[show abstract][hide abstract] ABSTRACT: PurposeThe aim of this investigation was to analyze whether the following platelet indices are useful markers for functional dependence and 1-year all-cause hospitalization and mortality in the elderly population: platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet–large cell ratio (P-LCR).Methods
The 119 participants in this study were 90 women and 29 men between the ages of 68 and 105 years who were selected from the Santa Teresa nursing home (Oviedo, Spain). We studied morbidity, sociodemographic characteristics, and functional status using the Barthel Index (BI) and Katz Index (KI) for activities of daily living.ResultsIn logistic regression models adjusted for age, sex, and anti-inflammatory drug use, low levels of PDW were associated with death at 1 year. When we applied logistic regression models adjusted for morbid conditions as well as age, sex, and anti-inflammatory drug use, the PDW remained statistically significant. No relation between PLT, MPV, or P-LCR and mortality was found. No statistical associations between the platelet indices studied and functional dependence or hospitalization were observed.Conclusion
Our data suggest that the PDW could be a predictor of 1-year mortality in the elderly population and may therefore serve as a useful tool for identifying individuals with a high risk of mortality who may benefit from preventative care or early-stage strategies.
Journal of Clinical Gerontology and Geriatrics. 03/2013; 4(1):12–16.
[show abstract][hide abstract] ABSTRACT: Eur J Clin Invest 2012; 42 (10): 1037-1046 ABSTRACT: Background Systemic low-grade inflammation is thought to be associated with an increased risk of adverse clinical outcomes in elderly population. We tested this notion with the goal of identifying useful potential biomarkers of 1-year hospitalization and mortality in the elderly population. Design A total of 120 institutionalized older subjects were enrolled as participants in this study, including 90 women and 30 men (ranging in age from 68 to 105 years), selected from Santa Teresa nursing home (Oviedo, Spain). We studied functional status, morbidity, socio-demographic characteristics and several inflammation and inflammation-related markers. Results The study included 95 non-hospitalized participants and 23 participants with at least one hospitalization during 1 year (19% of subjects). The study also included 100 survivors and 19 participants who died during the 1-year study (16% of subjects). In logistic regression models adjusted by age, sex, anti-inflammatory drug use and morbid conditions, high levels of interleukin 1 receptor antagonist (IL-1ra) and red blood cell distribution width (RDW) were associated with hospitalization and death at 1 year. Elevated levels of tumour necrosis factor α (TNF-α) were also associated with an increased risk of death at 1 year after adjusting for the same potential confounders. Multivariate logistic regression models showed that elevated serum levels of IL-1ra were intimately associated with 1-year subsequent hospitalization and mortality in aged subjects after adjusting for age, sex, anti-inflammatory drug use and morbid conditions. Conclusions Current data suggest that IL-1ra is a predictor of 1-year hospitalization and mortality in the elderly population.
European Journal of Clinical Investigation 04/2012; 42(10):1037-46. · 3.37 Impact Factor
[show abstract][hide abstract] ABSTRACT: In the present investigation we have analyzed the association between functional dependence and inflammatory biomarkers using the Barthel Index (BI) and the Katz Index (KI). This analysis may contribute to translational medicine by incorporating the clinical and laboratory data to better understand the relationship between chronic inflammation and functional dependence in the elderly population. The ultimate goal of this study was to identify possible useful biomarkers of functional dependence in the elderly. Participants in this study consisted of 120 older subjects (90 women and 30 men; range 68-105 years) who were selected from the Santa Teresa nursing home (Oviedo, Spain). We studied functional status using the following tools to diagnose the functional dependence by clinicians: BI and KI for activities of daily living. We analyzed morbidity, sociodemographic characteristics and a panel of inflammatory and inflammatory-related markers. In linear regression models adjusted by age, sex, anti-inflammatory drug use and morbid conditions high levels of interleukin 6 (IL-6) and soluble TNF receptor-I (sTNF-RI) were associated with functional dependence as measured using BI and KI. Elevated levels of red blood cell distribution width (RDW) were also associated with functional dependence measured using the KI after adjusting for the same potential confounders. The current results suggest that high IL-6, sTNF-RI and RDW levels are associated with the functional dependence in the elderly population. The results are consistent with the presumed underlying biological mechanism, in which the up-regulation of inflammatory mediators is associated with functional dependence in elderly subjects.
[show abstract][hide abstract] ABSTRACT: The objective of the present study was to investigate a large panel of oxidative stress biomarkers in long-term trained elderly men to analyse the effects of chronic training on an aged population. We collected blood samples from two groups of male volunteers older than 65 years who maintain a measure of functional independence: one group of sedentary subjects without a history of regular physical activity and the other of subjects who have sustained training, starting during middle age (mean training time = 49 ± 8 years). We studied morbidity and polypharmacy, as well as haematological parameters including red cell count, haemoglobin concentration, haematocrit, mean corpuscular volume, red cell distribution width and several oxidative biomarkers including protein carbonyl content and lipid peroxidation in plasma and erythrocytes, red blood cell H(2)O(2)-induced haemolysis test, plasma total antioxidant activity and the main antioxidant enzymes of erythrocytes: superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and glutathione-S-transferase. After adjusting for confounding factors, we observed an increase in all oxidative damage biomarkers in the plasma and erythrocytes of the long-term exercise group. However, we reported a decrease in the number of diseases per subject with statistical differences nearly significant (p = 0.061), reduced intake of medications per subject and lower levels of red cell distribution width in the chronic exercise group. These results indicate that chronic exercise from middle age to old age increases oxidative damage; however, chronic exercise appears to be an effective strategy to attenuate the age-related decline in the elderly.
