title: Inflammation, Depression, and Slow Gait: A High Mortality Phenotype in Later Life.
abstract: BACKGROUND
  Inflammation, slow gait, and depression individually are associated with mortality, yet little is known about the trajectories of these measures, their interrelationships, or their collective impact on mortality.
  
  
  METHODS
  Longitudinal latent class analysis was used to evaluate trajectories of depression (Center for Epidemiologic Studies Depression ≥ 10), slow gait (<1.0 m/s), and elevated inflammation (interleukin 6 > 3.2 pg/mL) using data from the Health Aging and Body Composition Study. Logistic regression was used to identify their associations with mortality.
  
  
  RESULTS
  For each outcome, low-probability (n inflammation = 1,656, n slow gait = 1,471, n depression = 1,458), increasing-probability (n inflammation = 847, n slow gait = 880, n depression = 1,062), and consistently high-probability (n inflammation = 572, n slow gait = 724, n depression = 555) trajectories were identified, with 22% of all participants classified as having increasing or consistently high-probability trajectories on inflammation, slow gait, and depression (meaning probability of impairment on each outcome increased from low to moderate/high or remained high over 10 years). Trajectories of slow gait were associated with inflammation (r = .40, p < .001) and depression (r = .49, p < .001). Although worsening trajectories of inflammation were independently associated with mortality (p < .001), the association between worsening trajectories of slow gait and mortality was only present in participants with worsening depression trajectories (p < .01). Participants with increasing/consistently high trajectories of depression and consistently high trajectories of inflammation and slow gait (n = 247) have an adjusted-morality rate of 85.2%, greater than all other classification permutations.
  
  
  CONCLUSIONS
  Comprehensive assessment of older adults is warranted for the development of treatment strategies targeting a high-mortality risk phenotype consisting of inflammation, depression, and slow gait speed.
authors.affiliation: Division of Geriatric Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons. and pb2410@cumc.columbia.edu.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Brown
authors.affiliation: Division of Geriatric Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons. and.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Roose
authors.affiliation: Division of Geriatric Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons. and Division of Biostatistics, Columbia University's Mailman School of Public Health.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Division of Geriatric Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons. and Division of Biostatistics, Columbia University's Mailman School of Public Health.
authors.forename: Melanie
authors.initials: M
authors.lastname: Wall
authors.affiliation: Division of Geriatric Psychiatry, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons. and.
authors.forename: Bret R
authors.initials: BR
authors.lastname: Rutherford
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco.
authors.forename: Hilsa N
authors.initials: HN
authors.lastname: Ayonayon
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pennsylvania.
authors.forename: Meryl A
authors.initials: MA
authors.lastname: Butters
authors.affiliation: Intramural Research Program, Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, Maryland.
authors.forename: Tamara
authors.initials: T
authors.lastname: Harris
authors.affiliation: Medicine and Clinical & Translational Science, Center for Aging and Population Health, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.affiliation: University of Tennessee Health Science Center, Memphis.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Satterfield
authors.affiliation: Translational Gerontology Branch, National Institute on Aging, Harbor Hospital, Baltimore, Maryland.
authors.forename: Eleanor M
authors.initials: EM
authors.lastname: Simonsick
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco. Department of Neurology and Department of Psychiatry, University of California, San Francisco.
authors.forename: Kristine
authors.initials: K
authors.lastname: Yaffe
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D015897:Comorbidity / Q000639:trends; D003863:Depression / Q000401:mortality / Q000503:physiopathology*; D004185:Disability Evaluation; D005260:Female; D005684:Gait / Q000502:physiology*; D015577:Geriatric Assessment; D006801:Humans; D007249:Inflammation / Q000401:mortality / Q000503:physiopathology*; D015850:Interleukin-6 / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality / Q000639:trends*; D010641:Phenotype; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015850:Interleukin-6
keywords: Depression; Frailty; Inflammation; Mortality; Slow Gait