Sarcopenia, frailty, cognitive impairment and mortality in elderly patients with non-valvular atrial fibrillation

Calleja, Marisol; Miquélez, A. Arenas; Díez-Manglano, Jesús; Gullón, Alejandra; Pose, Antonio; Formiga, Francesç; Mostaza, José María; Cepeda, J.M.; Suárez, Carmen

doi:10.1016/j.rceng.2019.04.002

Cited by 12 publications

(11 citation statements)

References 40 publications

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“…Moreover, almost all studies have focused on the association between sarcopenia and various adverse cardiovascular events of patients with heart disease. 18 , 24 , 25 – 26 To date, there have been no large population-based studies exploring the longitudinal relationship between sarcopenia and CVD in middle-aged and older adults.…”

Section: Introductionmentioning

confidence: 99%

Association between sarcopenia and cardiovascular disease among middle-aged and older adults: Findings from the China health and retirement longitudinal study

et al. 2022

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Background Little is known about the association between sarcopenia and cardiovascular disease (CVD) among middle-aged and older adults. Using the nationally representative data from the China Health and Retirement Longitudinal Study (CHARLS), we conducted cross-sectional and longitudinal analyses to investigate the association between sarcopenia status and CVD in middle-aged and older Chinese population.Methods The sample comprised 15,137 participants aged at least 45 years from the CHARLS 2015. Sarcopenia status was defined according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria. CVD was defined as the presence of physician-diagnosed heart disease and/or stroke. A total of 11,863 participants without CVD were recruited from the CHARLS 2015 and were followed up in 2018. Cox proportional hazards regression models were conducted to examine the effect of sarcopenia on CVD.

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Section: Introductionmentioning

confidence: 99%

Association between sarcopenia and cardiovascular disease among middle-aged and older adults: Findings from the China health and retirement longitudinal study

et al. 2022

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“…AF is currently regarded as an independent risk factor for cognitive dysfunction. 1–4 Two multicenter randomized controlled trials, ONTARGET and TRANSCEND, drew the similar conclusion that AF was independently associated with an increased risk of dementia. 1 Therefore, AF and cognitive decline could together form a vicious circle resulting in a poor prognosis.…”

Section: Discussionmentioning

confidence: 92%

“…A few recent studies have focused on the relationship between AF and cognitive function, drawing the conclusion that AF is a risk factor for cognitive dysfunction. 1–4 However, both AF and cognitive dysfunction are related to aging, and a causal relationship between these two factors cannot necessarily be established. Additionally, whether AF or subsequent stroke plays a more important role in the development of cognitive dysfunction is unclear.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing cognitive function in patients with atrial fibrillation: a cross-sectional clinical study

Xiong

Shen

et al. 2019

J Int Med Res

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Background The factors that influence cognitive function in patients with atrial fibrillation (AF) remain unclear. Methods This study involved an AF group and control group (normal sinus rhythm) of 150 patients each. Cognitive function was assessed with the adjusted Mini-Mental State Examination (MMSEadj) score and Memory and Executive Screening (MES) score. The relationship between cognitive function and the CHA2DS2VASc score was analyzed. Subgroup analysis was performed according to stroke history. Clinical factors affecting the MMSE score were screened by logistic regression analysis. Results Baseline data were similar between the two groups. The MMSEadj and MES scores were significantly lower in the AF than control group; the mean MMSEadj score in the AF non-stroke subgroup and control non-stroke subgroup was 26.2 ± 2.7 and 27.9 ± 2.0, respectively. In non-stroke patients with AF, the MMSEadj and MES scores were negatively correlated with the CHA2DS2VASc score. Factors significantly influencing the MMSE score in these patients were age, education, smoking history, NT-proB-type natriuretic peptide, hemoglobin, and anticoagulation. Conclusion AF is associated with cognitive dysfunction regardless of stroke history. High CHA2DS2VASc scores are associated with impaired cognitive function. Factors influencing cognitive function in non-stroke patients with AF are age, education, smoking history, NT-proB-type natriuretic peptide, hemoglobin, and anticoagulation.

