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BACKGROUND AND AIMS: Knowledge of how intrinsic capacity (IC) shape functional ability (FA) trajectories in later life remains unclear. We investigated the changes in IC and their impact on 5-years FA trajectories in the Chinese older population. METHODS: A total of 1640 older adults from the Rugao Longitudinal Ageing Study were included and analyzed. FA was assessed by The Lawton Instrumental Activities of Daily Living Scale (IADLs). We used cognition, psychology, locomotion, sensory capacity, and vitality to capture the multiple domains of IC according to the ICOPE method. The IC was derived retrospectively from variables collected before this was described by WHO. RESULTS: At baseline, a higher IC was associated with higher IADLs (ß = 0.98, 95% CI 0.90, 1.06, P < 0.001). Individuals with declines in IC between wave1 and wave2 experienced a faster decline in IADLs over time (ß = - 0.28, 95% CI - 0.40, - 0.16, P < 0.001) after considering covariates. One or more impairment IC scores at baseline strongly predicted death (HR = 1.20, 95% CI 1.11, 1.30, P < 0.001). In addition, according to the IC scores at baseline, we stratify IC in low, middle, and high, compared with those in the high IC score, those in the low were associated with a 2.56-fold (95% CI 1.64, 4.01, P < 0.001) higher risk of mortality, after adjustment for variables. CONCLUSION: Changes in IC shape FA trajectories. IC impairment is associated with an increased risk of death. Assessing intrinsic capacity would facilitate early identification of older adults at high risk of adverse outcomes and prompt targeted interventions.
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Actividades Cotidianas , Envejecimiento , Longevidad , Anciano , Humanos , Actividades Cotidianas/psicología , Pueblos del Este de Asia , Estudios Retrospectivos , Estado FuncionalRESUMEN
BACKGROUND AND AIMS: To explore whether frailty, defined by frailty index (FI), is associated with the risk of elevated B-type natriuretic peptide (BNP), a surrogate endpoint of cardiovascular events. METHODS: Data of 1382 community-dwelling elders who had no documented cardiovascular diseases aged 70-84 years from the ageing arm of the Rugao Longevity and Ageing Study was used. Traditional risk factor index (TI) was constructed using eight established cardiovascular-related risk factors. FI was constructed using 36 health deficits. Elevated BNP was defined as BNP ≥ 100pg/mL. Cardiovascular events include incident major cardiovascular events and cardiovascular death. RESULTS: During a 3-year follow-up period, 97 participants had cardiovascular events. TI was not associated with the risk of elevated BNP, but was associated with cardiovascular events (HR = 1.16, 95% CI 1.01-1.34). Frailty index was not only associated with cardiovascular events (HR = 1.32, 95% CI 1.06-1.64), but also associated with elevated BNP with an OR of 1.22 (95% CI 1.02-1.47) for each 0.1 increment. Further, both frailty (OR = 1.93, 95% CI 1.67-3.17) and pre-frailty (OR = 1.54, 95% CI 1.06-2.25) were associated with increased risk of elevated BNP. CONCLUSION: FI is associated with increased risks of both cardiovascular events and surrogated endpoint of cardiovascular disease-elevated BNP. Frailty may be a non-traditional risk factor of cardiovascular diseases and frailty index may be a measurement for early identifying high risk elderly individuals of cardiovascular abnormities.
