Frailty and risk for heart failure in older adults: The health, aging, and body composition study

The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults. Frailty is common in the elderly and is associated with adverse health outcomes. Impact of frailty on HF risk is not known. We assessed the association between frailty, using the Heal...

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Vydané v:	The American heart journal Ročník 166; číslo 5; s. 887 - 894
Hlavní autori:	Khan, Hassan, Kalogeropoulos, Andreas P., Georgiopoulou, Vasiliki V., Newman, Anne B., Harris, Tamara B., Rodondi, Nicolas, Bauer, Douglas C., Kritchevsky, Stephen B., Butler, Javed
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States Mosby, Inc 01.11.2013 Elsevier Limited
Predmet:	Aged Aging Body Composition Cardiovascular Cardiovascular disease Cholesterol Female Follow-Up Studies Frail Elderly Frailty Heart attacks Heart Failure - epidemiology Heart Failure - physiopathology Hospitalization - statistics & numerical data Humans Incidence Male Older people Risk Risk Assessment
ISSN:	0002-8703, 1097-6744, 1097-6744
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Abstract	The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults. Frailty is common in the elderly and is associated with adverse health outcomes. Impact of frailty on HF risk is not known. We assessed the association between frailty, using the Health ABC Short Physical Performance Battery (HABC Battery) and the Gill index, and incident HF in 2825 participants aged 70 to 79 years. Mean age of participants was 74 ± 3 years; 48% were men and 59% were white. During a median follow up of 11.4 (7.1-11.7) years, 466 participants developed HF. Compared to non-frail participants, moderate (HR 1.36, 95% CI 1.08-1.71) and severe frailty (HR 1.88, 95% CI 1.02-3.47) by Gill index was associated with a higher risk for HF. HABC Battery score was linearly associated with HF risk after adjusting for the Health ABC HF Model (HR 1.24, 95% CI 1.13-1.36 per SD decrease in score) and remained significant when controlled for death as a competing risk (HR 1.30; 95% CI 1.00-1.55). Results were comparable across age, sex, and race, and in sub-groups based on diabetes mellitus or cardiovascular disease at baseline. Addition of HABC Battery scores to the Health ABC HF Risk Model improved discrimination (change in C-index, 0.014; 95% CI 0.018-0.010) and appropriately reclassified 13.4% (net-reclassification-improvement 0.073, 95% CI 0.021-0.125; P = .006) of participants (8.3% who developed HF and 5.1% who did not). Frailty is independently associated with risk of HF in older adults.
AbstractList	The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults. Frailty is common in the elderly and is associated with adverse health outcomes. Impact of frailty on HF risk is not known. We assessed the association between frailty, using the Health ABC Short Physical Performance Battery (HABC Battery) and the Gill index, and incident HF in 2825 participants aged 70 to 79 years. Mean age of participants was 74 ± 3 years; 48% were men and 59% were white. During a median follow up of 11.4 (7.1-11.7) years, 466 participants developed HF. Compared to non-frail participants, moderate (HR 1.36, 95% CI 1.08-1.71) and severe frailty (HR 1.88, 95% CI 1.02-3.47) by Gill index was associated with a higher risk for HF. HABC Battery score was linearly associated with HF risk after adjusting for the Health ABC HF Model (HR 1.24, 95% CI 1.13-1.36 per SD decrease in score) and remained significant when controlled for death as a competing risk (HR 1.30; 95% CI 1.00-1.55). Results were comparable across age, sex, and race, and in sub-groups based on diabetes mellitus or cardiovascular disease at baseline. Addition of HABC Battery scores to the Health ABC HF Risk Model improved discrimination (change in C-index, 0.014; 95% CI 0.018-0.010) and appropriately reclassified 13.4% (net-reclassification-improvement 0.073, 95% CI 0.021-0.125; P = .006) of participants (8.3% who developed HF and 5.1% who did not). Frailty is independently associated with risk of HF in older adults. Objective The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults. Background Frailty is common in the elderly and is associated with adverse health outcomes. Impact of frailty on