PMID- 31493520 OWN - NLM STAT- MEDLINE DCOM- 20200713 LR - 20210110 IS - 1873-6815 (Electronic) IS - 0531-5565 (Linking) VI - 127 DP - 2019 Nov TI - Associations of C-reactive protein and homocysteine concentrations with the impairment of intrinsic capacity domains over a 5-year follow-up among community-dwelling older adults at risk of cognitive decline (MAPT Study). PG - 110716 LID - S0531-5565(19)30426-7 [pii] LID - 10.1016/j.exger.2019.110716 [doi] AB - BACKGROUND: The World Health Organization (WHO) recently proposed an innovative model of care focusing on functional rather than disease-based perspectives, based on a construct of intrinsic capacity (IC). OBJECTIVE: This study aimed to analyze if low-grade inflammation (LGI) (chronically raised C-reactive protein - CRP) and hyperhomocysteinemia (HHcy) were associated with variation in IC domains (mobility, cognition, psychological and vitality) and in a combined IC Z-score over a 5-year follow-up among non-demented, community-dwelling older adults at risk of cognitive decline. DESIGN: This observational study included 1516 subjects >/=70 years (64.5% female, mean age 75.4 years, SD = 4.5), volunteers from the interventional study Multidomain Alzheimer Preventive Trial (MAPT). Plasma CRP (at baseline, 6 and 12 months) and homocysteine (at baseline) concentrations were measured. LGI was defined as having >/=2 consecutively CRP readings >3 to 10 mg/L between baseline and 12 months, and HHcy was defined as homocysteine >15 muM/L. IC domains were operationalized as follows: Psychological. Depressive symptoms evaluated by the Geriatric Depression Scale (GDS); Mobility. Assessed by the Short Physical Performance Battery (SPPB); Cognitive function. Examined by a Z-score combining four tests; Vitality. Based on hand grip strength. Outcomes were combined into a composite IC Z-score. RESULTS: IC Z-score decreased among groups with no inflammation and LGI after 5 years, but this decrease was more pronounced among the LGI group (unadjusted mean group difference: 0.09, 95%CI: 0.01 to 0.16; p = 0.032). Participants with HHcy also presented IC Z-score decreases over time. Combined conditions provided more pronounced declines, even after adjusting for potential confounders. CONCLUSION: LGI and HHcy were both related with impairment on the combined IC levels among older adults after a 5-year follow-up. Identifying biomarkers that strongly associate with IC may help to settle strategies aiming to prevent the incidence and slow down the evolution of age-related functional decline and care dependency. CI - Copyright (c) 2019 Elsevier Inc. All rights reserved. FAU - Giudici, Kelly Virecoulon AU - Giudici KV AD - Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France. Electronic address: kellygiudici@gmail.com. FAU - de Souto Barreto, Philipe AU - de Souto Barreto P AD - Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France. FAU - Guerville, Florent AU - Guerville F AD - Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France. FAU - Beard, John AU - Beard J AD - University of Sydney, Sydney, Australia. FAU - Araujo de Carvalho, Islene AU - Araujo de Carvalho I AD - Department of Ageing and Life Course, World Health Organization, Geneva, Switzerland. FAU - Andrieu, Sandrine AU - Andrieu S AD - UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital (CHU, Toulouse), France. FAU - Rolland, Yves AU - Rolland Y AD - Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France. FAU - Vellas, Bruno AU - Vellas B AD - Gerontopole of Toulouse, Institute of Ageing, Toulouse University Hospital (CHU Toulouse), Toulouse, France; UPS/Inserm UMR1027, University of Toulouse III, Toulouse, France. CN - MAPT/DSA group LA - eng GR - 001/WHO_/World Health Organization/International PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20190904 PL - England TA - Exp Gerontol JT - Experimental gerontology JID - 0047061 RN - 0 (Biomarkers) RN - 0LVT1QZ0BA (Homocysteine) RN - 9007-41-4 (C-Reactive Protein) SB - IM MH - Activities of Daily Living MH - Aged MH - Biomarkers/metabolism MH - Body Mass Index MH - C-Reactive Protein/*metabolism MH - Cognitive Dysfunction/metabolism/*physiopathology MH - Depression/physiopathology MH - Female MH - Follow-Up Studies MH - Geriatric Assessment MH - Hand Strength/physiology MH - Homocysteine/*metabolism MH - Humans MH - Independent Living MH - Inflammation/physiopathology MH - Male MH - Mobility Limitation MH - Neuropsychological Tests MH - Prospective Studies MH - Risk Factors MH - Time Factors OTO - NOTNLM OT - Aging OT - C-reactive protein OT - Homocysteine OT - Inflammation OT - Intrinsic capacity OT - Older adults EDAT- 2019/09/08 06:00 MHDA- 2020/07/14 06:00 CRDT- 2019/09/08 06:00 PHST- 2019/06/21 00:00 [received] PHST- 2019/08/05 00:00 [revised] PHST- 2019/08/30 00:00 [accepted] PHST- 2019/09/08 06:00 [pubmed] PHST- 2020/07/14 06:00 [medline] PHST- 2019/09/08 06:00 [entrez] AID - S0531-5565(19)30426-7 [pii] AID - 10.1016/j.exger.2019.110716 [doi] PST - ppublish SO - Exp Gerontol. 2019 Nov;127:110716. doi: 10.1016/j.exger.2019.110716. Epub 2019 Sep 4.