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 | |
| Publication status | Published - 2018 |
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Bibliographical note
© 2017 The Author(s) Published by S. Karger AG, Basel.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
Cite this
}
Predicting Trajectories of Functional Decline in 60- to 70-Year-Old People. / Jonkman, Nini H; Del Panta, Vieri; Hoekstra, Trynke; Colpo, Marco; van Schoor, Natasja M; Bandinelli, Stefania; Cattelani, Luca; Helbostad, Jorunn L; Vereijken, Beatrix; Pijnappels, Mirjam; Maier, Andrea B.
In: Gerontology, Vol. 64, No. 3, 2018, p. 212-221.Research output: Contribution to Journal › Article › Academic › peer-review
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
N1 - © 2017 The Author(s) Published by S. Karger AG, Basel.
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
UR - http://www.scopus.com/inward/record.url?scp=85038110018&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85038110018&partnerID=8YFLogxK
U2 - 10.1159/000485135
DO - 10.1159/000485135
M3 - Article
VL - 64
SP - 212
EP - 221
JO - Gerontology
JF - Gerontology
SN - 0304-324X
IS - 3
ER -