Sun Jae Park,Jihun Song,Hye Jun Kim,Jaewon Kim,Seogsong Jeong,Young Jun Park,Jaewon Lee,Minseo Kim,Ji Yoon Nam,Yun Hwan Oh,Yoosun Cho,In Sun Ryou,Sanghyuk Bae,Sang Min Park
{"title":"Combined effects of statin medication adherence and fine particulate air pollution on cardiovascular disease among older adults.","authors":"Sun Jae Park,Jihun Song,Hye Jun Kim,Jaewon Kim,Seogsong Jeong,Young Jun Park,Jaewon Lee,Minseo Kim,Ji Yoon Nam,Yun Hwan Oh,Yoosun Cho,In Sun Ryou,Sanghyuk Bae,Sang Min Park","doi":"10.1093/gerona/glaf079","DOIUrl":"https://doi.org/10.1093/gerona/glaf079","url":null,"abstract":"BACKGROUNDEmerging research suggests the potential combined effects of statin medication and fine particulate matter exposure on cardiovascular disease (CVD) risk among older adults. These findings underscore the need for further detailed investigations. This cohort study aims to examine the combined effects of adherence to statins and particulate matter with aerodynamic diameter ≤2.5 μm (PM2.5) exposure on CVD among older adults in South Korea.METHODSThis nationwide study included 791,244 individuals aged 65 years or older diagnosed with dyslipidemia. Statin medication adherence was estimated using the medication possession ratio (MPR) over a two-year period. Fine particulate matter levels were measured based on participants' residential locations. The primary outcome was CVD, defined as a diagnosis requiring at least two days of hospitalization. Multivariable Cox proportional hazard models were performed to assess the combined effects of statin MPR and PM2.5 exposure on CVD risk.RESULTSIntermediate-to-high statin adherence (MPR≥0.5) was associated with a reduced risk of CVD, regardless of PM2.5 concentrations. Individuals with the lowest statin adherence (MPR<0.5) and the highest PM2.5 concentrations had an elevated risk of CVD (adjusted hazard ratio [aHR], 1.05; 95% confidence interval [CI], 1.02-1.07). Conversely, individuals with the highest statin adherence (MPR≥0.8) and the highest PM2.5 concentrations showed a lower risk of CVD (aHR, 0.88; 95% CI, 0.85-0.91).CONCLUSIONSLow statin adherence may contribute to an elevated CVD risk in older adults exposed to high PM2.5 concentrations, while moderate-to-high statin adherence may reduce the risk of CVD regardless of PM2.5 levels.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"120 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hannah Schmid, Valentin Max Vetter, Jan Homann, Vivien Bahr, Christina M Lill, Vera Regitz-Zagrosek, Lars Bertram, Ilja Demuth
{"title":"Cross-sectional and Longitudinal Relationship between Sex Hormones and Six Epigenetic Clocks in Older Adults: Results of the Berlin Aging Study II (BASE-II)","authors":"Hannah Schmid, Valentin Max Vetter, Jan Homann, Vivien Bahr, Christina M Lill, Vera Regitz-Zagrosek, Lars Bertram, Ilja Demuth","doi":"10.1093/gerona/glaf106","DOIUrl":"https://doi.org/10.1093/gerona/glaf106","url":null,"abstract":"Beyond their essential roles in regulating reproduction and development, sex hormones play a crucial role in the aging processes. Observational studies have indicated that low sex hormone concentrations in older age are associated with adverse health events. DNA methylation age acceleration (DNAmAA) estimated from epigenetic clocks quantifies differences in biological aging. DNAmAA was previously shown to be associated with age at menopause, ovariectomy, hormone replacement therapy and testosterone level. We analysed the relationship between estradiol, dehydroepiandrosterone sulfate (DHEAS) and the Free Androgen Index (FAI) with DNAmAA estimators from six epigenetic clocks (Horvath’s, Hannum’s, 7-CpG clock, PhenoAge, GrimAge, DunedinPACE) in 1,404 participants of the Berlin Aging Study II (BASE-II, mean age at baseline 68.7 ±3.7 years, 48% women). The relationship was investigated in multiple linear regression models cross-sectionally at two time points and longitudinally over on average 7.3 years of follow-up. We did not observe any consistent associations between the sex hormones and DNAmAA estimators investigated. However, we found several nominal associations (alpha=0.05) of unclear relevance. For instance, we identified an inverse association between DHEAS and Horvath’s DNAmAA, i.e. a reduced biological age with higher DHEAS levels in men at baseline. In women we found an inverse association between estradiol and DunedinPACE (baseline) and a positive association with GrimAge (follow-up). In longitudinal analyses, ΔDHEAS and ΔDunedinPACE were inversely associated in both sexes. Our results suggest that sex hormones play at best a minor role with respect to biological aging in the older population studied here.