469 research outputs found
Aging and the burden of multimorbidity: Associations with inflammatory and anabolic hormonal biomarkers
No full textBackground. Multimorbidity increases with aging, but risk factors beyond age are unknown. Objective. To investigate the association of inflammatory and anabolic hormonal biomarkers with presence and prospective development of multimorbidity. Methods. Nine-year longitudinal study of 1018 participants aged 60 years or older (InCHIANTI Study). Multimorbidity was evaluated at baseline and follow-up visits as number of diagnosed diseases from a predefined list of 15 candidate chronic conditions, defined according to standard clinical criteria. Linear mixed models were used to test cross-sectional and longitudinal associations between candidate biomarkers and multimorbidity. Results. At baseline, multimorbidity was significantly higher in older participants (p <. 001) and higher IL-6, IL-1ra, TNF-α receptor II (TNFAR2), and lower dehydroepiandrosterone sulfate were associated with higher number of diseases, independent of age, sex, body mass index, and education. The rate of longitudinal increase in number of chronic diseases was significantly steeper in participants who were older at baseline (p <. 001). In addition, higher baseline IL-6 and steeper increase of IL-6 levels were significantly and independently associated with a steeper increase in multimorbidity over time (p <. 001 and p =. 003, respectively). Sensitivity analyses, performed using 15 different models obtained by removing each of 15 conditions included in the original list of candidate diseases, confirmed that results were not driven by any specific condition. Conclusions. Accumulation of chronic diseases accelerates at older ages and in persons with higher baseline levels and steeper increase over time of IL-6. High IL-6 and increase in IL-6 may serve as early warning sign to better target interventions aimed at reducing the burden of multimorbidity
sj-docx-1-ahd-10.1177_00914150241231192 - Supplemental material for Sleep Duration Polygenic Risk and Phenotype: Associations with Biomarkers of Accelerated Aging in the Baltimore Longitudinal Study of Aging
No full textSupplemental material, sj-docx-1-ahd-10.1177_00914150241231192 for Sleep Duration Polygenic Risk and Phenotype: Associations with Biomarkers of Accelerated Aging in the Baltimore Longitudinal Study of Aging by David W. Sosnowski, Emily J. Smail, Brion S. Maher, Ann Zenobia Moore, Pei-Lun Kuo, Mark N. Wu, Dominique V. Low, Katie L. Stone, Eleanor M. Simonsick, Luigi Ferrucci and Adam P. Spira in The International Journal of Aging and Human Development</p
Loss of weight in obese older adults: A biomarker of impending expansion of multimorbidity?
No full textObjectives To determine whether weight loss in older adults may be a marker of impending burden of multimorbidity regardless of initial weight, testing the hypotheses that obesity but not overweight in elderly adults is associated with greater number of diseases than normal weight and that obese older adults who lose weight over time have the greatest burden of multimorbidity. Design Longitudinal cohort study (Invecchiare in Chianti Study). Setting Community. Participants Individuals aged 60 and older at baseline followed for an average of 4 years (N = 1,025). Measurements Multimorbidity was measured as number of diagnosed diseases. Baseline body mass index (BMI) was categorized as normal weight (2), overweight (25.0-29.9 kg/m2), and obese (≥30.0 kg/m2). Loss of weight was defined as decrease over time in BMI of at least 0.15 kg/m2 per year. Age, sex, and education were covariates. Results Baseline obesity was cross-sectionally associated with high multimorbidity and greater longitudinal increase of multimorbidity than normal weight (P =.005) and overweight (P <.001). Moreover, obese participants who lost weight over follow-up had a significantly greater increase in multimorbidity than other participants, including obese participants who maintained or gained weight over time (P =.005). In nonobese participants, changes in weight had no effect on changes in multimorbidity over time. Sensitivity analyses confirmed that one specific disease did not drive the association and that competing mortality did not bias the association. Conclusion Loss of weight in obese older persons is a strong biomarker of impending expansion of multimorbidity. Older obese individuals who lose weight should receive thoughtful medical attention
