Evidence map›Paper›PMID 32423871›Full record

ArticleMechanisms of ageing and development2020

Derivation of a measure of physiological multisystem dysregulation: Results from WHAS and health ABC.

Alden L Gross, Michelle C Carlson, Nadia M Chu, Mara A McAdams-DeMarco, Dan Mungas, Eleanor M Simonsick, Ravi Varadhan, Qian-Li Xue, Jeremy Walston, Karen Bandeen-Roche

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Mechanisms of ageing and development, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.2field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 16 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Alden L GrossDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: agross14@jhu.edu.
Michelle C CarlsonDepartment of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Nadia M ChuDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Mara A McAdams-DeMarcoDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Dan MungasDepartment of Psychiatry, University of California, Davis, CA, USA.
Eleanor M SimonsickDepartment of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Intramural Research Program, National Institute on Aging, Baltimore, Maryland, USA.
Ravi VaradhanDivision of Biostatistics & Bioinformatics, Sidney Kimmel Comprehensive Cancer Care Center, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Qian-Li XueDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Jeremy WalstonDepartment of Medicine, Division of Geriatric Medicine and Gerontology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Karen Bandeen-RocheDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Johns Hopkins University · USJohns Hopkins Medicine · USSidney Kimmel Comprehensive Cancer Center · USUniversity of California, Davis · US

Funding

Translational Research Central ServicesP30CA006973 · NCI · JOHNS HOPKINS UNIVERSITY · PI Rosalie Wollett · 1985 to 2026
$208.6M
Technological Assessment and Solutions Core - RC4P30AG021334 · NIA · JOHNS HOPKINS UNIVERSITY · PI Jeremy D Walston · 2003 to 2026
$33.2M
Pathogenesis of physical disability in Aging womenR37AG019905 · NIA · JOHNS HOPKINS UNIVERSITY · PI FRIED, LINDA P · 2001 to 2010
$9.0M
Kidney transplantation in older, frail and cognitively impaired adults with ESRD: Balancing utility vs. justiceR01AG055781 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI MCADAMS DEMARCO, MARA A. · 2017 to 2021
$4.2M
RISK FACTORS FOR PHYSICAL DISABILITY IN AGING WOMENR01AG011703 · NIA · JOHNS HOPKINS UNIVERSITY · PI FRIED, LINDA P · 1994 to 2004
$3.5M
Peripheral Nerve Function Decline in an Aged CohortR01AG028050 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI STROTMEYER, ELSA S. · 2007 to 2015
$3.5M
End of Life in the Very OldR01NR012459 · NINR · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ALBERT, STEVEN M, LUNNEY, JUNE R · 2011 to 2015
$2.7M
DYNAMICS OF HEALTH .AGING . AND BODY COMPOSITION /Pittsburgh/-260962101N01AG062101 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 1996 to 2004
$996k
DYNAMICS OF HEALTH . AGING . AND BODY COMPOSITION /Memphis/-26062103N01AG062103 · NIA · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · 1996 to 2004
$793k
Intersection of Physiologic Frailty and Cognitive Performance in Older Adults: An Integrative Data AnalysisK01AG050699 · NIA · JOHNS HOPKINS UNIVERSITY · PI GROSS, ALDEN L. · 2016 to 2020
$648k
WOMEN'S HEALTH AND AGING-12112N01AG012112 · NIA · JOHNS HOPKINS UNIVERSITY · 1991 to 2003
$500k
Frailty, Post-Transplant Delirium, and Neurocognitive Underpinnings of AlzheimersK01AG064040 · NIA · JOHNS HOPKINS UNIVERSITY · PI CHU, NADIA MIKHAIL · 2020 to 2022
$390k
NCI NIH HHS P30 CA006973NIA NIH HHS K01 AG050699NIA NIH HHS K01 AG064040NIA NIH HHS N01 AG012112NIA NIH HHS N01 AG062101NIA NIH HHS N01 AG062103NIA NIH HHS P30 AG021334NIA NIH HHS R01 AG011703NIA NIH HHS R01 AG028050NIA NIH HHS R01 AG055781NIA NIH HHS R37 AG019905NINR NIH HHS R01 NR012459
6 · The paper itself

Abstract

introductionMultifactorial biological processes underpin dysregulation over several individual physiological systems. However, it is challenging to characterize and model this multisystemic dysregulation and its relationship with individual physiologic systems. We operationalized a theory-driven measure of multisystem dysregulation and empirically tested for measurement differences by key characteristics.

methodsWe used the Women's Health and Aging Studies (WHAS) I and II (N = 649), and the Health ABC study (N = 1515). Twelve biomarkers representing multiple systems including stress response (e.g., inflammation), endocrine system, and energy regulation were identified. A series of confirmatory factor analyses (CFA) were conducted to evaluate the interplay between physiological systems and underlying multisystem dysregulation. We evaluated convergent criterion validity of a score for multisystem dysregulation against the physical frailty phenotype, and predictive criterion validity with incidence of walking difficulty and mortality.

resultsA bifactor CFA, a model in which dysregulation of individual systems proceeds independently of generalized dysregulation, fit data well in WHAS (RMSEA: 0.019; CFI: 0.977; TLI: 0.961) and Health ABC (RMSEA: 0.047; CFI: 0.874; TLI: 0.787). The general dysregulation factor was associated with frailty (OR: 2.2, 95 % CI: 1.4, 3.5), and elevated risk of incident walking difficulty and mortality. Findings were replicated in Health ABC. DISCUSSION: Biomarker data from two epidemiologic studies support the construct of multisystem physiological dysregulation. Results further suggest system-specific and system-wide processes have unique and non-overlapping contributions to dysregulation in biological markers.

Indexed as

AgingHealth StatusAgedBiomarkersBody CompositionFactor Analysis, StatisticalFemaleFrail ElderlyFrailtyHumansMiddle AgedPhenotypePsychometricsReproducibility of ResultsSensitivity and SpecificitySurveys and QuestionnairesBiomarkersBiomarkersFrailtyPsychometrics

Identifiers

PMID32423871
PMCPMC7375911
OpenAlexW3024816227

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.