In this study the investigators will incorporate a wide range of clinical variables associated with aging and cardiovascular disease to determine whether they are associated with mutation status independent of chronologic age. Clinically, aging can be operationalized using geriatric assessment, which entails a comprehensive multi-dimensional assessment of the health of an older adult, including measures of comorbidity, polypharmacy, functional status, cognition, depression, falls, social activities and social support. Given that aging is heterogeneous, geriatric assessment allows greater specificity for aging than chronological age alone.
Study Type
OBSERVATIONAL
Enrollment
2,000
-Baseline and no more frequently than every 6 months until death
* 10 items about daily functional status * Baseline and no more frequently than every 6 months until death
* 7 items about daily functional status * Baseline and no more frequently than every 6 months until death
* 1 item about daily functional status * Baseline and no more frequently than every 6 months until death
* 1 item about daily functional status * Baseline and no more frequently than every 6 months until death
* 13 items about comorbidity * Baseline and no more frequently than every 6 months until death
* 4 items about social activity * Baseline and no more frequently than every 6 months until death
* 2 items about nutrition * Baseline and no more frequently than every 6 months until death
-Baseline and no more frequently than every 6 months until death
* Participants will rinse their mouths 2 times with water for 20-30 seconds and discard the expectorated sample. One side of the inner cheek (buccal mucosa) will then be scraped with a cotton swab 20 times (alternatively, the tongue will be brushed 20 times with a toothbrush) * Baseline and no more frequently than every 6 months until death
* 7 items about heart health and smoking history * Baseline and no more frequently than every 6 months until death
* Research coordinator will test gait speed * Baseline and no more frequently than every 6 months until death
* Research coordinator will test grip strength * Baseline and no more frequently than every 6 months until death
-Baseline and no more frequently than every 6 months until death
-Baseline and no more frequently than every 6 months until death
-1 optional bone marrow biopsy
-For Arm E only
Washington University School of Medicine
St Louis, Missouri, United States
RECRUITINGBackground mutation rate in hematopoietic stem cells from older adults regardless of a prior cancer diagnosis as measured by the number and frequency of hematopoietic-specific mutations
-The investigators will sequence the coding region of some or all of the genes in an individual's blood cells and compare results to their matched mouth cells to define hematopoietic-specific mutations. The number of hematopoietic-specific mutations per individual and the frequency of individuals with mutations will be measured.
Time frame: Estimated to be 10 years
Presence or absence of geriatric syndromes as measured by hematopoietic stem cell mutations
-The presence or absence of geriatric syndromes will be correlated with the mutation status of individuals.
Time frame: Estimated to be 10 years
Determine the natural history of mutations in older adults with clonal hematopoiesis as measured by risk to develop blood cancer/geriatric syndrome/illness/cardiovascular disease
-Individuals with mutations will be followed longitudinally to monitor the fraction of hematopoietic cells with mutations, the functional consequences of mutations in their blood cells, and the risk of developing a blood cancer, geriatric syndrome, cardiovascular disease, or other illness.
Time frame: Estimated to be 10 years
Presence or absence of cardiovascular disease as measured by hematopoietic stem call mutations
Time frame: Estimated to be 10 years
Determine whether expansion of clonal hematopoiesis (CH) occurs following acute trauma
-Measures change in variant allele fraction
Time frame: Estimated to be 10 years
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