Energy Metabolism and the Burden of Multimorbidity in Older Adults: Results From the Baltimore Longitudinal Study of Aging
No full textExcessively elevated resting metabolic rate (RMR) for persons of a certain age, sex, and body composition is a mortality risk factor. Whether elevated RMR constitutes an early marker of health deterioration in older adult has not been fully investigated. Using data from the Baltimore Longitudinal Study of Aging, we hypothesized that higher RMR (i) was cross-sectionally associated with higher multimorbidity and (ii) predicted higher multimorbidity in subsequent follow-ups. The analysis included 695 Baltimore Longitudinal Study of Aging participants, aged 60 or older at baseline, of whom 248 had follow-up data available 2 years later and 109 four years later. Multimorbidity was assessed as number of chronic diseases. RMR was measured by indirect calorimetry and was tested in regression analyses adjusted for covariates age, sex, and dual-energy x-ray absorptiometry-measured total body fat mass and lean mass. Baseline RMR and multimorbidity were positively associated, independent of covariates (p = .002). Moreover, in a three-wave bivariate autoregressive cross-lagged model adjusted for covariates, higher prior RMR predicted greater future multimorbidity above and beyond the cross-sectional and autoregressive associations (p = .034). RMR higher than expected, given age, sex, and body composition, predicts future higher multimorbidity in older adults and may be used as early biomarker of impending health deterioration. Replication and the development of normative data are required for clinical translation
Lower Mitochondrial Energy Production of the Thigh Muscles in Patients With Low‐Normal Ankle‐Brachial Index
No full text
Background
Lower muscle mitochondrial energy production may contribute to impaired walking endurance in patients with peripheral arterial disease. A borderline ankle‐brachial index (ABI) of 0.91 to 1.10 is associated with poorer walking endurance compared with higher
ABI
. We hypothesized that in the absence of peripheral arterial disease, lower
ABI
is associated with lower mitochondrial energy production.
Methods and Results
We examined 363 men and women participating in the Baltimore Longitudinal Study of Aging with an
ABI
between 0.90 and 1.40. Muscle mitochondrial energy production was assessed by post‐exercise phosphocreatine recovery rate constant (
k
PC
r) measured by phosphorus magnetic resonance spectroscopy of the left thigh. A lower post‐exercise phosphocreatine recovery rate constant reflects decreased mitochondria energy production.The mean age of the participants was 71±12 years. A total of 18.4% had diabetes mellitus and 4% were current and 40% were former smokers. Compared with participants with an
ABI
of 1.11 to 1.40, those with an
ABI
of 0.90 to 1.10 had significantly lower post‐exercise phosphocreatine recovery rate constant (19.3 versus 20.8 ms
−1
,
P
=0.015). This difference remained significant after adjusting for age, sex, race, smoking status, diabetes mellitus, body mass index, and cholesterol levels (
P
=0.028). Similarly, post‐exercise phosphocreatine recovery rate constant was linearly associated with
ABI
as a continuous variable, both in the
ABI
ranges of 0.90 to 1.40 (standardized coefficient=0.15,
P
=0.003) and 1.1 to 1.4 (standardized coefficient=0.12,
P
=0.0405).
Conclusions
An
ABI
of 0.90 to 1.10 is associated with lower mitochondrial energy production compared with an
ABI
of 1.11 to 1.40. These data demonstrate adverse associations of lower
ABI
values with impaired mitochondrial activity even within the range of a clinically accepted definition of a normal
ABI
. Further study is needed to determine whether interventions in persons with
ABIs
of 0.90 to 1.10 can prevent subsequent functional decline.
