Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Nini H Jonkman; Vieri Del Panta; Trynke Hoekstra; Marco Colpo; Natasja M van Schoor; Stefania Bandinelli; Luca Cattelani; Jorunn L Helbostad; Beatrix Vereijken; Mirjam Pijnappels; Andrea B Maier

doi:10.1159/000485135

Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Nini H Jonkman, Vieri Del Panta, Trynke Hoekstra, Marco Colpo, Natasja M van Schoor, Stefania Bandinelli, Luca Cattelani, Jorunn L Helbostad, Beatrix Vereijken, Mirjam Pijnappels, Andrea B Maier

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

BACKGROUND: Early identification of people at risk of functional decline is essential for delivering targeted preventive interventions.

OBJECTIVE: The aim of this study is to identify and predict trajectories of functional decline over 9 years in males and females aged 60-70 years.

METHODS: We included 403 community-dwelling participants from the InCHIANTI study and 395 from the LASA study aged 60-70 years at baseline, of whom the majority reported no functional decline at baseline (median 0, interquartile range 0-1). Participants were included if they reported data on ≥2 measurements of functional ability during a 9-year follow-up. Functional ability was scored with 6 self-reported items on activities of daily living. We performed latent class growth analysis to identify trajectories of functional decline and applied multinomial regression models to develop prediction models of identified trajectories. Analyses were stratified for sex.

RESULTS: Three distinct trajectories were identified: no/little decline (219 males, 241 females), intermediate decline (114 males, 158 females), and severe decline (36 males, 30 females). Higher gait speed showed decreased risk of functional limitations in males (intermediate limitations, odds ratio [OR] 0.74, 95% CI 0.57-0.97; severe limitations, OR 0.42, 95% CI 0.26-0.66). The final model in males further included the predictors fear of falling and alcohol intake (no/little decline, area under the receiver operating curve [AUC] 0.68, 95% CI 0.62-0.73; intermediate decline, AUC 0.63, 95% CI 0.56-0.69; severe decline, AUC 0.79, 95% CI 0.71-0.87). In females, higher gait speed showed a decreased risk of intermediate limitations (OR 0.51, 95% CI 0.38-0.68) and severe limitations (OR 0.18, 95% CI 0.07-0.44). Other predictors in females were age, living alone, economic satisfaction, balance, physical activity, BMI, and cardiovascular disease (no/little decline, AUC 0.80, 95% CI 0.75-0.85; intermediate decline, AUC 0.74, 95% CI 0.69-0.79; severe decline, AUC 0.95, 95% CI 0.91-0.99).

CONCLUSION: Already in people aged 60-70 years, 3 distinct trajectories of functional decline were identified in these cohorts over a 9-year follow-up. Predictors of trajectories differed between males and females, except for gait speed. Identification of people at risk is the basis for targeting interventions.

Original language	English
Pages (from-to)	212-221
Number of pages	10
Journal	Gerontology
Volume	64
Issue number	3
Early online date	13 Dec 2017
DOIs	https://doi.org/10.1159/000485135
Publication status	Published - 2018

Bibliographical note

Funding

This work was supported by funding from the European Union's Horizon 2020 research and innovation programme (grant agreement number 689238). The InCHIANTI baseline study (1998-2000) was supported as a "targeted project" by the Italian Ministry of Health (ICS110.1/RF97.71) and by the US National Institute on Aging (Contracts 263 MD 9164, 263 MD 8213360); the InCHIANTI Follow-Up 1 (2001-2003) was funded by the US Na-tional Institute on Aging (Contracts N.1-AG-1-1, N.1-AG-1-2111); and the InCHIANTI Follow-Ups 2 and 3 (2004-2010) were fi-nanced by the US National Institute on Aging (Contract N01-AG-5-0002). The Longitudinal Aging Study Amsterdam was sup-ported by a grant from the Netherlands Ministry of Health Welfare and Sports, Directorate of Long-Term Care. The funding agencies had no role in the design, execution, analysis and interpretation of data, or writing of the study.

