Associations between ideal cardiovascular health, frailty & age related declines

描述(申请人提供)：通常伴随着衰老而来的身体和认知功能的下降会导致在日常生活和虚弱的活动中失去独立性--最终导致残疾和死亡。确凿的证据表明 慢性疾病，如心血管疾病(CVD)，在发展中起着关键作用，年龄相关的下降和残疾的严重程度也是如此。这表明，旨在降低血管风险的干预措施也可能对与年龄相关的下降产生积极影响。最近，美国心脏协会发布了2020年的战略影响目标，其中包括旨在改善心血管健康和降低心血管疾病和中风死亡率的目标，并为定义心血管健康提供了一个结构。这个被命名为生活简单7的概念是基于证据，即健康因素(血压、血糖和胆固醇浓度)和健康行为(吸烟状况、身体质量指数、饮食质量和体力活动)的组合与“长寿、无病生存、生活质量和较低的医疗费用”相关。使用具有全国代表性的数据进行的调查表明，符合这些健康标准的人数越多，总死亡率和心血管疾病死亡率的风险就越低。然而，令人惊讶的是，关于坚持这一广泛推广的心血管疾病预防策略是否会对年龄相关的功能结果产生有益影响，人们知之甚少。因此，该项目的总体目标是在NIH支持的[两项]老龄化[纵向研究]、INCHIANTI研究[和巴尔的摩老龄化纵向研究]中，研究遵守理想的心血管健康指标与死亡率、虚弱、下肢功能变化、活动能力、肌肉力量和认知之间的关系。我们假设，在[中年人]和老年人中，对理想心血管健康的更高忠诚度与：(I)存活，(Ii)不那么虚弱，(Iii)下肢功能、灵活性和肌肉力量的指标较小的下降，以及(Iii)认知指标随时间的较小下降。这项研究的结果将解决知识方面的一个关键差距，为临床医生提供证据 利用现有的和广泛推广的心血管疾病预防战略，延缓与衰老相关的下降的发生和发展。

DESCRIPTION (provided by applicant): Declines in physical and cognitive function that generally accompany aging can lead to loss of independence in performing activities of daily living and frailty- eventually leading to disability and death. Substantial evidence indicates that chronic disease, such as cardiovascular disease (CVD), plays a key role in the development, and severity of age-associated declines and disability. This suggests that interventions designed to reduce vascular risk are also likely to have positive effects on age-associated declines. Recently, the American Heart Association released its strategic impact goals for 2020, which include aims to improve cardiovascular health and decrease mortality from CVD and stroke, and provide a construct for defining cardiovascular health. This construct named Life's Simple 7 is based on evidence that the combination of health factors (blood pressure, blood glucose and cholesterol concentrations) and health behaviors (smoking status, body mass index, diet quality, and physical activity) is associated with "longevity, disease-free survival, quality of life, and lower health care costs". Investigations using nationally representative data have demonstrated that meeting a greater number of these health criteria was associated with a lower risk of total and CVD mortality. Yet, surprisingly, not much is known about whether adherence to this widely promoted CVD prevention strategy has a beneficial impact on age-related functional outcomes. Therefore, the overall goal of the project is to examine the relationships between adherence to ideal cardiovascular health metrics with mortality, frailty, changes in lower extremity function, mobility, muscle strength and cognition in [two] NIH-supported, [longitudinal studies] of aging, the InCHIANTI study [and the Baltimore Longitudinal Study of Aging]. We hypothesize that in [middle-aged] and older adults, a higher adherence to ideal cardiovascular health is associated with: (i) survival, (ii) being less frail, (iii) smaller declines in measures of lower extremity fuction, mobility and muscle strength, and (iii) smaller declines in measures of cognition over time. Results of the study will address a critical gap in knowledge, providing evidence for clinicians to utilize an existing and widely promoted CVD prevention strategy for delaying the onset and progression of aging-related declines.