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Howlett SE. How to Assess Frailty in Preclinical Models and Relate It to Clinical Paradigms. Can J Cardiol 2024; 40:1487-1489. [PMID: 38311168 DOI: 10.1016/j.cjca.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/25/2024] [Accepted: 01/27/2024] [Indexed: 02/10/2024] Open
Affiliation(s)
- Susan E Howlett
- Departments of Pharmacology and Medicine (Geriatric Medicine), Dalhousie University, Halifax, Nova Scotia, Canada.
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de Matos DG, de Santana JL, Mendelson AA, Duhamel TA, Villar R. Integrated Dynamic Autonomic and Cardiovascular Regulation during Postural Transitions in Older Adults Living with Frailty: A Systematic Review Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:566. [PMID: 36612888 PMCID: PMC9819247 DOI: 10.3390/ijerph20010566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/25/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
Older adults often experience episodes of a sudden drop in blood pressure when standing, known as orthostatic hypotension (OH). OH is associated with an increased risk of life-threatening health problems, falls, and death. Although OH has been studied in older adults, the integrated dynamic autonomic and cardiovascular regulation during postural transitions in older adults with frailty remains scarce and poorly understood. The primary aim of this systematic review is to determine the association between how active (e.g., lie-to-stand) and passive (head-up tilt) postural transitions affect the dynamic integrated autonomic and cardiovascular regulatory responses, comparing older adults with different levels of frailty (non-frail, pre-frail, or frail). A second aim is to perform a meta-analysis to compare autonomic and cardiovascular responses during active postural transitions in non-frail, pre-frail, and frail older adults. The systematic review will be outlined according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. The meta-analysis will generate estimates of the comparative autonomic and cardiovascular responses after active postural transitions in adults who are non-frail, pre-frail, and frail. This systematic review will provide critical information on how integrated dynamic autonomic and cardiovascular regulation occurs during postural transitions in older adults with different frailty statuses.
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Affiliation(s)
- Dihogo Gama de Matos
- Cardiorespiratory & Physiology of Exercise Research Laboratory, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Jefferson Lima de Santana
- Cardiorespiratory & Physiology of Exercise Research Laboratory, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Asher A. Mendelson
- Section of Critical Care, Department of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
| | - Todd A. Duhamel
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Albrechtsen Research Centre, Winnipeg, MB R2H 2A6, Canada
| | - Rodrigo Villar
- Cardiorespiratory & Physiology of Exercise Research Laboratory, Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
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Macêdo GAD, Freire YA, Browne RAV, Câmara M, Cabral LLP, Schwade D, Paulo-Pereira R, Silva RDM, Silva AMB, Farias-Junior LF, Duhamel TA, Costa EC. Pre-Frailty Phenotype and Arterial Stiffness in Older Adults Free of Cardiovascular Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192013469. [PMID: 36294048 PMCID: PMC9603482 DOI: 10.3390/ijerph192013469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/06/2022] [Accepted: 10/11/2022] [Indexed: 06/02/2023]
Abstract
PURPOSE Arterial stiffness is a subclinical marker of cardiovascular disease (CVD). The pre-frailty phenotype is associated with a higher risk for CVD. This study investigated the association between the pre-frailty phenotype and arterial stiffness in community-dwelling older adults without diagnosed CVD. METHODS In total, 249 community-dwelling older adults aged 60-80 years were included in this cross-sectional study. The pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Participants with one or two standardized Fried criteria were classified as pre-frail and those with zero criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The data were analyzed using the generalized linear model. RESULTS From 249 participants (66.1 ± 5.3 years; 79.5% females), 61.8% (n = 154) were pre-frail and 38.2% (n = 95) robust. Pre-frail older adults had a higher aPWV (β = 0.19 m/s; p = 0.007) compared to their robust peers. CONCLUSIONS The pre-frailty phenotype was associated with higher arterial stiffness in community-dwelling older adults aged 60-80 years. Pre-frail older adults may have a higher risk for CVD.