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Enfermedades Cardiovasculares , Fragilidad , Péptido Natriurético Encefálico/sangre , Anciano , Anciano de 80 o más Años , Biomarcadores , Enfermedades Cardiovasculares/diagnóstico , Femenino , Humanos , Vida Independiente , Longevidad , Masculino , Factores de RiesgoRESUMEN
BACKGROUND AND AIMS: This study aimed at investigating whether depression symptoms are associated with prevalent and incident physical frailty in Chinese older population. METHODS: We analyzed data of 1168 older Chinese adults aged 70 and above in the aging arm of the Rugao Longevity and Aging Study (RuLAS). Depressive symptoms (Geriatric Depression Scale ≥ 6) were assessed by the Geriatric Depression Scale. Frailty was defined using Fried phenotype criteria at baseline and 3-year survey. RESULTS: At baseline, 8.9% of the participants had depression symptoms. The prevalence of pre-frailty and frailty were 34.5% and 5.9%, respectively. The percentages of depressive symptoms increase from robust (5.3%) to pre-frail (11.2%), and then to frail (31.9%) groups. After adjustments of multiple covariates, depressive symptoms were associated with both prevalent pre-frailty (OR = 1.75, 95% CI 1.08-2.84) and prevalent frailty (OR = 5.64, 95% CI 2.85-11.14) at baseline. At 3-year survey, 9.3% participants reported the development of frailty. After multiple adjustments, depressive symptoms were associated with a 2.79-fold (95% CI 1.09-7.10) increased risk of 3-year incident frailty. CONCLUSION: Depressive symptoms are associated with prevalent and incident frailty in Chinese older population. Together with the observations of the European populations, depressive symptoms may be a candidate risk factor of frailty.
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Depresión , Fragilidad , Anciano , Envejecimiento , Pueblo Asiatico , Estudios Transversales , Depresión/epidemiología , Anciano Frágil , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , Longevidad , Persona de Mediana EdadRESUMEN
BACKGROUND: To explore the cross-sectional and longitudinal associations between frailty and incident depressive symptoms in a Chinese elderly sample. METHODS: We analysed data of 1264 older Chinese elders aged 70-87 years in the Rugao Longevity and Ageing Study. The frailty phenotype was assessed using the Fried criteria and depression symptoms was measured by the Geriatric Depression Scale. RESULTS: At baseline, 10.6% of participants had depressive symptoms and 9.0% had frailty. In cross-sectional analysis, both pre-frailty (odds ratio (OR) = 2.18, 95% CI 1.35-3.51) and frailty (OR = 4.64, 95% CI 2.49-8.66) were associated with depressive symptoms. In longitudinal analyses, frailty (OR = 2.12, 95% CI 1.17-3.83), instead of pre-frailty, was associated with 1.5-year incident depressive symptoms in a full-adjusted model among participants free of baseline depressive symptoms. In the components of frailty, lower grip strength was associated with increased risk of depressive symptoms onset (OR = 1.56, 95% CI 1.06-2.29). CONCLUSIONS: Frailty and lower grip strength were associated with incident depressive symptoms in a Chinese elderly sample. Interventions designed to prevent depressive symptoms may be useful by utilising physical aspects of the elderly population.
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Envejecimiento , Depresión , Fragilidad , Anciano , Anciano de 80 o más Años , Envejecimiento/psicología , China/epidemiología , Estudios Transversales , Depresión/epidemiología , Anciano Frágil , Fragilidad/diagnóstico , Fragilidad/epidemiología , Evaluación Geriátrica , Humanos , LongevidadRESUMEN
Objective: To examine the associations of the actinin alpha 3 gene (ACTN3) R577X polymorphism with physical performance and frailty in an older Chinese population. Methods: Data from 1,463 individuals (57.8% female) aged 70-87 years from the Rugao Longevity and Ageing Study were used. The associations between R577X and timed 5-m walk, grip strength, timed Up and Go test, and frailty index (FI) based on deficits of 23 laboratory tests (FI-Lab) were examined. Analysis of variance and linear regression models were used to evaluate the genetic effects of ACTN3 R577X on physical performance and FI-Lab. Results: The XX and RX genotypes of the ACTN3 R557X polymorphism accounted for 17.1 and 46.9%, respectively. Multivariate regression analysis revealed that in men aged 70-79 years, the ACTN3 577X allele was significantly associated with physical performance (5-m walk time, regression coefficient (ß) = 0.258, P = 0.006; grip strength, ß = -1.062, P = 0.012; Up and Go test time ß = 0.368, P = 0.019). In women aged 70-79 years, a significant association between the ACTN3 577X allele and the FI-Lab score was observed, with a regression coefficient of ß = 0.019 (P = 0.003). These findings suggest an age- and gender-specific X-additive model of R577X for 5-m walk time, grip strength, Up and Go Test time, and FI-Lab score. Conclusion: The ACTN3 577X allele is associated with an age- and sex-specific decrease in physical performance and an increase in frailty in an older population.
