title: Predictors of short-term mortality, cognitive and physical decline in older adults in northwest Russia: a population-based prospective cohort study.
abstract: BACKGROUND
  The classical phenotype, accumulated deficit model and self-report approach of frailty were found not useful in older adults in northwest Russia. More research is needed to identify predictors of adverse outcomes in this population.
  
  
  OBJECTIVE
  The aim of this study is to identify predictors of mortality, autonomy and cognitive decline in a population that is characterized by a high cardiovascular morbidity and mortality rate.
  
  
  METHODS
  A population-based prospective cohort study of 611 community-dwelling individuals 65+. Anthropometry, medical history nutritional status were recorded. An evaluation of cognitive, physical and autonomy function, spirometry, and laboratory tests were performed. The total follow-up was 5 years. Multiple imputation, backward stepwise Cox regression analysis, C-statistic, risk reclassification analysis and the bootstrapping techniques were used to analyze the data.
  
  
  RESULTS
  We found that the combination of increasing age, male sex, low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s and anemia was associated with mortality for people 65+. The substitution of anemia with anemia + high level of C-reactive protein (hCRP) and the addition of high brain natriuretic peptide (hBNP) levels improved the classification of older persons at risk for mortality.
  
  
  CONCLUSIONS
  The combination of low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s, anemia with hCRP levels and hBNP identified older persons at a higher risk for mortality. These predictors may be used for the development of a prediction model to detect older people who are at risk for adverse health outcomes in northwest Russia.
authors: Institut de Recherche Santé et Société, Université Catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte 30.05, 1200, Woluwe-Saint-Lambert, Brussels, Belgium. anna.turusheva@gmail.com.
authors: Anna
authors: http://orcid.org/0000-0003-3347-0984
authors: A
authors: Turusheva
authors: The Northwestern State Medical University named after I.I. Mechnikov, Prosveshenya 45, St. Petersburg, Russia, 194 291.
authors: Elena
authors: E
authors: Frolova
authors: Institut de Recherche Santé et Société, Université Catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte 30.05, 1200, Woluwe-Saint-Lambert, Brussels, Belgium.
authors: Eralda
authors: E
authors: Hegendoerfer
authors: Institut de Recherche Santé et Société, Université Catholique de Louvain, Clos Chapelle-aux-Champs, 30 bte 30.05, 1200, Woluwe-Saint-Lambert, Brussels, Belgium.|Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35 Blok d, Box 7001, 3000, Louvain, Belgium.
authors: Jean-Marie
authors: JM
authors: Degryse
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D000073496:Frailty / Q000453:epidemiology*; D006801:Humans; D008297:Male; D009026:Mortality / Q000639:trends*; D009752:Nutritional Status / Q000502:physiology; D010807:Physical Endurance; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012426:Russia / Q000453:epidemiology; D012737:Sex Factors
keywords: Mental decline; Mortality; Older adults; Physical decline; Risk prediction model; Russia