Elevated IL-6 and CRP levels are associated with incident self-reported major mobility disability: A pooled analysis of older adults with slow gait speed

Abstract Background Elevated Interleukine-6 (IL-6) and C-reactive protein (CRP) are associated with aging-related reductions in physical function, but little is known about their independent and combined relationships with major mobility disability (MMD), defined as the self-reported inability to walk a quarter-mile. Methods We estimated the absolute and relative effect of elevated baseline IL-6, CRP, and their combination on self-reported MMD risk among older adults (≥68 years; 59% female) with slow gait speed (<1.0m/s). Participants were MMD-free at baseline. IL-6 and CRP were assessed using a central laboratory. The study combined a cohort of community dwelling high-functioning older adults (Health ABC) with two trials of low-functioning adults at risk of MMD (LIFE-P, LIFE). Analyses utilized Poisson regression for absolute MMD incidence and proportional hazards models for relative risk. Results We found higher MMD risk per unit increase in log IL-6 [HR=1.26 (95% CI 1.13 to 1.41)]. IL-6 meeting pre-determined threshold considered to be high (>2.5 pg/mL) was similarly associated with higher risk of MMD [HR=1.31 (95% CI: 1.12 to 1.54)]. Elevated CRP (CRP >3.0 mg/L) was also associated with increased MMD risk [HR=1.38 (95% CI: 1.10 to 1.74)]. The CRP effect was more pronounced among participants with elevated IL-6 [HR=1.62 (95% CI: 1.12 to 2.33)] compared to lower IL-6 levels [HR=1.19 (95% CI: 0.85 to 1.66)]. Conclusions High baseline IL-6 and CRP were associated with increased risk of MMD among older adults with slow gait speed. A combined biomarker model suggests CRP was associated with MMD when IL-6 was elevated.

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Resistance training improves mobility disability in community-dwelling older adults: a meta-analysis

Innovation in Aging ◽

10.1093/geroni/igab046.3253 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 904-904

Author(s):

Christina Prevett ◽

Kevin Moncion ◽

Stuart Phillips ◽

Julie Richardson ◽

Ada Tang

Keyword(s):

Older Adults ◽

Resistance Training ◽

Physical Function ◽

Gait Speed ◽

Positive Impact ◽

Community Dwelling ◽

Mobility Disability ◽

Exercise Interventions ◽

Walking Capacity ◽

Community Dwelling Older Adults

Abstract Mobility disability is the impairment in function that affects the performance of daily tasks due to declines in physical function. Exercise interventions, particular resistance training, may have a positive impact on mobility disability, but the evidence for the effects of resistance training in older adults with mobility disability has not been previously systematically reviewed. This study was a systematic review of evidence related to resistance training on physical function for adults over 65 years of age with mobility disability. Four databases (PEDro, MedLine, Ovid, Web of Science) were searched from inception to February 2, 2021 for randomized controlled trials. Twenty-four articles from 22 studies (3,656 participants) were included in the review. Mean participant age ranged from 63-87 years and exercise interventions ranged from 10 weeks to 12 months in duration. Greater changes in 6-minute Walk Test (6MWT) distance (n=638, p<0.0001; mean difference (MD) 16.1 metres; 95%CI 12.3-19.9), lower extremity strength (n=785, p<0.0001; standard MD 2.01; 95%CI 1.27-2.75) and usual gait speed (n=2,106, p<0.001; MD 0.05 metres/second, 95%CI 0.03-0.07) were seen with resistance training as compared to control. These results were maintained if resistance training was a sole intervention or a component of a multi-component program. Sensitivity analysis based on risk of bias concerns did not change results. This review demonstrates that resistance training improves walking capacity, strength and walking speed in community-dwelling older adults and may facilitate aging in place. Since improvements in strength and gait speed contribute to independence, our results indicate highly beneficial outcomes for older persons.

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Socioeconomic Status, Frailty, and All-Cause Mortality in Korean Older Adults: A 3-Year Population-Based Prospective Study

BioMed Research International ◽

10.1155/2017/1903589 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Jinkyung Cho ◽

Inhwan Lee ◽

Soo Hyun Park ◽

Youngyun Jin ◽

Donghyun Kim ◽

...

