Associations of C-reactive protein and homocysteine concentrations with the impairment of intrinsic capacity domains over a 5-year follow-up among community-dwelling older adults at risk of cognitive decline (MAPT Study).
Exp Gerontol
; 127: 110716, 2019 11.
Article
em En
| MEDLINE
| ID: mdl-31493520
ABSTRACT
BACKGROUND:
The World Health Organization (WHO) recently proposed an innovative model of care focusing on functional rather than disease-based perspectives, based on a construct of intrinsic capacity (IC).OBJECTIVE:
This study aimed to analyze if low-grade inflammation (LGI) (chronically raised C-reactive protein - CRP) and hyperhomocysteinemia (HHcy) were associated with variation in IC domains (mobility, cognition, psychological and vitality) and in a combined IC Z-score over a 5-year follow-up among non-demented, community-dwelling older adults at risk of cognitive decline.DESIGN:
This observational study included 1516 subjects ≥70â¯years (64.5% female, mean age 75.4â¯years, SDâ¯=â¯4.5), volunteers from the interventional study Multidomain Alzheimer Preventive Trial (MAPT). Plasma CRP (at baseline, 6 and 12â¯months) and homocysteine (at baseline) concentrations were measured. LGI was defined as having ≥2 consecutively CRP readings >3 to 10â¯mg/L between baseline and 12â¯months, and HHcy was defined as homocysteine >15⯵M/L. IC domains were operationalized as follows Psychological. Depressive symptoms evaluated by the Geriatric Depression Scale (GDS); Mobility. Assessed by the Short Physical Performance Battery (SPPB); Cognitive function. Examined by a Z-score combining four tests; Vitality. Based on hand grip strength. Outcomes were combined into a composite IC Z-score.RESULTS:
IC Z-score decreased among groups with no inflammation and LGI after 5â¯years, but this decrease was more pronounced among the LGI group (unadjusted mean group difference 0.09, 95%CI 0.01 to 0.16; pâ¯=â¯0.032). Participants with HHcy also presented IC Z-score decreases over time. Combined conditions provided more pronounced declines, even after adjusting for potential confounders.CONCLUSION:
LGI and HHcy were both related with impairment on the combined IC levels among older adults after a 5-year follow-up. Identifying biomarkers that strongly associate with IC may help to settle strategies aiming to prevent the incidence and slow down the evolution of age-related functional decline and care dependency.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Proteína C-Reativa
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Disfunção Cognitiva
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Homocisteína
Tipo de estudo:
Clinical_trials
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article