Graciani Auxiliadora, García-Esquinas Esther, López-García Esther, Banegas José R, Rodríguez-Artalejo Fernando
From the Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
Circ Cardiovasc Qual Outcomes. 2016 May;9(3):239-45. doi: 10.1161/CIRCOUTCOMES.115.002294. Epub 2016 May 10.
The major cardiovascular risk factors and existing cardiovascular disease have been linked to increased risk of the frailty syndrome. However, the association between ideal cardiovascular health and the risk of frailty in older adults is uncertain.
Prospective cohort study of 1745 individuals (≥60 years and free of cardiovascular disease) recruited during 2008 to 2010. Cardiovascular health was defined as having 7 ideal metrics: never smoking, physically active, healthy diet, body mass index <25 kg/m(2), untreated serum cholesterol <200 mg/dL, untreated blood pressure <140/90 mm Hg, and untreated fasting serum glucose <100 mg/dL. Participants were followed-up through 2012 to assess incident frailty, defined as ≥3 of the 5 Fried criteria. Statistical analyses were performed with Cox regression and adjusted for main confounders. During a mean follow-up of 3.5 years, 117 cases of incident frailty were identified. Compared with meeting 0 to 1 ideal metrics, the hazard ratio (95% confidence interval) of frailty was 0.51 (0.30-0.84) for 2 metrics and 0.630 (0.39-0.99) for ≥3 metrics. Results were similar after excluding incident cases of cardiovascular disease. The number of ideal metrics showed a tendency to a reduced risk of all frailty criteria. The cardiovascular metrics associated with the greatest reduction of frailty risk were being physically active and ideal body mass index.
Reaching old age in ideal cardiovascular health is associated with a reduced risk of frailty. This highlights the importance of a life-course approach for frailty prevention.
主要心血管危险因素及现患心血管疾病与衰弱综合征风险增加相关。然而，老年人理想心血管健康状况与衰弱风险之间的关联尚不确定。
对2008年至2010年招募的1745名个体（≥60岁且无心血管疾病）进行前瞻性队列研究。心血管健康定义为具备7项理想指标：从不吸烟、身体活动、健康饮食、体重指数<25kg/m²、未治疗的血清胆固醇<200mg/dL、未治疗的血压<140/90mmHg以及未治疗的空腹血清葡萄糖<100mg/dL。对参与者随访至2012年以评估新发衰弱情况，新发衰弱定义为符合5项弗里德标准中的≥3项。采用Cox回归进行统计分析，并对主要混杂因素进行校正。在平均3.5年的随访期间，共识别出117例新发衰弱病例。与符合0至1项理想指标相比，符合2项指标时衰弱的风险比（95%置信区间）为0.51（0.30 - 0.84），符合≥3项指标时为0.630（0.39 - 0.99）。排除心血管疾病新发病例后结果相似。理想指标数量显示出所有衰弱标准风险降低的趋势。与衰弱风险降低幅度最大相关的心血管指标是身体活动和理想体重指数。
以理想心血管健康状态步入老年与衰弱风险降低相关。这凸显了采用生命历程方法预防衰弱的重要性。