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Actinina/genética , Fragilidad/genética , Longevidad/genética , Polimorfismo Genético , Factores de Edad , Anciano , Anciano de 80 o más Años , Pueblo Asiatico/genética , China/epidemiología , Femenino , Fragilidad/diagnóstico , Fragilidad/etnología , Fragilidad/fisiopatología , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Evaluación Geriátrica/métodos , Fuerza de la Mano , Humanos , Masculino , Fenotipo , Reacción en Cadena en Tiempo Real de la Polimerasa , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Prueba de PasoRESUMEN
OBJECTIVES: to examine the associations of two common CRP gene polymorphisms with CRP levels, frailty and co-morbidity in an elderly Chinese population. DESIGN: a population-based cohort study. SETTING AND PARTICIPANTS: we obtained data on 1,723 elderly participants aged 70-84 from the ageing arm of the Rugao Longevity and Ageing study (RuLAS), a population-based observational cohort study conducted in Rugao, Jiangsu province, China. MEASUREMENTS: the genotyping of two common CRP gene polymorphisms (rs1205 and rs3093059) was performed. Items concerning the frailty index and co-morbidity were collected. RESULTS: the mean age of the study population was 75.3 ± 3.9 years, and 53.5% (n = 922) were women. The minor allele frequencies of rs1205 and rs3093059 were 42.4% (C allele) and 16.9% (C allele), respectively. The polymorphisms rs1205 and rs3093059 were significantly associated with CRP levels (ß = 0.113 and 0.222, all P < 0.001). Non-significant association between rs1205 and rs3093059 and frailty, as well as between rs3093059 and co-morbidity was observed. However, SNP rs1205 CC genotype had an increased odds of co-morbidity compared with the TT genotype (odds ratio (OR):1.53; 95% confidence interval (CI): 1.16-2.02). Each additional copy of the C allele of SNP rs1205 was associated with 1.23 times (95% CI: 1.07-1.41) odds of co-morbidity. The significance remained after controlling for covariates such as education level, etc. CONCLUSIONS: among elderly Chinese individuals, two CRP gene polymorphisms were significantly associated with CRP levels. However, none of them was associated with frailty. The preliminary findings warrant further validations.
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Envejecimiento/etnología , Envejecimiento/genética , Proteína C-Reactiva/genética , Comorbilidad , Susceptibilidad a Enfermedades/etnología , Anciano , Anciano de 80 o más Años , Pueblo Asiatico/genética , Proteína C-Reactiva/metabolismo , China , Estudios de Cohortes , Intervalos de Confianza , Femenino , Evaluación Geriátrica/métodos , Humanos , Longevidad/genética , Masculino , Oportunidad Relativa , Polimorfismo de Nucleótido Simple , Análisis de SupervivenciaRESUMEN
Objective: To explore the associations of common mitochondrial DNA polymorphisms with chronic kidney disease (CKD). Methods: Data from 286 longevous individuals aged 95 years or older from the longevity arm from the Rugao Longevity and Ageing Study (RuLAS) were used. Twenty-eight common haplogroups defined by 33 single nucleotide polymorphisms were genotyped using SNaPshot minisequencing reaction assays. The creatinine-based estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Results: The prevalence of CKD was 23.6% among the longevous participants aged 95 years and older. The D haplogroup (67.37 ± 14.72 vs. 70.65 ± 11.07, p = 0.045), the D5 haplogroup (60.86 ± 18.36 vs. 70.34 ± 11.53, p = 0.002), and the 5178A allele (67.23 ± 14.48 vs. 70.75 ± 11.10, p = 0.029) were associated with lower eGFR levels compared with noncarriers. The D5 haplogroup (13.8% vs. 3.6%, p = 0.005) was significantly higher, while D haplogroup (35.4% vs. 24%, p = 0.067) and the 5178A allele (36.9% vs. 24.9%, p = 0.056) were borderline significantly higher in CKD individuals than those without CKD. Further, after adjusting for multiple covariates, the D haplogroup, the D5 haplogroup, and the 5178A allele were associated with increased odds of CKD with odds ratios of 1.93 (95% confidence interval [CI]: 1.00-3.72, p = 0.050), 4.76 (95% CI: 1.49-15.22, p = 0.009) and 2.04 (95% CI: 1.05-3.96, p = 0.035), respectively. Conclusions: The D and D5 haplogroups, as well as the 5178A allele are associated with decreased eGFR levels and an increased risk of CKD in a longevous population.
