Dynamics of traditional metabolic risk factors associate with specific causes of death in old age.
BACKGROUND
In contrast to middle age, higher body mass index (BMI), cholesterol levels, and blood pressures associate no longer with increased mortality in old age. With increasing age, these risk factors are prone to change over time. It is unclear whether dynamics of these traditional metabolic risk factors in late life associate with mortality and whether they occur in concert with each other.


METHODS
Within the Leiden 85-plus Study, a prospective population-based study of 599 participants aged 85 years, participants were annually assessed during a 5-year follow-up period and observed for mortality for 10 years.


RESULTS
BMI, total cholesterol levels, glucose levels, and blood pressures declined and HDL cholesterol levels increased between ages 85 and 90 years (all p < .005). Participants who died at age 90 years had stronger annual declines in BMI, total cholesterol levels, and diastolic blood pressure and weaker increases in HDL cholesterol levels than participants who survived until the end of follow-up (all p < or = .001). In a principal component analysis, annual changes in total, LDL, and HDL cholesterol levels; blood pressures; and glucose, albumin, hemoglobin, leukocyte, and C-reactive protein levels grouped together in one component (all correlation r with component >.40), which associated with all-cause and cancer mortality.


CONCLUSIONS
In old age, larger declines in BMI, total cholesterol levels, and blood pressures and weaker increases in HDL cholesterol levels associate with mortality. We identified distinct clustering in the dynamics of these traditional metabolic risk factors and indicators of health and disease in a profile that is suggestive of underlying wasting disease.
Department of Gerontology and Geriatrics (C2-R), Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands. p.van_vliet@lumc.nl
Peter
P
van Vliet
Anna M
AM
Oleksik
Diana
D
van Heemst
Anton J M
AJ
de Craen
Rudi G J
RG
Westendorp
D000367:Age Factors; D000368:Aged / Q000502:physiology* / Q000706:statistics & numerical data; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D009026:Mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011581:Psychological Tests; D012307:Risk Factors
D001786:Blood Glucose; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002784:Cholesterol