, hands down along the torso, without prior training. The duration of SB was measured using a stopwatch three times with an interval of 5 minutes. Take into account the greatest result.

7. The electrocardiographic interval Q - T was recorded on a 2-channel ELKAR-2 electrocardiograph. Results were recorded in seconds.

8. The Wexler Digital Symbol Test (TV) was performed using a standard protocol form. The number of correctly filled cells was counted over 90 seconds.

9. A subjective health assessment (POP) was carried out using a questionnaire that included 29 questions: 1) Do you have headaches? 2) Can you say that you easily wake up from any noise? 3) Do heart pains bother you? 4) Do you think your vision has deteriorated in recent years? 5) Do you think your hearing has deteriorated in recent years? 6) Do you try to drink only boiled water? 7) Are you younger in age on the bus, tram, trolley bus? 8) Do you feel pain in the joints? 9) Do you visit the beach? 10) Does a change in the weather affect your well-being? 11) Are there times when you lose sleep due to unrest? 12) Do constipation bother you? 13) Do you think that now they are as efficient as before? 14) Do you have pain in the liver area? 15) Do you have dizziness? 16) Do you think that it has become more difficult for you to concentrate now than in past years? 17) Do you feel weakened by memory, forgetfulness? 18) Do you feel burning, tingling, “crawling creeps” in various parts of the body? 19) Do you have such periods when you feel joyfully excited, happy? 20) Does the noise or ringing in your ears bother you? 21) Do you keep one of the following medicines in your home medicine cabinet: validol, nitroglycerin, heart drops? 22) Do you have swelling on your legs? 23) Do you have to give up some dishes? 24) Do you have shortness of breath when walking fast? 25) Do you have pain in the lower back? 26) Do you have to use any mineral water for medicinal purposes? 27) Does your mouth taste bad taste? 28) Can you say that you began to cry easily? 29) How do you assess your health condition: good, satisfactory, bad, very bad? For the first 28 questions, the possible answers are “Yes” or “No”. The answers “Yes” to questions No. 1-8, 10-12, 14-18, 20-28 and answers “No” to questions No. 9, 13, 19 were considered unfavorable and the following possible answers were placed on question No. 29 : "good", "satisfactory", "bad" and "very bad". After filling out the questionnaire, the total number of unfavorable answers was calculated (it could vary from 0 to 29).

The proposed method for determining the biological age of a person is illustrated by examples of specific performance for healthy patients, patients with polymorbid pathology and patients with accelerated aging of different age males.

Example 1. Patient A., husband., 42 years old. Almost healthy. Surveyed by the proposed method.

Revealed:

Acuity of hearing (OS) - 20 dB;

Electrocardiographic interval Q - T (QT) - 0.41 s .;

Visual acuity, accommodation (A) - 8.33333 diopters;

Vital lung capacity (VC) - 3760 ml,

Arterial diastolic pressure (ADD) - 93 mm Hg;

Arterial systolic pressure (ADS) - 139 mmHg

Arterial pulse pressure (ADP = ADS-ADD) - 46 mm Hg;

Static balancing (SB) - 9 s;

Veksler Alphanumeric Test (TV) - 43 points;

Subjective Health Assessment (POPs) - 20 points;

Body weight (MT) - 107 kg.

We calculate the biological age according to the claimed formula, we get 42.57 years. Thus, for a given patient of middle age, relatively healthy, there is practically no difference between calendar age and biological age.

Example 2. Patient D., husband., 76 years. Almost healthy. Surveyed by the proposed method.

Revealed:

Acuity of hearing (OS) - 85 dB;

Electrocardiographic interval Q - T (QT) - 0.36 s;

Visual acuity, accommodation (A) - 4 diopters;

Vital lung capacity (VC) - 3820 ml;

Arterial systolic pressure (ADS) - 109 mm Hg

Arterial diastolic pressure (ADD) - 76 mm Hg;

Arterial pulse pressure (ADP) - 33 mm Hg;

Static balancing (SB) - 1 s;

Symbol-digital test of Wexler (TV) - 43 points;

Subjective Health Assessment (POPs) - 19 points;

Body weight (MT) - 59 kg.

We calculate the biological age according to the formula, we get 69.58 years, which is 6.5 years less than the calendar age.

