Szewieczek Jan, Francuz Tomasz, Dulawa Jan, Legierska Katarzyna, Hornik Beata, Włodarczyk Iwona, Janusz-Jenczeń Magdalena, Batko-Szwaczka Agnieszka
Department of Geriatrics, School of Health Sciences in Katowice, SUM, SPSK NR 7 SUM GCM, ul. Ziolowa 45/47, 40-635, Katowice, Poland,
Age (Dordr). 2015 Oct;37(5):85. doi: 10.1007/s11357-015-9822-9. Epub 2015 Aug 21.
Centenarians represent a rapidly growing population. To better characterize this specific age group, we have performed a cross-sectional study to observe associations between functional measures and a range of biochemical markers, including inflammatory markers and their significance as predictors of 360-day survival. Medical history and physical and functional assessment (Mini-Mental State Examination (MMSE), Katz Index (activities of daily living, ADL) and Barthel Index (Barthel Index) of Activities of Daily Living, and Lawton Instrumental Activities of Daily Living Scale (Lawton IADL)) were conducted on 86 101.9 ± 1.2-year-old (mean ± SD) subjects (70 women, 16 men). Blood tests were performed on 84 subjects of whom 43 also had extended biomarker assessment. As a reference group 30 51.8 ± 5.0-year old healthy subjects (20 women, 10 men) were recruited. The centenarians received follow-up phone calls. Fifty-two centenarians (60 %) survived ≥360 days. Longer survival was associated with higher MMSE (hazard ratio, HR = 0.934, 95 % confidence interval (CI) 0.896-0.975, P = .002), ADL (HR = 0.840, 95 % CI 0.716-0.985, P = .032), Barthel Index (HR = 0.988, 95 % CI 0.977-0.999, P = .026), and albumin level (HR .926, 95 % CI 0.870-0.986, P .016) and with lower white blood cell (WBC) (HR = 1.161, 95 % CI 1.059-1.273, P = .001), C-reactive protein (CRP) (HR = 1.032, 95 % CI 1.014-1.050, P < .001), IL-6 (HR = 1.182, 95 % CI 1.047-1.335, P = .007), and endothelin-1 (ET-1) level (HR = 3.711, 95 % CI 1.233-11.169, P = .020). Centenarians had higher 360-day survival probability with MMSE ≥13 (P < .001), ADL ≥1 (P < .001), Barthel Index ≥15 (P < .001), Lawton IADL ≥10 points (P = .009), WBC <8.3 G/L (P = .039), CRP <10 mg/L (P < .001), IL-6 <6 pg/mL (P .002), and ET-1 <1.1 pg/mL (P .007). Our results indicate that functional measures, inflammatory markers, and endothelin-1 are predictors of 360-day survival in centenarians.
百岁老人的数量正在迅速增长。为了更好地描述这个特定年龄组的特征,我们进行了一项横断面研究,以观察功能指标与一系列生化标志物之间的关联,包括炎症标志物及其作为360天生存率预测指标的意义。我们对86名年龄为101.9±1.2岁(均值±标准差)的受试者(70名女性,16名男性)进行了病史、身体和功能评估(简易精神状态检查表(MMSE)、卡茨指数(日常生活活动能力,ADL)、巴氏日常生活活动指数(Barthel指数)以及劳顿工具性日常生活活动量表(Lawton IADL))。对84名受试者进行了血液检测,其中43名还进行了扩展生物标志物评估。作为参照组,招募了30名年龄为51.8±5.0岁的健康受试者(20名女性,10名男性)。对百岁老人进行了随访电话调查。52名百岁老人(60%)存活时间≥360天。存活时间较长与较高的MMSE(风险比,HR = 0.934,95%置信区间(CI)0.896 - 0.975,P = 0.002)、ADL(HR = 0.840,95% CI 0.716 - 0.985,P = 0.032)、巴氏指数(HR = 0.988,95% CI 0.977 - 0.999,P = 0.026)以及白蛋白水平(HR 0.926,95% CI 0.870 - 0.986,P 0.016)相关,且与较低的白细胞(WBC)(HR = 1.161,95% CI 1.059 - 1.273,P = 0.001)、C反应蛋白(CRP)(HR = 1.032,95% CI 1.014 - 1.050,P < 0.001)、白细胞介素-6(IL-6)(HR = 1.182,95% CI 1.047 - 1.335,P = 0.007)以及内皮素-1(ET-1)水平(HR = 3.711,95% CI 1.233 - 11.169,P = 0.020)相关。当MMSE≥13(P < 0.001)、ADL≥1(P < 0.001)、巴氏指数≥15(P < 0.001)、劳顿IADL≥10分(P = 0.009)、WBC < 8.3 G/L(P = 0.039)、CRP < 10 mg/L(P < 0.001)、IL-6 < 6 pg/mL(P 0.002)以及ET-1 < 1.1 pg/mL(P 0.007)时,百岁老人具有较高的360天生存概率。我们的结果表明,功能指标、炎症标志物和内皮素-1是百岁老人360天生存率的预测指标。