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Physical resilience may offset mortality risks associated with genetic predisposition to shorter survival: A population-based cohort study","authors":"Lea Stark, Federico Triolo, Davide Liborio Vetrano, Debora Rizzuto, Israel Contador, Amaia Calderón-Larrañaga, Serhiy Dekhtyar","doi":"10.1093/gerona/glaf101","DOIUrl":"https://doi.org/10.1093/gerona/glaf101","url":null,"abstract":"Background Physical resilience (PR), the ability to recover from health adversities, is thought to buffer health challenges during aging. However, PR’s association with mortality and its ability to offset the negative effects of genetic susceptibility to shorter lifespan remain unknown. Methods Data on 3,041 individuals (age: 60+) from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K) were analyzed. PR was assessed at baseline (2001-2004) using residual gait speed for a given level of chronic diseases, medications, and sociodemographics, categorized as low (residual SD’s ≤ -1), moderate (-1 &lt; SD &lt; 1), or high resilience (SD ≥ 1). A genetic risk score (GRS) was derived from four SNPs linked to longevity (hTERT, APOE, TOMM40, IGF-1R). Cox proportional hazard models and Laplace regression examined 18-year mortality and median survival, respectively. PR was assessed as the moderator of the GRS-mortality association in stratified analysis. Results Compared to individuals with moderate PR, those with low resilience had higher mortality risk (HR: 1.28; 95% CI [1.09, 1.51]), with the opposite pattern in those with high PR (HR: 0.71; 95% CI [0.60, 0.84]). Above-median levels of GRS were associated with increased mortality risk (HR: 1.34; 95% CI [1.18, 1.52]). Stratified by PR, mortality risk associated with higher GRS was elevated among those with low and moderate resilience but not among older adults with high resilience. Conclusion PR appears to partly modify mortality risk associated with genetic predisposition to shorter survival. Fostering PR could benefit personalized therapeutic strategies to support healthy aging.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143927271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kacey Chae,Amie F Bettencourt,Denise K Houston,Eleanor M Simonsick,Luigi Ferrucci,Rita R Kalyani,Nancy Schoenborn,Jeanne M Clark,Kimberly A Gudzune
{"title":"Association between changes in body composition and physical function after intensive behavioral weight-loss intervention: a Look AHEAD trial subgroup analysis.","authors":"Kacey Chae,Amie F Bettencourt,Denise K Houston,Eleanor M Simonsick,Luigi Ferrucci,Rita R Kalyani,Nancy Schoenborn,Jeanne M Clark,Kimberly A Gudzune","doi":"10.1093/gerona/glaf103","DOIUrl":"https://doi.org/10.1093/gerona/glaf103","url":null,"abstract":"BACKGROUNDIntentional weight-loss improves physical function among older adults with obesity, despite the associated lean mass loss. However, prior studies have not assessed impacts of weight-loss on physical function and body composition among older adults with type 2 diabetes mellitus (T2DM) and obesity, a population at high-risk for sarcopenia and functional decline. Our objective was to examine differences in body composition changes by physical function status among middle-aged and older adults with T2DM and overweight/obesity participating in an intensive weight-loss intervention of diet and exercise over 12 months.METHODSWe conducted a secondary analysis of 12-month data from the Look AHEAD dual-energy X-ray absorptiometry (DXA) substudy among participants randomized to intervention (n=603). Independent variables included DXA-derived percent change in appendicular lean mass (ALM) and fat mass (FM). The dependent variable was SF-36 physical function subscale change categorized as worsened (decrease ≥5), stable (change ±4), or improved (increase ≥5). We examined the associations using ANOVA.RESULTSOverall, participants had a mean age of 58.3 (SD 6.7) and 63% were women - 8% had worsened, 69% stable, and 22% improved physical function. Differences in mean percent ALM change between physical function groups were non-significant (worsened -3.7%; stable -4.8%; improved -5.6% (p=0.05)). Mean percent FM change was significantly different across physical function groups (worsened -9.3%; stable -14.6%; improved -17.9% (p<0.01)).CONCLUSIONSLean mass loss associated with lifestyle weight-loss intervention does not negatively impact physical function, rather the intervention appears to improve physical function by reducing adiposity among adults with T2DM and overweight/obesity.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peter Martin,Leonard W Poon,Gina Lee,Hardeep K Obhi,Bradley J Willcox,Kamal H Masaki
