Background: Societal aging – as a global demographic phenomenon – shows no indication of abating. As a result, the problem of age-associated disability and related long-term care is emerging as a major public health challenge. It is important that methods for identifying older adults at risk of adverse outcomes are implemented early.
Methods: The study group consisted of 145 individuals, 44.1% women, who were randomized from community-dwelling 60– 74-year-old adults. A comprehensive geriatric assessment was supplemented with Fried frailty phenotype evaluation and blood tests (including adhesion molecules, matrix metalloproteinases and neurotrophic factors). A follow-up by phone call was made for at least 3 years after the initial examination. Composite endpoint (CE) included falls, hospitalization, institutionalization and death.
Results: Mean study group age was 66.5 ± 4.1 years () and mean number of diseases was 3.7 ± 2.2. Functional status of the subjects was good, as indicated by high Barthel Index scores of 99.1 ± 2.4, MMSE scores of 29.0 ± 1.5 and no frailty case. During a three-year follow-up, 71 participants (49.0%) experienced any CE-events. The Wilcoxon-Gehan test indicates that a higher probability of three-year CE completion was associated with an age > 65 years (P = 0.006), coronary artery disease (CAD) (P = 0.008), 6-Minute Walk Test < 432 m (P = 0.034), serum glucose > 120 mg/dL (P = 0.047), serum cortisol > 10 μg/dL (P = 0.011), leptin ≥ 15 ng/mL (P = 0.018), P-selectin ≥ 23 ng/mL (P = 0.006) and GDNF ≥ 20 pg/mL (P = 0.004). CAD (OR = 3.64, 95% CI = 1.53− 8.69, P = 0.004), educational status (OR = 0.87, 95% CI = 0.77− 0.98, P = 0.022) and P-selectin levels (OR = 1.07, 95% CI = 1.02− 1.13, P = 0.013) were independent measures predicting three-year CE occurrence in multivariate logistic regression analysis adjusted for clinical and functional measures, and blood tests.
Conclusion: Coronary artery disease, poorer lower educational status and higher P-selectin levels were predictive of adverse outcomes in the community-dwelling healthy-aging early-old adults during three-year follow-up.



中文翻译：

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健康老龄化成人不良结果的预测因素：冠状动脉疾病、较低的教育状况和较高的 P-选择素水平

背景：社会老龄化——作为一种全球人口现象——没有减弱的迹象。因此，与年龄相关的残疾和相关的长期护理问题正在成为一项重大的公共卫生挑战。尽早实施识别有不良后果风险的老年人的方法很重要。
方法：该研究组由 145 名个体组成，其中 44.1% 为女性，她们从居住在社区的 60-74 岁成年人中随机分配。全面的老年评估辅以 Fried 虚弱表型评估和血液测试（包括粘附分子、基质金属蛋白酶和神经营养因子）。在初次检查后至少 3 年进行电话随访。复合终点（CE）包括跌倒、住院、住院和死亡。
结果：平均研究组年龄为 66.5 ± 4.1 岁（)，平均疾病数为 3.7 ± 2.2。受试者的功能状态良好，Barthel 指数得分高 99.1 ± 2.4，MMSE 得分 29.0 ± 1.5，没有虚弱病例。在三年的随访中，71 名参与者 (49.0%) 经历了任何 CE 事件。Wilcoxon-Gehan 检验表明，三年 CE 完成的较高概率与年龄 > 65 岁 (P = 0.006)、冠状动脉疾病 (CAD) (P = 0.008)、6 分钟步行测试 < 432 m 相关(P = 0.034)，血清葡萄糖 > 120 mg/dL (P = 0.047)，血清皮质醇 > 10 μg/dL (P = 0.011)，瘦素 ≥ 15 ng/mL (P = 0.018)，P-选择素 ≥ 23 ng /mL (P = 0.006) 和 GDNF ≥ 20 pg/mL (P = 0.004)。CAD (OR = 3.64, 95% CI = 1.53− 8.69, P = 0.004)、教育状况 (OR = 0.87, 95% CI = 0.77− 0.98, P = 0.022) 和 P-选择素水平 (OR = 1.07, 95% CI = 1.02− 1.13，P = 0。
结论：冠状动脉疾病、较差的较低教育状况和较高的 P-选择素水平可预测社区居住的健康老龄化早期老年人在 3 年随访期间的不良结局。