Growth differentiation factor 15 predicts physical function impairment in Spanish older adults: a real-world prospective study

Abstract

Growth differentiation factor 15 (GDF15) is an emerging biomarker of disease burden, but few studies explore its association with physical function impairment using validated objective measures. We evaluated the cross-sectional and longitudinal association between GDF15 and impaired physical function in older adults, assessed with five validated tools. Data were collected from 2481 individuals ≥ 65 years-old in the Seniors-ENRICA-2 cohort. Serum GDF15 was measured once, at baseline, and physical function was assessed at baseline and after 2.2 years using the following measures: lower-extremity performance (Short Physical Performance Battery), agility (Nagi scale), mobility (Nagi and Rosow & Breslau questionnaires), weakness (measured grip strength) and frailty (Deficit Accumulation Index). Analyses were performed with logistic regression and adjusted for relevant potential confounders.The odds ratios (95% confidence interval) per 25% increment in GDF15 in cross-sectional and prospective analyses were: 1.06 (1.01–1.12) and 1.18 (1.08–1.30) for reduced lower-extremity performance; 1.18 (1.12–1.26) and 1.21 (1.08–1.35) for impaired agility; 1.19 (1.11–1.27) and 1.21 (1.08–1.35) for impaired mobility; 1.15 (1.09–1.22) and 1.13 (1.02–1.25) for weakness; and 1.24 (1.16–1.33) and 1.18 (1.06–1.31) for frailty. Results were similar among participants without cardiovascular disease or diabetes. Higher levels of serum GDF15 are associated with prevalent and incident impaired physical function in older adults. GDF15 could serve as a convenient biomarker to identify older adults at risk of functional decline. Further studies should elucidate the underlying mechanisms, explore its potential to improve risk prediction, and assess the therapeutic value of modifying GDF15.