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Cox Proportional Hazards Model ◽

Low Ses ◽

Increased Risk ◽

All Cause Mortality

Background. Little is known regarding the effects of socioeconomic status (SES) and frailty on mortality in Korea. Objective. This study investigated the combined impact of low SES and frailty on all-cause mortality in Korean older adults. Methods. Study sample at baseline comprised 7,960 community-dwelling adults (56.8% women) aged 65 years and older. The Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of low SES and frailty for all-cause mortality. Results. Overall, low SES plus frailty resulted in an increased risk of all-cause mortality (HR = 1.56, 95% CI = 1.09–2.23, P=0.015) even after adjustments for all the measured covariates, as compared with high SES plus nonfrailty (HR = 1). Among older adults aged 65–75 years, the increased mortality risk of either low SES plus nonfrailty (HR = 1.37, 95% CI = 1.02–1.84, P=0.038) or high SES plus frailty (HR = 2.09, 95% CI = 1.12–3.91, P=0.021) remained significant even after adjustments for all the covariates, as compared with high SES plus nonfrailty (HR = 1). Conclusion. The current findings suggest that either low SES or frailty is significantly associated with increased all-cause mortality in Korean older adults.

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Racial variation in the relationship of anemia with mortality and mobility disability among older adults

Blood ◽

10.1182/blood-2006-10-055384 ◽

2007 ◽

Vol 109 (11) ◽

pp. 4663-4670 ◽

Cited By ~ 81

Author(s):

Kushang V. Patel ◽

Tamara B. Harris ◽

Marion Faulhaber ◽

Sara B. Angleman ◽

Stephanie Connelly ◽

...

Keyword(s):

Adverse Events ◽

Black Men ◽

Proportional Hazards ◽

Community Dwelling ◽

World Health ◽

Mobility Disability ◽

Who Criteria ◽

Risk Of Death ◽

Increased Risk ◽

Health Organization

Abstract Anemia is more common among older blacks than older whites. However, it is unclear whether anemia predicts adverse events similarly in both races. Data on 1018 black and 1583 white adults aged 71 to 82 years were analyzed. Anemia, as defined by World Health Organization (WHO) criteria, was used to predict mortality over 6 years and incidence of mobility disability over 4 years. In proportional hazards models of mortality in whites, the age-adjusted hazard ratio (HR) for anemia in men was 1.96 (95% confidence interval [CI]: 1.35, 2.83) and in women was 2.86 (95% CI: 1.69, 4.82). In contrast, anemia was not associated with mortality in black men (HR = 1.15 [95% CI: 0.77, 1.72]) or women (HR = 1.39 [95% CI: 0.91, 2.14]). Higher mortality rate was observed only in black men with hemoglobin values more than 20 g/L (2.0 g/dL) below the WHO cutoff, whereas mortality rates were elevated in white men with hemoglobin values 1 to 10, 11 to 20, and more than 20 g/L below the WHO cutoff. In conclusion, anemia was significantly associated with increased risk of death and mobility disability in community-dwelling older whites. Conversely, older blacks classified as anemic by WHO criteria were not at risk for adverse events, indicating that alternative criteria are warranted.

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Impact of anemia on hospitalization and mortality in older adults

Blood ◽

10.1182/blood-2005-10-4308 ◽

2006 ◽

Vol 107 (10) ◽

pp. 3841-3846 ◽

Cited By ~ 193

Author(s):

Bruce F. Culleton ◽

Braden J. Manns ◽

Jianguo Zhang ◽

Marcello Tonelli ◽

Scott Klarenbach ◽

...

Keyword(s):

