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Focus: Kidney Function
In 2012, two age-adapted formulas were developed to evaluate the kidney function in individuals aged 70 and older (so-called BIS1 and BIS2 equations). Through these formulas, kidney function in old age could be evaluated more precisely. It became clear that out of the underlying biomarkers cystatin C and creatinine, cystatin C is probably the more suitable marker for the precise evaluation of kidney function in old age. You can find the corresponding publication here.
By founding the European Kidney Function Consortium (EKFC), further evaluation formulas could be developed that - as opposed to the conventional equations - include the life-course aspect by considering the physiological decline of kidney function starting from the age of 40. Consequently, these equations could be considered valid for the entire lifespan (Full Age Spectrum = FAS) from the age of 2 through the age of 100. You can find the corresponding publication here.
Within the context of our cooperation with our colleagues in Norway and Iceland, we compared the pooled data pertaining to the measured kidney function (GFR) in healthy elderly individuals and those with several chronic diseases. It was shown that “healthy aging” was accompanied by a higher mean mGFR in comparison to “unhealthy aging”. However, a lower mGFR distribution was observed in healthy elderly individuals in comparison to younger individuals. You can find the corresponding publication here.
Focus: Arterial Hypertonia (High Blood Pressure)
Based on the BIS-data, it was shown that blood pressure <140/90 mmHg in old age may not be favorable for all individuals. Out of all BIS participants who were treated by antihypertensive drugs (N=1628), individuals whose blood pressure was <140/90 mmHg and were older than 80 years of age or had already suffered from a brain stroke or myocardial infarction had an even higher risk of death during the course of the study when compared to similar individuals whose blood pressure was >140/90 mmHg. You can find the corresponding publication here.
These results were confirmed in another study in which exclusively BIS patients who suffer from congestive heart failure (N=544) were observed. It was also found that blood pressure <140/90 mmHg was not associated with a lower risk of mortality. Time-dependent analysis showed that it was associated with an even higher risk of mortality in comparison to patients with blood pressure >140/90 mmHg. You can find the corresponding publication here.
Polypharmacy is an unsolved problem in the medical care of elderly patients. We were able to show that polypharmacy plays a major role in our age cohort. Our study participants (mean age 80 years) were on 6.2 medications on average and the number of medications continued to rise in participants older than 80 years. Medications for treatment of cardiovascular diseases were the most commonly identified, followed by lipid-lowering drugs, ß-blockers and ACE-inhibitors. You can find the corresponding publication here.