{"title":"From 70 to 100: The Kuakini Hawaii Centenarian Study.","authors":"Peter Martin,Leonard W Poon,Gina Lee,Hardeep K Obhi,Bradley J Willcox,Kamal H Masaki","doi":"10.1093/gerona/glaf078","DOIUrl":"https://doi.org/10.1093/gerona/glaf078","url":null,"abstract":"BACKGROUNDPast research has highlighted the association of family longevity, support, functioning, and health and well-being factors in predicting longevity. Based on the Georgia Adaptation Model that examined the impact of clusters of bio-psycho-social predictors on extreme longevity and adaptation, the current study aimed to employ seven clusters of behavioral and social predictors on longevity of Japanese-American men from Hawaii.METHODSA sample of 3,734 men (Mage = 77.82 years) from the Kuakini Honolulu Heart Program was included in this research. We focused on three research questions. One, WHO survived to their 70s, 80s, 90s, and 100s? Two, WHAT behavioral and social predictors were found to predict survivors of the different ages? Three, are the survival predictors the same or different for the Japanese-American men compared to extant findings in the literature?RESULTSOur results demonstrated four distinct groups of survivors (70s, 80s, 90s, and 100+) and highlighted differentiating characteristics among groups. Moreover, regression analyses suggested that cognition, ADL functioning, health behaviors, diabetes, and father's age at death were significantly associated with longevity. Finally, survival characteristics found among the Japanese-American men replicated many findings reported in the literature.CONCLUSIONSThe results indicate that there are individual differences for survivors in the Kuakini Honolulu Study, as this sample reaches 70, 80, 90, or 100 years of life.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dental checkups and all-cause mortality in older adults aged ≥75 years: a large retrospective cohort study.","authors":"Naoko Otsuki,Tomoaki Mameno,Yuya Kanie,Maki Shinzawa,Kazunori Ikebe,Ryohei Yamamoto","doi":"10.1093/gerona/glaf100","DOIUrl":"https://doi.org/10.1093/gerona/glaf100","url":null,"abstract":"BACKGROUNDAlthough regular visits to dentists improve oral health status, few studies have reported an association between dental checkups and all-cause mortality in older adults. This 3-year retrospective cohort study aimed to clarify an association between dental checkups and all-cause mortality in older adults.METHODSA total of 946,709 older adults aged ≥75 years, community-based residents in Japan, who were eligible for the public dental checkup program between April 2018 and March 2019. Exposure was dental checkup history stratified by dental visits at dental facilities. An association between dental checkups and the incidence of all-cause mortality was assessed using the Cox proportional hazards model adjusted for clinically relevant factors and the propensity score-matching analysis.RESULTSDuring the median observational period of 35 months, all-cause mortality was observed in 76,566 (20.5%) men and 84,423 (14.7%) women. The multivariable-adjusted Cox proportional hazards model showed that the No checkup groups were at significantly higher risk of all-cause mortality in both men and women, respectively. Propensity score-matching analysis ascertained that the No checkup/No visit group was at significantly higher risk of all-cause mortality than the Checkup/No visit group.CONCLUSIONSThe present large retrospective cohort study of 946,709 older adults showed that dental checkups predicted the risk of all-cause mortality as clinically useful information. The findings of the present study suggest that municipal healthcare planning should recommend dental checkups in older adults.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chenkai Wu, Yanxin Wang, Junhan Tang, Jianhong Xu, Jonathan K L Mak, Qian-Li Xue
