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Wang Q, Zhou C, Dong C, Zhang J, Xie Z, Sun H, Fu C, Hao W, Zhu D. Midlife Life's Simple 7, Psychosocial Health, and Physical Frailty, Hospital Frailty, and Comprehensive Frailty 10 Years Later. Nutrients 2023; 15:nu15102412. [PMID: 37242295 DOI: 10.3390/nu15102412] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
This study aims to examine the associations between midlife Life's Simple 7 (LS7) status, psychosocial health (social isolation and loneliness), and late-life multidimensional frailty indicators, and to investigate their synergistic effect on frailty. We used cohort data from the UK Biobank. Frailty was assessed using physical frailty phenotype, hospital frailty risk score, and frailty index. Cox proportional-hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) on the association between the LS7 score, psychosocial health, and frailty. For the association of LS7 with physical and comprehensive frailty, 39,047 individuals were included. After a median follow-up of 9.0 years, 1329 (3.4%) people were identified with physical frailty, and 5699 (14.6%) with comprehensive frailty. For the association of LS7 with hospital frailty, 366,570 people were included. After a median follow-up of 12.0 years, 18,737 (5.1%) people were identified with hospital frailty. Compared to people with a poor LS7 score, those with an intermediate (physical frailty: 0.64, 0.54-0.77; hospital frailty: 0.60, 0.58-0.62; and comprehensive frailty: 0.77, 0.69-0.86) and optimal LS7 score (physical frailty: 0.31, 0.25-0.39; hospital frailty: 0.39, 0.37-0.41; and comprehensive frailty: 0.62, 0.55-0.69) were associated with a lower risk of frailty. Poor psychosocial health was associated with an increased risk of frailty. People who had a poor psychosocial status and poor LS7 score had the highest risk of frailty. A better LS7 score in midlife was associated with a reduced risk of physical, hospital, and comprehensive frailty. There was a synergistic effect of psychosocial status and LS7 on frailty.
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Affiliation(s)
- Qi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Chunmiao Zhou
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Caiyun Dong
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jiajun Zhang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Ziwei Xie
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Huizi Sun
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Chunying Fu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Wenting Hao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
- National Health Commission Key Lab of Health Economics and Policy Research, Shandong University, Jinan 250012, China
| | - Dongshan Zhu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
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Quach J, Theou O, Godin J, Rockwood K, Kehler DS. The impact of cardiovascular health and frailty on mortality for males and females across the life course. BMC Med 2022; 20:394. [PMID: 36357932 PMCID: PMC9650802 DOI: 10.1186/s12916-022-02593-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/03/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The effect of frailty and poor cardiovascular health on mortality for males and females is not fully elucidated. We investigated whether the combined burden of frailty and poor cardiovascular health is associated with all-cause and cardiovascular disease (CVD) mortality by sex and age. METHODS We analyzed data of 35,207 non-institutionalized US residents aged 20-85 years old (mean age [standard deviation]: 46.6 [16.7 years], 51.4% female, 70.8% White, 10.3% Black, 13.2% Hispanic) from the National Health and Nutrition Examination Survey (1999-2015). Cardiovascular health was measured with the American Heart Association's Life's Simple 7 score (LS7). A 33-item frailty index (FI) was constructed to exclude cardiovascular health deficits. We grouped the FI into 0.1 increments (non-frail: FI < 0.10, very mildly frail: 0.1 ≤ FI < 0.20, mildly frail: 0.20 ≤ FI < 0.30, and moderately/severely frail: FI ≥ 0.30) and LS7 into tertiles (T1[poor] = 0-7, T2[intermediate] = 8-9, T3[ideal] = 10-14). All-cause and CVD mortality data were analyzed up to 16 years. All regression models were stratified by sex. RESULTS The average FI was 0.09 (SD 0.10); 29.6% were at least very mildly frail, and the average LS7 was 7.9 (2.3). Mortality from all-causes and CVD were 8.5% (4228/35,207) and 6.1% (2917/35,207), respectively. The median length of follow-up was 8.1 years. The combined burden of frailty and poor cardiovascular health on mortality risk varied according to age in males (FI*age interaction p = 0.01; LS7*age interaction p < 0.001) but not in females. In females, poor FI and LS7 combined to predict all-cause and CVD mortality in a dose-response manner. All-cause and CVD mortality risk was greater for older males (60 and 70 years old) who were at least mildly frail and had intermediate cardiovascular health or worse (hazard ratio [lower/higher confidence interval ranges] range: all-cause mortality = 2.02-5.30 [1.20-4.04, 3.15-6.94]; CVD-related mortality = 2.22-7.16 [1.03-4.46, 4.49-11.50]) but not for younger males (30, 40, and 50 years old). CONCLUSIONS The combined burden of frailty and LS7 on mortality is similar across all ages in females. In males, this burden is greater among older people. Adding frailty to assessments of overall cardiovascular health may identify more individuals at risk for mortality and better inform decisions to implement preventative or treatment approaches.
