PREDICTORS OF CARDIOVASCULAR DISEASE IN THE ELDERLY

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Evidence suggests that cardiovascular risk factors which have been identified by study of middle-aged populations may not have the same predictive value in the elderly; especially the "oldest old" aged 75 and above. This proposal seeks support to evaluate factors associated with cardiovascular morbidity and mortality in a cohort of 795 men and women aged 75 years or older at the time of a comprehensive examination conducted between 1984 and 1987. This cohort is a subset of the Rancho Bernardo Chronic Disease Study, and additional data is available for all subjects from a visit which averaged 12 years earlier (1972-74). All data necessary for the proposed analyses have been collected. (Additional events may be obtained from future annual morbidity questionnaires, and annual mortality follow-up -- both of which are supported by other sources). Mortality follow-up is complete for over 99% of subjects, and incident morbidity information is available for myocardial infarction, coronary bypass surgery and stroke. This unique database includes measurements which will allow: 1) prospective analyses of the effects of putative cardiovascular risk factors on disease incidence in the elderly, 2) prospective analyses of the impact of change in risk factors on events in the elderly, 3) exploration of risk factors not classically associated with cardiovascular events in younger populations but which may be important in the very old, and, 4) cross-sectional description of putative risk factors in an aged population. This database has been assembled for other purposes, the funding for which does not provide for study of these data to assess such hypotheses related to aging. Support is requested for 3 years to conduct analyses and prepare reports utilizing this unique resource.