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dc.creatorRosero Bixby, Luis
dc.creatorDow, William H.
dc.date.accessioned2015-01-16T19:21:27Z
dc.date.available2015-01-16T19:21:27Z
dc.date.issued2012
dc.identifier.citationhttp://www.pophealthmetrics.com/content/10/1/11es_ES
dc.identifier.urihttp://hdl.handle.net/10669/11260
dc.descriptionartículo -- Universidad de Costa Rica, Centro Centroamericano de Población. 2012es_ES
dc.description.abstractBackground: Little is known about adult health and mortality relationships outside high-income nations, partly because few datasets have contained biomarker data in representative populations. Our objective is to determine the prognostic value of biomarkers with respect to total and cardiovascular mortality in an elderly population of a middle-income country, as well as the extent to which they mediate the effects of age and sex on mortality. Methods: This is a prospective population-based study in a nationally representative sample of elderly Costa Ricans. Baseline interviews occurred mostly in 2005 and mortality follow-up went through December 2010. Sample size after excluding observations with missing values: 2,313 individuals and 564 deaths. Main outcome: prospective death rate ratios for 22 baseline biomarkers, which were estimated with hazard regression models. Results: Biomarkers significantly predict future death above and beyond demographic and self-reported health conditions. The studied biomarkers account for almost half of the effect of age on mortality. However, the sex gap in mortality became several times wider after controlling for biomarkers. The most powerful predictors were simple physical tests: handgrip strength, pulmonary peak flow, and walking speed. Three blood tests also predicted prospective mortality: C-reactive protein (CRP), glycated hemoglobin (HbA1c), and dehydroepiandrosterone sulfate (DHEAS). Strikingly, high blood pressure (BP) and high total cholesterol showed little or no predictive power. Anthropometric measures also failed to show significant mortality effects. Conclusions: This study adds to the growing evidence that blood markers for CRP, HbA1c, and DHEAS, along with organ-specific functional reserve indicators (handgrip, walking speed, and pulmonary peak flow), are valuable tools for identifying vulnerable elderly. The results also highlight the need to better understand an anomaly noted previously in other settings: despite the continued medical focus on drugs for BP and cholesterol, high levels of BP and cholesterol have little predictive value of mortality in this elderly population.es_ES
dc.language.isoen_USes_ES
dc.publisherPopulation Health Metrics 10(1)es_ES
dc.subjectMortalityes_ES
dc.subjectBiomarkerses_ES
dc.subjectCosta Ricaes_ES
dc.subjectDeath risk factorses_ES
dc.subjectSaludes_ES
dc.subjectCardiovascular mortalityes_ES
dc.titlePredicting mortality with biomarkers: a population-based prospective cohort study for elderly Costa Ricanses_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.typeArtículo científicoes_ES
dc.identifier.doi10.1186/1478-7954-10-11
dc.description.procedenceUCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Sociales::Centro Centroamericano de Población (CCP)es_ES


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