Frailty and cardiovascular outcomes in the National Health and Aging Trends Study

Abstract Aims Physical frailty is a commonly encountered geriatric syndrome among older adults without coronary heart disease (CHD). The impact of frailty on the incidence of long-term cardiovascular outcomes is not known.We aimed to evaluate the long-term association of frailty, measured by the Fri...

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Vydané v:European heart journal Ročník 42; číslo 37; s. 3856 - 3865
Hlavní autori: Damluji, Abdulla A, Chung, Shang-En, Xue, Qian-Li, Hasan, Rani K, Moscucci, Mauro, Forman, Daniel E, Bandeen-Roche, Karen, Batchelor, Wayne, Walston, Jeremy D, Resar, Jon R, Gerstenblith, Gary
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: England Oxford University Press 01.10.2021
Predmet:
Aged
Aged, 80 and over
Aging
Ethnicity
Female
Frail Elderly
Frailty - epidemiology
Geriatric Assessment
Humans
Male
Medicare
Minority Groups
Prospective Studies
United States - epidemiology
United States
Frailty
Older adults
Coronary disease
ISSN:0195-668X, 1522-9645, 1522-9645
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Shrnutí:Abstract Aims Physical frailty is a commonly encountered geriatric syndrome among older adults without coronary heart disease (CHD). The impact of frailty on the incidence of long-term cardiovascular outcomes is not known.We aimed to evaluate the long-term association of frailty, measured by the Fried frailty phenotype, with all-cause-mortality and MACE among older adults without a history of CHD at baseline in the National Health and Aging Trends Study. Methods and Results We used the National Health and Aging Trends Study, a prospective cohort study linked to a Medicare sample. Participants with a prior history of CHD were excluded. Frailty was measured during the baseline visit using the Fried physical frailty phenotype. Cardiovascular outcomes were assessed during a 6-year follow-up. Of the 4656 study participants, 3259 (70%) had no history of CHD 1 year prior to their baseline visit. Compared to those without frailty, subjects with frailty were older (mean age 82.1 vs. 75.1 years, P < 0.001), more likely to be female (68.3% vs. 54.9%, P < 0.001), and belong to an ethnic minority. The prevalence of hypertension, falls, disability, anxiety/depression, and multimorbidity was much higher in the frail and pre-frail than the non-frail participants. In a Cox time-to-event multivariable model and during 6-year follow-up, the incidences of death and of each individual cardiovascular outcomes were all significantly higher in the frail than in the non-frail patients including major adverse cardiovascular event (MACE) [hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.53, 2.06], death (HR 2.70, 95% CI 2.16, 3.38), acute myocardial infarction (HR 1.95, 95% CI 1.31, 2.90), stroke (HR 1.71, 95% CI 1.34, 2.17), peripheral vascular disease (HR 1.80, 95% CI 1.44, 2.27), and coronary artery disease (HR 1.35, 95% CI 1.11, 1.65). Conclusion In patients without CHD, frailty is a risk factor for the development of MACEs. Efforts to identify frailty in patients without CHD and interventions to limit or reverse frailty status are needed and, if successful, may limit subsequent adverse cardiovascular events. Graphical abstract The ageing of the US population and the influence of frailty on the incidence of cardiovascular outcomes in over 6 years of follow-up. (A) Estimates on the projected number (%) of all older adults in 2040 were obtained from www.census.gov. (B) The cumulative incidence of each cardiovascular outcome during 6 years of follow-up was derived from the National Health and Aging and Trends Study.
Bibliografia:ObjectType-Article-1
SourceType-Scholarly Journals-1
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content type line 23
ISSN:0195-668X
1522-9645
1522-9645
DOI:10.1093/eurheartj/ehab468