Associations between ideal cardiovascular health, frailty & age related declines

描述（由申请人提供）：通常伴随衰老的身体和认知功能下降可能导致日常生活活动的独立性丧失和虚弱-最终导致残疾和死亡。大量证据表明， 慢性疾病，如心血管疾病（CVD），在与年龄相关的衰退和残疾的发展和严重性中起关键作用。这表明，旨在降低血管风险的干预措施也可能对年龄相关的下降产生积极影响。最近，美国心脏协会发布了其2020年的战略影响目标，其中包括改善心血管健康，降低心血管疾病和中风的死亡率，并提供定义心血管健康的结构。这个名为Life's Simple 7的结构是基于健康因素（血压，血糖和胆固醇浓度）和健康行为（吸烟状况，体重指数，饮食质量和体育活动）的组合与“长寿，无病生存，生活质量和较低的医疗保健成本”相关的证据。使用全国代表性数据进行的调查表明，满足这些健康标准中的更多标准与总死亡率和CVD死亡率的较低风险相关。然而，令人惊讶的是，对于坚持这种广泛推广的CVD预防策略是否对年龄相关的功能结果产生有益影响，我们知之甚少。因此，该项目的总体目标是在[两项] NIH支持的老龄化[纵向研究] InCHIANTI研究[和巴尔的摩老龄化纵向研究]中，检查坚持理想心血管健康指标与死亡率、虚弱、下肢功能变化、活动性、肌肉力量和认知之间的关系。我们假设，在[中年]和老年人中，对理想心血管健康的更高坚持与以下因素相关：（i）生存率，（ii）不那么虚弱，（iii）下肢功能，活动性和肌肉力量指标下降较小，（iii）随着时间的推移，认知指标下降较小。研究结果将解决知识的关键差距，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策略，以延缓衰老相关衰退的发生和进展。

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.