Clinical Interventions in Aging (Aug 2022)
Predictors of Adverse Outcomes in Healthy Aging Adults: Coronary Artery Disease, Lower Educational Status and Higher P-Selectin Levels
Abstract
Agnieszka Batko-Szwaczka,1 Tomasz Francuz,2 Agnieszka Kosowska,2 Anna Cogiel,1 Joanna Dudzińska-Griszek,1 Krzysztof Wilczyński,1 Beata Hornik,3 Magdalena Janusz-Jenczeń,3 Iwona Włodarczyk,3 Bartosz Wnuk,4 Joanna Szołtysek,4 Jacek Durmała,4 Jan Dulawa,5 Jan Szewieczek1 1Department of Geriatrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 2Department of Biochemistry, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 3Department of Internal Nursing, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 4Department of Rehabilitation, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland; 5Department of Internal Medicine and Metabolic Diseases, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, PolandCorrespondence: 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 [email protected]: 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 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.Keywords: comprehensive geriatric assessment, frailty phenotype, community-dwelling older adults, healthy aging, adverse events, coronary artery disease, education, P-selectin
