RISK OF CARDIOVASCULAR DISEASE MORBIDITY AND MORTALITY IN FRAIL AND PRE-FRAIL OLDER ADULTS: RESULTS FROM A META-ANALYSIS AND EXPLORATORY META-REGRESSION ANALYSIS

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Abstract

Frailty is common and associated with poorer outcomes in the elderly, but its role as potential cardiovascular disease (CVD) risk factor requires clarification. We thus aimed to meta-analytically evaluate the evidence of frailty and pre-frailty as risk factors for CVD. Two reviewers selected all studies comparing data about CVD prevalence or incidence rates between frail/pre-frail vs. robust. The association between frailty status and CVD in cross-sectional studies was explored by calculating and pooling crude and adjusted odds ratios (ORs) ±95% confidence intervals (CIs); the data from longitudinal studies were pooled using the adjusted hazard ratios (HRs). Eighteen cohorts with a total of 31,343 participants were meta-analyzed. Using estimates from 10 cross-sectional cohorts, both frailty and pre-frailty were associated with higher odds of CVD than robust participants. Longitudinal data were obtained from 6 prospective cohort studies. After a median follow-up of 4.4 years, we identified an increased risk for faster onset of any-type CVD in the frail (HR=1.70 [95%CI, 1.18–2.45]; I ²=66%) and pre-frail (HR=1.23 [95%CI, 1.07–1.36]; I ²=67%) vs. robust groups. Similar results were apparent for time to CVD mortality in the frail and pre-frail groups. In conclusion, frailty and pre-frailty constitute addressable and independent risk factors for CVD in older adults.

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Journal

Journal ID (nlm-journal-id): 101128963

Journal ID (pubmed-jr-id): 29630

Journal ID (nlm-ta): Ageing Res Rev

Journal ID (iso-abbrev): Ageing Res. Rev.

Title: Ageing research reviews

ISSN (Print): 1568-1637

ISSN (Electronic): 1872-9649

Publication date Nihms-submitted: 7 June 2018

Publication date (Electronic): 28 January 2017

Publication date (Print): May 2017

Publication date PMC-release: 16 July 2018

Volume: 35

Pages: 63-73

Affiliations

[1 ]Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy

[2 ]Institute of clinical Research and Education in Medicine (IREM), Padova, Italy

[3 ]Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

[4 ]Physiotherapy Department, South London and Maudsley NHS FoundationTrust, Denmark Hill, London SE5 8AZ, United Kingdom

[5 ]Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8 AF, United Kingdom

[6 ]Department of Neurosciences, University of Padova, Padova, Italy

[7 ]National Health Care System, Monselice, Padova Local Unit ULSS 17, Italy

[8 ]Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy

[9 ]Surgical Pathology Unit, Santa Chiara Hospital, Trento, Italy

[10 ]National Research Council, Neuroscience Institute - Aging Branch, Padova, Italy

[11 ]South Oaks Hospital, Northwell Health, 400 Sunsrise Highway, Amityville, NY 11701, USA, USA

[12 ]Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA

[13 ]Division of Geriatrics and Nutritional Sciences and Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA

[14 ]Department of Clinical and Experimental Sciences, Brescia University, Brescia, Italy

[15 ]CEINGE Biotecnologie Avanzate, Napoli, Italy

[16 ]University of Helsinki and Helsinki University Hospital, Helsinki, Finland

[17 ]University of Oulu, Center for Life Course Health Research, Oulu, Finland

[18 ]Centre de Recherche Inserm, Bordeaux, France

[19 ]University Victor Segalen Bordeaux 2, Bordeaux, France

[20 ]CMRR Paris Nord AP-HP, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, INSERM, U942, Université Paris Diderot, Sorbonne Paris Cité, UMRS 942, Paris, France

[21 ]CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France

[22 ]University of Bordeaux, Neuroepidemiology, UMR897, Bordeaux, France

[23 ]University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Division of Chronic Disease Epidemiology, Hirschengraben 84, CH-8001 Zurich, Switzerland

[24 ]Division of Cardiology, Department of Science, Città della Salute e della Scienza, Turin, Italy

[25 ]Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy

[26 ]Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil

[27 ]Department of Cardiology, Hospital Clínico Universitario, School of Medicine, University of Valencia, Valencia, Spain

[28 ]Clinical Epidemiology and Biometric Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy

[29 ]The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA

[32 ]Hofstra Northwell School of Medicine, Hempstead, NY, USA

[33 ]The Feinstein Institute for Medical Research, Manhasset, NY, USA

[32 ]Albert Einstein College of Medicine, Bronx, NY, USA

Author notes

Corresponding Author: Nicola Veronese, MD. University of Padova, Department of Medicine, Geriatrics Division, Padova, Italy. ilmannato@ 123456gmail.com . Phone: 00390498218492; fax: 00390498211218

[*]

These two authors equally contributed to this research.

Article

Accession ID: PMC6047747 Pmcid ID: PMC6047747 Pmc-uid ID: 6047747 Manuscript ID: nihpa950132

DOI: 10.1016/j.arr.2017.01.003

PMC ID: 6047747

PubMed ID: 28143778

SO-VID: 6735b3a0-35d8-4e81-969b-85e77e9809af

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