Frailty and risk for heart failure in older adults: the health, aging, and body composition study.

Frailty and risk for heart failure in older adults: the health, aging, and body composition study.
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DOI:
10.1016/j.ahj.2013.07.032
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发表时间:
2013-11
影响因子:
4.8
通讯作者:
Butler J
Butler J
中科院分区:
医学2区
文献类型:
--
作者:
Khan H;Kalogeropoulos AP;Georgiopoulou VV;Newman AB;Harris TB;Rodondi N;Bauer DC;Kritchevsky SB;Butler J

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评估老年人虚弱与心力衰竭(HF)风险之间的关系。虚弱在老年人中很常见,并与不良的健康结果有关。虚弱对HF风险的影响尚不清楚。我们评估了2825名年龄在70-79岁的参与者中,使用健康ABC短期身体表现组合(HABC组合)和Gill指数的虚弱与HF事件之间的关联。参与者的平均年龄为74± 3岁; 48%为男性,59%为白色。在中位随访11.4(7.1-11.7)年期间,466名参与者发生了HF。与非虚弱受试者相比,根据Gill指数,中度(风险比HR 1.36,95%CI 1.08-1.71)和重度虚弱(HR 1.88,95%CI 1.02-3.47)与HF风险较高相关。在调整健康ABC HF模型后,HABC组合评分与HF风险呈线性相关(HR 1.24,95%CI 1.13,1.36/SD评分下降),并在控制死亡作为竞争风险时保持显著性(HR 1.30; 95%CI 1.00-1.55)。结果在不同年龄、性别和人种之间以及基于基线时糖尿病或心血管疾病的亚组之间具有可比性。在健康ABC HF风险模型中增加HABC组合评分改善了辨别力(C指数变化,0.014; 95%CI 0.018-0.010),并对13.4%的参与者进行了适当的重新分类(NRI 0.073,95%CI 0.021-0.125; P=0.006)(8.3%发生HF,5.1%未发生HF)。虚弱与老年人HF风险独立相关。
To assess the association between frailty and risk for heart failure (HF) in older adults. Frailty is common in the elderly and is associated with adverse health outcomes. Impact of frailty on HF risk is not known. We assessed the association between frailty, using the Health ABC Short Physical Performance Battery (HABC battery) and the Gill index, and incident HF in 2825 participants aged 70-79 years. Mean age of participants was 74±3years; 48% were men and 59% were white. During a median follow up of 11.4 (7.1-11.7) years, 466 participants developed HF. Compared to non-frail participants, moderate (hazard ratio HR 1.36, 95%CI 1.08-1.71) and severe frailty (HR 1.88, 95%CI 1.02-3.47) by Gill index was associated with a higher risk for HF. HABC battery score was linearly associated with HF risk after adjusting for the Health ABC HF Model (HR 1.24, 95%CI 1.13, 1.36 per SD decrease in score), and remained significant when controlled for death as a competing risk (HR 1.30; 95%CI 1.00-1.55). Results were comparable across age, sex, and race, and in sub-groups based on diabetes mellitus or cardiovascular disease at baseline. Addition of HABC battery scores to the Health ABC HF Risk Model improved discrimination (change in C-index, 0.014; 95%CI 0.018-0.010) and appropriately reclassified 13.4% (NRI 0.073, 95%CI 0.021-0.125; P=0.006) of participants (8.3% who developed HF and 5.1% who did not). Frailty is independently associated with risk of HF in older adults.
DOI: 10.1002/sim.4085
发表时间: 2011-01-15
影响因子: 2
作者:
Pencina, Michael J.;D'Agostino, Ralph B., Sr.;Steyerberg, Ewout W.
通讯作者: Steyerberg, Ewout W.
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发表时间: 1994-12-28
影响因子: 120.7
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发表时间: 2001-03-01
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影响因子: 4.6
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DOI: 10.1016/s1885-5857(08)60231-5
发表时间: 2008-08-01
影响因子: 5.9
作者:
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通讯作者: Valle, Vicente