The Association Between Some Hormonal and Metabolic Parameters and Geriatric Syndromes in Adults Aged 90 and Older

Aim. This study aimed to investigate the associations between hormonal and metabolic status and geriatric syndromes in centenarians.

Materials and methods. The study was carried out at Pirogov Russian National Research Medical University together with the Federal State Budgetary Institution FMBA. The study group included participants aged 90 and older, for whom a comprehensive geriatric assessment was carried out with the past medical history, the use of geriatric scales and questionnaires (MMSE, SARC-F, MNA and others), as well as collection of blood samples for assessment lipid profile parameters, carbohydrate metabolism indicators, hormones, telomere length. Special attention was paid to the assessment of hormonal-metabolic status in participants aged 90 and older with frailty and associations between vitamin D levels and geriatric syndromes. The study was approved by the local ethics committee (protocol No. 30 of December 24, 2019). Statistical analysis and data visualization were performed using the programming languages R version 4.1.3 and Python version 3.9.

Results. A total of 3007 people who met the inclusion criteria were enrolled in the study. Frailty was found in 627 (82.6%) of 759 men and 2061 (91.7%) of 2248 women. It was found that a statistically significant inverse association with frailty had the following: 25-OH vitamin D levels (increasing the concentration of 25-OH vitamin D by 10 ng/ml reduced the odds of having SA by 11% (95% CI 0.0001%, 21%) , apolipoprotein A1 (a 10 mg/dL increase in apolipoprotein A1 concentration reduced the odds of having SA by 8% (95% CI 3%, 12%), albumin (a 10 g/L increase in albumin reduced the odds of having SA by 36% (95 % CI 12%, 53%) and free triiodothyronine (a 2 pmol/L increase in free triiodothyronine reduced the odds of having SA by 37% (95% CI 8%, 57%). The mean 25-hydroxyvitamin D level in the group was 9 ng/ ml, 86.7% of participants had 25(OH) D deficiency, 8.4% had insufficiency. According to the results of intergroup comparison, a significant association with the vitamin D level group was shown by malnutrition, sarcopenia and cognitive impairment. However, when adjusting for nutritional status, diet and physical activity, the statistical significance of the association of vitamin D levels remained only for cognitive impairment.

Conclusion. Low levels of 25-OH vitamin D, apolipoprotein A1, free triiodothyronine and albumin can be considered as possible biomarkers associated with the presence of frailty among people aged 90 and older. The preventive value of correcting these parameters deserves further study. Also, this study, for the first time in the Russian Federation, highlights the problem of vitamin D deficiency in the population aged 90 and older and its associations with the presence of geriatric syndromes. The obtained results on the association of vitamin D deficiency with cognitive impairment can become a starting point for subsequent intervention studies on the possibility of modifying this condition with nutritional supplements.