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Cardiovascular Dysfunction and Frailty Among Older Adults in the Community: The ARIC Study.

TitleCardiovascular Dysfunction and Frailty Among Older Adults in the Community: The ARIC Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsNadruz W, Kitzman D, Windham BGwen, Kucharska-Newton AMaria, Butler K, Palta P, Griswold ME, Wagenknecht LE, Heiss G, Solomon SD, Skali H
Secondary AuthorsShah AM
JournalJ Gerontol A Biol Sci Med Sci
Volume72
Issue7
Pagination958-964
Date Published2017 Jul 01
ISSN1758-535X
KeywordsAged, Aged, 80 and over, Blood Pressure, Cardiovascular Diseases, Cardiovascular System, Echocardiography, Exercise Test, Female, Frail Elderly, Humans, Hypertrophy, Left Ventricular, Male, Prevalence, Risk Factors, United States
Abstract

Background: The contribution of cardiovascular dysfunction to frailty in older adults is uncertain. This study aimed to define the relationship between frailty and cardiovascular structure and function, and determine whether these associations are independent of coexisting abnormalities in other organ systems.

Methods: We studied 3,991 older adults (mean age 75.6±5.0 years; 59% female) from the Atherosclerosis Risk in Communities (ARIC) Study in whom the following six organ systems were uniformly assessed: cardiac (by echocardiography), vascular (by ankle-brachial-index and pulse-wave-velocity), pulmonary (by spirometry), renal (by estimated glomerular filtration rate), hematologic (by hemoglobin), and adipose (by body mass index and bioimpedance). Frailty was defined by the presence of ≥3 of the following: low strength, low energy, slowed motor performance, low physical activity, or unintentional weight loss.

Results: Two hundred eleven (5.3%) participants were frail. In multivariable analyses adjusted for demographics, diabetes, hypertension, and measures of other organ system function, frailty was independently and additively associated with left ventricular hypertrophy (odds ratio [OR] = 1.72; 95% confidence interval [CI] = 1.30-2.40), reduced global longitudinal strain (reflecting systolic function; OR = 1.68; 95% CI = 1.16-2.44), and greater left atrial volume index (reflecting diastolic function; OR = 1.60; 95% CI = 1.13-2.27), which together demonstrated the greatest association with frailty (OR = 2.10; 95% CI = 1.57-2.82) of the systems studied. Lower magnitude associations were observed for vascular and pulmonary abnormalities, anemia, and impaired renal function. Cardiovascular abnormalities remained associated with frailty after excluding participants with prevalent cardiovascular disease.

Conclusions: Abnormalities of cardiac structure and function are independently associated with frailty, and together show the greatest association with frailty among the organ systems studied.

DOI10.1093/gerona/glw199
Alternate JournalJ Gerontol A Biol Sci Med Sci
PubMed ID27733425
PubMed Central IDPMC5458397
Grant ListU01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
R01 AG053938 / AG / NIA NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
R01 HL070825 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
T32 HL007055 / HL / NHLBI NIH HHS / United States
K99 AG052830 / AG / NIA NIH HHS / United States