@article {1103, title = {Sleep-disordered breathing and frailty in the Cardiovascular Health Study Cohort.}, journal = {Am J Epidemiol}, volume = {170}, year = {2009}, month = {2009 Jul 15}, pages = {193-202}, abstract = {

Sleep-disordered breathing (SDB) is associated with pathophysiology that may influence the development and progression of frailty. Using data collected in 1995-1996, the authors explored the relation between SDB and components of frailty among 1,042 participants of the Cardiovascular Health Study. Diagnosis of SDB was based on the results of overnight polysomnography, and severe SDB was defined as an apnea-hypopnea index of >30 per hour of sleep. Slow walking speed, low grip strength, exhaustion, low physical activity, and unexplained weight loss were referred to as frailty indicator variables. There were 584 (56\%) female and 458 (44\%) male participants, and the mean age was 77 (standard deviation, 4) years. There was independent association between severe SDB and 1 or more frailty indicator variables (adjusted odds ratio = 4.85, 95\% confidence interval: 1.40, 16.78), slow walking speed (adjusted odds ratio = 2.67, 95\% confidence interval: 1.04, 6.84), and low grip strength (adjusted odds ratio = 3.29, 95\% confidence interval: 1.36, 7.96) among female study participants. The finding of an independent association between SDB and frailty indicator variables among older women could have important implications in interventions aimed at preventing or delaying the progression of frailty.

}, keywords = {Activities of Daily Living, Aged, Cardiovascular Diseases, Cardiovascular System, Cohort Studies, Confidence Intervals, Exercise Tolerance, Female, Frail Elderly, Hand Strength, Humans, Logistic Models, Male, Mobility Limitation, Models, Statistical, Motor Activity, Muscle Strength, Odds Ratio, Polysomnography, Psychometrics, Risk Factors, Sleep Apnea, Obstructive, Weight Loss}, issn = {1476-6256}, doi = {10.1093/aje/kwp108}, author = {Endeshaw, Yohannes W and Unruh, Mark L and Kutner, Michael and Newman, Anne B and Bliwise, Donald L} } @article {1264, title = {Patterns and predictors of recovery from exhaustion in older adults: the cardiovascular health study.}, journal = {J Am Geriatr Soc}, volume = {59}, year = {2011}, month = {2011 Feb}, pages = {207-13}, abstract = {

OBJECTIVES: To estimate the likelihood of, and factors associated with, recovery from exhaustion in older adults.

DESIGN: Secondary analysis of a cohort study.

SETTING: Six annual examinations in four U.S. communities.

PARTICIPANTS: Four thousand five hundred eighty-four men and women aged 69 and older.

MEASUREMENTS: Exhaustion was considered present when a participant responded "a moderate amount" or "most of the time" to either of two questions: "How often have you had a hard time getting going?" and "How often does everything seem an effort?"

RESULTS: Of the 964 participants who originally reported exhaustion, 634 (65.8\%) were exhaustion free at least once during follow-up. When data from all time points were considered, 48\% of those who reported exhaustion were exhaustion free the following year. After adjustment for age, sex, race, education, and marital status, 1-year recovery was less likely in individuals with worse self-rated health and in those who were taking six or more medications or were obese, depressed, or had musculoskeletal pain or history of stroke. In proportional hazards models, the following risk factors were associated with more persistent exhaustion over 5 years: poor self-rated health, six or more medications, obesity, and depression. Recovery was not less likely in participants with a history of cancer or heart disease.

CONCLUSION: Exhaustion is common in old age but is dynamic, even in those with a history of cancer and congestive heart failure. Recovery is especially likely in seniors who have a positive perception of their overall health, take few medications, and are not obese or depressed. These findings support the notion that resiliency is associated with physical and psychological well-being.

}, keywords = {Aged, Aging, Cardiovascular Physiological Phenomena, Exercise Test, Exercise Tolerance, Female, Follow-Up Studies, Geriatric Assessment, Health Status, Humans, Male, Predictive Value of Tests, Recovery of Function, Retrospective Studies, United States}, issn = {1532-5415}, doi = {10.1111/j.1532-5415.2010.03238.x}, author = {Whitson, Heather E and Thielke, Stephen and Diehr, Paula and O{\textquoteright}Hare, Ann M and Chaves, Paulo H M and Zakai, Neil A and Arnold, Alice and Chaudhry, Sarwat and Ives, Diane and Newman, Anne B} }