実年齢は予防医療の最適指標ではない可能性を示す研究(New Study Finds Chronological Age May Not Be the Best Guide to Prevention and Care)

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2026-08-12 ロックフェラー大学

米ロックフェラー大学の研究者らは、医療現場で広く用いられている年齢基準による診療ガイドラインについて、その妥当性を再検討する必要性を指摘した。多くの疾患では、検診開始年齢や治療方針の決定に暦年齢が用いられているが、実際には同じ年齢でも健康状態や生物学的老化の進行度には大きな個人差が存在する。研究では、加齢と疾患リスクの関係を分析し、年齢のみを基準とした画一的な医療判断では、一部の患者で過剰診断や過少診断が生じる可能性を示した。研究者らは、生物学的年齢や個人の健康指標、遺伝的要因などを組み合わせたより精密なリスク評価の必要性を提唱している。今回の成果は、予防医療や疾病スクリーニング、治療方針決定の個別化を進める上で重要な知見となり、高齢化社会における医療資源の効率的活用や患者中心医療の実現にも貢献すると期待される。

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年齢層間および年齢層内における多疾患併存の変動 Variation in multimorbidity between and within age groups

Joel E. Cohen,T. J. Lin,Alice Eggleston,Mirta Milanes,Amro Hassan,Andrea Cassells & Jonathan N. Tobin
Journal of Population Aging  Published:01 July 2026
DOI:https://doi.org/10.1007/s12062-026-09571-7

Fig. 1

Abstract

The chronic conditions associated with age are an increasing challenge to individual and public health in many countries. In general, older age groups have a greater average multiplicity of chronic conditions (greater “multimorbidity”). But the variation (not only the average) of multimorbidity within groups of increasing age seems not to have been studied empirically. The variation in multimorbidity in groups of increasing age could, in principle, increase or decrease. We use the enhanced Charlson Comorbidity Index (eCCI) as a quantitative index of a person’s concurrent chronic medical conditions (multimorbidities) in 39 categories, weighted by severity. We demonstrate systematic relationships between the mean eCCI and the variance of eCCI of people by age group in de-identified electronic health records of 238,156 adults served by four United States health systems (HSs), two in Chicago, two in New York City. The relation of variance to mean eCCI across age groups is described by a generalization of Taylor’s power law. Within almost every age group, the frequency distribution of eCCI per individual is well approximated by a negative binomial distribution. The means and the variances of the fitted negative binomial distributions within age groups account approximately for the relations of mean and variance of eCCI across age groups. The clear findings that variance of eCCI within an age group rises with the mean eCCI, and that the variance exceeds the mean, imply that increasing average multimorbidity brings more variable or heterogeneous multimorbidity. Both clinical care and health policy need to take account of the variation or heterogeneity of multimorbidity among older adults.

医療・健康
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