Example 3. Patient S., husband., 41 years. He was examined before being discharged from the Hospital of war veterans. Surveyed by the proposed method.

Revealed:

Acuity of hearing (OS) - 35 dB;

Electrocardiographic interval Q - T (QT) - 0.36 s;

Visual acuity, accommodation (A) - 5.1 diopters;

Vital capacity of the lungs (VC) - 3700 ml,

Arterial systolic pressure (ADD) - 152 mm Hg;

Arterial diastolic pressure (ADD) - 98 mm Hg;

Pulse blood pressure (ADP) - 54 mm Hg;

Static balancing (SB) - 5 s;

Symbol-digital test of Wexler (TV) - 73 points;

Subjective Health Assessment (POPs) - 13 points;

Body weight (MT) - 95 kg.

We calculate the biological age according to the formula, we get 51.58 years, which is 10.58 years more than its calendar age. Thus, the patient’s bio-age significantly (by 25%) exceeds his calendar age, which is explained by the disease just transferred.

Example 4. Patient B., husband., 67 years old, was also examined before being discharged from the Hospital of war veterans. Surveyed by the proposed method.

Revealed:

Acuity of hearing (OS) - 45 dB;

The electrocardiographic interval Q - T (QT) - 0.42 s;

Visual acuity, accommodation (A) - 3.45 diopters;

Vital lung capacity (VC) - 1560 ml;

Arterial systolic pressure (ADD) - 100 mm Hg;

Arterial diastolic pressure (ADD) - 70 mm Hg;

Arterial pulse pressure (ADP) - 30 mm Hg;

Static balancing (SB) - 1 s;

Symbol-digital test of Wexler (TV) - 17 points;

Subjective Health Assessment (POPs) - 19 points;

Body weight (MT) - 59.5 kg.

We calculate the biological age using the formula, we get 73.6 years, which is 6.6 years (almost 10%) more than its calendar age.

From the above examples 1-4 shows that the biological age in elderly patients is usually slightly lower than the calendar. However, after the disease, he exceeds the calendar age, which can be used in the clinic to increase the reliability of forecasting.

Finally, consider a couple of examples of accelerated aging.

Example 5. Patient Sk., Male, 47 years old. He was examined before being discharged from the Hospital of war veterans. Surveyed by the proposed method.

Revealed:

Acuity of hearing (OS) - 55 dB;

Electrographic interval Q-T (QT) - 0.32 s;

Visual acuity, accommodation (A) - 3.33 diopters;

Vital lung capacity (VC) - 27.00 ml;

Arterial systolic pressure (ADD) - 122 mm Hg;

Arterial diastolic pressure (ADD) - 77 mm Hg;

Arterial pulse pressure (ADD) - 45 mm Hg;

Static balancing (SB) - 8 s;

Wexler's Digital Symbol Test (TV) - 40 points;

Subjective Health Assessment (POPs) - 17 points;

Body weight (MT) - 80 kg.

We calculate the biological age by the formula, we get 59.35 years, which is 12.35 years (26%) more than the calendar age. Within a year, the patient died.

Example 6. Patient Bn., Husband., 70 years. He was examined before being discharged from the Hospital of war veterans. Surveyed by the proposed method.

Revealed:

Acuity of hearing (OS) - 90 dB;

Electrocardiographic interval Q - T (QT) - 0.38 s;

Visual acuity, accommodation (A) - 2.7 diopters;

Vital lung capacity (VC) - 2840 ml,

Arterial systolic pressure (ADD) - 160 mm Hg;

Arterial diastolic pressure (ADD) - 100 mm Hg;

Arterial pulse pressure (ADP) - 60 mm Hg;

Static balancing (SB) - 2 s;

Symbol-digital eats Wexler (TV) - 17 points;

Subjective Health Assessment (POPs) - 19 points;

Body weight (MT) - 80 kg.

We calculate the biological age by the formula, we get 75 years, which is 5 years (7.17%) more than the calendar age. Within a year, the patient died.

Clinical testing of the proposed method was carried out on the basis of the Hospital of war veterans, on patients and healthy people living in the Sverdlovsk region. In total, the study used data from 2367 men aged 18 to 91 years.

