Dataset Information

High-sensitivity C-reactive protein and mobility disability in older adults.

ABSTRACT: to determine the association of high sensitivity C-reactive protein (HsCRP) levels with a risk of mobility disability and decline in older adults with and without vascular disease.prospective cohort.community-residing population.six hundred and twenty-four adults age 70 and older (62% women) with gait and HsCRP assessments.incident mobility disability (velocity <70 cm/s) and annual rates of decline on gait velocity.elevated HsCRP levels (? 3 mg/l) at baseline present in 224 of the 624 eligible subjects was associated with a faster annual decline in gait velocity of 0.91 cm/s (P=0.02). Subjects with elevated HsCRP levels had increased risk of mobility disability (hazard ratio: 1.85, 95% CI: 1.09-3.14). Each one-unit increase in log HsCRP levels in the 406 subjects without prevalent mobility disability was associated with increased risk of mobility disability (hazard ratio: 1.33, 95% CI: 1.05-1.68). The association of baseline HsCRP levels with mobility disability and decline was stronger in the 224 individuals without vascular disease. The associations were not significant in the 400 subjects with vascular disease.HsCRP levels predict mobility disability and accelerated decline in walking speed in older adults. These associations were stronger in those without vascular disease.

SUBMITTER: Verghese J

PROVIDER: S-EPMC3500856 | biostudies-other | 2012 Jul

REPOSITORIES: biostudies-other

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High-sensitivity C-reactive protein and mobility disability in older adults.

Verghese Joe J Holtzer Roee R Lipton Richard B RB Wang Cuiling C

Age and ageing 20120314 4

<h4>Objective</h4>to determine the association of high sensitivity C-reactive protein (HsCRP) levels with a risk of mobility disability and decline in older adults with and without vascular disease.<h4>Design</h4>prospective cohort.<h4>Setting</h4>community-residing population.<h4>Subjects</h4>six hundred and twenty-four adults age 70 and older (62% women) with gait and HsCRP assessments.<h4>Main outcome measures</h4>incident mobility disability (velocity <70 cm/s) and annual rates of decline on ...[more]

PMID: 22417984

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Project description:ObjectiveTo identify quantitative measurement variables that characterize mobility in older adults, meet reliability and validity criteria, distinguish fall risk, and predict future falls.DesignObservational study with 1-year weekly falls follow-up.SettingMobility laboratory.ParticipantsCommunity-dwelling volunteers (N=74; age, 65-94y) categorized at entry as 27 nonfallers or 47 fallers by using Medicare criteria (1 injury fall or >1 noninjury fall in the previous year).InterventionsNone.Main outcome measuresTest-retest and within-subject reliability, criterion and concurrent validity; predictive ability indicated by observed sensitivity and specificity to entry fall-risk group (falls status), Tinetti Performance Oriented Mobility Assessment (POMA), computerized dynamic posturography Sensory Organization Test (SOT), and subsequent falls reported weekly.ResultsMeasurement variables were selected that met reliability (intraclass coefficient of correlation >.6) and/or discrimination (P<.01) criteria (clinical variables: turn steps and time, gait velocity, step-in-tub time, downstairs time; forceplate variables: quiet standing Romberg ratio sway area, maximal lean anterior-posterior excursion, sit-to-stand medial-lateral excursion, sway area). Sets were created (3 clinical, 2 forceplate) using combinations of variables appropriate for older adults with different functional activity levels, and composite scores were calculated. Scores identified entry falls status and concurred with POMA and SOT scores. The full clinical set (5 measurement variables) produced sensitivity of 80% and specificity of 74% to falls status. Composite scores were more sensitive and specific overall in predicting subsequent injury falls and multiple falls compared with falls status and POMA or SOT score.ConclusionsSets of quantitative measurement variables obtained with this mobility battery provided sensitive prediction of future injury falls and screening for multiple subsequent falls by using tasks that should be appropriate to diverse participants.

Project description:BackgroundThe ability to walk at various speeds is essential to independence for older adults. Maintaining fast walking requires changes in spatial-temporal measures, increasing step length and/or decreasing step time. It is unknown how mobility affects the parameters that change between preferred and fast walking.Research questionHow does preferred walking performance and measures of strength and mobility relate to the approach (decreasing step time or increasing step length) older adults at risk for mobility disability use to maintain fast walking speeds?.MethodsPeak isokinetic dynamometry of knee and ankle and several mobility evaluations, including the Timed Up-and-Go, Short Physical Performance Battery, and Dynamic Gait Index, assessed mobility and strength in 57 participants, aged 65-80. Biomechanical gait analysis was used to analyze step length, step time, gait speed at preferred and fast gait speeds and ground reaction force during preferred walking. A score combining the differences between step length and time at fast and preferred speeds (Length-Time Difference) separated participants into two groups: (1) Length, representing a predominant increase in step length to walk fast and (2) Time, a predominant decrease in step time.ResultsThose who decreased step time to produce increased speed performed worse during repeated chair stands (p = .006) with no difference in isokinetic strength (p ≥ .15). During preferred walking, the Time group displayed increased propulsive impulse compared to the Length group (p = .007), despite no differences in preferred speed, step length, or time (p ≥ .50).SignificanceWhile kinetics of preferred walking differed between groups separated by Length-Time Difference, basic spatial-temporals of preferred walking did not in this homogenous population. Length-Time Difference relates to a common mobility assessment and could be easily calculated by clinicians to provide a quantitative and more sensitive measure of ambulatory performance.

Dataset Information

High-sensitivity C-reactive protein and mobility disability in older adults.

Publications

High-sensitivity C-reactive protein and mobility disability in older adults.

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