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Abstract: TH-PO796

Association of ACR Trajectories With Frailty Worsening or Death in Community-Dwelling Older Adults

Session Information

Category: Geriatric Nephrology

  • 1200 Geriatric Nephrology

Authors

  • Mielke, Nina, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Schneider, Alice, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Ebert, Natalie, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • van der Giet, Markus, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Huscher, Doerte, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
  • Kuhlmann, Martin K., Vivantes Klinikum im Friedrichshain, Berlin, Berlin, Germany
  • Schaeffner, Elke, Charite Universitatsmedizin Berlin, Berlin, Berlin, Germany
Background

Elevated Albumin-creatinine-ratio (ACR) has been associated with prevalent and incident frailty. We analyzed the association of ACR trajectories over 6 years and frailty status worsening or death in the successive 2-year follow up window in data of the Berlin Initiative Study (BIS).

Methods

Prospective population-based cohort of old adults interviewed biennially with a standardized questionnaire incl. geriatric and physical examination. 6-year ACR trajectories were constructed using either “no albuminuria (A0)” or “albuminuria (A1) (30 – 300 mg/g)” or “A2 (>300 mg/g)” over four study visits. Trajectories were distinguished into “stable A0” or “all other” trajectories of albuminuria incl. incident albuminuria. Frailty was assessed at the 3rd (frailty baseline) and 4th follow-up. Frailty worsening was defined as the transition from robust to prefrail or frail, or from prefrail to frail within the 2-year period. Association between ACR trajectories and the ordinal outcome of no worsening, frailty worsening, or death was analyzed using partial proportional odds regression.

Results

At frailty baseline, mean age was 84 yrs, 46% were male, and 48% were prefrail and 31% frail. Participants with trajectories of albuminuria during the previous 6 years (N=342) were older (86 vs. 84 yrs), were less physically active, had higher prevalence of diabetes (39% vs. 24%) or CVD (83% vs. 66%) and had a lower mean eGFR of 45 compared to 53 mL/min/1.73 m2 in participants with stable A0 trajectories (N=729).
After 2.1 (2.0-2.3) years, 960 (90%) participants had valid information on frailty transition: 187 (17.5%) worsened and 111 (10.3%) died. In the multivariable model1 the odds of frailty worsening for participants with albuminuria trajectories during the 6 yrs preceding initial frailty assessment were 1.5-fold higher compared to participants with stable A0 trajectories. The odds for death were even higher with albuminuria trajectories.

Conclusion

In older adults, albuminuria trajectories are associated with 1.5-fold higher odds for frailty worsening independent of death.

Funding

  • Private Foundation Support