Nuffield Department of Population Health, University of Oxford, Oxford, UK.
TILDA, Department of Medical Gerontology, Trinity College, Dublin, Ireland.
Age Ageing. 2018 Sep 1;47(5):714-720. doi: 10.1093/ageing/afy080.
to examine the associations of cardiovascular disease (CVD) and cardiovascular risk factors with frailty.
a cross-sectional study.
the Irish Longitudinal Study on Ageing (TILDA).
frailty measures were obtained on 5,618 participants and a subset of 4,330 participants with no prior history of CVD.
cardiovascular risk factors were combined in three composite CVD risk scores (Systematic Coronary Risk Evaluation [SCORE], Ideal Cardiovascular Health [ICH] and Cardiovascular Health Metrics [CHM]).
a frailty index (40-items) was used to screen for frailty.
the associations of CVD risk factors with frailty were examined using logistic regression.
overall, 16.4% of participants had frailty (7.6% at 50-59 years to 42.5% at 80+ years), and the prevalence was higher in those with versus those without prior CVD (43.0% vs. 10.7%). Among those without prior CVD, mean levels of CVD risk factors were closely correlated with higher frailty index scores. Combined CVD risk factors, assessed using SCORE, were linearly and positively associated with frailty. Compared to low-to-moderate SCOREs, the odds ratio (OR) (95% confidence interval, CI) of frailty for those with very high risk was 3.18 (2.38-4.25). Conversely, ICH was linearly and inversely associated with frailty, with an OR for optimal health of 0.29 (0.21-0.40) compared with inadequate health.
the concordant positive associations of SCORE and inverse associations of ICH and CHM with frailty highlight the potential importance of optimum levels of CVD risk factors for prevention of disability in frail older people.
研究心血管疾病（CVD）和心血管危险因素与虚弱之间的关联。
横断面研究。
爱尔兰老龄化纵向研究（TILDA）。
对 5618 名参与者进行了虚弱评估，对没有 CVD 既往史的 4330 名参与者进行了虚弱评估的子集。
心血管危险因素合并为三个复合 CVD 风险评分（系统性冠状动脉风险评估[SCORE]、理想心血管健康[ICH]和心血管健康指标[CHM]）。
使用虚弱指数（40 项）筛查虚弱。
使用逻辑回归检查 CVD 危险因素与虚弱的关联。
总体而言，16.4%的参与者存在虚弱（50-59 岁为 7.6%，80 岁以上为 42.5%），且既往 CVD 患者的患病率高于无既往 CVD 患者（43.0% vs. 10.7%）。在无既往 CVD 的患者中，CVD 危险因素的平均水平与较高的虚弱指数评分密切相关。使用 SCORE 评估的复合 CVD 危险因素与虚弱呈线性正相关。与低至中度 SCORE 相比，极高风险的衰弱比值比（OR）（95%置信区间[CI]）为 3.18（2.38-4.25）。相反，ICH 与虚弱呈线性负相关，与健康不足相比，最佳健康的 OR 为 0.29（0.21-0.40）。
SCORE 的一致性正相关和 ICH 和 CHM 的负相关与虚弱的关联突出表明，CVD 危险因素的最佳水平对于预防虚弱老年人的残疾具有重要意义。
