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Cited by 809

The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.

Associations of Subclinical Cardiovascular Disease With Frailty

Open access
Newman, A. B., Gottdiener, J. S., McBurnie, M. A., Hirsch, C. H., Kop, W. J., Tracy, R., Walston, J. D., Fried, L. P.·2001·The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
DOI 10.1093/gerona/56.3.m158
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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 criteria included 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 be 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 (45%) 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 (odds ratio [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-arm 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.

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Metadata

Authors
Newman, A. B., Gottdiener, J. S., McBurnie, M. A., Hirsch, C. H., Kop, W. J., Tracy, R., Walston, J. D., & Fried, L. P.
Venue
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
Publisher
Oxford University Press (OUP)
Published
2001-03-01
Volume
56
Issue
3
Pages
M158-M166
ISSN
  • 1079-5006 (ISSN-L)
  • 1758-535X
DOI
10.1093/gerona/56.3.m158
OpenAlex
W2109982307
Cited by
809
References
10
FWCI
8.58
Type
journal article
Language
en
Open access
bronze

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