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Affiliation(s)
- Jack Quach
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.,Geriatric Medicine, Dalhousie University and Nova Scotia Health, NS, Halifax, Canada
| | - Olga Theou
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.,Geriatric Medicine, Dalhousie University and Nova Scotia Health, NS, Halifax, Canada
| | - Judith Godin
- Geriatric Medicine, Dalhousie University and Nova Scotia Health, NS, Halifax, Canada
| | - Kenneth Rockwood
- Geriatric Medicine, Dalhousie University and Nova Scotia Health, NS, Halifax, Canada.
| | - Dustin Scott Kehler
- School of Physiotherapy, Dalhousie University, Halifax, NS, Canada.,Geriatric Medicine, Dalhousie University and Nova Scotia Health, NS, Halifax, Canada
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Li N, Huang F, Li H, Lin S, Yuan Y, Zhu P. Examining the independent and interactive association of physical activity and sedentary behaviour with frailty in Chinese community-dwelling older adults. BMC Public Health 2022; 22:1414. [PMID: 35879692 PMCID: PMC9313602 DOI: 10.1186/s12889-022-13842-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/18/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND While physical inactivity or prolonged sitting has been linked to an increased risk of frailty, the interaction between sitting time (ST), physical activity (PA) and frailty is not well understood. The aim of this study was to examine the dose-response relationship between PA, ST and frailty and further to evaluate the interaction effect of PA and ST on frailty in the context of regular COVID-19 epidemic prevention and control in China. METHODS A cross-sectional analysis was performed on 1458 participants (age ≥ 60) enrolled from a prospective cohort study of frailty in elderly people of Fujian Province. PA and ST levels were assessed using the International Physical Activity Questionnaire. A 40-item frailty index (FI) quantified frailty. Multivariable logistic regression and linear regression models were applied to examine the dose-response relationship between PA or ST and frailty level. Interaction plots were used to visualise the interaction effects of PA and ST on frailty. RESULTS Compared with light PA, the odds ratios (ORs) for frailty were significantly lower for moderate PA (OR, 0.609 [95% CI, 0.419, 0.885], P < .001) and vigorous PA (OR, 0.399 [95% CI, 0.236,0.673], P < .001). Comparing subjects with ST < 4 h/day, those with ST ≥ 8 h/day were significantly more likely to be diagnosed with frailty (OR, 3.140 [95% CI, 1.932, 5.106], P < .001), 6-8 h/day (OR, 1.289 [95% CI, 0.835, 1.989], P >0.05), and 4-6 h/day (OR, 1.400 [95% CI, 0.972, 2.018], P >0.05). Each one unit increase in metabolic equivalents (h/day) of PA was related to an average 0.928 (0.887, 0.971) decrease in prevalence of frailty, while each one unit increase in sitting time (h/day) was related to average 1.114 (1.046,1.185) increase in prevalence of frailty. Negative interactive effects of PA and ST on frailty were observed (P < 0.001). CONCLUSION There are nonlinear and linear dose-response relationships between PA, SB and frailty respectively. In addition, excess ST may counteract the beneficial effects of PA on frailty. Interventions that focus on reducing excess ST may be effective strategies to reduce the risk of frailty and should be taken seriously by public health authorities, especially in the context of regular epidemic prevention and control in China.
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Affiliation(s)
- Na Li
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Nursing, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China.,The School of Nursing, Fujian Medical University, Fuzhou, Fujian, People's Republic of China
| | - Feng Huang
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Hong Li
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Nursing, Fujian Provincial Hospital, Fuzhou, Fujian, People's Republic of China
| | - Siyang Lin
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Yin Yuan
- Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.,Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China
| | - Pengli Zhu
- The Shengli Clinical Medical College of Fujian Medical University, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China. .,Fujian Provincial Key Laboratory of Geriatrics, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China. .,Department of Geriatric Medicine, Fujian Provincial Hospital, 134 Dongjie Road, Fuzhou, Fujian, 350100, People's Republic of China.
