Trajectories of function and biomarkers with age: the CHS All Stars Study

Anne B. Newman, Jason L. Sanders, Jorge Kizer, Robert M. Boudreau, Michelle C. Odden, Adina Zeki Al Hazzouri, Alice M. Arnold

Research output: Contribution to journalArticle

28 Scopus citations


BACKGROUND: Multimorbidity is a major driver of physical and cognitive impairment, but rates of decline are also related to ageing. We sought to determine trajectories of decline in a large cohort by disease status, and examined their correspondence with biomarkers of ageing processes including growth hormone, sex steroid, inflammation, visceral adiposity and kidney function pathways.

METHODS: We have followed the 5888 participants in the Cardiovascular Health Study (CHS) for healthy ageing and longevity since 1989-90. Gait speed, grip strength, modified mini-mental status examination (3MSE) and the digit symbol substitution test (DSST) were assessed annually to 1998-99 and again in 2005-06. Insulin-like growth hormone (IGF-1), dehydroepiandrosterone sulphate (DHEAS), interleukin-6 (IL-6), adiponectin and cystatin-C were assessed 3-5 times from stored samples. Health status was updated annually and dichotomized as healthy vs not healthy. Trajectories for each function measure and biomarker were estimated using generalized estimating equations as a function of age and health status using standardized values.

RESULTS: Trajectories of functional decline showed strong age acceleration late in life in healthy older men and women as well as in chronically ill older adults. Adiponectin, IL-6 and cystatin-C tracked with functional decline in all domains; cystatin-C was consistently associated with functional declines independent of other biomarkers. DHEAS was independently associated with grip strength and IL-6 with grip strength and gait speed trajectories.

CONCLUSIONS: Functional decline in late life appears to mark a fundamental ageing process in that it occurred and was accelerated in late life regardless of health status. Cystatin C was most consistently associated with these functional declines.

Original languageEnglish (US)
Pages (from-to)1135-1145
Number of pages11
JournalInternational Journal of Epidemiology
Issue number4
StatePublished - Aug 1 2016



  • Ageing
  • biomarkers
  • cognitive function
  • disability
  • gait speed
  • grip strength

ASJC Scopus subject areas

  • Epidemiology

Cite this

Newman, A. B., Sanders, J. L., Kizer, J., Boudreau, R. M., Odden, M. C., Zeki Al Hazzouri, A., & Arnold, A. M. (2016). Trajectories of function and biomarkers with age: the CHS All Stars Study. International Journal of Epidemiology, 45(4), 1135-1145.