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ADN Mitocondrial/genética , Insuficiencia Renal Crónica/genética , Anciano de 80 o más Años , China , Creatinina , ADN Mitocondrial/metabolismo , Femenino , Expresión Génica/genética , Perfilación de la Expresión Génica/métodos , Genes erbB-1/genética , Genotipo , Tasa de Filtración Glomerular , Haplotipos/genética , Humanos , Longevidad , Masculino , Mitocondrias/genética , Polimorfismo de Nucleótido Simple/genética , Insuficiencia Renal Crónica/metabolismo , Transcriptoma/genéticaRESUMEN
BACKGROUND: To explore the associations of frailty phenotype and frailty index (FI) defined frailty and pre-frailty with mortality in a Chinese elderly population. METHODS: Data of 1788 community-dwelling elders aged 70-84 years from the ageing arm of Rugao Longevity and Ageing Study, a prospective cohort study, were used. Frailty phenotype was defined using modified Fried's phenotype (FP) criteria and FI was constructed using 45 health deficits. Mortality was ascertained using the Death Registry of Rugao's Civil Affairs Bureau. RESULTS: During 3-year follow-up, 149 (8.3%) of the 1788 elderly subjects died. For frailty phenotype, about 9.5% of the elderly were frail and 43% were pre-frail. For FI, frail (FI > 0.21) was approximately 27.5%, and pre-frail (FI: 0.1-0.21) was approximately 51.3%. Highest mortality was observed among frail participants defined by both FP and FI criteria (all Log Rank P < 0.05). Frailty defined by the frailty index was associated with a 2.31 fold (95% CI 1.16-4.6) risk of all-cause death compared with robust elderly. Compared with the robust elderly, not only frailty (HR 2.24, 95% CI 1.31-3.83) defined by frailty phenotype but also pre-frailty (HR 1.51, 95% CI 1.03-2.21) was associated with risk of all-cause mortality. CONCLUSIONS: Frailty, defined by either phenotype or index, is associated with increased risks of mortality in elderly Chinese community population.
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Fragilidad , Longevidad , Anciano , Anciano de 80 o más Años , Envejecimiento , Causas de Muerte , Femenino , Anciano Frágil , Humanos , Vida Independiente , Masculino , Fenotipo , Estudios Prospectivos , RiesgoRESUMEN
BACKGROUND: Risk factors for heart rate-corrected QT interval (QTc) proglongation should be explored to stratify high-risk individuals to aid the prevention of incident cardiovascular events and mortality. The diversity of risk factors for QTc prolongation suggests that use of the frailty index (FI), indicating general health deficits, may be an effective approach, especially in the elderly, to identify the risk of QTc prolongation. METHODS: We used the data of 1,780 individuals aged 70-87 years from the Rugao Longevity and Ageing Study (RuLAS), a community-based longitudinal study. The FI was constructed using 20 routine laboratory tests, plus the body mass index and measures of systolic and diastolic blood pressures (FI-Lab). RESULTS: The mean FI-Lab value was 0.24±0.09. The mean heart rate-corrected QT interval (QTc) was 407±38 ms. The prevalence of QTc prolongation was 5.2% in elderly community populations aged 70-87 years. A higher FI-Lab value was associated with a higher risk for QTc prolongation. Each 10% increase in the FI-Lab value increased the odds ratio (OR) by 33% (OR: 1.33; 95% CI: 1.07-1.64). Compared with the lowest quartile, the top quartile FI-Lab score was associated with a 2.50-fold QTc prolongation risk in elderly individuals (95% CI: 1.21-5.19). CONCLUSION: An FI based on routine laboratory data can identify older adults at increased risk for QTc prolongation. The FI approach may therefore be useful for the risk stratification of QTc prolongation.
