gms | German Medical Science

Mortality risk in population is associated with conventional risk factors such as blood pressure, cholesterol, smoking, and body mass index. They have weaknesses in prediction and physiological explanation of differences in health at old ages. We apply the Holter monitoring for a study of determinants of health among the Russian elderly. Links between health outcomes and physiological toll scores based on Holter data and other biomarkers were studied. Data and methods. Randomly selected elderly Muscovites: 185 individuals aged 67 to 86 from the Moscow Lipid Research Clinics Cohort, set up in 1975-83. Data was collected as a part of the Moscow Pilot study in 2002-03. They included physical performance tests, blood pressure, cholesterol, BMI, HDL, urinary cortisol, epinephrine and norepinephrine excretion, ECG, and 24-hour Holter monitoring parameters. The principal health outcomes were: self-rated health, mobility limitations, number of reported diseases, grip strength, stress score, immediate recall. The health outcomes were predicted by regression models with control for age and sex. Results. The Conventional, the Framingham, and the Holter scores were constructed. The Conventional and the Framingham scores were built on established risk factors. The Holter score included characteristics of the circadian profile of heart rate, presence of arrhythmia, sleep duration, and sleep-awake heart rate pattern. The Framingham score was associated with the number of diseases. Among the risk scores the Holter score was the best predictor of self-rated health (p<0.001) and the number of diseases (p<0.05), and one of the best predictors of the grip strength (p<0.001). For the mobility limitations and stress score only the combination of Holter and Conventional scores was significant at p<0.05. For the cognitive function (immediate recall) Conventional, and Combined (Holter + Conventional) scores provided the highest significance (p<0.0001).