Key result
Older adults with increasing or consistently high trajectories of depression, inflammation, and slow gait exhibited a high-risk phenotype with an adjusted mortality rate of 85.2%, compared to 48.3% in those with low-probability trajectories.
Why the study?
Do longitudinal trajectories of inflammation, depression, and slow gait predict mortality in older adults?
Cohort (n=3,075)
Yes
Do longitudinal trajectories of inflammation, depression, and slow gait predict mortality in older adults?
A high-mortality risk phenotype consisting of consistently high or increasing trajectories of inflammation, depression, and slow gait speed is associated with an 85.2% adjusted mortality rate over 15 years in older adults.
Answers are grounded in this paper and cite their sources.
Identifies high-mortality phenotype in older adults; hypothesis-generating and should not yet change practice.
BACKGROUND: Inflammation, slow gait, and depression individually are associated with mortality, yet little is known about the trajectories of these measures, their interrelationships, or their collective impact on mortality. METHODS: Longitudinal latent class analysis was used to evaluate trajectories of depression (Center for Epidemiologic Studies Depression ≥ 10), slow gait (<1.0 m/s), and elevated inflammation (interleukin 6 > 3.2 pg/mL) using data from the Health Aging and Body Composition Study. Logistic regression was used to identify their associations with mortality. RESULTS: For each outcome, low-probability (n inflammation = 1,656, n slow gait = 1,471, n depression = 1,458), increasing-probability (n inflammation = 847, n slow gait = 880, n depression = 1,062), and consistently high-probability (n inflammation = 572, n slow gait = 724, n depression = 555) trajectories were identified, with 22% of all participants classified as having increasing or consistently high-probability trajectories on inflammation, slow gait, and depression (meaning probability of impairment on each outcome increased from low to moderate/high or remained high over 10 years). Trajectories of slow gait were associated with inflammation (r = .40, p < .001) and depression (r = .49, p < .001). Although worsening trajectories of inflammation were independently associated with mortality (p < .001), the association between worsening trajectories of slow gait and mortality was only present in participants with worsening depression trajectories (p < .01). Participants with increasing/consistently high trajectories of depression and consistently high trajectories of inflammation and slow gait (n = 247) have an adjusted-morality rate of 85.2%, greater than all other classification permutations. CONCLUSIONS: Comprehensive assessment of older adults is warranted for the development of treatment strategies targeting a high-mortality risk phenotype consisting of inflammation, depression, and slow gait speed.
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Brown et al. (2015) conducted a cohort in Functionally intact older adults (n=3,075). Increasing or consistently high trajectories of inflammation, depression, and slow gait vs. Low-probability trajectories for inflammation, depression, and slow gait was evaluated on Mortality. Older adults with increasing or consistently high trajectories of depression, inflammation, and slow gait exhibited a high-risk phenotype with an adjusted mortality rate of 85.2%, compared to 48.3% in those with low-probability trajectories.
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