Funders	Funder number
Italian Ministry of Health	ICS110.1/RF97.71
Netherlands Ministry of Health Welfare and Sports, Directorate of Long-Term Care
US Na-tional Institute on Aging	N01-AG-5-0002, N.1-AG-1-2111, N.1-AG-1-1
US National Institute on Aging	263 MD 9164, 263 MD 8213360, 2001-2003
Horizon 2020 Framework Programme	689238

Keywords

Accidental Falls/prevention & control
Activities of Daily Living
Aged
Aging/physiology
Alcohol Drinking
Cohort Studies
Fear
Female
Healthy Aging/physiology
Humans
Longitudinal Studies
Male
Middle Aged
Regression Analysis
Risk Factors
Walking Speed

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1159/000485135

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Cite this

@article{3f2a553778f14198ae2a8f088f0736af,

title = "Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People",

abstract = "BACKGROUND: Early identification of people at risk of functional decline is essential for delivering targeted preventive interventions.OBJECTIVE: The aim of this study is to identify and predict trajectories of functional decline over 9 years in males and females aged 60-70 years.METHODS: We included 403 community-dwelling participants from the InCHIANTI study and 395 from the LASA study aged 60-70 years at baseline, of whom the majority reported no functional decline at baseline (median 0, interquartile range 0-1). Participants were included if they reported data on ≥2 measurements of functional ability during a 9-year follow-up. Functional ability was scored with 6 self-reported items on activities of daily living. We performed latent class growth analysis to identify trajectories of functional decline and applied multinomial regression models to develop prediction models of identified trajectories. Analyses were stratified for sex.RESULTS: Three distinct trajectories were identified: no/little decline (219 males, 241 females), intermediate decline (114 males, 158 females), and severe decline (36 males, 30 females). Higher gait speed showed decreased risk of functional limitations in males (intermediate limitations, odds ratio [OR] 0.74, 95% CI 0.57-0.97; severe limitations, OR 0.42, 95% CI 0.26-0.66). The final model in males further included the predictors fear of falling and alcohol intake (no/little decline, area under the receiver operating curve [AUC] 0.68, 95% CI 0.62-0.73; intermediate decline, AUC 0.63, 95% CI 0.56-0.69; severe decline, AUC 0.79, 95% CI 0.71-0.87). In females, higher gait speed showed a decreased risk of intermediate limitations (OR 0.51, 95% CI 0.38-0.68) and severe limitations (OR 0.18, 95% CI 0.07-0.44). Other predictors in females were age, living alone, economic satisfaction, balance, physical activity, BMI, and cardiovascular disease (no/little decline, AUC 0.80, 95% CI 0.75-0.85; intermediate decline, AUC 0.74, 95% CI 0.69-0.79; severe decline, AUC 0.95, 95% CI 0.91-0.99).CONCLUSION: Already in people aged 60-70 years, 3 distinct trajectories of functional decline were identified in these cohorts over a 9-year follow-up. Predictors of trajectories differed between males and females, except for gait speed. Identification of people at risk is the basis for targeting interventions.",

keywords = "Accidental Falls/prevention & control, Activities of Daily Living, Aged, Aging/physiology, Alcohol Drinking, Cohort Studies, Fear, Female, Healthy Aging/physiology, Humans, Longitudinal Studies, Male, Middle Aged, Regression Analysis, Risk Factors, Walking Speed",

author = "Jonkman, {Nini H} and {Del Panta}, Vieri and Trynke Hoekstra and Marco Colpo and {van Schoor}, {Natasja M} and Stefania Bandinelli and Luca Cattelani and Helbostad, {Jorunn L} and Beatrix Vereijken and Mirjam Pijnappels and Maier, {Andrea B}",

