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      Clinical Interventions in Aging (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on prevention and treatment of diseases in people over 65 years of age. Sign up for email alerts here.

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      Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels

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          Abstract

          Background

          Societal aging – as a global demographic phenomenon – shows no indication of abating. As a result, the problem of age-associated disability and related long-term care is emerging as a major public health challenge. It is important that methods for identifying older adults at risk of adverse outcomes are implemented early.

          Methods

          The study group consisted of 145 individuals, 44.1% women, who were randomized from community-dwelling 60–74-year-old adults. A comprehensive geriatric assessment was supplemented with Fried frailty phenotype evaluation and blood tests (including adhesion molecules, matrix metalloproteinases and neurotrophic factors). A follow-up by phone call was made for at least 3 years after the initial examination. Composite endpoint (CE) included falls, hospitalization, institutionalization and death.

          Results

          Mean study group age was 66.5 ± 4.1 years ( ) and mean number of diseases was 3.7 ± 2.2. Functional status of the subjects was good, as indicated by high Barthel Index scores of 99.1 ± 2.4, MMSE scores of 29.0 ±1.5 and no frailty case. During a three-year follow-up, 71 participants (49.0%) experienced any CE-events. The Wilcoxon-Gehan test indicates that a higher probability of three-year CE completion was associated with an age >65 years (P = 0.006), coronary artery disease (CAD) (P = 0.008), 6-Minute Walk Test <432 m (P = 0.034), serum glucose >120 mg/dL (P = 0.047), serum cortisol >10 μg/dL (P = 0.011), leptin ≥15 ng/mL (P = 0.018), P-selectin ≥23 ng/mL (P = 0.006) and GDNF ≥20 pg/mL (P = 0.004). CAD (OR = 3.64, 95% CI = 1.53−8.69, P = 0.004), educational status (OR = 0.87, 95% CI = 0.77−0.98, P = 0.022) and P-selectin levels (OR = 1.07, 95% CI = 1.02−1.13, P = 0.013) were independent measures predicting three-year CE occurrence in multivariate logistic regression analysis adjusted for clinical and functional measures, and blood tests.

          Conclusion

          Coronary artery disease, poorer lower educational status and higher P-selectin levels were predictive of adverse outcomes in the community-dwelling healthy-aging early-old adults during three-year follow-up.

          Most cited references67

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          A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation

          The objective of this study was to develop a prospectively applicable method for classifying comorbid conditions which might alter the risk of mortality for use in longitudinal studies. A weighted index that takes into account the number and the seriousness of comorbid disease was developed in a cohort of 559 medical patients. The 1-yr mortality rates for the different scores were: "0", 12% (181); "1-2", 26% (225); "3-4", 52% (71); and "greater than or equal to 5", 85% (82). The index was tested for its ability to predict risk of death from comorbid disease in the second cohort of 685 patients during a 10-yr follow-up. The percent of patients who died of comorbid disease for the different scores were: "0", 8% (588); "1", 25% (54); "2", 48% (25); "greater than or equal to 3", 59% (18). With each increased level of the comorbidity index, there were stepwise increases in the cumulative mortality attributable to comorbid disease (log rank chi 2 = 165; p less than 0.0001). In this longer follow-up, age was also a predictor of mortality (p less than 0.001). The new index performed similarly to a previous system devised by Kaplan and Feinstein. The method of classifying comorbidity provides a simple, readily applicable and valid method of estimating risk of death from comorbid disease for use in longitudinal studies. Further work in larger populations is still required to refine the approach because the number of patients with any given condition in this study was relatively small.
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            "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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              Frailty in Older Adults: Evidence for a Phenotype

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                Author and article information

                Journal
                Clin Interv Aging
                Clin Interv Aging
                cia
                Clinical Interventions in Aging
                Dove
                1176-9092
                1178-1998
                05 August 2022
                2022
                : 17
                : 1173-1185
                Affiliations
                [1 ]Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia , Katowice, Poland
                [2 ]Department of Biochemistry, Faculty of Medical Sciences in Katowice, Medical University of Silesia , Katowice, Poland
                [3 ]Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia , Katowice, Poland
                [4 ]Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia , Katowice, Poland
                [5 ]Department of Internal Medicine and Metabolic Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia , Katowice, Poland
                Author notes
                Correspondence: Agnieszka Batko-Szwaczka, Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia , Poniatowskiego 15, Katowice, 40-055, Poland, Tel +48323598239, Fax +48322059483, Email abatko-szwaczka@sum.edu.pl
                Author information
                http://orcid.org/0000-0003-0281-7041
                http://orcid.org/0000-0002-4426-2227
                http://orcid.org/0000-0002-0106-9216
                http://orcid.org/0000-0001-9485-600X
                http://orcid.org/0000-0002-2574-6955
                http://orcid.org/0000-0002-0763-7106
                http://orcid.org/0000-0002-2230-9258
                http://orcid.org/0000-0002-8674-2245
                Article
                363881
                10.2147/CIA.S363881
                9362850
                35957925
                8939f38c-fcea-4681-a344-22eeb7cb825b
                © 2022 Batko-Szwaczka et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 24 February 2022
                : 02 July 2022
                Page count
                Figures: 2, Tables: 6, References: 69, Pages: 13
                Funding
                Funded by: funded by Medical University of Silesia grants to statutory;
                This project was funded by Medical University of Silesia grants to statutory work (contracts KNW-1-014/K/6/Z, KNW-1-055/K/7/Z and KNW-1-026/K/8/Z and PCN-1-030/K/0/2).
                Categories
                Original Research

                Health & Social care
                comprehensive geriatric assessment,frailty phenotype,community-dwelling older adults,healthy aging,adverse events,coronary artery disease,education,p-selectin

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