RU2617801C1 - Method for biological age determination for women - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: clinical and functional indices are measured: hearing acuity, vital capacity, accommodation, subjective health assessment, time of statistical balancing on one leg, arterial systolic, diastolic and pulse pressure, expiratory breath hold, body weight, R-R 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 and woman's health due to comprehensive assessment of the most significant indicators.

4 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 volume.The calculation of BV is carried out according to the following formulas ( equations stvennoj linear regression):

_Women BV = 18.409 + 2.447 ⋅ KSKV + 0.272 ⋅ VG + 0.234 Т OT + 0.251 ⋅ ADS + 0.018 В PV-0.094 ⋅ ZI-0.159 ⋅ IRS-0.237 ⋅ ADD-0.895 ⋅

respectively, where:

KSKV - coefficient of aging of skin and hair, points;

VG - eye age, cm;

OT - waist circumference, cm;

ADS - systolic blood pressure, mm Hg;

PV - an indicator of attention for the Bourdon test,%;

ZI - dental index,%;

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

ADD - diastolic blood pressure, mm Hg;

CT - coefficient of thermoregulation,%.

These digital indicators are constants of the regression equation.

However, the use of indicators that are not used in normal practice, such as skin aging, eye age, dental index, and thermoregulation coefficient, severely limits the use of this method. It is also noteworthy that the authors use such an indicator as proper bio-age (DBA), with which (and not with calendar age), the authors further compare the calculated patient BV. 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 according to the formulas “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, the first option). We consider it as a prototype.

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 women is carried out according to the following formula (multiple linear regression equation):

BV _zheshtsin = 16.271 + 0.280 ⋅ ADS-0.193 ⋅ ADD-0.105 ⋅ ADP-0.125 ⋅ Se + 1.202 ⋅ Sm1-0.003 ЕЛ ZHEL + 0.065 Д Zdvid-0.621 ⋅ A + 0.277 ⋅ O-0.070 ⋅ SB + 0.207 ⋅ MT + 0.039 ⋅COZ-0.152⋅TV,

where: BV _women - the biological age of women (year);

ADS - systolic blood pressure (mmHg);

ADD - diastolic blood pressure (mmHg);

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 (in m / s);

JELL - vital lung capacity (in ml);

ZDvyd - breath holding time on exhalation (sec);

A - accommodation (in diopters);

OS - acuity of hearing (in decibels);

SB - static balancing on the left leg (sec);

MT - body weight (kg);

POPs - subjective assessment of health (in points);

TV - a symbol-digital test of Wexler (in points).

This method is used in the clinic, but its disadvantages include a low coefficient of determination - 0.58 (or 0.76 correlation with the calendar age), which is insufficient accuracy in determining the biological age.

The task of the invention is the development of an objective and affordable method for determining the biological age of women based on indicators used in the clinic.

The technical result of the proposed solution 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 in that in a method for determining the biological age of women, including measuring clinical and functional health indicators: hearing acuity, lung capacity, accommodation, subjective health assessment, statistical balancing time on one leg, arterial systolic, diastolic and pulse pressure, breath holding on exhalation, body weight; conducting a regression analysis and calculating the biological age according to the formula, additionally measure the electrocardiographic interval R-R, regression analysis is carried out on the basis of "derived indicators", and the calculation of biological age is carried out according to the following formula:

BV _(women) = 61.227398-335.370632⋅ОС / ЖЕЛ + 0.000132⋅ЖЕЛ⋅А-0.015122⋅СОЗ⋅СБ-0.004449 ЖЕЛ / ОС + 0.007565АДП⋅R-R + 0.258682⋅ЗДдд / СБ + 18.610504⋅ОС / МТ-40.050124⋅МТ / ЖЕЛ-278.162339⋅А / АДС + 1.248208⋅А⋅RR-0.45265⋅ОС⋅R-R + 32.648747⋅OS / ADD + 0.035463⋅A⋅OS-0.00285⋅YEL / R-R + 130.131371⋅ADS / YEL-66.673514⋅A / MT,

Where:

BV _(women ) - the biological age of women;

OS - hearing acuity, dB (decibel);

JELL - vital lung capacity, ml;

A - accommodation, diopters;

POPs - subjective assessment of health, score;

SB - statistical balancing on the left leg, sec;

ADS - arterial systolic pressure, mm RT. pillar;

ADD - arterial diastolic pressure, mm RT. pillar;

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

R-R - electrocardiographic interval R-R, sec;

ZDvyd - breath holding on exhalation, in s;

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, as well as the effectiveness of treatment of existing pathologies, we have not identified 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 (CV) than the initial indicators of the patient.

The coefficients used in the multiple linear regression equation are obtained experimentally on the basis of the above indicators of 1901 women with a calendar age of 20 to 91 years.

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

1. Blood pressure systolic (ADS) and diastolic (ADD), was 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 using 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 R-R was recorded on a 2-channel ELKAR-2 electrocardiograph. Results were recorded in seconds.

8. The duration of the breath-holding after deep exhalation (HW) was measured using a stopwatch in seconds three times with an interval of 5 minutes. Take into account the largest values of ZVyd.

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 NN 1-8, 10-12, 14-18, 20-28 and answers “No” to questions NN 9, 13, 19 were considered unfavorable and the following possible answers were placed to 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 of different ages of the female sex and female patients with polymorbid pathology.

