High urinary catecholamine excretion predicts mortality and functional decline in high-functioning, community-dwelling older persons: MacArthur Studies of Successful Aging
Db. Reuben et al., High urinary catecholamine excretion predicts mortality and functional decline in high-functioning, community-dwelling older persons: MacArthur Studies of Successful Aging, J GERONT A, 55(10), 2000, pp. M618-M624
Citations number
39
Categorie Soggetti
Public Health & Health Care Science","Medical Research General Topics
Journal title
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
Purpose. Catecholamine release is a marker of stress, and high plasma norep
inephrine levels have been associated with increased mortality. The predict
ive value of high urinary catecholamine excretion for functional decline an
d mortality in healthier older persons has not been determined.
Subjects and Methods. We used data from the MacArthur Studies of Successful
Aging to determine the effects of high urinary catecholamine excretion on
3- and 7-year mortality and functional decline. In 1988, 765 high-functioni
ng older subjects provided complete overnight urine samples for norepinephr
ine and epinephrine, and 199 of these provided repeat samples in 1991. Subj
ects who were in the top tertile of urinary norepinephrine or epinephrine e
xcretion in 1988 were considered high excreters; those in the top tertile i
n both 1988 and 1991 were considered sustained high excreters. We used biva
riate and multivariate analysis to examine the: relations between high cate
cholamine excretion and mortality and Rosow-Breslau functional decline in 1
991 and 1995.
Results. In multivariate analysts, subjects with high baseline urinary excr
etion of epinephrine, norepinephrine, or either catecholamine were at highe
r risk for mortality and functional decline at 3 and 7 years, although the
magnitude of risk (adjusted odds-ratios ranged from 1.1 to 3.1) varied depe
nding upon specific catecholamine and outcome measure. Subjects who had sus
tained high urinary norepinephrine excretion were also at increased risk fo
r 4-year mortality or functional decline.
Conclusions. High urinary catecholamine excretion in high-functioning, comm
unity-dwelling older persons likely reflects subclinical sympathetic stimul
ation and is a marker of increased risk for functional decline and mortalit
y.