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1.  Inflammation, telomere length and grip strength: a 10 year longitudinal study 
Calcified tissue international  2014;95(1):54-63.
Telomere attrition has been associated with age related diseases although causality is unclear and controversial; low grade systemic inflammation (inflammaging) has also been implicated in age-related pathogenesis. Unpicking the relationship between ageing, telomere length (TL) and inflammaging is hence essential to the understanding of ageing and management of age-related diseases. This longitudinal study explores whether telomere attrition is a cause or consequence of ageing and whether inflammaging explains some of the associations between TL and one marker of ageing, grip strength.
We studied 253 Hertfordshire Ageing Study participants at baseline and 10 year follow up (mean age at baseline 67.1years). Participants completed a health questionnaire and had blood samples collected for immune-endocrine and telomere analysis at both time points. Physical ageing was characterised at follow-up using grip strength (GS).
Faster telomere attrition was associated with lower GS at follow-up (β=0.98, p=0.035). This association was completely attenuated when adjusted for inflammaging burden (p=0.86) over the same period. Similarly, greater inflammaging burden was associated with lower GS at follow-up (e.g. interleukin1β (IL-1β): β=−2.18, p=0.001), however, these associations were maintained when adjusted for telomere attrition (IL-1β, p=0.006).
We present evidence that inflammaging may be driving telomere attrition and in-part explains the associations which have previously been reported between TL and grip strength. Thus biomarkers of physical ageing, such as inflammaging, may require greater exploration. Further work is now indicated.
PMCID: PMC4098723  PMID: 24858709
Telomere; epidemiology; sarcopenia; inflammation; ageing; osteoporosis; grip strength
2.  Immune-endocrine biomarkers as predictors of frailty and mortality: a 10-year longitudinal study in community-dwelling older people 
Age  2012;35(3):963-971.
Frailty is a multidimensional geriatric syndrome characterised by a state of increased vulnerability to disease. Its causes are unclear, limiting opportunities for intervention. Age-related changes to the immune-endocrine axis are implicated. This study investigated the associations between the immune-endocrine axis and frailty as well as mortality 10 years later among men and women aged 65 to 70 years. We studied 254 participants of the Hertfordshire Ageing Study at baseline and 10-year follow-up. At baseline, they completed a health questionnaire and had collection of blood samples for immune-endocrine analysis. At follow-up, Fried frailty was characterised and mortality ascertained. Higher baseline levels of differential white cell counts (WCC), lower levels of dehydroepiandosterone sulphate (DHEAS) and higher cortisol:DHEAS ratio were all significantly associated with increased odds of frailty at 10-year follow-up. Baseline WCC and cortisol:DHEAS clearly discriminated between individuals who went on to be frail at follow-up. We present the first evidence that immune-endocrine biomarkers are associated with the likelihood of frailty as well as mortality over a 10-year period. This augments our understanding of the aetiology of frailty, and suggests that a screening programme at ages 60–70 years could help to identify individuals who are at high risk of becoming frail and who would benefit from early, targeted intervention, for example with DHEA supplementation or anti-inflammatory strategies. Progress towards the prevention of frailty would bring major health and socio-economic benefits at the individual and the population level.
PMCID: PMC3636387  PMID: 22388931
Frailty; Aging; Immunosenescence; Inflam-aging; White Blood Cells; DHEAS; Screening
3.  Prospective cohort study showing changes in the monthly incidence of Pneumocystis carinii pneumonia 
Postgraduate Medical Journal  2003;79(929):164-166.
Pneumocystis carinii pneumonia (PCP) remains a serious opportunistic infection in HIV infected individuals. Seasonal changes in climate are associated with changes within individual susceptibility to infection. The possibility of monthly variability in the incidence of PCP was therefore examined by means of a cohort study of a database of 8640 HIV infected individuals attending the Chelsea and Westminster Hospital. There were 792 cases of PCP diagnosed since 1985. A marked decline was observed in the incidence of PCP in mid-1992 coincident with the introduction of PCP prophylaxis. There was a further decline in 1996 after the introduction of highly active antiretroviral therapy. Despite no significant monthly variation in the mean attendance to clinic and CD4 count, both new and all cases of PCP were higher in January than in other months (15.9% and 14.5% of all cases, respectively). A correlation with low rainfall in January and new cases of PCP was observed. These data are consistent with an influence of climatic conditions on the presentation of PCP. The diagnosis of PCP is more common in winter months suggesting that this is a transmissible infection.
PMCID: PMC1742624  PMID: 12697918

Results 1-3 (3)