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Fitness and Cognition: Encouraging Findings and Methodological Considerations for Future Work
No full text
Sex-Specific Correlates of Walking Speed in a Wide Age-Ranged Population
No full textThe goals of this cross-sectional study were to explore correlates of walking speed in a large wide age-ranged population and to identify factors affecting lower walking speed at older ages. Participants were 3,872 community-dwelling adults in the first follow-up of the SardiNIA study who completed a 4-m walking test. Sex-specific correlates of walking speed included marital status, height, waist circumference, pulse wave velocity, comorbidity, subjective health, strength, and personality. Effect modifiers of the age--walking speed association included extraversion ( =55 years, p = .012) in women, and openness (
MAGNESIUM AND MUSCLE PERFORMANCE IN OLDER PERSONS: THE INCHIANTI STUDY
No full textBackground: The role of magnesium in maintaining muscle integrity
and function in older adults is largely unknown.
Objective: We aimed to investigate the relation between serum
magnesium concentrations and muscle performance in older
subjects.
Design: Data are from the baseline examination conducted between
September 1998 and March 2000 of the InCHIANTI (aging in the
Chianti area) study, a prospective epidemiologic survey of risk factors
for late-life disability. From among 1453 randomly selected
community residents completing a home interview, 1138men(46%)
and women (aged 66.7 15.2 y; x SD) with complete data on
muscle performance and serum magnesium who were not severely
cognitively compromised and had no evidence of kidney disease or
hypercalcemia were included in the analysis. Muscle performance
was evaluated by grip strength, lower-leg muscle power, knee extension
torque, and ankle extension isometric strength and was normalized
for age and body mass index (BMI) within each sex.
Results: After adjustment for age, sex, BMI, laboratory variables,
presence of chronic diseases, muscle area, muscle density, and physical
activity level, serum magnesium concentrations were significantly
associated with indexes of muscle performance, including grip strength
( 2.0 0.5, P 0.0002), lower-leg muscle power ( 8.8 2.7,
P 0.001), knee extension torque ( 31.2 7.9, P 0.0001), and
ankle extension strength ( 3.8 0.5, P 0.0001).
Conclusions: The serum magnesium concentration is an independent
correlate of muscle performance in older persons. Whether
magnesium supplementation improves muscle function remains to
be shown
Just Get Out the Door! Importance of Walking Outside the Home for Maintaining Mobility: Findings from the Women's Health and Aging Study
No full textTo determine the association between volitional walking behavior and change in walking ability and lower extremity function over 1 year in functionally limited older women. Design : Longitudinal cohort study. Setting : Data were collected in participant's homes in Baltimore, Maryland. Participants : One thousand two cognitively intact community-resident female Medicare beneficiaries aged 65 and older enrolled in the Women's Health and Aging Study. Measurements : Reported walking behavior and change in reported walking difficulty, usual and rapid gait speed, and lower extremity physical performance score over 1 year. Results : Of 800 functionally limited women who could walk unassisted at baseline and were alive and contacted 1 year later, 226 (28%) walked regularly, at least eight blocks per week. These women exhibited better health and functioning than nonwalkers (e.g., lower prevalence of depressive and fatigue symptoms and cardiovascular disease and higher mean ankle-arm index, forced expiratory volume in the first second, and gait speed). One year later, independent of initial functional status, social-psychological and behavioral factors, and health conditions, walkers were 1.8 times (95% confidence interval=1.2–2.7; P =.002) more likely to maintain reported walking ability and showed less decline in customary walking speed (0.009 m/s vs −0.070 m/s; P =.001) and functional performance score (−0.17 vs −0.73; P =.01) than women who walked less than eight blocks. Conclusion : The strength, consistency, and specificity of the association between walking behavior and maintenance of mobility provide strong evidence that even a small amount of regular walking can confer short-term protection from further mobility loss in functionally limited women. The observation that most women capable of walking at least eight blocks per week were not doing so indicates the need to get more women “out the door” and to encourage those who walk a little to walk a little more.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65601/1/j.1532-5415.2005.53103.x.pd
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