title: SENIORLAB: a prospective observational study investigating laboratory parameters and their reference intervals in the elderly.
abstract: BACKGROUND
  In clinical practice, laboratory results are often important for making diagnostic, therapeutic, and prognostic decisions. Interpreting individual results relies on accurate reference intervals and decision limits. Despite the considerable amount of resources in clinical medicine spent on elderly patients, accurate reference intervals for the elderly are rarely available. The SENIORLAB study set out to determine reference intervals in the elderly by investigating a large variety of laboratory parameters in clinical chemistry, hematology, and immunology.
  
  
  METHODS
  The SENIORLAB study is an observational, prospective cohort study. Subjectively healthy residents of Switzerland aged 60 years and older were included for baseline examination (n = 1467), where anthropometric measurements were taken, medical history was reviewed, and a fasting blood sample was drawn under optimal preanalytical conditions. More than 110 laboratory parameters were measured, and a biobank was set up. The study participants are followed up every 3 to 5 years for quality of life, morbidity, and mortality. The primary aim is to evaluate different laboratory parameters at age-related reference intervals. The secondary aims of this study include the following: identify associations between different parameters, identify diagnostic characteristics to diagnose different circumstances, identify the prevalence of occult disease in subjectively healthy individuals, and identify the prognostic factors for the investigated outcomes, including mortality.
  
  
  CONCLUSIONS
  To obtain better grounds to justify clinical decisions, specific reference intervals for laboratory parameters of the elderly are needed. Reference intervals are obtained from healthy individuals. A major obstacle when obtaining reference intervals in the elderly is the definition of health in seniors because individuals without any medical condition and any medication are rare in older adulthood. Reference intervals obtained from such individuals cannot be considered representative for seniors in a status of age-specific normal health. In addition to the established methods for determining reference intervals, this longitudinal study utilizes a unique approach, in that survival and long-term well-being are taken as indicators of health in seniors. This approach is expected to provide robust and representative reference intervals that are obtained from an adequate reference population and not a collective of highly selected individuals.
  
  
  BACKGROUND
  The present study was registered under International Standard Randomized Controlled Trial Number registry: ISRCTN53778569.
authors.affiliation: Kantonsspital Graubünden, Chur Labormedizinisches Zentrum Dr. Risch, Liebefeld bei Bern, Bern, Switzerland Private University Triesen, Liechtenstein University of Bern, University Institute of Clinical Chemistry, Bern, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Risch
authors.forename: Urs
authors.initials: U
authors.lastname: Nydegger
authors.forename: Lorenz
authors.initials: L
authors.lastname: Risch
mesh_terms: D000368:Aged; D000375:Aging; D019963:Clinical Chemistry Tests / Q000592:standards; D019411:Clinical Laboratory Techniques / Q000592:standards*; D005260:Female; D064368:Healthy Volunteers; D006403:Hematologic Tests / Q000592:standards; D006801:Humans; D007159:Immunologic Tests / Q000592:standards; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012016:Reference Values; D013557:Switzerland