title: Years of able life in older persons--the role of cardiovascular imaging and biomarkers: the Cardiovascular Health Study.
abstract: BACKGROUND
  As the U.S. population grows older, there is greater need to examine physical independence. Previous studies have assessed risk factors in relation to either disability or mortality, but an outcome that combines both is still needed.
  
  
  RESULTS
  The Cardiovascular Health Study is a population-based, prospective study where participants underwent baseline echocardiogram, measurement of carotid intima-media thickness (IMT), and various biomarkers, then followed for up to 18 years. Years of able life (YAL) constituted the number of years the participant was able to perform all activities of daily living. Linear regression was used to model the relationship between selected measures and outcomes, adjusted for confounding variables. Among 4902 participants, mean age was 72.6 ± 5.4 years, median YAL for males was 8.8 (interquartile range [IQR], 4.3 to 13.8) and 10.3 (IQR, 5.8 to 15.8) for females. Reductions in YAL in the fully adjusted model for females and males, respectively, were: -1.34 (95% confidence interval [CI], -2.18, -0.49) and -1.41 (95% CI, -2.03, -0.8) for abnormal left ventricular (LV) ejection fraction, -0.5 (95% CI, -0.78, -0.22) and -0.62 (95% CI, -0.87, -0.36) per SD increase in LV mass, -0.5 (95% CI, -0.7, -0.29) and -0.79 (95% CI, -0.99, -0.58) for IMT, -0.5 (95% CI, -0.64, -0.37) and -0.79 (95% CI, -0.94, -0.65) for N-terminal pro-brain natriuretic peptide, -1.08 (95% CI, -1.34, -0.83) and -0.73 (95% CI, -0.97, -0.5) for high-sensitivity troponin-T, and -0.26 (95% CI, -0.42, -0.09) and -0.23 (95% CI, -0.41, -0.05) for procollagen-III N-terminal propeptide. Most tested variables remained significant even after adjusting for incident cardiovascular (CV) disease.
  
  
  CONCLUSIONS
  In this population-based cohort, variables obtained by CV imaging and biomarkers of inflammation, coagulation, atherosclerosis, myocardial injury and stress, and cardiac collagen turnover were associated with YAL, an important outcome that integrates physical ability and longevity in older persons.
authors.affiliation: Division of Cardiovascular Medicine, University of Iowa, Iowa City, IA (L.I.A.) Carver College of Medicine and the College of Public Health, University of Iowa, Iowa City, IA (L.I.A., R.B.W.).
authors.forename: Laith I
authors.initials: LI
authors.lastname: Alshawabkeh
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA (L.M.Y., T.M.B., A.M.A.).
authors.forename: Laura M
authors.initials: LM
authors.lastname: Yee
authors.affiliation: Department of Medicine, Hackensack University Medical Center, Hackensack, NJ (J.M.G.).
authors.forename: Julius M
authors.initials: JM
authors.lastname: Gardin
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD (J.S.G.).
authors.forename: John S
authors.initials: JS
authors.lastname: Gottdiener
authors.affiliation: School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR (M.C.O.).
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Odden
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA (L.M.Y., T.M.B., A.M.A.).
authors.forename: Traci M
authors.initials: TM
authors.lastname: Bartz
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA (L.M.Y., T.M.B., A.M.A.).
authors.forename: Alice M
authors.initials: AM
authors.lastname: Arnold
authors.affiliation: Divisions of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA (K.J.M.).
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Mukamal
authors.affiliation: Department of Internal Medicine, University of Iowa, Iowa City, IA (R.B.W.) Carver College of Medicine and the College of Public Health, University of Iowa, Iowa City, IA (L.I.A., R.B.W.).
authors.forename: Robert B
authors.initials: RB
authors.lastname: Wallace
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D004452:Echocardiography; D005260:Female; D006801:Humans; D057187:Independent Living / Q000706:statistics & numerical data*; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011347:Procollagen / Q000097:blood; D011446:Prospective Studies; D013318:Stroke Volume; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011347:Procollagen; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); C041876:procollagen Type III-N-terminal peptide; D020097:Natriuretic Peptide, Brain
keywords: activities of daily living; aging; biomarkers; imaging