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Affiliation(s)
- Geovani Araújo Dantas Macêdo
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Yuri Alberto Freire
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Rodrigo Alberto Vieira Browne
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Marcyo Câmara
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Ludmila Lucena Pereira Cabral
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Daniel Schwade
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Winnipeg, MB R3T 2N2, Canada
| | - Ronildo Paulo-Pereira
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
| | - Raíssa de Melo Silva
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Alana Monteiro Bispo Silva
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Luiz Fernando Farias-Junior
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
| | - Todd A. Duhamel
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Institute of Cardiovascular Sciences, St. Boniface General Hospital Research Centre, Winnipeg, MB R3T 2N2, Canada
| | - Eduardo Caldas Costa
- ExCE Research Group, Department of Physical Education, Federal University of Rio Grande do Norte, Natal 59078-970, RN, Brazil
- Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal 59012-570, RN, Brazil
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Frailty status and cardiovascular disease risk profile in middle-aged and older females. Exp Gerontol 2020; 140:111061. [PMID: 32814098 DOI: 10.1016/j.exger.2020.111061] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 08/11/2020] [Accepted: 08/13/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Frailty and pre-frailty are known to increase the risk of developing cardiovascular disease (CVD). However, the risk profiles of females are not well characterized. The aim of this study is to characterize the CVD risk profiles of robust, pre-frail and frail females. METHODS Cross-sectional analysis of 985 females ≥55 years with no self-reported history of CVD were recruited. Frailty was assessed using the Fried Criteria with the cut-points standardized to the cohort. Framingham risk scores (FRS), the 4-test Rasmussen Disease Score (RDS), and the CANHEART health index were used to characterize composite CVD risk. Individual measures of CVD risk included blood lipids, artery elasticity assessments, exercise blood pressure response, 6-min walk test (6MWT), sedentary time and PHQ-9 score. RESULTS The cohort comprised of 458 (46.4%) robust, 464 (47.1%) pre-frail and 63 (6.4%) frail females with a mean age of 66 ± 6 (SD) years. Pre-frail females were at increased odds of taking diabetes medications (OR 3.04; 95% CI 1.27-7.27), hypertension medications (OR 2.02; 95% CI 1.44-2.82), having an exaggerated blood pressure response to exercise (OR 1.878; 95% CI 1.39-2.50), mild depression symptoms (OR 2.38; 95% CI 1.68-338), and lower fitness as assessed by 6MWT (OR 5.74; 95% CI 3.18-10.37), even after controlling for age and relevant medications. Pre-frail females were also at increased odds for having CVD risk scores indicating higher risk with the FRS (OR 1.52; 95% CI 1.12-2.05), the RDS (OR 1.60; 95% CI 1.21-2.10) and the CANHEART risk score (OR 3.07; 95% CI 2.04-4.62). These odds were higher when frail females were compared to their robust peers. CONCLUSION Frailty and pre-frailty were associated with higher odds of presenting with CVD risk factors as compared to robust females, even after controlling for age.
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Boreskie KF, Oldfield CJ, Hay JL, Moffatt TL, Hiebert BM, Arora RC, Duhamel TA. Myokines as biomarkers of frailty and cardiovascular disease risk in females. Exp Gerontol 2020; 133:110859. [PMID: 32017952 DOI: 10.1016/j.exger.2020.110859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/20/2020] [Accepted: 01/31/2020] [Indexed: 02/07/2023]
Abstract
Frailty is a risk factor for cardiovascular disease (CVD). Biomarkers have the potential to detect the early stages of frailty, such as pre-frailty. Myokines may act as biomarkers of frailty-related disease progression, as a decline in muscle health is a hallmark of the frailty phenotype. This study is a secondary analysis of 104 females 55 years of age or older with no previous history of CVD. Differences in systemic myokine concentrations based on frailty status and CVD risk profile were examined using a case-control design. Propensity matching identified two sets of 26 pairs with pre-frailty as the exposure variable in low or elevated CVD risk groups for a total 104 female participants. Frailty was assessed using the Fried Criteria (FC) and CVD risk was assessed using the Framingham Risk Score (FRS). Factorial ANOVA compared the main effects of frailty, CVD risk, and their interaction on the concentrations of 15 myokines. Differences were found when comparing elevated CVD risk status with low for the concentrations of EPO (384.76 ± 1046.07 vs. 206.63 ± 284.61 pg/mL, p = .001), FABP3 (2772.61 ± 3297.86 vs. 1693.31 ± 1019.34 pg/mL, p = .017), FGF21 (193.17 ± 521.09 vs. 70.18 ± 139.51 pg/mL, p = .010), IL-6 (1.73 ± 4.97 vs. 0.52 ± 0.89 pg/mL, p = .023), and IL-15 (2.62 ± 10.56 vs. 0.92 ± 1.25 pg/mL, p = .022). Pre-frail females had lower concentrations of fractalkine compared to robust (27.04 ± 20.60 vs. 103.62 ± 315.45 pg/mL, p = .004). Interaction effects between frailty status and CVD risk for FGF21 and OSM were identified. In elevated CVD risk, pre-frail females, concentrations of FGF21 and OSM were lower than that of elevated CVD risk, robust females (69.10 ± 62.86 vs. 317.24 ± 719.69, p = .011; 1.73 ± 2.32 vs. 24.43 ± 69.21, p = .018, respectively). These data identified specific biomarkers of CVD risk and biomarkers of frailty that are exacerbated with CVD risk.
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Affiliation(s)
- Kevin F Boreskie
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada; Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Christopher J Oldfield
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Jacqueline L Hay
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Teri L Moffatt
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada
| | - Brett M Hiebert
- Cardiac Sciences Program, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada
| | - Rakesh C Arora
- Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada; Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Todd A Duhamel
- Faculty of Kinesiology & Recreation Management, University of Manitoba, Winnipeg, Manitoba, Canada; Institute of Cardiovascular Sciences, St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, Manitoba, Canada.
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