title: Assessment of health status by molecular measures in adults ranging from middle-aged to old: Ready for clinical use?
abstract: In addition to measures already used in clinical practice, molecular measures have been proposed to assess health status, but these have not yet been introduced into clinical practice. We aimed to test the association of functional capacity measures used in current practice and molecular measures with age and health status. The cohort consisted of 178 middle-aged to old participants of the Leiden Longevity Study (range 42-82years). We tested associations between functional capacity measures (physical tests: grip strength, 4-meter walk, chair stand test; cognitive tests: Stroop test, digit symbol substitution test and 15-picture learning test) with age and with cardiovascular or metabolic disease as a measure of the health status. These associations with age and health status were also tested for molecular measures (C reactive protein (CRP), numbers of senescent p16INK4a positive cells in the epidermis and dermis and putative immunosenescence (presence of CD57+ T cells)). All functional capacity measures were associated with age. CRP and epidermal p16INK4a positivity were also associated with age, but with smaller estimates. Grip strength and the Stroop test were associated with cardiovascular or metabolic disease, as was epidermal p16INK4a positivity. All associations with cardiovascular or metabolic disease attenuated when adjusting for age. In conclusion, in middle-aged to old persons, the molecular measures tested here were more weakly associated with age and health status than functional capacity measures. Whether these molecular measures associate more closely with health status in the elderly or in specific groups of patients needs to be explored further.
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, The Netherlands.
authors.forename: M E C
authors.initials: ME
authors.lastname: Waaijer
authors.affiliation: Department of Public health and Center of Healthy Aging, University of Copenhagen, Copenhagen, Denmark.
authors.forename: R G J
authors.initials: RG
authors.lastname: Westendorp
authors.affiliation: Department of Internal Medicine II, Centre for Medical Research, University of Tübingen, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Goldeck
authors.affiliation: Unilever Discover, Colworth Science Park, Sharnbrook, Bedfordshire, UK.
authors.forename: D A
authors.initials: DA
authors.lastname: Gunn
authors.affiliation: Department of Internal Medicine II, Centre for Medical Research, University of Tübingen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Pawelec
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Center, The Netherlands; Netherlands Consortium for Healthy Aging, Leiden University Medical Center, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Stijntjes
authors.affiliation: Netherlands Consortium for Healthy Aging, Leiden University Medical Center, The Netherlands; Department of Molecular Epidemiology, Leiden University Medical Center, The Netherlands.
authors.forename: P E
authors.initials: PE
authors.lastname: Slagboom
authors.affiliation: Department of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, Amsterdam, The Netherlands; Department of Medicine and Aged Care, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia. Electronic address: andrea.maier@mh.org.au.
authors.forename: A B
authors.initials: AB
authors.lastname: Maier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D018737:Hand Strength / Q000502:physiology; D006304:Health Status; D006801:Humans; D000068884:Immunosenescence; D016014:Linear Models; D008136:Longevity / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D057190:Stroop Test; D025803:Tumor Suppressor Protein p14ARF / Q000032:analysis; D000070857:Walk Test
chemical_list: D015415:Biomarkers; D025803:Tumor Suppressor Protein p14ARF; D002097:C-Reactive Protein
keywords: Aging; CD57; Functional capacity; Immunosenescence; Senescence; p16INK4a