Example 1. Patient N., 54 years old. Almost healthy. Surveyed by the proposed method. Revealed:

Acuity of hearing (OS) - 25 dB;

Electrographic interval R-R (R-R) - 0.8763 s;

Visual acuity, accommodation (A) - 2 diopters;

Vital lung capacity (VC) - 2660.42 ml,

Diastolic blood pressure (ADD) - 76 mmHg;

Systolic blood pressure (ADS) - 118 mmHg;

Pulse blood pressure (ADP) - 42 mmHg;

Holding the breath on the exhale (ZDvyd) - 28 in s;

Static balancing (SB) - 5 s;

Subjective Health Assessment (POPs) - 14 points;

Body weight (MT) - 85 kg.

We calculate the biological age according to the formula, we get 58, 78 years, which is 4, 78 years more than the real calendar age.

Example 2. Patient L., 67 years old. Almost healthy. Surveyed by the proposed method. Revealed:

Acuity of hearing (OS) - 10 dB;

Electrographic interval R-R (R-R) - 1.2 s;

Visual acuity, accommodation (A) - 1 diopter;

Vital lung capacity (VC) - 2440 ml,

Diastolic blood pressure (ADD) - 75 mmHg;

Systolic blood pressure (ADS) - 135 mmHg;

Pulse blood pressure (ADP) - 60 mmHg;

The breath holding on an exhalation (ZDvyd) - 65 in with;

Static balancing (SB) - 18 s;

Subjective Health Assessment (POPs) - 12 points;

Body weight (MT) - 50 kg.

We calculate bio-age by the formula, we get 58.99 years, which is 8.01 years less than the calendar age.

Example 3. Patient A., 24 years old. She was examined before being discharged from the Hospital of war veterans. Surveyed by the proposed method. Revealed:

Acuity of hearing (OS) - 5 dB;

Electrographic interval R-R (R-R) - 0.8044 s;

Visual acuity, accommodation (Acc) - 7.14 diopters;

Vital lung capacity (VC) - 3190 ml,

Diastolic blood pressure (ADD) - 63 mmHg;

Systolic blood pressure (ADS) - 87 mmHg;

Pulse blood pressure (ADP) - 24 mmHg;

Holding the breath on the exhale (ZDvyd) - 22 s;

Static balancing (SB) - 10 s;

Subjective Health Assessment (POPs) - 15 points;

Body weight (MT) - 60 kg.

We calculate bio-age according to the formula, we get 30.8 years, which is 6.8 years (28%!) More than the calendar. As we see, the disease affects women in the direction of a significant increase in biological age.

Example 4. Patient M., 70 years old. She 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 R-R (R-R) - 0.93 s;

Visual acuity, accommodation (A) - 1 diopter;

Vital lung capacity (VC) - 1240 ml,

Diastolic blood pressure (ADD) - 70 mmHg;

Systolic blood pressure (ADS) - 115 mmHg;

Pulse blood pressure (ADP) - 45 mmHg;

Holding the breath on the exhale (ZDvyd) - 16 s;

Static balancing (SB) - 8 s;

Subjective Health Assessment (POPs) - 19 points;

Body weight (MT) - 52.5 kg.

We calculate the biological age according to the formula, we get 72.94 years, which is 2.94 years (4.2%) more than the calendar.

As you can see, the biological age in elderly patients is somewhat lower than the calendar, and after the disease, it is still higher than the calendar age, which can be used in the clinic to increase the reliability of prediction. After all, a formally recovered patient leaves the clinic with an increase in biological age.

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 1901 women aged 20 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 the method we proposed for women was 0.86, while that of the prototype method was 0.76.

2) Biological age, when compared with the calendar age, makes it possible 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 both in 883 healthy women and in 1018 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 women was 24% in young people (P <0.001) with an average age of 30 years, and 18% in old women (P <0.001) with an average age of 70 years. The group of patients with polymorbid pathology was composed 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 evaluate biological age according to our methods.

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

In our proposed method, the regression analysis formulas included 11 indicators for women, which, firstly, can easily be determined in the clinic, and secondly, the most versatile characterize the aging process of a person.

Claims (14)

A method for determining the biological age in women, including the measurement of clinical and functional health indicators: hearing acuity, lung vital capacity, accommodation, subjective health assessment, time of statistical balancing on one leg, arterial systolic, diastolic and pulse pressure, breath holding on exhalation, body weight ; conducting a regression analysis and calculating the biological age according to the formula, characterized in that the electrocardiographic interval R-R is additionally measured, a regression analysis is carried out on the basis of “derived indicators”, and biological age is calculated according to the following formula

where BV _(women) is the biological age of women; OS - hearing acuity, dB (decibel); JELL - vital lung capacity, ml; A - accommodation, diopters; POPs - subjective assessment of health, score; SB - statistical balancing on the left leg, sec; ADS - arterial systolic pressure, mm Hg; ADD - arterial diastolic pressure, mmHg;             ADP - arterial pulse pressure (ADP = ADS - ADD), mm Hg; R-R - electrocardiographic interval R-R, sec; ZDvyd - breath holding on exhalation, sec; MT - body weight, kg.