Medical Challenges of Improving the Quality of a Longer Life

Association Between Myocardial Infarction and Fractures

“…39 Furthermore, deficits such as sensory impairments, locomotor disturbances, and cognitive disorders, which are frequently overlooked in the traditional disease-specific model of cardiac care applied to MI patients, 23, 40 should be assessed and treated. 34, 36 Participation in secondary prevention programs, found to be consistently underused in this population 41 as in others, 42 should be aggressively pursued given the beneficial role of physical activity for the prevention of bone loss and falls, crucial elements in fracture prevention. 42, 43 …”

“…17 Consequently, the population of MI survivors has increased, often at the expense of increased disability, 34 and there is increased awareness of the burden of frailty in these patients. 35 Indeed, our data reveal that the dramatic decline in 30-day case fatality rate in Olmsted County was primarily driven by improved short-term survival of women and elderly patients.…”

“…35 Indeed, our data reveal that the dramatic decline in 30-day case fatality rate in Olmsted County was primarily driven by improved short-term survival of women and elderly patients. Hence, the trend of increasing fracture risk, an expected outcome of frailty-related impairments, 34, 36 in the aftermath of MI may be a result. Furthermore, while long-term survival remained largely unchanged among 30-day survivors in this population 13 and others, 14 the deaths shifted from cardiovascular to noncardiovascular causes.…”

Risk Factors for Frailty in a Large Prevalent Cohort of Hemodialysis Patients

“…22 Reducing the likelihood that individuals will experience falls, loss of functional independence, and institutionalization would have profound quality of life benefits as well as being cost-effective. A physical performance measure such as walk speed that requires little time to perform may be especially useful in the outpatient clinical setting as a screening tool to identify individuals who are at risk for frailty.…”

Cardiovascular and Noncardiovascular Disease Associations with Hip Fractures

“…15–17 The aging population on one hand, 37 and the prolonged survival of cardiovascular patients on the other, 16,38,39 have presumably led to an increase in the number of cardiac patients with frailty-related impairments. 40 Frailty in turn is a risk factor for falls and fractures, 41,42 particularly in the hip. 43 Our systematic examination of disease history reported herein revealed that coronary heart disease, other forms of heart disease (including heart failure), hypertension, and diabetes demonstrated the sharpest increase in association to hip fracture over time, which was more pronounced among elderly women.…”