Associations of subclinical cardiovascular disease with frailty
Associations of subclinical cardiovascular disease with frailty
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DOI：
10.1093/gerona/56.3.m158
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发表时间：
2001-03-01
影响因子：
5.1
通讯作者：
Fried, LP
中科院分区：
文献类型：
--
作者：
Newman, AB;Gottdiener, JS;Fried, LP
背景。老年虚弱的健康被定义为生理储备的丧失，与瘦质量的丧失、神经内分泌失调和免疫功能障碍有关。对虚弱的定义和潜在的病理生理描述的工作很少。心血管健康研究（CHS）对5201名社区老年人进行队列研究，根据5项临床标准中的3项来定义虚弱状态。这五个标准包括自我报告的体重减轻、握力低、能量低、步态速度慢和体力活动少。我们检查了虚弱（3/5标准）或中度虚弱状态（1或2/5标准）与非虚弱（0/5）的患者的临床和亚临床心血管疾病谱。我们假设虚弱的严重程度与报告的心血管疾病（CVD）的高患病率以及通过无创测试测量的更大程度的CVD有关。在4,735名符合条件的参与者中，2,289人（48%）不虚弱，299人（6%）虚弱，2,147人（454）处于中度虚弱状态。体弱者比非体弱者（71.5岁）或中度（73.4岁）年龄大（77.2岁）（p < 0.001）。虚弱状态与临床CVD相关，与充血性心力衰竭关系最为密切(优势比[OR] = 7.51（95%可信区间[CI] = 4.66-12.12）。在没有CVD事件史的患者中（n = 1,259），虚弱与许多CVD的非侵入性测量相关。颈动脉狭窄组bbb75 %（调整OR = 3.41），踝臂指数
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 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 (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