This competing renewal of Peripheral nerve function in an aged cohort will determine for the first time if poor sensorimotor peripheral nerve function, a novel potential risk factor, is associated with major clinical outcomes of fall injuries requirin medical care, fractures, Medicare utilization, Medicare expenditures, and mortality in older adults. In the initial funding period of this project, we demonstrated that loss of sensorimotor peripheral nerve function is very common in both diabetic and non-diabetic older adults. We found significant and independent predictors for nerve function decline, such as taller height, white race, and older age, and preventable, disease-related factors such as diabetes, renal impairment (high cystatin C), subclinical peripheral vascular disease, and low vitamin B12. Poor nerve function can be detected long before presenting as overt clinical peripheral neuropathy and we have established associations with lower bone mineral density, muscle strength and physical performance. These associations are not explained by diabetes. These musculoskeletal factors likely contribute to fall injuries, fractures, and increased mortality. Utilization and expenditures associated with peripheral nerve decline in older adults are not characterized. We will link our cohort data to Centers for Medicare Services data to determine if sensorimotor peripheral nerve function predicts fall injuries and is associated with higher utilization, total expenditures, and mortality.
The specific aims are to determine if poor peripherl sensory and motor nerve function is associated with 1) treated fall injuries, including fractures, and 2) greater total and fall-related Medicare utilization, Medicare expenditures, and mortality. The Health ABC Study is a large NIA supported cohort study that included 3075 black and white men and women (42% Black;52% women) at baseline in 1997-98, with an initial assessment of nerve function in 2000-01. In the first stage of this project, we reassessed peripheral nerve function in 2007-2008 (N=1175, aged 80-89 and mean 83.3?2.7 years) to determine rates of sensory and motor nerve function decline and risk factors for decline. In this renewal we will take the next step and prospectively assess the major geriatric outcomes associated with poor nerve function. Our initial R01 did not assess fall injuries or fractures and did not include medical utilization and expenditures, which have been only recently linked to the Health ABC data. The availability of linked Medicare data enriches our opportunities to fully characterize these outcomes. This project will define the major clinical outcomes of peripheral nerve function: treated fall injuries, fractures, medical utilization, expenditures and death. Our well characterizd epidemiologic cohort with linked Medicare data provides the ideal opportunity for this work. We will generate a validated approach that may be applied to Medicare data to examine injurious fall outcomes in our other large epidemiologic cohorts. The ultimate goal is to determine if peripheral nerve testing identifies older adults at higher risk for fall injuries, fractures and deth that may benefit from preventive measures for nerve decline or clinical outcomes.
This competing renewal will determine for the first time if poor sensorimotor peripheral nerve function, a novel potential risk factor, is associated with major clinical outcomes of fall injuries requiring medical care, fractures, total and fall-related Medicae utilization/expenditures, and mortality in older adults. In the initial funding period, we demonstrated that loss of sensorimotor peripheral nerve function is very common in both diabetic and non- diabetic older adults, has preventable risk factors, and is related to lower bone mineral density, muscle strength and physical performance. The ultimate goal is to determine if peripheral nerve testing identifies older adults at a higher risk for fall injuries, fractures and death that may benefit from preventive measures for nerve decline or clinical outcomes.
|Tranah, Gregory J; Katzman, Shana M; Lauterjung, Kevin et al. (2018) Mitochondrial DNA m.3243A?>?G heteroplasmy affects multiple aging phenotypes and risk of mortality. Sci Rep 8:11887|
|Brewster, Katharine K; Ciarleglio, Adam; Brown, Patrick J et al. (2018) Age-Related Hearing Loss and Its Association with Depression in Later Life. Am J Geriatr Psychiatry 26:788-796|
|Hong, Jaeyoung; Hatchell, Kathryn E; Bradfield, Jonathan P et al. (2018) Transethnic Evaluation Identifies Low-Frequency Loci Associated With 25-Hydroxyvitamin D Concentrations. J Clin Endocrinol Metab 103:1380-1392|
|Segna, D; Bauer, D C; Feller, M et al. (2018) Association between subclinical thyroid dysfunction and change in bone mineral density in prospective cohorts. J Intern Med 283:56-72|
|Lunney, June R; Albert, Steven M; Boudreau, Robert et al. (2018) Three Year Functional Trajectories Among Old Age Survivors and Decedents: Dying Eliminates a Racial Disparity. J Gen Intern Med 33:177-181|
|Sparto, Patrick J; Newman, A B; Simonsick, E M et al. (2018) Contributions to lateral balance control in ambulatory older adults. Aging Clin Exp Res 30:633-641|
|Xu, Jiayi; Bartz, Traci M; Chittoor, Geetha et al. (2018) Meta-analysis across Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium provides evidence for an association of serum vitamin D with pulmonary function. Br J Nutr 120:1159-1170|
|Oelsner, Elizabeth C; Balte, Pallavi P; Cassano, Patricia A et al. (2018) Harmonization of Respiratory Data From 9 US Population-Based Cohorts: The NHLBI Pooled Cohorts Study. Am J Epidemiol 187:2265-2278|
|Lunney, June R; Albert, Steven M; Boudreau, Robert et al. (2018) Mobility Trajectories at the End of Life: Comparing Clinical Condition and Latent Class Approaches. J Am Geriatr Soc 66:503-508|
|Buford, Thomas W; Manini, Todd M; Kairalla, John A et al. (2018) Mitochondrial DNA Sequence Variants Associated With Blood Pressure Among 2 Cohorts of Older Adults. J Am Heart Assoc 7:e010009|
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