Absolute Cardiovascular Disease Risk Assessed in Old Age Predicts Disability and Mortality: A Retrospective Cohort Study of Community-Dwelling Older Adults

被引:8
|
作者
Makino, Keitaro [1 ,3 ]
Lee, Sangyoon [1 ]
Bae, Seongryu [1 ]
Chiba, Ippei [1 ]
Harada, Kenji [1 ]
Katayama, Osamu [1 ]
Shinkai, Yohei [1 ]
Shimada, Hiroyuki [2 ]
机构
[1] Natl Ctr Geriatr & Gerontol, Dept Prevent Gerontol, Ctr Gerontol & Social Sci, 7-430 Morioka Cho, Obu City, Aichi 4748511, Japan
[2] Natl Ctr Geriatr & Gerontol, Ctr Gerontol & Social Sci, Obu City, Aichi, Japan
[3] Japan & Japan Soc Promot Sci, Chiyoda Ku, Tokyo, Japan
来源
JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2021年 / 10卷 / 24期
基金
日本科学技术振兴机构; 日本学术振兴会;
关键词
aged; cardiovascular diseases; mortality; risk assessment; MILD COGNITIVE IMPAIRMENT; FRAILTY; SCORE; POPULATION; PREVENTION; PATIENT; PROFILE; CARE;
D O I
10.1161/JAHA.121.022004
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Evidence is limited on the predictive validity of absolute cardiovascular disease (CVD) risk, estimated by multivariable assessments in old age, for disability and mortality. We aimed to examine the longitudinal associations of absolute CVD risk assessed using region-specific risk estimation charts with disability and mortality among community-dwelling people aged >= 65 years. Methods and Results This retrospective cohort study included 7456 community-dwelling people aged >= 65 years (mean age, 73.7 years) without CVD and functional decline at baseline. They lived in either Obu City or Midori Ward of Nagoya City, Aichi Prefecture, Japan. We estimated absolute CVD risk using the revised World Health Organization CVD risk estimation charts and stratified risk levels into 3 categories: low (<10%), mid (10% to <20%), and high (>= 20%). We followed up the functional disability incidence and all-cause mortality monthly for 5 years. The prevalence of each CVD risk level based on the laboratory-based model was as follows: low CVD risk, 1096 (14.7%); mid CVD risk, 5510 (73.9%); and high CVD risk, 850 (11.4%). During follow-up, the incidence rates of disability and mortality were 33.4 per 1000 and 12.4 per 1000 person-years, respectively. Cox regression analysis showed that the adjusted hazard ratios (95% CIs) for disability incidence were 1.32 (1.13-1.56) and 1.44 (1.18-1.77) in mid and high CVD risk levels, respectively (reference: low CVD risk level); for mortality incidence, they were 1.53 (1.16-2.01) and 2.02 (1.45-2.80) in mid and high CVD risk levels, respectively (reference: low CVD risk level). Conclusions Absolute CVD risk was associated with both disability and mortality in people aged >= 65 years. Estimated CVD risk levels may be useful surrogate markers for disability and mortality risks even when assessed in old age.
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页数:20
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