Research Paper Volume 15, Issue 3 pp 748—764
Intrinsic capacity differs from functional ability in predicting 10-year mortality and biological features in healthy aging: results from the I-Lan longitudinal aging study
- 1 Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan
- 2 Department of Geriatric Medicine, National Yang Ming Chiao Tung University, School of Medicine, Taipei, Taiwan
- 3 Department of Family Medicine, Taipei Veterans General Hospital Yuanshan Branch, Yi-Lan County, Taiwan
- 4 Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
- 5 Center of Health and Aging, Hualien Tzu Chi Hospital Buddhist Tzu Chi Medical Foundation, Hualien County, Taiwan
- 6 Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- 7 School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- 8 Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
- 9 Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
Received: July 28, 2022 Accepted: January 23, 2023 Published: February 6, 2023
https://doi.org/10.18632/aging.204508How to Cite
Copyright: © 2023 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
This study aimed to explore the biological features and mortality risk of intrinsic capacity (IC) and functional ability (FA). Based on data from 1839 participants from the I-Lan Longitudinal Aging Study, multivariable Cox proportional hazard models were used to evaluate the predictive ability of IC (range 0–100) and FA (range 0–100) on 10-year mortality. Of 2038 repeated measurements for IC within a 7-year observational period, multivariable logistic regression was used to compare biological features of participants with maintained, improved and rapidly deteriorated IC. A 1-point increased IC value was associated with a 5% (HR 0.95, 95% CI 0.93–0.97, p < 0.001) decrease in mortality risk. Low IC (HR 1.94, 95% CI 1.39–2.70, p < 0.001) was associated with higher mortality risk. Hyperglycemia (OR 1.40, 95% CI 1.09–1.81, p = 0.010), low serum levels of DHEA-S (OR 3.33, 95% CI 1.32–8.41, p = 0.011), and high serum levels of C-reactive protein (OR 1.45, 95% CI 1.05–2.00, p = 0.023) were associated with low IC at baseline. Low serum levels of DHEA-S (middle tertile OR 1.84, 95% CI 1.15–2.95, p = 0.012; lowest tertile OR 2.25, 95% CI 1.34–3.77, p = 0.002) and vitamin D deficiency (OR 1.82, 95% CI 1.02–3.27, p = 0.044) were associated with rapid deterioration of IC. IC and FA predicted 10-year mortality, whereas chronic inflammation, hyperglycemia, and low DHEA-S were associated with low IC status. Low DHEA-S and vitamin D deficiency may be considered as potential biomarkers of rapid IC declines, which implies underlying biological mechanisms of healthy aging.
Abbreviations
WHO: World Health Organization; IC: Intrinsic Capacity; FA: Functional Ability; ICOPE: Integrated Care for Older People; DHEA-S: dehydroepiandrosterone sulfate; IGF-1: insulin-like growth Factor 1; hsCRP: high-sensitivity C-reactive protein; ILAS: I-Lan Longitudinal Aging Study; MMSE: Mini-Mental State Examination; AWGS: Asian Working Group for Sarcopenia; MNA: Mini Nutritional Assessment; CESD: Epidemiologic Studies—Depression scale; SMAF: Functional Autonomy Measurement System; ADL: activities of daily living; IADL: instrumental activities of daily living; CCI: Charlson’s comorbidity index; LDL: low-density lipoprotein cholesterol; HOMA-IR : homeostasis model assessment-insulin resistance -insulin resistance; NLR: neutrophil-to-lymphocyte ratio; FAI: free androgen index; ROC: Receiver operating curve.