Vascular Calcification as an Underrecognized Risk Factor for Frailty in 1783 Community-Dwelling Elderly Individuals
Journal
Journal of the American Heart Association
Journal Volume
9
Journal Issue
18
Pages
e017308
Date Issued
2020
Abstract
BACKGROUND: Vascular calcification (VC) is associated with high morbidity and mortality among older adults, a population that exhibits a higher tendency for developing frailty at the same time. Whether VC serves as a risk factor for the development of frailty in this population remains unclear. METHODS AND RESULTS: We analyzed a prospectively assembled cohort of community-dwelling older adults between 2014 and 2017 (n=1783). Frailty and prefrailty were determined on the basis of the Study of Osteoporotic Fractures criteria, and VC was measured using semiquantitative aortic arch calcification (AAC) and abdominal aortic calcification scoring. We conducted multiple logistic regression with prefrailty or frailty as the dependent variable, incorporating sociodemographic profiles, comorbidities, medications, laboratory data, AAC status/severity, and other geriatric phenotypes. Among all participants, 327 (18.3%) exhibited either prefrailty (15.3%) or frailty (3.1%), and 648 (36.3%) exhibited AAC. After adjusting for multiple confounders, we found that AAC incidence was associated with a substantially higher probability of prefrailty or frailty (odds ratio [OR], 11.9; 95% CI, 7.9–15.4), with a dose-responsive relationship (OR for older adults with AAC categories 1, 2, and 3 was 9.3, 13.6, and 52.5, respectively). Similar association was observed for older adults with abdominal aortic calcification (OR, 5.0; 95% CI, 1.3–19.5), and might be replicable in another cohort of patients with end-stage renal disease. CONCLUSIONS: Severity of VC exhibited a linear positive relationship with frailty in older adults. Our findings suggest that a prompt diagnosis and potential management of VC may assist in risk mitigation for patients with frailty. ? 2020 The Authors.
Other Subjects
antidiabetic agent; antihypertensive agent; antilipemic agent; anxiolytic agent; hypnotic agent; sedative agent; abdominal aorta; aged; aortic calcification; Article; cohort analysis; community dwelling person; comorbidity; controlled study; demography; diabetes mellitus; disease severity; end stage renal disease; female; frailty; geriatrics; human; human cell; hyperlipidemia; hypertension; incidence; laboratory test; major clinical study; male; odds ratio; phenotype; practice guideline; probability; prospective study; quantitative diagnosis; risk assessment; risk factor; risk management; scoring system; very elderly; blood vessel calcification; complication; frailty; independent living; pathology; risk factor; severity of illness index; thoracic aorta; Aged; Aorta, Thoracic; Female; Frailty; Humans; Independent Living; Male; Prospective Studies; Risk Factors; Severity of Illness Index; Vascular Calcification
Publisher
NLM (Medline)
Type
journal article