note = "{\textcopyright} 2017 The Author(s) Published by S. Karger AG, Basel.",

year = "2018",

doi = "10.1159/000485135",

language = "English",

volume = "64",

pages = "212--221",

journal = "Gerontology",

issn = "0304-324X",

publisher = "S. Karger AG",

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TY - JOUR

T1 - Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

AU - Jonkman, Nini H

AU - Del Panta, Vieri

AU - Hoekstra, Trynke

AU - Colpo, Marco

AU - van Schoor, Natasja M

AU - Bandinelli, Stefania

AU - Cattelani, Luca

AU - Helbostad, Jorunn L

AU - Vereijken, Beatrix

AU - Pijnappels, Mirjam

AU - Maier, Andrea B

PY - 2018

Y1 - 2018

N2 - BACKGROUND: Early identification of people at risk of functional decline is essential for delivering targeted preventive interventions.OBJECTIVE: The aim of this study is to identify and predict trajectories of functional decline over 9 years in males and females aged 60-70 years.METHODS: We included 403 community-dwelling participants from the InCHIANTI study and 395 from the LASA study aged 60-70 years at baseline, of whom the majority reported no functional decline at baseline (median 0, interquartile range 0-1). Participants were included if they reported data on ≥2 measurements of functional ability during a 9-year follow-up. Functional ability was scored with 6 self-reported items on activities of daily living. We performed latent class growth analysis to identify trajectories of functional decline and applied multinomial regression models to develop prediction models of identified trajectories. Analyses were stratified for sex.RESULTS: Three distinct trajectories were identified: no/little decline (219 males, 241 females), intermediate decline (114 males, 158 females), and severe decline (36 males, 30 females). Higher gait speed showed decreased risk of functional limitations in males (intermediate limitations, odds ratio [OR] 0.74, 95% CI 0.57-0.97; severe limitations, OR 0.42, 95% CI 0.26-0.66). The final model in males further included the predictors fear of falling and alcohol intake (no/little decline, area under the receiver operating curve [AUC] 0.68, 95% CI 0.62-0.73; intermediate decline, AUC 0.63, 95% CI 0.56-0.69; severe decline, AUC 0.79, 95% CI 0.71-0.87). In females, higher gait speed showed a decreased risk of intermediate limitations (OR 0.51, 95% CI 0.38-0.68) and severe limitations (OR 0.18, 95% CI 0.07-0.44). Other predictors in females were age, living alone, economic satisfaction, balance, physical activity, BMI, and cardiovascular disease (no/little decline, AUC 0.80, 95% CI 0.75-0.85; intermediate decline, AUC 0.74, 95% CI 0.69-0.79; severe decline, AUC 0.95, 95% CI 0.91-0.99).CONCLUSION: Already in people aged 60-70 years, 3 distinct trajectories of functional decline were identified in these cohorts over a 9-year follow-up. Predictors of trajectories differed between males and females, except for gait speed. Identification of people at risk is the basis for targeting interventions.

AB - BACKGROUND: Early identification of people at risk of functional decline is essential for delivering targeted preventive interventions.OBJECTIVE: The aim of this study is to identify and predict trajectories of functional decline over 9 years in males and females aged 60-70 years.METHODS: We included 403 community-dwelling participants from the InCHIANTI study and 395 from the LASA study aged 60-70 years at baseline, of whom the majority reported no functional decline at baseline (median 0, interquartile range 0-1). Participants were included if they reported data on ≥2 measurements of functional ability during a 9-year follow-up. Functional ability was scored with 6 self-reported items on activities of daily living. We performed latent class growth analysis to identify trajectories of functional decline and applied multinomial regression models to develop prediction models of identified trajectories. Analyses were stratified for sex.RESULTS: Three distinct trajectories were identified: no/little decline (219 males, 241 females), intermediate decline (114 males, 158 females), and severe decline (36 males, 30 females). Higher gait speed showed decreased risk of functional limitations in males (intermediate limitations, odds ratio [OR] 0.74, 95% CI 0.57-0.97; severe limitations, OR 0.42, 95% CI 0.26-0.66). The final model in males further included the predictors fear of falling and alcohol intake (no/little decline, area under the receiver operating curve [AUC] 0.68, 95% CI 0.62-0.73; intermediate decline, AUC 0.63, 95% CI 0.56-0.69; severe decline, AUC 0.79, 95% CI 0.71-0.87). In females, higher gait speed showed a decreased risk of intermediate limitations (OR 0.51, 95% CI 0.38-0.68) and severe limitations (OR 0.18, 95% CI 0.07-0.44). Other predictors in females were age, living alone, economic satisfaction, balance, physical activity, BMI, and cardiovascular disease (no/little decline, AUC 0.80, 95% CI 0.75-0.85; intermediate decline, AUC 0.74, 95% CI 0.69-0.79; severe decline, AUC 0.95, 95% CI 0.91-0.99).CONCLUSION: Already in people aged 60-70 years, 3 distinct trajectories of functional decline were identified in these cohorts over a 9-year follow-up. Predictors of trajectories differed between males and females, except for gait speed. Identification of people at risk is the basis for targeting interventions.

KW - Accidental Falls/prevention & control

KW - Activities of Daily Living

KW - Aged

KW - Aging/physiology

KW - Alcohol Drinking

KW - Cohort Studies

KW - Fear

KW - Female

KW - Healthy Aging/physiology

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Regression Analysis

KW - Risk Factors

KW - Walking Speed

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U2 - 10.1159/000485135

DO - 10.1159/000485135

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C2 - 29232671

AN - SCOPUS:85038110018

SN - 0304-324X

VL - 64

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JO - Gerontology

JF - Gerontology

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ER -

Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

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Supplementary Material for: Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

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Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Datasets

Supplementary Material for: Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People

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