HF risk is not known. Methods We assessed the association between frailty, using the Health ABC Short Physical Performance Battery (HABC Battery) and the Gill index, and incident HF in 2825 participants aged 70 to 79 years. Results Mean age of participants was 74 ± 3 years; 48% were men and 59% were white. During a median follow up of 11.4 (7.1-11.7) years, 466 participants developed HF. Compared to non-frail participants, moderate (HR 1.36, 95% CI 1.08-1.71) and severe frailty (HR 1.88, 95% CI 1.02-3.47) by Gill index was associated with a higher risk for HF. HABC Battery score was linearly associated with HF risk after adjusting for the Health ABC HF Model (HR 1.24, 95% CI 1.13-1.36 per SD decrease in score) and remained significant when controlled for death as a competing risk (HR 1.30; 95% CI 1.00-1.55). Results were comparable across age, sex, and race, and in sub-groups based on diabetes mellitus or cardiovascular disease at baseline. Addition of HABC Battery scores to the Health ABC HF Risk Model improved discrimination (change in C-index, 0.014; 95% CI 0.018-0.010) and appropriately reclassified 13.4% (net-reclassification-improvement 0.073, 95% CI 0.021-0.125; P = .006) of participants (8.3% who developed HF and 5.1% who did not). Conclusions Frailty is independently associated with risk of HF in older adults. The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults.OBJECTIVEThe aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults.Frailty is common in the elderly and is associated with adverse health outcomes. Impact of frailty on HF risk is not known.BACKGROUNDFrailty is common in the elderly and is associated with adverse health outcomes. Impact of frailty on HF risk is not known.We assessed the association between frailty, using the Health ABC Short Physical Performance Battery (HABC Battery) and the Gill index, and incident HF in 2825 participants aged 70 to 79 years.METHODSWe assessed the association between frailty, using the Health ABC Short Physical Performance Battery (HABC Battery) and the Gill index, and incident HF in 2825 participants aged 70 to 79 years.Mean age of participants was 74 ± 3 years; 48% were men and 59% were white. During a median follow up of 11.4 (7.1-11.7) years, 466 participants developed HF. Compared to non-frail participants, moderate (HR 1.36, 95% CI 1.08-1.71) and severe frailty (HR 1.88, 95% CI 1.02-3.47) by Gill index was associated with a higher risk for HF. HABC Battery score was linearly associated with HF risk after adjusting for the Health ABC HF Model (HR 1.24, 95% CI 1.13-1.36 per SD decrease in score) and remained significant when controlled for death as a competing risk (HR 1.30; 95% CI 1.00-1.55). Results were comparable across age, sex, and race, and in sub-groups based on diabetes mellitus or cardiovascular disease at baseline. Addition of HABC Battery scores to the Health ABC HF Risk Model improved discrimination (change in C-index, 0.014; 95% CI 0.018-0.010) and appropriately reclassified 13.4% (net-reclassification-improvement 0.073, 95% CI 0.021-0.125; P = .006) of participants (8.3% who developed HF and 5.1% who did not).RESULTSMean age of participants was 74 ± 3 years; 48% were men and 59% were white. During a median follow up of 11.4 (7.1-11.7) years, 466 participants developed HF. Compared to non-frail participants, moderate (HR 1.36, 95% CI 1.08-1.71) and severe frailty (HR 1.88, 95% CI 1.02-3.47) by Gill index was associated with a higher risk for HF. HABC Battery score was linearly associated with HF risk after adjusting for the Health ABC HF Model (HR 1.24, 95% CI 1.13-1.36 per SD decrease in score) and remained significant when controlled for death as a competing risk (HR 1.30; 95% CI 1.00-1.55). Results were comparable across age, sex, and race, and in sub-groups based on diabetes mellitus or cardiovascular disease at baseline. Addition of HABC Battery scores to the Health ABC HF Risk Model improved discrimination (change in C-index, 0.014; 95% CI 0.018-0.010) and appropriately reclassified 13.4% (net-reclassification-improvement 0.073, 95% CI 0.021-0.125; P = .006) of participants (8.3% who developed HF and 5.1% who did not).Frailty is independently associated with risk of HF in older adults.CONCLUSIONSFrailty is independently associated with risk of HF in older adults.