Older Adults ◽

Proportional Hazards ◽

Prognostic Significance ◽

The Elderly ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Normal Kidney ◽

Increased Risk ◽

All Cause Mortality ◽

Community Dwelling Older Adults

Although anemia is common in older adults, its prognostic significance is uncertain. A total of 17 030 community-dwelling subjects 66 years and older were identified between July 1 and December 31, 2001, and followed until December 31, 2004. Cox proportional hazards analyses were performed to determine the associations between anemia (defined as hemoglobin < 110 g/L) and hemoglobin and all-cause mortality, all-cause hospitalization, and cardiovascular-specific hospitalization. Overall, there were 1983 deaths and 7278 first hospitalizations. In patients with normal kidney function, adjusting for age, sex, diabetes mellitus, and comorbidity, anemia was associated with an increased risk for death (hazard ratio [HR], 4.29; 95% confidence interval [CI], 3.55-5.12), first all-cause hospitalization (HR, 2.16; 95% CI, 1.88-2.48), and first cardiovascular-specific hospitalization (HR, 2.49; 95% CI, 1.99-3.12). An inverse J-shaped relationship between hemoglobin and all-cause mortality was observed; the lowest risk for mortality occurred at hemoglobin values between 130 to 150 g/L for women and 140 to 170 g/L for men. Anemia is associated with an increased risk for hospitalization and death in community-dwelling older adults. Consideration should be given to redefine “normal” hemoglobin values in the elderly. Clinical trials are also necessary to determine whether anemia correction improves quality or quantity of life in this population.

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Olfaction and risk of dementia in a biracial cohort of older adults

Neurology ◽

10.1212/wnl.0000000000003558 ◽

2016 ◽

Vol 88 (5) ◽

pp. 456-462 ◽

Cited By ~ 39

Author(s):

Kristine Yaffe ◽

Daniel Freimer ◽

Honglei Chen ◽

Keiko Asao ◽

Andrea Rosso ◽

...

Keyword(s):

Older Adults ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

The Body ◽

Black And White ◽

The Poor ◽

Cox Proportional Hazards Models ◽

Increased Risk ◽

Health Aging

Objective:Prior studies indicate that olfactory function may be an early marker for cognitive impairment, but the body of evidence has been largely restricted to white populations.Methods:We studied 2,428 community-dwelling black and white older adults (baseline age 70–79 years) without dementia enrolled in the Health, Aging, and Body Composition (Health ABC) study. Olfaction was measured as odor identification (OI) with the 12-item Cross Cultural Smell Identification Test in year 3. We defined incident dementia over 12 years on the basis of hospitalization records, prescription for dementia medication, or 1.5-SD decline in race-stratified global cognition score. We assessed dementia risk associated with OI score (by tertile) using Cox proportional hazards models. All analyses were stratified by race.Results:Poorer OI in older adults without dementia was associated with increased risk of dementia. After adjustment for demographics, medical comorbidities, and lifestyle characteristics, white participants in the poor or moderate OI tertile had greater risk of dementia (adjusted hazard ratio [HR] 3.34, 95% confidence interval [CI] 2.45–4.54; and HR 1.84, 95% CI 1.33–2.54, respectively) compared to those in the good tertile of function. Among blacks, worse OI was associated with an increased risk of dementia, but the magnitude of the effect was weaker (p for interaction = 0.04) for the poor OI tertile (adjusted HR 2.03, 95% CI 1.44–2.84) and for the moderate tertile (adjusted HR 1.42, 95% CI 0.97–2.10). There was no interaction between OI and APOE ε4 and risk of dementia.Conclusions:While the magnitude of the association was stronger in whites, we found that poor OI was associated with increased risk of dementia among both black and white older adults.

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Walking Skill Can Be Assessed in Older Adults: Validity of the Figure-of-8 Walk Test

Physical Therapy ◽

10.2522/ptj.20080121 ◽

2010 ◽

Vol 90 (1) ◽

pp. 89-99 ◽

Cited By ~ 109

Author(s):

Rebecca J. Hess ◽

Jennifer S. Brach ◽

Sara R. Piva ◽

Jessie M. VanSwearingen

Keyword(s):