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“…Although there is substantial literature on the association of mortality with sarcopenia based on various clinical definitions of sarcopenia, 34–36 studies on SARC‐F scores and mortality are sparse, based on relatively short follow‐up periods and adjusted for limited number of covariates 18,19,37 . In the MEC, covariate adjusted HRs between all‐cause mortality and SARC‐F (as continuous and categorical variables) were statistically significant, in both men and women, and by race/ethnicity; the HRs for SARC‐F ≥ 4 ranged from 2.87 to 5.12 in men, and from 2.20 to 4.17 in women.…”

Section: Discussionmentioning

confidence: 99%

“…In a meta‐analysis of five studies (one USA, one Spain, and three Asia) that tested SARC‐F in relation to mortality, a significant two‐fold increased risk was found. 17 However, two of the five studies had little information on covariates, 12 , 18 and the two studies showing the strongest association had only 1 year of follow‐up. 18 , 19 …”

Section: Introductionmentioning

confidence: 99%

Prognostic utility of self‐reported sarcopenia (SARC‐F) in the Multiethnic Cohort

Setiawan

Lim

et al. 2022

J cachexia sarcopenia muscle

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Background Age‐related loss in skeletal muscle mass, quality, and strength, known as sarcopenia, is a well‐known phenomenon of aging and is determined clinically using methods such as dual‐energy X‐ray absorptiometry (DXA). However, these clinical methods to measure sarcopenia are not practical for population‐based studies, and a five‐question screening tool known as SARC‐F has been validated to screen for sarcopenia. Methods We investigated the relationship between appendicular skeletal lean mass/height2 (ALM/HT2) (kg/m2) assessed by DXA and SARC‐F in a subset of 1538 (778 men and 760 women) participants in the Multiethnic Cohort (MEC) Study after adjustment for race/ethnicity, age, and body mass index (BMI) at the time of DXA measurement. We then investigated the association between SARC‐F and mortality among 71 283 (41 757 women and 29 526 men) participants in the MEC, who responded to the five SARC‐F questions on a mailed questionnaire as part of the MEC follow‐up in 2012–2016. Results In women, SARC‐F score was significantly inversely associated with ALM/HT2 after adjusting for race/ethnicity, and age and BMI at DXA (r = −0.167, P < 0.001); the result was similar in men although it did not reach statistical significance (r = −0.056, P = 0.12). Among the 71 000+ MEC participants, SARC‐F score ≥ 4, as an indicator of sarcopenia, was higher in women (20.9%) than in men (11.2%) (P < 0.0001) and increased steadily with increasing age (6.3% in <70 vs. 41.3% in 90+ years old) (P < 0.0001). SARC‐F score ≥ 4 was highest among Latinos (30.8% in women and 16.1% in men) and lowest in Native Hawaiian women (15.6%) and Japanese American men (8.9%). During an average of 6.8 years of follow‐up, compared with men with SARC‐F score of 0–1 (indicator of no sarcopenia), men with SARC‐F 2–3 (indicator of pre‐sarcopenia) and SARC‐F ≥ 4 had significantly increased risk of all‐cause mortality [hazard ratio (HR) = 1.00, 1.77, 3.73, P < 0.001], cardiovascular disease (CVD) mortality (HR = 1.00, 1.85, 3.98, P < 0.001), and cancer mortality (HR = 1.00, 1.46, 1.96, P < 0.001) after covariate adjustment. Comparable risk association patterns with SARC‐F scores were observed in women (all‐cause mortality: HR = 1.00, 1.47, 3.10, P < 0.001; CVD mortality: HR = 1.00, 1.59, 3.54, P < 0.001; cancer mortality: HR = 1.00, 1.30, 1.77, P < 0.001). These significant risk patterns between SARC‐F and all‐cause mortality were found across all sex–race/ethnic groups considered (12 in total). Conclusions An indicator of sarcopenia, determined using SARC‐F, showed internal validity against DXA and displayed racial/ethnic and sex differences in distribution. SARC‐F was associated with all‐cause mortality as well as cause‐specific mortality.

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Sarcopenia, frailty, cognitive impairment and mortality in elderly patients with non-valvular atrial fibrillation

Cited by 12 publications

References 40 publications

Association between sarcopenia and cardiovascular disease among middle-aged and older adults: Findings from the China health and retirement longitudinal study

Association between sarcopenia and cardiovascular disease among middle-aged and older adults: Findings from the China health and retirement longitudinal study

Factors influencing cognitive function in patients with atrial fibrillation: a cross-sectional clinical study

Prognostic utility of self‐reported sarcopenia (SARC‐F) in the Multiethnic Cohort

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