[show abstract][hide abstract] ABSTRACT: Studies of the role of oxidative stress in functional dependence among the aging population are limited. In this report, we address this situation through an analysis of a large panel of blood oxidative biomarkers in elderly population. Because the analysis of multiple biomarkers increases the complexity of data interpretation, this investigation has utilized both an analysis of single biomarkers in addition to employment of the statistical data reduction tool principal component analysis that might allow for a clearer description of redox status as compared with a single measure alone.
We studied three groups of participants older than 65 years based on their Barthel Index: an independent group (100-95), a moderately dependent group (94-60), and a severely dependent group (59-0).
We observed a significant increase in circulating protein carbonyl levels in the severely dependent group as compared with the independent and moderately dependent groups. Using principal component analysis, we found at least three factors (an erythrocyte-related component, a protein damage-related component, and a plasma-related component) that could be used to assess the different oxidative parameters in our population. We discovered a significant association of higher levels of the protein damage-related component with the severely dependent group.
Protein damage levels could be assessed in clinical use as a biomarker of severe dependence. Furthermore, our results support the hypothesis that functional decline could be associated in part due to oxidative stress. Finally, we show that principal component analysis could be a useful statistical tool in the analysis of age-related decline.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 12/2011; 67(6):663-70. · 4.31 Impact Factor
[show abstract][hide abstract] ABSTRACT: The objective of the present study was to investigate the changes in a large panel of emergent geriatric biomarkers in long-term trained elderly men to analyze the effects of long-term exercise on an aged population. We collected blood samples from two groups of male volunteers older than 65 years who maintain a measure of functional independence: one group of sedentary subjects without a history of regular physical activity and the other of subjects who have sustained training, starting during adulthood (mean training time = 49 ± 8 years). We studied morbidity, polypharmacy, cellular and serological inflammatory parameters, and endocrine mediators. After adjusting for confounding factors, we observed reduced medication intake per subject and lower number of diseases per subject with statistical differences nearly significant in the long-term exercise group. We showed that long-term training was associated with lower levels of white blood cell counts, neutrophil counts, interleukin-6, interleukin-10, interleukin-1 receptor antagonist, and soluble TNF receptor-I. Furthermore, we noted an increase in the concentrations of insulin-like growth factor-1 and dehydroepiandrosterone in the long-term training group. We concluded that long-term exercise training from adulthood to old age is clearly associated with a healthy profile of emergent geriatric biomarkers. Long-term training could improve the inflammatory-endocrine imbalance associated with disease, frailty, functional decline, and mortality in elderly men. Our results point to the benefits of prolonged exercise from adulthood to old age.
[show abstract][hide abstract] ABSTRACT: The present study investigated the changes in several erythrocyte oxidative stress biomarkers in hypoxic elderly individuals to analyze the deleterious effects of low oxyhemoglobin saturation in an elderly population. We collected blood samples from one normoxic middle-aged group and two groups composed of individuals older than 75 years of age: one normoxic group and one hypoxic group. Aging appeared to provoke a defective erythrocyte antioxidant defense associated with increased oxidative damage in the elderly population. Acute hypoxia activated an insufficient antioxidant defense response as suggested by the oxidative damage observed. The oxidative imbalance presented in older participants and increased in hypoxia participants had a direct effect on glyceraldehyde-3-phosphate dehydrogenase cell distribution. Oxidative stress levels altered Band 3 protein and mediated caspase-3 activation in erythrocyte from the aged group although it was not extended to hypoxic individuals. Therefore, aged participants appeared to activate an insufficient antioxidant response against hypoxia-related oxidative stress.
The Journals of Gerontology Series A Biological Sciences and Medical Sciences 11/2010; 66(4):376-84. · 4.31 Impact Factor
[show abstract][hide abstract] ABSTRACT: Oxidative stress has been reported to increase during aging and conditions of hypoxia. Although low oxygen saturation has a key role in the development of several age-related diseases, the underlying mechanisms are still unknown. We analyzed the relationship between aging and hypoxia by examining oxidative stress and inflammation-related cytokines. We collected blood samples from three volunteer experimental groups, consisting of one group of normoxic middle-aged people and two groups of individuals older than 75 years, which comprised a subgroup of normoxic subjects and another with oxyhemoglobin saturation lower than 95% (hypoxic). Our results showed a fall in antioxidant defenses in older people with hypoxia. TNF-alpha, the first element in the cytokine cascade, was significantly increased in the aged population, implying that aging is accompanied by a gradual increase in this inflammatory biomarker. IL-6 was not associated with aging, but it was highly elevated under hypoxia conditions in elderly subjects. Thus, these parameters could be used as biological markers of different inflammatory processes triggered by oxidative stress induced by a decrease in antioxidant defenses in the elderly population, with TNF-alpha as an indicator of chronic processes, such as aging, and IL-6 as a marker for acute responses, such as hypoxia.