Associations of interleukin-6 with functional trajectories in older adults with cancer: Findings from the Health, Aging, and Body Composition Study
Background: Elevated markers of inflammation, such as interleukin-6 (IL-6), are associated with aging, cancer, and functional decline. We assessed the association of pre-diagnosis IL-6 levels with post-diagnosis functional trajectories among older adults with cancer. Black and White participants exp...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-06-01
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| Series: | Experimental Gerontology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0531556523001067 |
| _version_ | 1797776202358849536 |
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| author | Kah Poh Loh William Consagra Allison Magnuson Andrea Baran Nikesha Gilmore Smith Giri Marissa LoCastro Scott Isom Michael B. Sohn Grant R. Williams Denise K. Houston Barbara Nicklas Stephen Kritchevsky Heidi D. Klepin |
| author_facet | Kah Poh Loh William Consagra Allison Magnuson Andrea Baran Nikesha Gilmore Smith Giri Marissa LoCastro Scott Isom Michael B. Sohn Grant R. Williams Denise K. Houston Barbara Nicklas Stephen Kritchevsky Heidi D. Klepin |
| author_sort | Kah Poh Loh |
| collection | DOAJ |
| description | Background: Elevated markers of inflammation, such as interleukin-6 (IL-6), are associated with aging, cancer, and functional decline. We assessed the association of pre-diagnosis IL-6 levels with post-diagnosis functional trajectories among older adults with cancer. Black and White participants experience different social structures, therefore we sought to understand whether these associations differ between Black and White participants. Methods: We conducted secondary analysis of the Health Aging, Body, and Composition (ABC) prospective longitudinal cohort study. Participants were recruited from 4/1997 to 6/1998. We included 179 participants with a new cancer diagnosis and IL-6 level measured within 2 years before diagnosis. Primary endpoint was functional measures (self-reported ability to walk 1/4, 20-meter gait speed). Nonparametric longitudinal models were used to cluster the trajectories; multinomial and logistic regressions to model associations. Findings: Mean age was 74 (SD 2.9); 36 % identified as Black. For self-reported functional status, we identified 3 clusters: high stable, decline, low stable. For gait speed, we identified 2 clusters: resilient, decline. The relationship between cluster trajectory and IL-6 was different between Black and White participants (p for interaction<0.05). For gait speed, among White participants, a greater log IL-6 level was associated with greater odds of being in the decline vs. resilient cluster [Adjusted Odds Ratio (AOR): 4.31, 95 % CI: 1.43, 17.46]. Among Black participants, a greater log IL-6 levels were associated with lower odds of being in the decline vs. resilient cluster (AOR: 0.49, 95 % CI: 0.10, 2.08). Directionality was similar for self-reported ability to walk ¼ mile (high stable vs. low stable). Among White participants, a higher log IL-6 level was associated numerically with greater odds of being in the low stable vs. high stable cluster (AOR: 1.99, 95 % CI: 0.82, 4.85). Among Black participants, a higher log IL-6 level was associated numerically with lower odds of being in the low stable cluster vs. high stable cluster (AOR: 0.78, 95 % CI: 0.30, 2.00). Interpretation: The association between IL-6 levels and functional trajectories of older adults differed by race. Future analyses exploring stressors faces by other minoritized racial backgrounds are needed to determine the association between IL-6 and functional trajectories. Panel: Research in context: Evidence before this study: Previous research has shown that aging is the greatest risk factor for cancer and older adults with cancer experience a higher burden of comorbidities, increasing their risk of functional decline. Race has also been shown to be associated with increased risk for functional decline. Black individuals are exposed to more chronic negative social determinants, compared to White individuals. Previous work has shown that chronic exposure to negative social determinants leads to elevated levels of inflammatory markers, such as IL-6, but studies investigating the relationship between inflammatory markers and functional decline are limited.Added value of this study: Authors of this study sought to understand the association between pre-diagnosis IL-6 levels and functional trajectories post-diagnosis in older adults with cancer, and whether these associations differed between Black and White participants with cancer. Authors decided to utilize the data from the Health, Aging and Body Composition (Health ABC) Study. The Health ACB study was a prospective longitudinal cohort study that has a high representation of Black older adults and collected inflammatory cytokines and physical function data over time.Implications of all available evidence: This work adds to the literature by providing an opportunity to study the difference in the relationships between IL-6 levels and functional trajectories between older Black and White participants with cancer. Identifying factors associated with functional decline and its trajectories may inform treatment decision making and guide development of supportive care interventions to prevent functional decline. Additionally, given the disparities in clinical outcomes for Black individuals, a better understanding of the difference in functional decline based on race will allow more equitable care to be distributed. |
| first_indexed | 2024-03-12T22:46:34Z |
| format | Article |
| id | doaj.art-d2a293900b7d4d5c8b3e59eef90379f2 |
| institution | Directory Open Access Journal |
| issn | 1873-6815 |
| language | English |
| last_indexed | 2024-03-12T22:46:34Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Experimental Gerontology |
