Multisystem Trajectories Over the Adult Life Course and Relations to Cardiovascular Disease and Death

BackgroundComprehensive conjoint characterization of long-term trajectories representing several biological systems is lacking.MethodsWe measured serially indicators representing 14 distinct biological systems in up to 3,453 participants attending four Framingham Study examinations: bone mineral density, body mass index (BMI), C-reactive protein, glomerular filtration rate, forced vital capacity (FVC), 1 second forced expiratory volume/FVC ratio (FEV1/FVC), gait speed, grip strength, glycosylated hemoglobin (HbA1c), heart rate, left ventricular mass, Mini-Mental State Examination (MMSE), pulse pressure, and total/high-density lipoprotein cholesterol ratio (TC/HDL).ResultsWe observed that correlations among the 14 sex-specific trajectories were modest (r p p p p c-statistic compared with single occasion measures (delta-c compared with age- and sex-adjusted models: .032 vs .026 for CVD; .042 vs .030 for mortality).ConclusionsBiological systems age differentially over the life course. Longitudinal data on a parsimonious set of biomarkers reflecting key biological systems may facilitate identification of high-risk individuals.