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Titolo:
Associations of subclinical cardiovascular disease with frailty
Autore:
Newman, AB; Gottdiener, JS; McBurnie, MA; Hirsch, CH; Kop, WJ; Tracy, R; Walston, JD; Fried, LP;
Indirizzi:
Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA 15090 USA Univ Pittsburgh Pittsburgh PA USA 15090 atr Med, Pittsburgh, PA 15090 USA St Francis Hosp, Roslyn, NY USA St Francis Hosp Roslyn NY USASt Francis Hosp, Roslyn, NY USA Univ Calif Davis, Sacramento, CA 95817 USA Univ Calif Davis Sacramento CAUSA 95817 Davis, Sacramento, CA 95817 USA Georgetown Univ, Med Ctr, Washington, DC 20007 USA Georgetown Univ Washington DC USA 20007 Med Ctr, Washington, DC 20007 USA Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA Uniformed Serv Univ Hlth Sci Bethesda MD USA 20814 Bethesda, MD 20814 USA Univ Vermont, Colchester, VT USA Univ Vermont Colchester VT USAUniv Vermont, Colchester, VT USA Johns Hopkins Univ, Baltimore, MD 21218 USA Johns Hopkins Univ Baltimore MD USA 21218 s Univ, Baltimore, MD 21218 USA Univ Washington, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 iv Washington, Seattle, WA 98195 USA
Titolo Testata:
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
fascicolo: 3, volume: 56, anno: 2001,
pagine: M158 - M166
SICI:
1079-5006(200103)56:3<M158:AOSCDW>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
C-REACTIVE PROTEIN; ANKLE-ARM INDEX; OLDER PERSONS; RISK-FACTORS; HEALTH; ATHEROSCLEROSIS; INFLAMMATION; MORTALITY; ABNORMALITIES; PREVALENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Life Sciences
Citazioni:
46
Recensione:
Indirizzi per estratti:
Indirizzo: Newman, AB Univ Pittsburgh, Sch Med, Div Geriatr Med, 3250 5th Ave,Suite 300, Pittsburgh, PA 15090 USA Univ Pittsburgh 3250 5th Ave,Suite 300 Pittsburgh PA USA 15090
Citazione:
A.B. Newman et al., "Associations of subclinical cardiovascular disease with frailty", J GERONT A, 56(3), 2001, pp. M158-M166

Abstract

Background. Frail health in old age has been conceptualized as a loss of physiologic reserve associated with loss of lean mass, neuroendocrine dysregulation, and immune dysfunction. Little work has been done to define frailty and describe the underlying pathophysiology. Methods. Frailty status was defined in participants of the Cardiovascular Health Study (CHS), a cohort of 5,201 community-dwelling older adults, based on the presence of three out of five clinical criteria. The five criteriaincluded self-reported weight loss, low grip strength, low energy, slow gait speed, and low physical activity. We examined the spectrum of clinical and subclinical cardiovascular disease in those who were frail (3/5 criteria) or of intermediate frailty status (1 or 2/5 criteria), compared to those who were not frail (0/5). We hypothesized that the severity of frailty would he related to a higher prevalence of reported cardiovascular disease (CVD), as well as to a greater extent of CVD, measured by noninvasive testing. Results. Of 4,735 eligible participants, 2,289 (48%) were not frail, 299 (6%) were frail, and 2,147 (454) were of intermediate frailty status. Those who were frail were older (77.2 yrs) compared to those who were not frail (71.5 yrs) or intermediate (73.4 yrs) (p < .001). Frailty status was associated with clinical CVD and most strongly with congestive heart failure (oddsratio [OR] = 7.51 (95% confidence interval [CI] = 4.66-12.12). In those without a history of a CVD event (n = 1,259), frailty was associated with many noninvasive measures of CVD. Those with carotid stenosis >75% (adjusted OR = 3.41), ankle-arm index <0.8 (adjusted OR = 3.17) or 0.8-0.9 (adjusted OR = 2.01), major electrocardiography (ECG) abnormalities (adjusted OR = 1.58), greater left ventricular (LV) mass by echocardiography (adjusted OR = 1.16), and higher degree of infarct-like lesions in the brain (adjusted OR =1.71), were more likely to be frail compared to those who were not frail. The overall associations of each of these noninvasive measures of CVD with frailty level were significant (all p < .05). Conclusions. Cardiovascular disease was associated with an increased likelihood of frail health. In those with no history of CVD, the extent of underlying cardiovascular disease measured by carotid ultrasound and ankle-aim index, LV hypertrophy by ECG and echocardiography, was related to frailty. Infarct-like lesions in the brain on magnet resonance imaging were related to frailty as well.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 22:14:25