| spelling | doaj.art-d2a293900b7d4d5c8b3e59eef90379f22023-07-21T04:59:08ZengElsevierExperimental Gerontology1873-68152023-06-01177112185Associations of interleukin-6 with functional trajectories in older adults with cancer: Findings from the Health, Aging, and Body Composition StudyKah Poh Loh0William Consagra1Allison Magnuson2Andrea Baran3Nikesha Gilmore4Smith Giri5Marissa LoCastro6Scott Isom7Michael B. Sohn8Grant R. Williams9Denise K. Houston10Barbara Nicklas11Stephen Kritchevsky12Heidi D. Klepin13James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA; Corresponding author at: James P. Wilmot Cancer Center, Division of Hematology/Oncology, Department of Medicine, 601 Elmwood Avenue, Box 704, Rochester, NY 14642, USA.Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USAJames P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA; Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USAJames P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA; Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USAJames P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA; Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USADepartment of Medicine, Division of Hematology & Oncology, The University of Alabama at Birmingham, Birmingham, AL, USAJames P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USADepartment of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USADepartment of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USADepartment of Medicine, Division of Hematology & Oncology, The University of Alabama at Birmingham, Birmingham, AL, USADepartment of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USADepartment of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USADepartment of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USADepartment of Internal Medicine, Section on Hematology and Oncology, Wake Forest School of Medicine, Winston-Salem, NC, USABackground: Elevated markers of inflammation, such as interleukin-6 (IL-6), are associated with aging, cancer, and functional decline. We assessed the association of pre-diagnosis IL-6 levels with post-diagnosis functional trajectories among older adults with cancer. Black and White participants experience different social structures, therefore we sought to understand whether these associations differ between Black and White participants. Methods: We conducted secondary analysis of the Health Aging, Body, and Composition (ABC) prospective longitudinal cohort study. Participants were recruited from 4/1997 to 6/1998. We included 179 participants with a new cancer diagnosis and IL-6 level measured within 2 years before diagnosis. Primary endpoint was functional measures (self-reported ability to walk 1/4, 20-meter gait speed). Nonparametric longitudinal models were used to cluster the trajectories; multinomial and logistic regressions to model associations. Findings: Mean age was 74 (SD 2.9); 36 % identified as Black. For self-reported functional status, we identified 3 clusters: high stable, decline, low stable. For gait speed, we identified 2 clusters: resilient, decline. The relationship between cluster trajectory and IL-6 was different between Black and White participants (p for interaction<0.05). For gait speed, among White participants, a greater log IL-6 level was associated with greater odds of being in the decline vs. resilient cluster [Adjusted Odds Ratio (AOR): 4.31, 95 % CI: 1.43, 17.46]. Among Black participants, a greater log IL-6 levels were associated with lower odds of being in the decline vs. resilient cluster (AOR: 0.49, 95 % CI: 0.10, 2.08). Directionality was similar for self-reported ability to walk ¼ mile (high stable vs. low stable). Among White participants, a higher log IL-6 level was associated numerically with greater odds of being in the low stable vs. high stable cluster (AOR: 1.99, 95 % CI: 0.82, 4.85). Among Black participants, a higher log IL-6 level was associated numerically with lower odds of being in the low stable cluster vs. high stable cluster (AOR: 0.78, 95 % CI: 0.30, 2.00). Interpretation: The association between IL-6 levels and functional trajectories of older adults differed by race. Future analyses exploring stressors faces by other minoritized racial backgrounds are needed to determine the association between IL-6 and functional trajectories. Panel: Research in context: Evidence before this study: Previous research has shown that aging is the greatest risk factor for cancer and older adults with cancer experience a higher burden of comorbidities, increasing their risk of functional decline. Race has also been shown to be associated with increased risk for functional decline. Black individuals are exposed to more chronic negative social determinants, compared to White individuals. Previous work has shown that chronic exposure to negative social determinants leads to elevated levels of inflammatory markers, such as IL-6, but studies investigating the relationship between inflammatory markers and functional decline are limited.Added value of this study: Authors of this study sought to understand the association between pre-diagnosis IL-6 levels and functional trajectories post-diagnosis in older adults with cancer, and whether these associations differed between Black and White participants with cancer. Authors decided to utilize the data from the Health, Aging and Body Composition (Health ABC) Study. The Health ACB study was a prospective longitudinal cohort study that has a high representation of Black older adults and collected inflammatory cytokines and physical function data over time.Implications of all available evidence: This work adds to the literature by providing an opportunity to study the difference in the relationships between IL-6 levels and functional trajectories between older Black and White participants with cancer. Identifying factors associated with functional decline and its trajectories may inform treatment decision making and guide development of supportive care interventions to prevent functional decline. Additionally, given the disparities in clinical outcomes for Black individuals, a better understanding of the difference in functional decline based on race will allow more equitable care to be distributed.http://www.sciencedirect.com/science/article/pii/S0531556523001067Interleukin-6Functional trajectoriesOlder adultscancer |
| spellingShingle | Kah Poh Loh William Consagra Allison Magnuson Andrea Baran Nikesha Gilmore Smith Giri Marissa LoCastro Scott Isom Michael B. Sohn Grant R. Williams Denise K. Houston Barbara Nicklas Stephen Kritchevsky Heidi D. Klepin Associations of interleukin-6 with functional trajectories in older adults with cancer: Findings from the Health, Aging, and Body Composition Study Experimental Gerontology Interleukin-6 Functional trajectories Older adults cancer |
| title | Associations of interleukin-6 with functional trajectories in older adults with cancer: Findings from the Health, Aging, and Body Composition Study |
| title_full | Associations of interleukin-6 with functional trajectories in older adults with cancer: Findings from the Health, Aging, and Body Composition Study |
| title_fullStr | Associations of interleukin-6 with functional trajectories in older adults with cancer: Findings from the Health, Aging, and Body Composition Study |
| title_full_unstemmed | Associations of interleukin-6 with functional trajectories in older adults with cancer: Findings from the Health, Aging, and Body Composition Study |
| title_short | Associations of interleukin-6 with functional trajectories in older adults with cancer: Findings from the Health, Aging, and Body Composition Study |
| title_sort | associations of interleukin 6 with functional trajectories in older adults with cancer findings from the health aging and body composition study |
| topic | Interleukin-6 Functional trajectories Older adults cancer |
| url | http://www.sciencedirect.com/science/article/pii/S0531556523001067 |
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