Author	Khan, Hassan Kalogeropoulos, Andreas P. Bauer, Douglas C. Georgiopoulou, Vasiliki V. Rodondi, Nicolas Newman, Anne B. Harris, Tamara B. Kritchevsky, Stephen B. Butler, Javed
AuthorAffiliation	7 Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC 6 Departments of Medicine and Epidemiology & Biostatistics, University of California, San Francisco 3 Departments of Epidemiology and Medicine, University of Pittsburgh, Pittsburgh, PA 2 Cardiology Division, Emory University, Atlanta, GA 5 Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Switzerland 1 Department of Public Health and Primary Care, University of Cambridge, United Kingdom 4 Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD
AuthorAffiliation_xml	– name: 1 Department of Public Health and Primary Care, University of Cambridge, United Kingdom – name: 3 Departments of Epidemiology and Medicine, University of Pittsburgh, Pittsburgh, PA – name: 7 Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC – name: 5 Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Switzerland – name: 4 Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD – name: 2 Cardiology Division, Emory University, Atlanta, GA – name: 6 Departments of Medicine and Epidemiology & Biostatistics, University of California, San Francisco
Author_xml	– sequence: 1 givenname: Hassan surname: Khan fullname: Khan, Hassan organization: Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom – sequence: 2 givenname: Andreas P. surname: Kalogeropoulos fullname: Kalogeropoulos, Andreas P. organization: Cardiology Division, Emory University, Atlanta, GA – sequence: 3 givenname: Vasiliki V. surname: Georgiopoulou fullname: Georgiopoulou, Vasiliki V. organization: Cardiology Division, Emory University, Atlanta, GA – sequence: 4 givenname: Anne B. surname: Newman fullname: Newman, Anne B. organization: Departments of Epidemiology and Medicine, University of Pittsburgh, Pittsburgh, PA – sequence: 5 givenname: Tamara B. surname: Harris fullname: Harris, Tamara B. organization: Laboratory of Epidemiology, Demography and Biometry, National Institute on Aging, Bethesda, MD – sequence: 6 givenname: Nicolas surname: Rodondi fullname: Rodondi, Nicolas organization: Department of Ambulatory Care and Community Medicine, Lausanne University Hospital, Lausanne, Switzerland – sequence: 7 givenname: Douglas C. surname: Bauer fullname: Bauer, Douglas C. organization: Departments of Medicine and Epidemiology & Biostatistics, University of California, San Francisco, CA – sequence: 8 givenname: Stephen B. surname: Kritchevsky fullname: Kritchevsky, Stephen B. organization: Section of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston Salem, NC – sequence: 9 givenname: Javed surname: Butler fullname: Butler, Javed email: javed.butler@emory.edu, jbutle4@emory.edu organization: Cardiology Division, Emory University, Atlanta, GA
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/24176445$$D View this record in MEDLINE/PubMed
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Copyright	2013 Mosby, Inc. Mosby, Inc. 2013. Copyright Elsevier Limited Nov 2013 2013 Mosby, Inc. All rights reserved. 2013
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Snippet	The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults. Frailty is common in the elderly and is... Objective The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults. Background Frailty is common in... The aim of this study was to assess the association between frailty and risk for heart failure (HF) in older adults.OBJECTIVEThe aim of this study was to...
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SubjectTerms	Aged Aging Body Composition Cardiovascular Cardiovascular disease Cholesterol Female Follow-Up Studies Frail Elderly Frailty Heart attacks Heart Failure - epidemiology Heart Failure - physiopathology Hospitalization - statistics & numerical data Humans Incidence Male Older people Risk Risk Assessment
Title	Frailty and risk for heart failure in older adults: The health, aging, and body composition study
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