{"title":"Development and Validation of Mortality Prediction Models among Frail Participants in the UK Biobank Study","authors":"Chenkai Wu, Yanxin Wang, Junhan Tang, Jianhong Xu, Jonathan K L Mak, Qian-Li Xue","doi":"10.1093/gerona/glaf096","DOIUrl":"https://doi.org/10.1093/gerona/glaf096","url":null,"abstract":"Background Identifying effective risk assessment strategies and prediction models for frail populations is crucial for precise mortality risk identification and improved patient management. This study aimed to evaluate whether prediction models incorporating survey data combined with biomarkers, physical measurements, or both could enhance mortality risk prediction in frail individuals than survey-only models. Methods 15,754 frail participants aged 40-72 from the UK Biobank were included. We used Cox models to assess all-cause mortality risk and Light Gradient Boosting Machines for variable selection by sex. Performance was evaluated through discrimination, calibration, and reclassification. Results In the survey-only models, we selected 24 predictors for males and 19 for females; age, and number of treatments were the top predictors for both sexes. In the biomarker models, we selected 15 predictors for males and 24 for females. In the physical measurement models, we retained 24 predictors for males and 23 for females. The base models showed good discrimination: C-statistic was 0.73 (95% CI, 0.72–0.75) for males and 0.74 (95% CI, 0.72–0.76) for females in development, and 0.70 (95% CI, 0.65–0.75) for males and 0.78 (95% CI, 0.73–0.83) for females in validation. Although incorporating additional predictors led to some improvement in model performance, the overall enhancement was not substantial. Conclusions Survey-based models predicted mortality in frail individuals effectively, with only minor improvements from adding biomarkers or physical measurements. These findings highlighted the value of surveys in forecasting outcomes and informed personalized management strategies to improve health for the frail.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"96 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexis D Tanase, Haiying Chen, Michael E Miller, Christina E Hugenschmidt, Jeff D Williamson, Stephen B Kritchevsky, Robert G Lyday, Paul J Laurienti, Atalie C Thompson
{"title":"Contrast Sensitivity Predicts 30-month Functional Brain Network Integrity in Cognitively Unimpaired Older Adults: the Brain Networks and Mobility Study (B-NET)","authors":"Alexis D Tanase, Haiying Chen, Michael E Miller, Christina E Hugenschmidt, Jeff D Williamson, Stephen B Kritchevsky, Robert G Lyday, Paul J Laurienti, Atalie C Thompson","doi":"10.1093/gerona/glaf098","DOIUrl":"https://doi.org/10.1093/gerona/glaf098","url":null,"abstract":"Background Visual contrast sensitivity (CS) is critical to many functions in older adults and is associated with brain network community structure, but the direction of the relationship between CS and the brain remains unclear. Methods We evaluated whether baseline binocular CS predicts 30-month functional brain network organization in 172 community-dwelling older adults (mean age 76.4±4.8 years, 56.4% female, 11.6% non-white/Hispanic) that underwent functional MRI (fMRI) at rest and during a motor imagery (MI) task. We constructed separate distance regression models for each of the 8 subnetworks covering the entire brain, while controlling for the baseline brain networks, sex, and the number of volumes removed during motion scrubbing from head motion in the scanner. Results Worse baseline CS predicted lower community structure integrity at 30-months in the visual network (VN, β=0.0115; p&lt;0.0001), dorsal attention network (DAN, β=0.0075; p=0.0089), and default mode network both at rest (β=0.0173; p&lt;0.0001) and during the MI task (DMN, β=0.0103; p=0.0002). No other networks showed significant associations. The DAN did not have a relationship with CS at baseline but was significant at 30-months. Similar findings were observed in models that additionally controlled for baseline MoCA and change in MoCA score over 30 months. Conclusions Poor CS may identify a subset of older adults at risk of future decrements in brain circuits important for vision, cognitive and mobility functions. Future studies should explore if improving CS increases functional brain health.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143910148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kristina Van Dang,Eun Young Choi,Eileen Crimmins,Caleb Finch,Jennifer Ailshire
