{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T07:04:57Z","timestamp":1782284697685,"version":"3.54.5"},"reference-count":54,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2020,9,22]],"date-time":"2020-09-22T00:00:00Z","timestamp":1600732800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268200800007C"],"award-info":[{"award-number":["HHSN268200800007C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201200036C"],"award-info":[{"award-number":["HHSN268201200036C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201800001C"],"award-info":[{"award-number":["HHSN268201800001C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01HC55222"],"award-info":[{"award-number":["N01HC55222"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01HC85079"],"award-info":[{"award-number":["N01HC85079"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01HC85080"],"award-info":[{"award-number":["N01HC85080"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01HC85081"],"award-info":[{"award-number":["N01HC85081"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01HC85082"],"award-info":[{"award-number":["N01HC85082"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01HC85083"],"award-info":[{"award-number":["N01HC85083"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["N01HC85086"],"award-info":[{"award-number":["N01HC85086"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01HL080295"],"award-info":[{"award-number":["U01HL080295"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["U01HL130114"],"award-info":[{"award-number":["U01HL130114"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND\/OBJECTIVES<\/jats:title>\n                    <jats:p>Non\u2010esterified fatty acids (NEFAs) play central roles in the relationship between adiposity and glucose metabolism, and they have been implicated in the pathogenesis of cardiovascular disease, but few studies have assessed their effects on complex geriatric syndromes like frailty that cross multiple organ systems. We sought to determine the relationships between NEFAs and incident frailty, disability, and mobility limitation in a population\u2010based cohort of older persons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We analyzed 4,710 Cardiovascular Health Study (CHS) participants who underwent measurement of circulating total fasting NEFAs in 1992\u20131993 and were assessed for frailty in 1996\u20131997 and for disability and mobility limitation annually. We used ordinal logistic regression to model incident frailty, linear regression to model components of frailty, and Cox regression to model disability and mobility limitation in relation to baseline NEFAs. To ensure proportional hazards, we truncated follow\u2010up at 9\u2009years for disability and 6.5\u2009years for mobility limitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 42 participants became frail and 510 became pre\u2010frail over a 4\u2010year period, and we documented 1,720 cases of disability and 1,225 cases of mobility limitation during follow\u2010up. NEFAs were positively associated in a dose\u2010dependent manner with higher risks of incident frailty, disability, and mobility limitation. The adjusted odds ratios for frailty were 1.37 (95% confidence interval [CI] = 1.01\u20131.86; P = .04) across extreme tertiles and 1.17 (95% CI = 1.03\u20131.33; P = .01) per standard deviation increment. The corresponding hazard ratios for incident disability were 1.14 (95% CI = 1.01\u20131.30; P = .04) and 1.11 (95% CI = 1.06\u20131.17; P\u2009&lt;\u2009.0001); those for incident mobility limitation were 1.23 (95% CI = 1.06\u20131.43; P = .006) and 1.15 (95% CI = 1.08\u20131.22; P\u2009&lt;\u2009.0001). Results were largely consistent among both men and women. Among individual components of frailty, NEFAs were significantly associated with self\u2010reported exhaustion (\u03b2 = .07; standard error = .03; P = .02).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Circulating NEFAs are significantly associated with frailty, disability, and mobility limitation among older adults. These results highlight the broad spectrum of adverse health issues associated with NEFA in older adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.16793","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T01:35:34Z","timestamp":1600824934000},"page":"2890-2897","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["<scp>Non\u2010Esterified<\/scp>\n                    Fatty Acids and Risks of Frailty, Disability, and Mobility Limitation in Older Adults: The Cardiovascular Health Study"],"prefix":"10.1111","volume":"68","author":[{"given":"Peter","family":"Ahiawodzi","sequence":"first","affiliation":[{"name":"Department of Public Health Campbell University College of Pharmacy and Health Sciences  Buies Creek North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luc","family":"Djousse","sequence":"additional","affiliation":[{"name":"Division of Aging, Department of Medicine Brigham and Women\u02bcs Hospital and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim H.","family":"Ix","sequence":"additional","affiliation":[{"name":"Divisions of Nephrology and Preventive Medicine University of California, San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge R.","family":"Kizer","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Veterans Affairs Medical Center University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Russell P.","family":"Tracy","sequence":"additional","affiliation":[{"name":"Department of Pathology and Biochemistry University of Vermont College of Medicine  Burlington Vermont USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of a Biostatistics University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Newman","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology and Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth J.","family":"Mukamal","sequence":"additional","affiliation":[{"name":"Division of General Medicine Beth Israel Deaconess Medical Center and Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1079\/PNS19970076"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2261-14-159"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-004-1443-2"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1992.263.6.E1063"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI119636"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1210\/en.2009-1122"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurobiolaging.2012.05.017"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2018.07.034"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI117252"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.20811"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.2337\/diab.45.4.446"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-005-0051-0"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chembiol.2006.09.010"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15205"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.113.000521"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.03.010"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(91)90005-W"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.018610"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(94)00093-9"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/1047-2797(93)90105-D"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/41.2.264"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwf156"},{"key":"e_1_2_6_25_1","unstructured":"RuifengLi EllenHertzmark MaryLouie LinlinChen andDonnaSpiegelman. The SAS LGTPHCURV9 Macro.2011:1\u201352."},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwy041"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp068137"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10522-014-9536-x"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.52.12.2882"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0195"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gerinurse.2007.07.002"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.2337\/db13-1130"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00394-018-1786-y"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/424130"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2018.07.001"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1079\/BJN2002663"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-07-0169"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2017.12.021"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2008.02008.x"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2011.03597.x"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2015.04.007"},{"issue":"10","key":"e_1_2_6_42_1","first-page":"1173","article-title":"Fatigue: an overview","volume":"78","author":"Rosenthal TC","year":"2008","journal-title":"Am Fam Physician"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.21463"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI25151"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00014.2008"},{"issue":"5","key":"e_1_2_6_46_1","first-page":"592","article-title":"Oxidative stress, mitochondrial DNA mutation, and apoptosis in aging","volume":"232","author":"Lee H","year":"2007","journal-title":"Exp Biol Med (Maywood)"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.0000150649.39934.13"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.90287.2008"},{"issue":"2","key":"e_1_2_6_49_1","first-page":"789","article-title":"Mitochondrial dysfunction results from oxidative stress in the skeletal muscle of diet\u2010induced insulin\u2010resistant mice","volume":"118","author":"Bonnard C","year":"2008","journal-title":"J Clin Invest."},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.2337\/db08-0144"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcp.21936"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.53.2007.S130"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-7075-3-38"},{"issue":"1","key":"e_1_2_6_54_1","first-page":"1","article-title":"Chronic fatigue syndrome and mitochondrial dysfunction","volume":"2","author":"Myhill S","year":"2009","journal-title":"Int J Clin Exp Med."},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-26944-x"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16793","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.16793","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16793","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T19:06:34Z","timestamp":1762196794000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.16793"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,22]]},"references-count":54,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["10.1111\/jgs.16793"],"URL":"https:\/\/doi.org\/10.1111\/jgs.16793","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,22]]},"assertion":[{"value":"2020-04-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}