Pre-Frailty and Risk of Cardiovascular Disease in Elderly Men and Women

被引:217
作者
Sergi, Giuseppe [1 ]
Veronese, Nicola [1 ]
Fontana, Luigi [2 ,3 ,4 ,5 ]
De Rui, Marina [1 ]
Bolzetta, Francesco [1 ]
Zambon, Sabina [6 ,7 ]
Corti, Maria-Chiara [8 ]
Baggio, Giovannella [9 ]
Toffanello, Elena Debora [1 ]
Crepaldi, Gaetano [6 ]
Perissinotto, Egle [10 ]
Manzato, Enzo [1 ,6 ]
机构
[1] Univ Padua, Dept Med DIMED, Div Geriatr, I-35128 Padua, Italy
[2] Univ Brescia, Sch Med, Dept Clin & Expt Sci, Brescia, Italy
[3] Washington Univ, Sch Med, Div Geriatr & Nutr Sci, St Louis, MO USA
[4] Washington Univ, Sch Med, Ctr Human Nutr, St Louis, MO USA
[5] CEINGE Biotecnol Avanzate, Naples, Italy
[6] CNR, Inst Neurosci, Aging Branch, Padua, Italy
[7] Univ Padua, Dept Med & Surg Sci, Padua, Italy
[8] Azienda Unita Locale Socio Sanit 16, Padua, Italy
[9] Azienda Osped, Div Internal Med, Padua, Italy
[10] Univ Padua, Dept Cardiac Thorac & Vasc Sci, Unit Biostat Epidemiol & Publ Hlth, Padua, Italy
关键词
aging; frailty; risk factor; NURSING-HOME ADMISSION; OLDER-ADULTS; HEART-FAILURE; WALKING SPEED; HEALTH-STATUS; WHITEHALL II; MORTALITY; ASSOCIATION; DISABILITY; PERFORMANCE;
D O I
10.1016/j.jacc.2014.12.040
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BACKGROUND Frailty is an important risk factor for cardiovascular disease (CVD), but the impact of early, potentially reversible stages of frailty on CVD risk is unknown. OBJECTIVES This study sought to ascertain whether pre-frailty can predict the onset of CVD in a cohort of community-dwelling, not disabled, elderly people. METHODS A sample of 1,567 participants age 65 to 96 years without frailty or disability at baseline was followed for 4.4 years. Pre-frailty was defined as the presence of 1 or 2 modified Fried criteria (unintentional weight loss, low physical activity level, weakness, exhaustion, and slow gait speed), and incident CVD as onset of coronary artery diseases, heart failure, stroke, peripheral artery disease, or CVD-related mortality. RESULTS During follow-up, 551 participants developed CVD. Compared with participants who did not become frail, those with 1 modified Fried criterion (p = 0.03) and those with 2 criteria (p = 0.001) had a significantly higher risk of CVD, even after adjusting for several potential confounders (traditional risk factors for CVD, inflammatory markers, and hemoglobin A(1c) levels). Low energy expenditure (p = 0.03), exhaustion (p = 0.01), and slow gait speed (p = 0.03) were significantly associated with the onset of CVD, whereas unintentional weight loss and weakness were not. CONCLUSIONS Our findings suggest that pre-frailty, which is potentially reversible, is independently associated with a higher risk of older adults developing CVD. Among the physical domains of pre-frailty, low gait speed seems to be the best predictor of future CVD. (C) 2015 by the American College of Cardiology Foundation.
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收藏
页码:976 / 983
页数:8
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