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Cardiometabolic biomarker domains and functional ageing: Cross-cohort evidence for incident mobility limitation
Xing Cheng1, Xiaobo Wang2, Huiling Zhong3
1Department of Orthopedics I, Fogang County People's Hospital, 511600, Qingyuan, China; Department of Spine Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, 510080, Guangzhou, China.
Insights
Cardiometabolic biomarkers, especially glycaemic dysfunction, are linked to new mobility limitations in older adults. A simple biomarker score shows a relevant but incomplete association with functional aging risk.
Area of Science:
- Gerontology
- Cardiology
- Metabolic Health
Background:
- Cardiometabolic dysfunction is a potential contributor to functional aging.
- Consistent associations between biomarker domains and mobility limitation across diverse aging populations are not well-established.
Purpose of the Study:
- To investigate the association between cardiometabolic biomarkers and incident mobility limitation in three large, longitudinal aging cohorts.
- To evaluate a simple biomarker-burden score for predicting mobility limitation.
Main Methods:
- Utilized data from the English Longitudinal Study of Ageing (ELSA), China Health and Retirement Longitudinal Study (CHARLS), and Health and Retirement Study (HRS).
- Defined incident mobility limitation as new difficulty in physical functioning. Analyzed associations using modified Poisson regression.
- Developed and tested a biomarker score (systolic blood pressure, HbA1c, HDL cholesterol, C-reactive protein) across cohorts.
Main Results:
- Included 13,650 participants; glycaemic markers demonstrated the most consistent associations with mobility limitation.
- The biomarker score was associated with incident mobility limitation across all three cohorts (RR 1.31 in ELSA, 1.07 in CHARLS, 1.08 in HRS per 1-SD increase).
- Findings were robust to stricter mobility definitions and multiple imputation, though objective performance and medication analyses showed heterogeneity.
Conclusions:
- Cardiometabolic biomarkers, particularly glycaemic dysfunction, are reproducibly associated with increased risk of mobility limitation.
- A simple biomarker-burden score identifies a significant but incomplete aspect of functional aging risk.
Background:
Cardiometabolic dysfunction may contribute to functional ageing, but whether biomarker domains show consistent associations with mobility limitation across ageing populations remains unclear. We examined cardiometabolic biomarkers and a simple biomarker-burden score for incident mobility limitation in three longitudinal ageing cohorts.
Methods:
We used data from the English Longitudinal Study of Ageing, China Health and Retirement Longitudinal Study, and Health and Retirement Study. Participants with baseline mobility limitation were excluded. Incident mobility limitation was defined as new difficulty in at least one mobility-related physical functioning item at follow-up. Candidate markers represented blood pressure, glycaemic, lipid, and inflammatory domains. Associations were estimated using modified Poisson regression. An ELSA-derived score based on systolic blood pressure, HbA1c, HDL cholesterol, and log-transformed C-reactive protein was evaluated in CHARLS and HRS. Sensitivity analyses examined stricter mobility outcomes, objective performance, medication adjustment, and multiple imputation.
Results:
The analysis included 13,650 participants. Incident mobility limitation occurred in 292/1291 ELSA participants, 2842/6861 CHARLS participants, and 2160/5498 HRS participants. Glycaemic markers showed the most consistent associations. The score was associated with incident mobility limitation in ELSA, CHARLS, and HRS, with adjusted risk ratios of 1.31, 1.07, and 1.08 per 1-SD increase, respectively. Associations were supported by stricter mobility definitions and multiple imputation, although objective performance and medication-related analyses were heterogeneous. External discrimination was modest.
Conclusions:
Cardiometabolic biomarker domains, particularly glycaemic dysfunction, were reproducibly associated with incident mobility limitation. A simple biomarker-burden score captured a relevant but incomplete component of functional ageing risk.
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