Older Adults ◽

Physical Function ◽

Coefficient Of Variation ◽

Gait Speed ◽

Fear Of Falling ◽

Movement Control ◽

Community Dwelling ◽

Walk Test ◽

Step Width ◽

Mobility Disability

Background The Figure-of-8 Walk Test (F8W) involves straight and curved paths and was designed to represent walking skill in everyday life. Objective The purposes of this study were to validate the measure in older adults with walking difficulties and to explore correlates of the curved-path walking measure not represented by a straight-path walking measure. Design Fifty-one community-dwelling older adults with mobility disability participated in 2 baseline visits as part of an intervention study. Methods The F8W time, steps, and smoothness and measures of gait (gait speed, modified Gait Abnormality Rating Scale [GARS-M]), physical function (Late Life Function and Disabilities Index [LLFDI], Survey of Activities and Fear of Falling in the Elderly [SAFFE], Gait Efficacy Scale [GES], Physical Performance Test [PPT], and fall history), and movement control and planning (gait variability, Trail Making Test B [Trails B]) were recorded in each test session. Bivariate correlations for the F8W with each variable were conducted to examine concurrent and construct validity. Adjusted linear regression analyses were performed to explore the variance in mobility explained by F8W independent of gait speed. Results Figure-of-8 Walk Test time correlated with gait (gait speed, r=−.570; GARS-M, r=.281), physical function (LLFDI function, r=−.469; SAFFE restriction subscale, r=.370; PPT, r=−.353), confidence in walking (GES, r=−.468), and movement control (step length coefficient of variation, r=.279; step width coefficient of variation, r=−.277; Trails B, r=.351). Figure-of-8 Walk Test steps correlated with step width variability (r=−.339) and was related to fear of falling (t=−2.50). All correlations were significant (P<.05). Limitations This pilot study had a small sample size, and further research is needed. Conclusions The F8W is a valid measure of walking skill among older adults with mobility disability and may provide information complementary to gait speed.

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Screening prefrailty in Japanese community-dwelling older adults with daily gait speed and number of steps via tri-axial accelerometers

Scientific Reports ◽

10.1038/s41598-021-98286-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Naoto Takayanagi ◽

Motoki Sudo ◽

Yukari Yamashiro ◽

Ippei Chiba ◽

Sangyoon Lee ◽

...

Keyword(s):

Older Adults ◽

Gait Speed ◽

Early Stage ◽

Intermediate Stage ◽

Community Dwelling ◽

Increased Risk ◽

Risk Of Progression ◽

Care Assistance ◽

Community Dwelling Older Adults ◽

Self Administered Questionnaire

AbstractPrefrailty is an intermediate stage between non-frailty and frailty. It is associated with an increased risk of progression to frailty, which makes it important to screen older adults for prefrailty at an early stage. This study verified whether daily gait speed and number of steps measured using a tri-axial accelerometer could be used to identify prefrailty. In total, 1692 Japanese community-dwelling older adults were divided into robust (n = 1032) and prefrail (n = 660) groups based on the Kihon Checklist, which is a self-administered questionnaire. Both daily gait speed and number of steps were measured for two weeks using tri-axial accelerometers. We also calculated the area under the ROC curve and the cut-off values for these parameters. Our results showed that the cut-off value for daily gait speed was 106.3 cm/s, while that for number of steps was 6342.2. In addition, we found that the combined assessment of both cut-off values was a more effective way to screen older adults with prefrailty status compared to either parameter alone. This is also considered an effective way to reduce national expenditures for daily care assistance.

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Incident mobility disability, parkinsonism, and mortality in community-dwelling older adults

PLoS ONE ◽

10.1371/journal.pone.0246206 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0246206

Author(s):

Shahram Oveisgharan ◽

Lei Yu ◽

David A. Bennett ◽

Aron S. Buchman

Keyword(s):

Older Adults ◽

Rating Scale ◽

Cox Model ◽

Motor Impairment ◽

Community Dwelling ◽

Mobility Disability ◽

Risk Of Death ◽

Increased Risk ◽

Disease Rating ◽

Community Dwelling Older Adults

Background Mobility disability and parkinsonism are associated with decreased survival in older adults. This study examined the transition from no motor impairment to mobility disability and parkinsonism and their associations with death. Methods 867 community-dwelling older adults without mobility disability or parkinsonism at baseline were examined annually. Mobility disability was based on annual measured gait speed. Parkinsonism was based on the annual assessment of 26 items from the motor portion of the Unified Parkinson’s Disease Rating Scale. A multistate Cox model simultaneously examined the incidences of mobility disability and parkinsonism and their associations with death. Results Average age at baseline was 75 years old and 318 (37%) died during 10 years of follow-up. Mobility disability was almost 2-fold more common than parkinsonism. Some participants developed mobility disability alone (42%), or parkinsonism alone (5%), while many developed both (41%). Individuals with mobility disability or parkinsonism alone had an increased risk of death, but their risk was less than the risk in individuals with both impairments. The risk of death did not depend on the order in which impairments occurred. Conclusion The varied patterns of transitions from no motor impairment to motor impairment highlights the heterogeneity of late-life motor impairment and its contribution to survival. Further studies are needed to elucidate the underlying biology of these different transitions and how they might impact survival.

