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. 2016 Aug;45(4):1135-1145.
doi: 10.1093/ije/dyw092. Epub 2016 Jun 6.

Trajectories of function and biomarkers with age: the CHS All Stars Study

Anne B Newman  1 , Jason L Sanders  2 , Jorge R Kizer  3 , Robert M Boudreau  4 , Michelle C Odden  5 , Adina Zeki Al Hazzouri  6 , Alice M Arnold  7
Affiliations

Trajectories of function and biomarkers with age: the CHS All Stars Study

Anne B Newman et al. Int J Epidemiol. 2016 Aug.

Abstract

Background: Multimorbidity is a major driver of physical and cognitive impairment, but rates of decline are also related to ageing. We sought to determine trajectories of decline in a large cohort by disease status, and examined their correspondence with biomarkers of ageing processes including growth hormone, sex steroid, inflammation, visceral adiposity and kidney function pathways.

Methods: We have followed the 5888 participants in the Cardiovascular Health Study (CHS) for healthy ageing and longevity since 1989-90. Gait speed, grip strength, modified mini-mental status examination (3MSE) and the digit symbol substitution test (DSST) were assessed annually to 1998-99 and again in 2005-06. Insulin-like growth hormone (IGF-1), dehydroepiandrosterone sulphate (DHEAS), interleukin-6 (IL-6), adiponectin and cystatin-C were assessed 3-5 times from stored samples. Health status was updated annually and dichotomized as healthy vs not healthy. Trajectories for each function measure and biomarker were estimated using generalized estimating equations as a function of age and health status using standardized values.

Results: Trajectories of functional decline showed strong age acceleration late in life in healthy older men and women as well as in chronically ill older adults. Adiponectin, IL-6 and cystatin-C tracked with functional decline in all domains; cystatin-C was consistently associated with functional declines independent of other biomarkers. DHEAS was independently associated with grip strength and IL-6 with grip strength and gait speed trajectories.

Conclusions: Functional decline in late life appears to mark a fundamental ageing process in that it occurred and was accelerated in late life regardless of health status. Cystatin C was most consistently associated with these functional declines.

Keywords: Ageing; biomarkers; cognitive function; disability; gait speed; grip strength.

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Figures

Figure 1.
Figure 1.
Trajectories of functional decline in women and men by health status. a) Gait speed; b) grip strength; c) Modified Mini Mental State Examination (3MSE); d) Digit Symbol Substitution Test (DSST).
Figure 2.
Figure 2.
Trajectories of function and biomarkers by health status in women and men. a) Healthy women; b) healthy men; c) unhealthy women; d) unhealthy men. DSST, Digit Symbol Substitution Test; 3MSE, Modified Mini Mental State Examination; IL-6, interleukin-6; IGF-1, insulin-like growth factor; DHEAS, dihydroepiandrosterone sulphate.
See this image and copyright information in PMC

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