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Titolo:
RISK-FACTORS FOR 5-YEAR MORTALITY IN OLDER ADULTS - THE CARDIOVASCULAR HEALTH STUDY
Autore:
FRIED LP; KRONMAL RA; NEWMAN AB; BILD DE; MITTELMARK MB; POLAK JF; ROBBINS JA; GARDIN JM;
Indirizzi:
CARDIOVASC HLTH STUDY COLLABORAT RES GRP,COORDINATING CTR BALTIMORE MD 21205 JOHNS HOPKINS MED INST,DEPT EPIDEMIOL BALTIMORE MD 21205 UNIV WASHINGTON,DEPT BIOSTAT SEATTLE WA 98195 UNIV PITTSBURGH,DEPT MED PITTSBURGH PA 15261 NHLBI,DIV EPIDEMIOL & CLIN APPLICAT BETHESDA MD 20892 UNIV BERGEN,SCH PSYCHOL BERGEN NORWAY HARVARD UNIV,SCH MED,BRIGHAM & WOMENS HOSP,DEPT RADIOL BOSTON MA 02115 UNIV CALIF DAVIS,DEPT INTERNAL MED DAVIS CA 95616 UNIV CALIF IRVINE,DEPT MED,DIV CARDIOL IRVINE CA 92717 CHS COORDINATING CTR SEATTLE WA 98101 JOHNS HOPKINS MED INST,DEPT MED BALTIMORE MD 21205
Titolo Testata:
JAMA, the journal of the American Medical Association
fascicolo: 8, volume: 279, anno: 1998,
pagine: 585 - 592
SICI:
0098-7484(1998)279:8<585:RF5MIO>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
ALL-CAUSE MORTALITY; PHYSICAL-DISABILITY; NATIONAL COHORT; LONG-TERM; FOLLOW-UP; MEN; DISEASE; ASSOCIATION; ATHEROSCLEROSIS; CORONARY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
37
Recensione:
Indirizzi per estratti:
Citazione:
L.P. Fried et al., "RISK-FACTORS FOR 5-YEAR MORTALITY IN OLDER ADULTS - THE CARDIOVASCULAR HEALTH STUDY", JAMA, the journal of the American Medical Association, 279(8), 1998, pp. 585-592

Abstract

Context.-Multiple factors contribute to mortality in older adults, but the extent to which subclinical disease and other factors contributeindependently to mortality risk is not known. Objective.-To determinethe disease, functional, and personal characteristics that jointly predict mortality in community-dwelling men and women aged 65 years or older. Design.-Prospective population-based cohort study with 5 years of follow-up and a validation cohort of African Americans with 4.25-year follow-up. Setting.-Four US communities. Participants.-A total of 5201 and 685 men and women aged 65 years or older in the original and African American cohorts, respectively. Main Outcome Measures.-Five-yearmortality. Results.-In the main cohort, 646 deaths (12%) occurred within 5 years. Using Cox proportional hazards models, 20 characteristics(of 78 assessed) were each significantly (P<.05) and independently associated with mortality: increasing age, male sex, income less than $50 000 per year, low weight, lack of moderate or vigorous exercise, smoking for more than 50 pack-years, high brachial (>169 mm Hg) and low tibial (less than or equal to 127 mm Hg) systolic blood pressure, diuretic use by those without hypertension or congestive heart failure, elevated fasting glucose level (>7.2 mmol/L [130 mg/dL]), low albumin level (less than or equal to 37 g/L), elevated creatinine level (greater than or equal to 106 mu mol/L [1.2 mg/dL]), low forced vital capacity (12.06 mL), aortic stenosis (moderate or severe) and abnormal left ventricular ejection fraction (by echocardiography), major electrocardiographic abnormality, stenosis of internal carotid artery (by ultrasound), congestive heart failure, difficulty in any instrumental activity of daily living, and low cognitive function by Digit Symbol Substitution test score. Neither high-density lipoprotein cholesterol nor low-density lipoprotein cholesterol was associated with mortality. After adjustment for other factors, the association between age and mortality diminished, but the reduction in mortality with female sex persisted. Finally, the risk of mortality was validated in the second cohort; quintiles of risk ranged from 2% to 39% and 0% to 26% for the 2 cohorts. Conclusions.-Objective measures of subclinical disease and disease severity were independent and joint predictors of 5-year mortality in olderadults, along with male sex, relative poverty, physical activity, smoking, indicators of frailty, and disability. Except for history of congestive heart failure, objective, quantitative measures of disease were better predictors of mortality than was clinical history of disease.

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Documento generato il 05/12/20 alle ore 15:53:25