Functional measures, inflammatory markers and endothelin-1 as predictors of 360-day survival in centenarians.
Centenarians represent a rapidly growing population. To better characterize this specific age group, we have performed a cross-sectional study to observe associations between functional measures and a range of biochemical markers, including inflammatory markers and their significance as predictors of 360-day survival. Medical history and physical and functional assessment (Mini-Mental State Examination (MMSE), Katz Index (activities of daily living, ADL) and Barthel Index (Barthel Index) of Activities of Daily Living, and Lawton Instrumental Activities of Daily Living Scale (Lawton IADL)) were conducted on 86 101.9 ± 1.2-year-old (mean ± SD) subjects (70 women, 16 men). Blood tests were performed on 84 subjects of whom 43 also had extended biomarker assessment. As a reference group 30 51.8 ± 5.0-year old healthy subjects (20 women, 10 men) were recruited. The centenarians received follow-up phone calls. Fifty-two centenarians (60 %) survived ≥360 days. Longer survival was associated with higher MMSE (hazard ratio, HR = 0.934, 95 % confidence interval (CI) 0.896-0.975, P = .002), ADL (HR = 0.840, 95 % CI 0.716-0.985, P = .032), Barthel Index (HR = 0.988, 95 % CI 0.977-0.999, P = .026), and albumin level (HR .926, 95 % CI 0.870-0.986, P .016) and with lower white blood cell (WBC) (HR = 1.161, 95 % CI 1.059-1.273, P = .001), C-reactive protein (CRP) (HR = 1.032, 95 % CI 1.014-1.050, P < .001), IL-6 (HR = 1.182, 95 % CI 1.047-1.335, P = .007), and endothelin-1 (ET-1) level (HR = 3.711, 95 % CI 1.233-11.169, P = .020). Centenarians had higher 360-day survival probability with MMSE ≥13 (P < .001), ADL ≥1 (P < .001), Barthel Index ≥15 (P < .001), Lawton IADL ≥10 points (P = .009), WBC <8.3 G/L (P = .039), CRP <10 mg/L (P < .001), IL-6 <6 pg/mL (P .002), and ET-1 <1.1 pg/mL (P .007). Our results indicate that functional measures, inflammatory markers, and endothelin-1 are predictors of 360-day survival in centenarians.
Department of Geriatrics, School of Health Sciences in Katowice, SUM, SPSK NR 7 SUM GCM, ul. Ziolowa 45/47, 40-635, Katowice, Poland, jszewieczek@sum.edu.pl.
Jan
J
Szewieczek
Tomasz
T
Francuz
Jan
J
Dulawa
Katarzyna
K
Legierska
Beata
B
Hornik
Iwona
I
Włodarczyk
Magdalena
M
Janusz-Jenczeń
Agnieszka
A
Batko-Szwaczka
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011044:Poland / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends
D015415:Biomarkers; D019332:Endothelin-1; D002097:C-Reactive Protein