Frailty Index and Cardiovascular Disease among Middle-Aged and Older Chinese Adults: A Nationally Representative Cross-Sectional and Follow-Up Study

Liu, Xinyao; Dai, Guolin; He, Qile; Ma, Hao; Hu, Hongpu

doi:10.3390/jcdd9070228

Cited by 15 publications

(9 citation statements)

References 50 publications

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“…However, the subgroup analysis revealed that the frailty index was the strongest predictor of stroke occurrence in the population aged 45-65 years. This finding is in line with previous studies [14,18], indicating that assessing frailty during midlife can aid in preventing the onset of stroke later in life.…”

Section: Discussionsupporting

confidence: 92%

Dose–response relationship between Frailty Index and Stroke among middle-aged and elderly Chinese

Yang

et al. 2023

Preprint

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Background: Stroke has emerged as the leading cause of mortality in China, with the burden of the disease increasing with the aging population. Recent research has established a correlation between frailty and stroke, with the frailty index serving as a comprehensive measure of frailty in elderly populations. This study aimed to explore the dose-response relationship between frailty index and stroke, with the objective of providing a reference for effective stroke identification in middle-aged and elderly individuals, thereby preventing the onset of the disease. Methods: The data used in this study were derived from the China Health and Retirement Longitudinal Study (CHARLS) database from 2011 to 2018. Proportional hazards model was utilized to investigate the impact of frailty index on stroke risk, while restricted cubic spline analysis was employed to examine the dose-response relationship between frailty index and stroke. Subgroup analysis was used to further understand whether the frailty index has an effect on the occurrence of stroke in different subgroups. Results: A total of 11328 participants were included in the study, with 401 (3.3%) stroke patients. Frailty and pre-frailty were associated with a high risk of stroke events compared with robust group (HR, 3.89, 95%CI, 2.88-5.26) , (HR, 2.09 , 95%CI , 1.60-2.75), after adjusting for all covariates. There was a non-linear relationship between frailty index and stroke in the restricted cubic spline regression model. Frailty index was a risk factor of stroke when it exceeded 0.13. Taking the robust as reference, subgroup analysis results showed a significant interaction with the frailty index in all subgroup analyses except for the smoking group. Conclusion: Pre-frailty and frailty were significantly associated with stroke risk. Frailty index had a nonlinear relationship with stroke occurrence, and frailty index >0.13 was significantly correlated with stroke occurrence. Frailty index is an independent predictor of stroke occurrence.

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Section: Discussionsupporting

confidence: 92%

Dose–response relationship between Frailty Index and Stroke among middle-aged and elderly Chinese

Yang

et al. 2023

Preprint

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“…In a meta-analysis conducted by Veronese et al [ 3 ], it was observed that both pre-frail (hazard ratio (HR) 2.80; CI 95% 1.83–4.28) and frail (HR 3.89; CI 95% 2.39–6.34) older adults had a higher risk for mortality by CVD compared to robust older adults. More recently, some studies have confirmed the association of pre-frailty and frailty phenotypes with increased risk of CVD [ 12 , 13 , 14 , 15 ] and of developing major adverse cardiovascular events [ 12 ]. A recent meta-analysis that included 185,229 middle-aged and older adults found a 2-fold increase in risk in the frail group and 1.5-fold in the pre-frail group for mortality from CVD and cancer [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Pre-Frailty Phenotype and Arterial Stiffness in Older Adults Free of Cardiovascular Diseases

Macêdo

Freire

Browne

et al. 2022

IJERPH

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Purpose: Arterial stiffness is a subclinical marker of cardiovascular disease (CVD). The pre-frailty phenotype is associated with a higher risk for CVD. This study investigated the association between the pre-frailty phenotype and arterial stiffness in community-dwelling older adults without diagnosed CVD. Methods: In total, 249 community-dwelling older adults aged 60–80 years were included in this cross-sectional study. The pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Participants with one or two standardized Fried criteria were classified as pre-frail and those with zero criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The data were analyzed using the generalized linear model. Results: From 249 participants (66.1 ± 5.3 years; 79.5% females), 61.8% (n = 154) were pre-frail and 38.2% (n = 95) robust. Pre-frail older adults had a higher aPWV (β = 0.19 m/s; p = 0.007) compared to their robust peers. Conclusions: The pre-frailty phenotype was associated with higher arterial stiffness in community-dwelling older adults aged 60–80 years. Pre-frail older adults may have a higher risk for CVD.

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“…Interestingly, Atkins et al reported that sarcopenia might be associated with cardiovascular mortality ( 42 ). Another long-term follow-up study of 15,000 Chinese middle-aged and elderly people showed that compared with normal people, the incidence of cardiovascular disease in middle-aged and elderly people with sarcopenia increased by 72%, and the risk of cardiovascular events increased by 33% ( 43 ). Consistently, the present study indicated that sarcopenia was an independent risk factor for all-cause mortality in patients with DFUs.…”

Section: Discussionmentioning

confidence: 99%

Sarcopenia is an independent risk factor for all-cause mortality rate in patients with diabetic foot ulcers

Yang

Zhang

et al. 2023

Front. Nutr.

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ObjectiveThis study aimed to determine whether sarcopenia affects the all-cause mortality rate of patients with diabetic foot ulcers (DFUs).Research design and methodsThe clinic-based observational study included 217 patients treated at the Department of Endocrinology, the First Affiliated Hospital of Chongqing Medical University during a 4-year period. All subjects underwent dual-energy X-ray absorptiometry to determine their body composition during hospitalization. Diagnosis of sarcopenia was based on the Baumgartner diagnostic criteria. Patients were followed up regularly by phone calls until April 1, 2019, and their survival status was recorded.Univariate and multivariate Cox risk ratio regression models were used to analyze factors influencing the all-cause mortality rate of patients with DFUs.ResultsOf the 217 patients, 158 people survived (82.7%), 33 died (17.3%), and 26 were lost to follow-up. The median follow-up time was 23 (Range 11–34) months. The majority of patients were male (68.6%), with a mean age of 67.29 ± 11.14 years. The 5-year survival rate was 68.3% and 45.9% for all study patients (n = 217) and sarcopenia patients (n = 81), respectively. Multivariate Cox risk regression model showed that age (HR 1.042[95%CI:1.006, 1.078], P = 0.021), sarcopenia (HR 5.051[95%CI:1.968, 12.961], P = 0.001), and serum creatinine (HR 1.007[95%CI: 1.003, 1.010], P < 0.001) were independent risk factors for all-cause mortality rate of patients with DFUs. Kaplan-Meier survival curve indicated that the survival rate of patients with sarcopenia was significantly lower than non-sarcopenia patients (P < 0.001).ConclusionsSarcopenia is an independent risk factor for all-cause mortality of patients with DFUs and hence an important prognostic factor for patients with DFUs. Active prevention and improvement of sarcopenia can potentially improve the survival outcomes of this patient population.

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Frailty Index and Cardiovascular Disease among Middle-Aged and Older Chinese Adults: A Nationally Representative Cross-Sectional and Follow-Up Study

Cited by 15 publications

References 50 publications

Dose–response relationship between Frailty Index and Stroke among middle-aged and elderly Chinese

Dose–response relationship between Frailty Index and Stroke among middle-aged and elderly Chinese

Pre-Frailty Phenotype and Arterial Stiffness in Older Adults Free of Cardiovascular Diseases

Sarcopenia is an independent risk factor for all-cause mortality rate in patients with diabetic foot ulcers

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