Michelle C. Odden

The identification of protein targets that exhibit anti‐aging clinical potential could inform interventions to lengthen the human health span. Most previous proteomics research has been focused on chronological age instead of longevity. We leveraged two large population‐based prospective cohorts with long follow‐ups to evaluate the proteomic signature of longevity defined by survival to 90 years of age. Plasma proteomics was measured using a SOMAscan assay in 3067 participants from the Cardiovascular Health Study (discovery cohort) and 4690 participants from the Age Gene/Environment Susceptibility‐Reykjavik Study (replication cohort). Logistic regression identified 211 significant proteins in the CHS cohort using a Bonferroni‐adjusted threshold, of which 168 were available in the replication cohort and 105 were replicated (corrected p value <0.05). The most significant proteins were GDF‐15 and N‐terminal pro‐BNP in both cohorts. A parsimonious protein‐based prediction model was built using 33 proteins selected by LASSO with 10‐fold cross‐validation and validated using 27 available proteins in the validation cohort. This protein model outperformed a basic model using traditional factors (demographics, height, weight, and smoking) by improving the AUC from 0.658 to 0.748 in the discovery cohort and from 0.755 to 0.802 in the validation cohort. We also found that the associations of 169 out of 211 proteins were partially mediated by physical and/or cognitive function. These findings could contribute to the identification of biomarkers and pathways of aging and potential therapeutic targets to delay aging and age‐related diseases.

Background Inadequate treatment of high blood pressure (BP) can lead to preventable adverse events in nursing home residents, while excessive treatment can lead to associated harms. Methods Data were extracted from the VA electronic health record and Bar Code Medication Administration system on 40,079 long‐term care residents aged ≥65 years from October 2006 through September 2018 (FY2007‐2018). Hypertension prevalence at admission was identified by ICD code(s) in the year prior, and antihypertensive medication use was defined as administration ≥50% of days. BP measures were averaged over 2‐year epochs. Results The age‐standardized prevalence of hypertension diagnosis at admission increased from 75.2% in FY2007‐2008 to 85.1% in FY2017‐2018 ( p ‐value for trend <0.001). Rates of BP treatment and control among residents with hypertension at admission declined slightly over time ( p ‐values for trend <0.001) but remained high (80.3% treated in FY2017‐2018, 80.1% with average BP <140/90 mmHg). The age‐adjusted prevalence of chronic low BP (average <90/60 mmHg) also declined from 11.1% in FY2007‐2008 to 4.7% in FY2017‐2018 ( p ‐value for trend <0.001). Persons identified as Black race or Hispanic ethnicity and those with a history of diabetes, stroke, and renal disease were less likely to have an average BP <140/90 mmHg. Conclusions Hypertension is well controlled in VA nursing homes, and recent trends of less intensive BP control were accompanied by a lower prevalence of chronic low BP. Nonetheless, some high‐risk populations have average BP levels >140/90 mmHg. Future research is needed to better understand the benefits and harms of BP control in nursing home residents.