1) In comparison with the method of the prototype, this method showed higher accuracy in determining the biological age and, as a result, higher accuracy in assessing the rate of aging of a person. So, the accuracy (correlation of the calculated biological age with the calendar age of the patient) of our method was 0.87 for men, while the prototype method was 0.78.

2) Biological age, when compared with calendar age, allows you to assess the rate of aging of a person and, accordingly, his state of health. The biological age in the prototype was determined only in healthy people, while in the claimed method, the biological age was determined in both 287 healthy men and 2080 patients with various polymorbid pathologies. In our studies, the BV in patients on average exceeded the BV of the corresponding healthy age group. The difference in BV between healthy and sick men was 15% in young people (P <0.01) with an average age of 39 years and 12% in old ones (P <0.01) with an average age of 74 years.

A group of patients with polymorbid pathology was made up of patients who were hospitalized in the Sverdlovsk Regional Clinical Psychoneurological Hospital of war veterans. In these patients, mainly cardiovascular, oncological and other types of chronic pathology predominated. In the group with polymorbid pathology, patients were recruited without a pronounced mental pathology, without pronounced impaired motor functions (in particular, walking) and without impaired consciousness. The criterion for exclusion of patients from the study was the presence of all types of acute pathologies, injuries, amputations, strokes, tick-borne encephalitis and other conditions that do not allow them to assess biological age by the claimed method.

3) Biological age with polymorbid pathology before and after treatment was determined in 391 patients (men). A significant decrease in bio-age was observed by 3.1% (P <0.001) as a result of treatment.

4) Thus, the inventive method allows to evaluate the improvement in the health status of patients in the treatment of polymorbid pathology. This is especially important, given that patients with polymorbid (chronic) pathologies may not fully recover, and it is necessary to evaluate the improvement in health status.

5) In our studies, there is a group of patients with a known life expectancy (IPI). We divided them into two groups by age: young, with an average life expectancy of 39 years, and old, with an average life expectancy of 74 years. In the group of old people with IPI, bio-age exceeded the norm (indicators of healthy people of the same age) by 17.1% (p <0.001), and in the group of young people with IPI who died prematurely due to their illness, bio-age exceeded the norm by 54 , 7% (p <0.001). In other studied groups of patients, such strong deviations of bio-age from the norm (BV in healthy people of the same age) were not observed (maximum 15% in patients). Thus, biological age can be used to estimate probable life expectancy (the greater the excess of biological age, the lower the expected life expectancy). The prototype did not use data on people with a known life expectancy.

Our method allows you to identify individuals with an accelerated rate of aging and to individualize therapeutic measures in such a contingent of patients to predict their results, monitor effectiveness and dynamic observation.

Claims (14)

A method for determining the biological age in men, including the measurement of clinical and functional health indicators: hearing acuity, accommodation, lung capacity, arterial systolic, diastolic and pulse pressure, statistical balancing on the left leg, Wexler’s digital test for attention, body weight and subjective health assessment; conducting a regression analysis and calculating the biological age according to the formula, characterized in that they additionally measure the electrocardiographic interval Q-T, regression analysis is carried out on the basis of "derived indicators", and the calculation of biological age is performed according to the following formula: BV _(men) = 59.618948 + 0.757013 · OC⋅QT-0.000017 · A · ZHEL-0.010532 · ADP / SB-0.004649 · OS · SB-0.006269 · TV · POP-0 , 001478 · VC / QT-0.145022 · A / QT + 0.063113 · ADP / QT + 2.150934 · A / SB + 0.000058 · VEL · SB-0.004890 · SB · ADP-0.001936 · OS ² + 14.663394 · OS / ADD-100.9615 · A / ADD-90.670651 · MT / VEL + 0.001568 · VEL / OS, where BV _(men) is the biological age of men; OS - hearing acuity, dB; QT - electrocardiographic interval Q - T, s; A - accommodation, diopters; JELL - vital lung capacity, ml; ADS - arterial systolic pressure, mm RT. st .; ADD - arterial diastolic pressure, mm RT. st .; ADP - arterial pulse pressure (ADP = ADS-ADD), mm RT. st .; SB - statistical balancing on the left leg, s;             TV - a symbol-digital test of Wexler's attention, score; POPs - subjective assessment of health, score; MT - body weight, kg.