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.
|Suskind, Anne M; Cawthon, Peggy M; Nakagawa, Sanae et al. (2017) Urinary Incontinence in Older Women: The Role of Body Composition and Muscle Strength: From the Health, Aging, and Body Composition Study. J Am Geriatr Soc 65:42-50|
|van der Meij, Barbara S; Wijnhoven, Hanneke A H; Lee, Jung S et al. (2017) Poor Appetite and Dietary Intake in Community-Dwelling Older Adults. J Am Geriatr Soc 65:2190-2197|
|Wu, Chenkai; Shlipak, Michael G; Stawski, Robert S et al. (2017) Visit-to-Visit Blood Pressure Variability and Mortality and Cardiovascular Outcomes Among Older Adults: The Health, Aging, and Body Composition Study. Am J Hypertens 30:151-158|
|Valiani, Vincenzo; Sourdet, Sandrine; Schoeller, Dale A et al. (2017) Surveying predictors of late-life longitudinal change in daily activity energy expenditure. PLoS One 12:e0186289|
|Madero, Magdalena; Katz, Ronit; Murphy, Rachel et al. (2017) Comparison between Different Measures of Body Fat with Kidney Function Decline and Incident CKD. Clin J Am Soc Nephrol 12:893-903|
|Best, John R; Rosano, Caterina; Aizenstein, Howard J et al. (2017) Long-term changes in time spent walking and subsequent cognitive and structural brain changes in older adults. Neurobiol Aging 57:153-161|
|Baumgartner, Christine; da Costa, Bruno R; Collet, Tinh-Hai et al. (2017) Thyroid Function Within the Normal Range, Subclinical Hypothyroidism, and the Risk of Atrial Fibrillation. Circulation 136:2100-2116|
|Forman, Daniel E; Santanasto, Adam J; Boudreau, Robert et al. (2017) Impact of Incident Heart Failure on Body Composition Over Time in the Health, Aging, and Body Composition Study Population. Circ Heart Fail 10:|
|Contrera, Kevin J; Betz, Josh; Deal, Jennifer et al. (2017) Association of Hearing Impairment and Anxiety in Older Adults. J Aging Health 29:172-184|
|Aubert, Carole E; Bauer, Douglas C; da Costa, Bruno R et al. (2017) The association between subclinical thyroid dysfunction and dementia: The Health, Aging and Body Composition (Health ABC) Study. Clin Endocrinol (Oxf) 87:617-626|
Showing the most recent 10 out of 174 publications