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Envejecimiento/fisiología , Arritmias Cardíacas/etiología , Electrocardiografía , Fragilidad/complicaciones , Evaluación Geriátrica , Frecuencia Cardíaca/fisiología , Longevidad/fisiología , Anciano , Anciano de 80 o más Años , Arritmias Cardíacas/epidemiología , Arritmias Cardíacas/fisiopatología , China/epidemiología , Femenino , Fragilidad/epidemiología , Fragilidad/fisiopatología , Humanos , Masculino , Oportunidad Relativa , Prevalencia , Factores de RiesgoRESUMEN
OBJECTIVE: To examine the associations between genetic variants of KSR2 (kinase suppressor of RAS)-rs7973260, RAPGEF6 (guanine nucleotide exchange factor 6)-rs3756290, LOC105377703-rs4481363, and subjective well-being (SWB) and depressive symptoms (DSs) in Chinese elders, which were recently associated in a genome-wide association study conducted in Caucasians. The pleiotropic effects of KSR2-rs7973260 on metabolic phenotypes were also explored. MATERIALS AND METHODS: We used data from 1788 older individuals aged 70-84 years from the aging arm of the Rugao Longevity and Aging Study, a population-based cohort study conducted in the Jiangsu province of China. RESULTS: No significant distributions of genotype frequencies were observed between life-satisfied and -unsatisfied groups across those with the three polymorphisms. The level of SWB components (positive affect, negative affect, and affect balance) and DSs did not differ among genotypes of the three variants. However, the presence of GA+AA of KSR2-rs7973260 was significantly higher in the metabolic syndrome (MetS), severe hypertriglyceridemia (HTG), and diabetes groups than in control groups (43.7% vs. 37.6%, 46.4% vs. 37.6%, 45.8% vs. 37.9%, respectively). The A allele of rs7973260 was associated with increased risk of MetS, severe HTG, and diabetes with an odds ratios (95% confidence intervals) of 1.289 (1.002-1.658), 1.438 (1.076-1.921), and 1.384 (1.022-1.875), which remained significant after multiple adjustments. CONCLUSION: Rs7973260, rs3756290, and rs4481363 were not associated with SWB and DSs in Chinese elders. However, the KSR2-rs7973260 A allele exhibited pleiotropic effects on some metabolic phenotypes in Chinese elders. These effects should be validated in future studies.
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Depresión/genética , Proteínas Serina-Treonina Quinasas/genética , Anciano , Anciano de 80 o más Años , Alelos , Pueblo Asiatico/genética , Mentón , China , Estudios de Cohortes , Depresión/metabolismo , Autoevaluación Diagnóstica , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Variación Genética , Estudio de Asociación del Genoma Completo , Genotipo , Factores de Intercambio de Guanina Nucleótido/genética , Factores de Intercambio de Guanina Nucleótido/metabolismo , Humanos , Masculino , Metabolismo/genética , Fenotipo , Polimorfismo de Nucleótido Simple/genética , Proteínas Serina-Treonina Quinasas/metabolismoRESUMEN
OBJECTIVE: To observe clinical effect of different treatments for tennis elbow with small needle-knife according to its classification. METHODS: From March 2011 to December 2012,100 patients with 123 tennis elbows were treated with small needle-knife, including 36 males and 64 females, ranging in age from 29 to 76 years old (averaged, 49 years old). The course of disease ranged from 3 months to 2 years (averaged, 7.2 months). According to the classification, 46 elbows were with extra-articular type, 34 elbows with intra-articular type, 20 elbows with mixed type. All the patients were treated with small needle-knife by using different methods according to its classification. RESULTS: All patients were followed up for 6 to 12 months with an average of 8.2 months. After treatment, the symptoms and signs of the patients improved significantly (P < 0.01). According to the criteria of the Verhaar scoring system, 35 of 46 patients with extra-articular type got an excellent result, 9 good, 2 fair; 24 of 34 patients with intra-articular type got an excellent result, 9 good, 1 fair; 9 of 20 patients with mixed type got an excellent result, 8 good, 3 fair. CONCLUSION: The causes of tennis elbow can not be explained by single pathogenesy, the patients with tennis elbow should be treated with different methods according to its classification, and the therapeutic effects can be improved.