{"title":"The joint effects of exposure to ambient long-term air pollution and short-term heat on epigenetic aging in the Health and Retirement Study.","authors":"Kristina Van Dang,Eun Young Choi,Eileen Crimmins,Caleb Finch,Jennifer Ailshire","doi":"10.1093/gerona/glaf092","DOIUrl":"https://doi.org/10.1093/gerona/glaf092","url":null,"abstract":"Prior research has examined associations of exposure to air pollution and heat with epigenetic alterations separately; however, these two exposures commonly used to measure climate change typically co-occur. We examine joint effects of exposure to elevated PM2.5 and heat on DNA methylation (DNAm). Data come from the 2016 Health and Retirement Study DNAm Sample (N=3,947) and census tract level annual ambient PM2.5 concentrations and daily heat index data averaged 7-days before blood collection. We used five epigenetic aging measures: Horvath, Hannum, PhenoAge, GrimAge, DunedinPACE. Four categories of joint PM2.5 and heat were analyzed: (1=reference) low PM2.5 (<9.2 𝜇g/m3) and low heat (<80 on heat index); (2) low PM2.5 and high heat; (3) high PM2.5 and low heat; and (4) high PM2.5 and high heat. Linear regression models were adjusted for age, gender, race/ethnicity, education, neighborhood poverty, and cell type. Compared to the reference of low PM2.5 and heat, we found associations of short-term (7-day) high heat and long-term (annual) low PM2.5 with accelerated DNAm aging for Horvath (𝛽=0.74 95%CI:0.04, 1.15), Hannum (𝛽=0.74 95% CI:0.20, 1.28) and PhenoAge (𝛽=0.93 95% CI:0.33, 1.52). High PM2.5 and low heat had weaker associations (Horvath 𝛽=-0.001 95%CI:-0.68, 0.68, Hannum 𝛽=0.36 95%CI:-034, 1.05; PhenoAge 𝛽=0.18 95%CI:-0.56, 0.92), as did joint effects of high PM2.5 and high heat (Horvath 𝛽=0.11 95%CI:-0.68, 0.89, Hannum 𝛽=0.42 95%CI:-0.46, 1.20; PhenoAge 𝛽=0.56 95%CI:-0.30, 1.42). Exposure to short-term high heat and low air pollution may accelerate epigenetic aging.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Min Ji Kwak,Caroline Schaefer,Youngran Kim,Sunyang Fu,Chan Mi Park,Abhijeet Dhoble,Nahid Rianon,Holly M Holmes,Dae Hyun Kim
{"title":"Application of Claims-Based Frailty Index to a Structured Electronic Health Record Data.","authors":"Min Ji Kwak,Caroline Schaefer,Youngran Kim,Sunyang Fu,Chan Mi Park,Abhijeet Dhoble,Nahid Rianon,Holly M Holmes,Dae Hyun Kim","doi":"10.1093/gerona/glaf099","DOIUrl":"https://doi.org/10.1093/gerona/glaf099","url":null,"abstract":"BACKGROUNDThe Claims-based Frailty Index (CFI) has been developed and validated using Medicare claims data. However, whether CFI can be applied to structured EHR data has not been studied.METHODSWe applied the CFI to a structured EHR dataset (Explorys dataset) and a Medicare fee-for-service (FFS) 5% sample data and compared the prevalence of frailty from each dataset, using the cohort of older adults. Then, we assessed the odds ratio (OR) and area under the curve (AUC) of the frailty predicting adverse clinical outcomes, any hospital or emergency room (ER) visit, or any adverse drug events (ADEs) related encounter within 1 year in each dataset.RESULTSA total of 526,681 from the Explorys dataset (64.6% with Medicare insurance (Explorys-Medicare), and 35.4% with non-Medicare insurance (Explorys-non-Medicare)) and 346,070 individuals from the Medicare dataset were included. The prevalence of frailty, defined as CFI ≥0.25, among heart failure patients was 7.4% in the Explorys-Medicare dataset, 7.1% in Explorys-non-Medicare, and 14.2% in the Medicare dataset. The ORs of frailty for any hospital or ER visit were 3.57, 4.37, and 3.76 in Explorys-Medicare, Explorys-non-Medicare, and Medicare datasets, and for any ADE-related encounter, they were 2.61, 3.29, and 2.89, respectively. The AUC of the frailty index were 0.656, 0.676, and 0.697 for any hospital or ER visit and 0.654, 0.676, and 0.654 for any ADE-related encounter, respectively.CONCLUSIONSWhen the CFI was applied to a structured EHR dataset, it captured fewer frailty cases than the Medicare dataset but had similar performance in predicting adverse clinical outcomes.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143914849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}