Journal ArticleDOI
Role of frailty in patients with cardiovascular disease.
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TLDR
There exists a relation between frailty and CVD; frailty may lead to CVD, just as CVD may leadTo frailty, the presence of frailty confers an incremental increase in mortality.Abstract:
Frailty is a geriatric syndrome of increased vulnerability to stressors that has been implicated as a causative and prognostic factor in patients with cardiovascular disease (CVD). The American Heart Association and the Society of Geriatric Cardiology have called for a better understanding of frailty as it pertains to cardiac care in the elderly. The aim of this study was to systematically review studies of frailty in patients with CVD. A search was conducted of Ovid MEDLINE, EMBASE, the Cochrane Database, and unpublished sources. Inclusion criteria were an assessment of frailty using systematically defined criteria and a study population with prevalent or incident CVD. Nine studies were included, encompassing 54,250 elderly patients with a mean weighted follow-up of 6.2 years. In community-dwelling elders, CVD was associated with an odds ratio (OR) of 2.7 to 4.1 for prevalent frailty and an OR of 1.5 for incident frailty in those who were not frail at baseline. Gait velocity (a measure of frailty) was associated with an OR of 1.6 for incident CVD. In elderly patients with documented severe coronary artery disease or heart failure, the prevalence of frailty was 50% to 54%, and this was associated with an OR of 1.6 to 4.0 for all-cause mortality after adjusting for potential confounders. In conclusion, there exists a relation between frailty and CVD; frailty may lead to CVD, just as CVD may lead to frailty. The presence of frailty confers an incremental increase in mortality. The role of frailty assessment in clinical practice may be to refine estimates of cardiovascular risk, which tend to be less accurate in the heterogenous elderly patient population.read more
Citations
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Journal ArticleDOI
Frailty in elderly people
TL;DR: Developing more efficient methods to detect frailty and measure its severity in routine clinical practice would greatly inform the appropriate selection of elderly people for invasive procedures or drug treatments and would be the basis for a shift in the care of frail elderly people towards more appropriate goal-directed care.
Journal ArticleDOI
Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty
Luigi Ferrucci,Elisa Fabbri +1 more
TL;DR: Whether therapies to modulate inflammageing can reduce the age-related decline in health is discussed, and the hypothesis that inflammation affects CVD, multimorbidity, and frailty is supported by mechanistic studies but requires confirmation in humans.
Journal ArticleDOI
Frailty Assessment in the Cardiovascular Care of Older Adults
Jonathan Afilalo,Karen P. Alexander,Michael J. Mack,Mathew S. Maurer,Philip Green,Larry A. Allen,Jeffrey J. Popma,Luigi Ferrucci,Daniel E. Forman +8 more
TL;DR: This work sought to synthesize the existing body of evidence and offer a perspective on how to integrate frailty into clinical practice and contribute valuable prognostic insights incremental to existing risk models and assists clinicians in defining optimal care pathways for their patients.
Journal ArticleDOI
Gait speed as an incremental predictor of mortality and major morbidity in elderly patients undergoing cardiac surgery.
Jonathan Afilalo,Mark J. Eisenberg,Jean-Francois Morin,Howard Bergman,Howard Bergman,Johanne Monette,Johanne Monette,Nicolas Noiseux,Louis P. Perrault,Karen P. Alexander,Yves Langlois,Nandini Dendukuri,Patrick Chamoun,Georges Kasparian,Sophie Robichaud,S. Michael Gharacholou,J. F. Boivin +16 more
TL;DR: Gait speed is a simple and effective test that may identify a subset of vulnerable elderly patients at incrementally higher risk of mortality and major morbidity after cardiac surgery.
Journal ArticleDOI
Frailty syndrome: an overview
TL;DR: Frailty is a common and important geriatric syndrome characterized by age-associated declines in physiologic reserve and function across multiorgan systems, leading to increased vulnerability for adverse health outcomes, including obesity and specific diseases.
References
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Journal ArticleDOI
Frailty in Older Adults Evidence for a Phenotype
Linda P. Fried,Catherine M. Tangen,Jeremy D. Walston,Anne B. Newman,Calvin H. Hirsch,John S. Gottdiener,Teresa E. Seeman,Russell P. Tracy,Willem J. Kop,B Gregory Burke,Mary Ann McBurnie +10 more
TL;DR: This study provides a potential standardized definition for frailty in community-dwelling older adults and offers concurrent and predictive validity for the definition, and finds that there is an intermediate stage identifying those at high risk of frailty.
Journal Article
Cardiovascular Health Study Collaborative Research Group : Frailty in older adults : evidence for a phenotype
Journal ArticleDOI
Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement
TL;DR: This report hopes this report will generate further thought about ways to improve the quality of reports of meta-analyses of RCTs and that interested readers, reviewers, researchers, and editors will use the QUOROM statement and generate ideas for its improvement.
Journal ArticleDOI
Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care
TL;DR: A narrative review of current understanding of the definitions and distinguishing characteristics of each of these conditions, including their clinical relevance and distinct prevention and therapeutic issues, and how they are related is provided.
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