Abdulla A Damluji1, Shang-En Chung2, Qian-Li Xue3, Rani K Hasan4, Jeremy D Walston2, Daniel E Forman5, Karen Bandeen-Roche6, Mauro Moscucci7, Wayne Batchelor8, Jon R Resar4, Gary Gerstenblith4. 1. The Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, Va; Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md. Electronic address: Abdulla.Damluji@jhu.edu. 2. Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md. 3. Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md; Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. 4. Division of Cardiology, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Md. 5. Geriatric Cardiology Section, University of Pittsburgh, Pittsburgh, Penn; Geriatric Research, Education, and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, Penn. 6. Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Md. 7. Food and Drug Administration, Silver Spring, Md. 8. The Inova Center of Outcomes Research, Inova Heart and Vascular Institute, Falls Church, Va.
Abstract
BACKGROUND: Frailty, a clinical state of vulnerability, is associated with subsequent adverse geriatric syndromes in the general population. We examined the long-term impact of frailty on geriatric outcomes among older patients with coronary heart disease. METHODS: We used the National Health and Aging Trends Study, a prospective cohort study linked to a Medicare sample. Coronary heart disease was identified by self-report or International Classification of Diseases (ICD) codes 1-year prior to the baseline visit. Frailty was measured using the Fried physical frailty phenotype. Geriatric outcomes were assessed annually during a 6-year follow-up. RESULTS: Of the 4656 participants, 1213 (26%) had a history of coronary heart disease 1-year prior to their baseline visit. Compared to those without frailty, subjects with frailty were older (ages ≥75: 80.9% vs 68.9%, P < 0.001), more likely to be female, and belong to an ethnic minority. The prevalence of hypertension, stroke, falls, disability, anxiety/depression, and multimorbidity were much higher in the frail, than nonfrail, participants. In a discrete time survival model, the incidence of geriatric syndromes during 6-year follow-up including 1) dementia, 2) loss of independence, 3) activities of daily living disability, 4) instrumental activities of daily living disability, and 5) mobility disability were significantly higher in the frail than in the nonfrail older patients with coronary heart disease. CONCLUSION: In patients with coronary heart disease, frailty is a risk factor for the accelerated development of geriatric outcomes. Efforts to identify frailty in the context of coronary heart disease are needed, as well as interventions to limit or reverse frailty status for older patients with coronary heart disease.
BACKGROUND: Frailty, a clinical state of vulnerability, is associated with subsequent adverse geriatric syndromes in the general population. We examined the long-term impact of frailty on geriatric outcomes among older patients with coronary heart disease. METHODS: We used the National Health and Aging Trends Study, a prospective cohort study linked to a Medicare sample. Coronary heart disease was identified by self-report or International Classification of Diseases (ICD) codes 1-year prior to the baseline visit. Frailty was measured using the Fried physical frailty phenotype. Geriatric outcomes were assessed annually during a 6-year follow-up. RESULTS: Of the 4656 participants, 1213 (26%) had a history of coronary heart disease 1-year prior to their baseline visit. Compared to those without frailty, subjects with frailty were older (ages ≥75: 80.9% vs 68.9%, P < 0.001), more likely to be female, and belong to an ethnic minority. The prevalence of hypertension, stroke, falls, disability, anxiety/depression, and multimorbidity were much higher in the frail, than nonfrail, participants. In a discrete time survival model, the incidence of geriatric syndromes during 6-year follow-up including 1) dementia, 2) loss of independence, 3) activities of daily living disability, 4) instrumental activities of daily living disability, and 5) mobility disability were significantly higher in the frail than in the nonfrail older patients with coronary heart disease. CONCLUSION: In patients with coronary heart disease, frailty is a risk factor for the accelerated development of geriatric outcomes. Efforts to identify frailty in the context of coronary heart disease are needed, as well as interventions to limit or reverse frailty status for older patients with coronary heart disease.
Authors: J E Galvin; C M Roe; K K Powlishta; M A Coats; S J Muich; E Grant; J P Miller; M Storandt; J C Morris Journal: Neurology Date: 2005-08-23 Impact factor: 9.910
Authors: Jeremy Walston; Evan C Hadley; Luigi Ferrucci; Jack M Guralnik; Anne B Newman; Stephanie A Studenski; William B Ershler; Tamara Harris; Linda P Fried Journal: J Am Geriatr Soc Date: 2006-06 Impact factor: 5.562
Authors: Jama L Purser; Maragatha N Kuchibhatla; Gerda G Fillenbaum; Tina Harding; Eric D Peterson; Karen P Alexander Journal: J Am Geriatr Soc Date: 2006-11 Impact factor: 5.562
Authors: Jeremy Walston; Thomas N Robinson; Susan Zieman; Frances McFarland; Christopher R Carpenter; Keri N Althoff; Melissa K Andrew; Caroline S Blaum; Patrick J Brown; Brian Buta; E Wesley Ely; Luigi Ferrucci; Kevin P High; Stephen B Kritchevsky; Kenneth Rockwood; Kenneth E Schmader; Felipe Sierra; Kaycee M Sink; Ravi Varadhan; Arti Hurria Journal: J Am Geriatr Soc Date: 2017-04-19 Impact factor: 5.562
Authors: S Michael Gharacholou; Veronique L Roger; Ryan J Lennon; Charanjit S Rihal; Jeff A Sloan; John A Spertus; Mandeep Singh Journal: Am J Cardiol Date: 2012-03-20 Impact factor: 2.778
Authors: Jeremy Walston; Mary Ann McBurnie; Anne Newman; Russell P Tracy; Willem J Kop; Calvin H Hirsch; John Gottdiener; Linda P Fried Journal: Arch Intern Med Date: 2002-11-11
Authors: Shelly L Gray; Melissa L Anderson; Rebecca A Hubbard; Andrea LaCroix; Paul K Crane; Wayne McCormick; James D Bowen; Susan M McCurry; Eric B Larson Journal: J Gerontol A Biol Sci Med Sci Date: 2013-02-18 Impact factor: 6.053
Authors: Abdulla A Damluji; Jin Huang; Karen Bandeen-Roche; Daniel E Forman; Gary Gerstenblith; Mauro Moscucci; Jon R Resar; Ravi Varadhan; Jeremy D Walston; Jodi B Segal Journal: J Am Heart Assoc Date: 2019-08-31 Impact factor: 5.501
Authors: Swetha Pasala; Lauren B Cooper; Mitchell A Psotka; Shashank S Sinha; Christopher R deFilippi; Henry Tran; Behnam Tehrani; Matthew Sherwood; Kelly Epps; Wayne Batchelor; Abdulla A Damluji Journal: Am Heart J Date: 2021-12-16 Impact factor: 4.749
Authors: Abdulla A Damluji; Shang-En Chung; Qian-Li Xue; Rani K Hasan; Mauro Moscucci; Daniel E Forman; Karen Bandeen-Roche; Wayne Batchelor; Jeremy D Walston; Jon R Resar; Gary Gerstenblith Journal: Eur Heart J Date: 2021-10-01 Impact factor: 35.855