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J Gerontol A Biol Sci Med Sci. 2015 Jan;70(1):63-70. doi: 10.1093/gerona/glu127. Epub 2014 Aug 7.

Aging and the burden of multimorbidity: associations with inflammatory and anabolic hormonal biomarkers.

Author information

1
Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland. Department of Medical and Surgical Sciences, University of Bologna, Italy. elisa.fabbri@nih.gov.
2
Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland.
3
Department of Medical and Surgical Sciences, University of Bologna, Italy.
4
Department of Epidemiology and Public Health, Division of Gerontology, University of Maryland School of Medicine, Baltimore.
5
Department of Geriatric Medicine, ASF - Firenze, Florence, Italy.
6
Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland.

Abstract

BACKGROUND:

Multimorbidity increases with aging, but risk factors beyond age are unknown.

OBJECTIVE:

To investigate the association of inflammatory and anabolic hormonal biomarkers with presence and prospective development of multimorbidity.

METHODS:

Nine-year longitudinal study of 1018 participants aged 60 years or older (InCHIANTI Study). Multimorbidity was evaluated at baseline and follow-up visits as number of diagnosed diseases from a predefined list of 15 candidate chronic conditions, defined according to standard clinical criteria. Linear mixed models were used to test cross-sectional and longitudinal associations between candidate biomarkers and multimorbidity.

RESULTS:

At baseline, multimorbidity was significantly higher in older participants (p < .001) and higher IL-6, IL-1ra, TNF-α receptor II (TNFAR2), and lower dehydroepiandrosterone sulfate were associated with higher number of diseases, independent of age, sex, body mass index, and education. The rate of longitudinal increase in number of chronic diseases was significantly steeper in participants who were older at baseline (p < .001). In addition, higher baseline IL-6 and steeper increase of IL-6 levels were significantly and independently associated with a steeper increase in multimorbidity over time (p < .001 and p = .003, respectively). Sensitivity analyses, performed using 15 different models obtained by removing each of 15 conditions included in the original list of candidate diseases, confirmed that results were not driven by any specific condition.

CONCLUSIONS:

Accumulation of chronic diseases accelerates at older ages and in persons with higher baseline levels and steeper increase over time of IL-6. High IL-6 and increase in IL-6 may serve as early warning sign to better target interventions aimed at reducing the burden of multimorbidity.

KEYWORDS:

Aging; Chronic diseases.; Inflammation; Interleukin-6; Multimorbidity

PMID:
25104822
PMCID:
PMC4296167
DOI:
10.1093/gerona/glu127
[Indexed for MEDLINE]
Free PMC Article

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