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Measurement of organ structure and function enhances understanding of the physiological basis of frailty: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Measurement of organ structure and function enhances understanding of the physiological basis of frailty: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Sanders, JL, Boudreau, RM, Fried, LP, Walston, JD, Harris, TB, Newman, AB |
| Journal | J Am Geriatr Soc |
| Volume | 59 |
| Issue | 9 |
| Pagination | 1581-8 |
| Date Published | 2011 Sep |
| ISSN | 1532-5415 |
| Keywords | Aged, 80 and over, Cardiovascular Diseases, Chronic Disease, Cost of Illness, Cross-Sectional Studies, Female, Frail Elderly, Humans, Male |
| Abstract | <p><b>OBJECTIVES: </b>To determine whether disease burden is associated with frailty independent of diagnosed chronic disease and whether physiological measurements provide greater understanding of the etiology of frailty.</p><p><b>DESIGN: </b>Cross-sectional.</p><p><b>SETTING: </b>Community.</p><p><b>PARTICIPANTS: </b>Two thousand four hundred thirty-seven participants in the Cardiovascular Health Study, 1992/93 examination (mean age 74.8 ± 4.8, 43.4% male, 95.8% white).</p><p><b>MEASUREMENTS: </b>Disease burden and frailty were tabulated using 10-point scales (0 = healthy, 10 = unhealthy). Disease burden was the sum of measurements characterizing the vasculature, brain, kidneys, lungs, and glucose metabolism. Frailty was assessed using the frailty index reported by Fried. Multivariate linear models were used to determine the association between disease burden (predictor) and frailty (outcome).</p><p><b>RESULTS: </b>Unadjusted, 1-point-higher disease burden was associated with a 0.28-point-higher frailty score (P < .001). White matter grade, forced vital capacity, and cystatin-C were particularly strongly and significantly associated with frailty. Disease burden attenuated the association between frailty and age by 29%, and disease burden and age had similar associations with frailty. Disease burden attenuated the association between frailty and fibrinogen, Factor VIII, and C-reactive protein by 32%, 56%, and 83%, respectively. Frailty was associated with diagnosed depression, stroke, cognitive impairment, arthritis, and pulmonary disease but not coronary heart disease, diabetes mellitus, or kidney disease in the presence of a summary of disease burden. In the adjusted model, disease burden remained significantly associated with frailty (β = 0.11, P < .001).</p><p><b>CONCLUSION: </b>Disease burden was independently and significantly associated with frailty. These results emphasize that typically unrecognized physiological changes may contribute significantly to frailty.</p> |
| DOI | 10.1111/j.1532-5415.2011.03557.x |
| Alternate Journal | J Am Geriatr Soc |
| PubMed ID | 21883106 |
| PubMed Central ID | PMC3282048 |
| Grant List | P30 AG024827 / AG / NIA NIH HHS / United States UL1 TR000005 / TR / NCATS NIH HHS / United States 5-P30-AG-024827 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01HC-15103 / HC / NHLBI NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States R01-AG-023629 / AG / NIA NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States R01 AG023629-04 / AG / NIA NIH HHS / United States |