Serum Cholesterol Levels as a Measure of Frailty in Elderly Patients

Ranieri, Piera; Rozzini, Renzo; Franzoni, Simone; Barbisoni, Piera; Trabucchi, Marco

doi:10.1080/036107398244300

Cited by 57 publications

(18 citation statements)

References 23 publications

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“…The association between low levels of LDL-C and an increased risk of all cause mortality could be explained by reverse causation. Debilitation and illness have been hypothesised to cause a decrease in levels of cholesterol 18 19 and, in this study, comorbidities were more frequent in individuals with the lowest levels of LDL-C. Also, consistent with the theory that low levels of LDL-C are an indirect marker of severe disease, the association between low levels of LDL-C and the risk of all cause mortality was strongest in the age and sex adjusted model, and substantially reduced when adjusting for baseline comorbidities. An association remained after this adjustment, however, and after excluding individuals with less than five years of follow-up and known cardiovascular disease, cancer, and chronic obstructive pulmonary disease at baseline.…”

Section: Discussionmentioning

confidence: 99%

Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study

Johannesen

Langsted

Mortensen

et al. 2020

BMJ

146

127

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Objective To determine the association between levels of low density lipoprotein cholesterol (LDL-C) and all cause mortality, and the concentration of LDL-C associated with the lowest risk of all cause mortality in the general population. Design Prospective cohort study. Setting Denmark; the Copenhagen General Population Study recruited in 2003-15 with a median follow-up of 9.4 years. Participants Individuals randomly selected from the national Danish Civil Registration System. Main outcome measures Baseline levels of LDL-C associated with risk of mortality were evaluated on a continuous scale (restricted cubic splines) and by a priori defined centile categories with Cox proportional hazards regression models. Main outcome was all cause mortality. Secondary outcomes were cause specific mortality (cardiovascular, cancer, and other mortality). Results Among 108 243 individuals aged 20-100, 11 376 (10.5%) died during the study, at a median age of 81. The association between levels of LDL-C and the risk of all cause mortality was U shaped, with low and high levels associated with an increased risk of all cause mortality. Compared with individuals with concentrations of LDL-C of 3.4-3.9 mmol/L (132-154 mg/dL; 61st-80th centiles), the multivariable adjusted hazard ratio for all cause mortality was 1.25 (95% confidence interval 1.15 to 1.36) for individuals with LDL-C concentrations of less than 1.8 mmol/L (<70 mg/dL; 1st-5th centiles) and 1.15 (1.05 to 1.27) for LDL-C concentrations of more than 4.8 mmol/L (>189 mg/dL; 96th-100th centiles). The concentration of LDL-C associated with the lowest risk of all cause mortality was 3.6 mmol/L (140 mg/dL) in the overall population and in individuals not receiving lipid lowering treatment, compared with 2.3 mmol/L (89 mg/dL) in individuals receiving lipid lowering treatment. Similar results were seen in men and women, across age groups, and for cancer and other mortality, but not for cardiovascular mortality. Any increase in LDL-C levels was associated with an increased risk of myocardial infarction. Conclusions In the general population, low and high levels of LDL-C were associated with an increased risk of all cause mortality, and the lowest risk of all cause mortality was found at an LDL-C concentration of 3.6 mmol/L (140 mg/dL).

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Section: Discussionmentioning

confidence: 99%

Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study

Johannesen

Langsted

Mortensen

et al. 2020

BMJ

146

127

View full text Add to dashboard Cite

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“…Similar findings between total cholesterol and function outcomes post-stroke have been observed previously, 8 and other research suggests that a low cholesterol may be a marker of frailty and poor nutritional status in older age. 27 …”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Ischemic Stroke Survival and Recovery in Older Adults

Winovich

Longstreth

Arnold

et al. 2017

Stroke

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Background and Purpose-Little is known about factors that predispose older adults to poor recovery after a stroke. In this study, we sought to evaluate prestroke measures of frailty and related factors as markers of vulnerability to poor outcomes after ischemic stroke. Methods-In participants aged 65 to 99 years with incident ischemic strokes from the Cardiovascular Health Study, we evaluated the association of several risk factors (frailty, frailty components, C-reactive protein, interleukin-6, and cystatin C) assessed before stroke with stroke outcomes of survival, cognitive decline (≥5 points on Modified Mini-Mental State Examination), and activities of daily living decline (increase in limitations). Results-Among 717 participants with incident ischemic stroke with survival data, slow walking speed, low grip strength, and cystatin C were independently associated with shorter survival. Among participants <80 years of age, frailty and interleukin-6 were also associated with shorter survival. Among 509 participants with recovery data, slow walking speed, and low grip strength were associated with both cognitive and activities of daily living decline poststroke. C-reactive protein and interleukin-6 were associated with poststroke cognitive decline among men only. Frailty status was associated with activities of daily living decline among women only. Conclusions-Markers of physical function-walking speed and grip strength-were consistently associated with survival and recovery after ischemic stroke. Inflammation, kidney function, and frailty also seemed to be determinants of survival and recovery after an ischemic stroke. These markers of vulnerability may identify targets for differing pre and poststroke medical management and rehabilitation among older adults at risk of poor stroke outcomes.

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“…The relationships between lipid profiles and frailty have rarely been explored [11]. In a study on 637 hospitalized old patients, Ranieri et al concluded that lower serum cholesterol levels were an independent hematologic marker of frailty [27]. Low cholesterol level is a marker of malnutrition and could therefore be noncausally associated with frailty status.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Frailty Indicators and Association with Socioeconomic Status in Middle-Aged and Older Adults in a Swiss Region with Universal Health Insurance Coverage: A Population-Based Cross-Sectional Study

Guessous

Luthi

Bowling

et al. 2014

Journal of Aging Research

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Frailty prevalence in older adults has been reported but is largely unknown in middle-aged adults. We determined the prevalence of frailty indicators among middle-aged and older adults from a general Swiss population characterized by universal health insurance coverage and assessed the determinants of frailty with a special focus on socioeconomic status. Participants aged 50 and more from the population-based 2006–2010 Bus Santé study were included (N = 2,930). Four frailty indicators (weakness, shrinking, exhaustion, and low activity) were measured according to standard definitions. Multivariate logistic regressions were used to determine associations. Overall, 63.5%, 28.7%, and 7.8% participants presented no frailty indicators, one frailty indicator, and two or more frailty indicators, respectively. Among middle-aged participants (50–65 years), 75.1%, 22.2%, and 2.7% presented 0, 1, and 2 or more frailty indicators. The number of frailty indicators was positively associated with age, hypertension, and current smoking and negatively associated with male gender, body mass index, waist-to-hip ratio, and serum total cholesterol level. Lower income level but not education was associated with higher number of frailty indicators. Frailty indicators are frequently encountered in both older and middle-aged adults from the Swiss general population. Despite universal health insurance coverage, household income is independently associated with frailty.

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Serum Cholesterol Levels as a Measure of Frailty in Elderly Patients

Cited by 57 publications

References 23 publications

Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study

Association between low density lipoprotein and all cause and cause specific mortality in Denmark: prospective cohort study

Factors Associated With Ischemic Stroke Survival and Recovery in Older Adults

Prevalence of Frailty Indicators and Association with Socioeconomic Status in Middle-Aged and Older Adults in a Swiss Region with Universal Health Insurance Coverage: A Population-Based Cross-Sectional Study

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