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Dual Decline in Gait and Cognition Is Associated With Future Dementia: Evidence for a Phenotype

Innovation in Aging ◽

10.1093/geroni/igaa057.846 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 264-264

Author(s):

Manuel Montero Odasso ◽

Mark Speechley ◽

Richard Camicioli ◽

Nellie Kamkar ◽

Qu Tian ◽

...

Keyword(s):

Older Adults ◽

Gait Speed ◽

Regression Models ◽

Community Dwelling ◽

Hierarchical Regression ◽

Chi Square ◽

Cox Models ◽

Incident Dementia ◽

Risk Of Progression ◽

Community Dwelling Older Adults

Abstract BACKGROUND: The concurrent decline in gait speed and cognition are associated with future dementia. However, the clinical profile of those who present with dual-decline has not yet been described. We aimed to describe the phenotype and risk for incident dementia of individuals who present a dual-decline in comparison with non dual-decliners. METHODS: Prospective cohort of community-dwelling older adults free of dementia at baseline. We evaluated participants’ gait speed, cognition, medical status, functionality, incidence of adverse events, and dementia biannually over 7 years. Gait speed was assessed with a 6-meter electronic-walkway, and global cognition was assessed using the MoCA test. We compared characteristics between dual-decliners and non dual-decliners using t-test, Chi-square, and hierarchical regression models. We estimated incident dementia using Cox models. RESULTS: Among 144 participants (mean age 74.23 ± 6.72 years, 54% women), 17% progressed to dementia. Dual-decliners had a three-fold risk (HR: 3.12, 95%CI:1.23-7.93, p=0.017) of progression to dementia compared with non dual-decliners. Dual-decliners were significantly older with a higher prevalence of hypertension and dyslipidemia (p=0.002). Hierarchical regression models show that age and sex alone explained 3% of the variation in the dual-decliners group, while adding hypertension and dyslipidemia increased the explained variation to 8% and 10 %, respectively. The risk of becoming a dual-decliner was 4-fold if hypertension was present. CONCLUSION: Older adults with concurrent decline in gait speed and cognition represent a group at the highest risk of progression to dementia. These dual-decliners have a distinct phenotype with a higher prevalence of hypertension, a potentially treatable condition.

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Elevated plasma growth and differentiation factor 15 predicts incident anemia in older adults aged 60 years and older

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa324 ◽

2020 ◽

Author(s):

Yuko Yamaguchi ◽

Marta Zampino ◽

Toshiko Tanaka ◽

Stefania Bandinelli ◽

Yusuke Osawa ◽

...

Keyword(s):

Older Adults ◽

Proportional Hazards ◽

Proportional Hazards Model ◽

Cox Proportional Hazards ◽

Cox Proportional Hazards Model ◽

Differentiation Factor ◽

Hazards Model ◽

Increased Risk ◽

The Relationship

Abstract Background Anemia is common in older adults and associated with greater morbidity and mortality. The causes of anemia in older adults have not been completely characterized. Although elevated circulating growth and differentiation factor 15 (GDF-15) has been associated with anemia in older adults, it is not known whether elevated GDF-15 predicts the development of anemia. Methods We examined the relationship between plasma GDF-15 concentrations at baseline in 708 non-anemic adults, aged 60 years and older, with incident anemia during 15 years of follow-up among participants in the Invecchiare in Chianti (InCHIANTI) Study. Results During follow-up, 179 (25.3%) participants developed anemia. The proportion of participants who developed anemia from the lowest to highest quartile of plasma GDF-15 was 12.9%, 20.1%, 21.2%, and 45.8%, respectively. Adults in the highest quartile of plasma GDF-15 had an increased risk of developing anemia (Hazards Ratio 1.15, 95% Confidence Interval 1.09, 1.21, P<.0001) compared to those in the lower three quartiles in a multivariable Cox proportional hazards model adjusting for age, sex, serum iron, soluble transferrin receptor, ferritin, vitamin B12, congestive heart failure, diabetes mellitus, and cancer. Conclusions Circulating GDF-15 is an independent predictor for the development of anemia in older adults.

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