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Shakya S, Bajracharya R, Ledbetter L, Cary MP. The Association between Cardiometabolic Risk Factors and Frailty in Older Adults: A Systematic Review. Innov Aging 2022; 6:igac032. [PMID: 35795135 PMCID: PMC9250659 DOI: 10.1093/geroni/igac032] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives Enhanced management and prevention of frailty depend on our understanding of the association between potentially modifiable risk factors and frailty. However, the associations between potentially modifiable cardiometabolic risk factors and frailty are not clear. The purpose of this review was to appraise and synthesize the current evidence examining the associations between the cardiometabolic risk factors and frailty. Research Design and Methods Multiple databases, including MEDLINE (via PubMed), Embase (via Elsevier), and Web of Science (via Clarivate), were searched extensively. Studies that examined cardiometabolic risk factors and frailty as main predictors and outcome of interest, respectively, among older adults (≥60 years) were included. The Joanna Briggs Institute critical appraisal tools were used to evaluate the quality of studies. PRISMA (2020) guided this review, and findings were synthesized without meta-analysis. This systematic review was registered in PROSPERO (CRD42021252565). Results Twelve studies met the eligibility criteria and were included in the review. Abdominal obesity, hyperglycemia, and multiple co-occurring cardiometabolic risk factors were associated with the increased likelihood of frailty in older adults. There was inconsistency across the studies regarding the associations between dyslipidemia, elevated blood pressure, and frailty. Discussion and Implications Understanding the association between cardiometabolic risk factors and frailty can have translational benefits in developing tailored interventions for the prevention and management of frailty. More studies are needed to validate predictive and clinically significant associations between single and specific combinations of co-occurring cardiometabolic risk factors and frailty.
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Affiliation(s)
| | | | - Leila Ledbetter
- School of Medicine, Medical Center Library & Archives, Duke University, Durham, NC, USA
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Perazza LR, Brown-Borg HM, Thompson LV. Physiological Systems in Promoting Frailty. Compr Physiol 2022; 12:3575-3620. [PMID: 35578945 DOI: 10.1002/cphy.c210034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Frailty is a complex syndrome affecting a growing sector of the global population as medical developments have advanced human mortality rates across the world. Our current understanding of frailty is derived from studies conducted in the laboratory as well as the clinic, which have generated largely phenotypic information. Far fewer studies have uncovered biological underpinnings driving the onset and progression of frailty, but the stage is set to advance the field with preclinical and clinical assessment tools, multiomics approaches together with physiological and biochemical methodologies. In this article, we provide comprehensive coverage of topics regarding frailty assessment, preclinical models, interventions, and challenges as well as clinical frameworks and prevalence. We also identify central biological mechanisms that may be at play including mitochondrial dysfunction, epigenetic alterations, and oxidative stress that in turn, affect metabolism, stress responses, and endocrine and neuromuscular systems. We review the role of metabolic syndrome, insulin resistance and visceral obesity, focusing on glucose homeostasis, adenosine monophosphate-activated protein kinase (AMPK), mammalian target of rapamycin (mTOR), and nicotinamide adenine dinucleotide (NAD+ ) as critical players influencing the age-related loss of health. We further focus on how immunometabolic dysfunction associates with oxidative stress in promoting sarcopenia, a key contributor to slowness, weakness, and fatigue. We explore the biological mechanisms involved in stem cell exhaustion that affect regeneration and may contribute to the frailty-associated decline in resilience and adaptation to stress. Together, an overview of the interplay of aging biology with genetic, lifestyle, and environmental factors that contribute to frailty, as well as potential therapeutic targets to lower risk and slow the progression of ongoing disease is covered. © 2022 American Physiological Society. Compr Physiol 12:1-46, 2022.
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Affiliation(s)
- Laís R Perazza
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
| | - Holly M Brown-Borg
- Department of Biomedical Sciences, University of North Dakota, Grand Forks, North Dakota, USA
| | - LaDora V Thompson
- Department of Physical Therapy and Athletic Training, Boston University, Boston, Massachusetts, USA
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Sotos-Prieto M, Struijk EA, Fung TT, Rimm EB, Rodriguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Association between a lifestyle-based healthy heart score and risk of frailty in older women: a cohort study. Age Ageing 2022; 51:afab268. [PMID: 35136897 PMCID: PMC8826375 DOI: 10.1093/ageing/afab268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Evidence on the comprehensive role of lifestyle in frailty risk is scarce. To assess the association between a lifestyle-based Healthy Heart Score (HHS), which estimates the 20-year risk of cardiovascular disease (CVD), and risk of frailty among older women. METHODS Prospective cohort study in 121,700 nurses from the USA participating at the Nurses' Health Study. This study included 68,416 women aged ≥60 year with a follow-up from 1990 to 2014. The HHS was computed using the gender-specific beta-coefficients of the nine lifestyle factors, including current smoking, high body mass index, low physical activity, lack of moderate alcohol intake and unhealthy diet. Frailty incidence was assessed every 4 years from 1992 to 2014 as having ≥3 of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses and weight loss ≥5%. RESULTS During 22 years of follow-up, 11,041 total incident cases of frailty were ascertained. Compared to women in the lowest quintile of the HHS (lowest estimated CVD risk), the multivariable-adjusted hazard ratio of frailty across quintiles was: Q2:1.67 (95% confidence interval 1.53, 1.82); Q3: 2.34 (2.15, 2.53); Q4: 3.54 (3.28, 3.83) and Q5: 5.92 (5.48, 6.38); P-trend > 0.001. Results were consistent for each frailty criterion, among participants with 0 frailty criteria at baseline, when using only baseline exposure or in 6-year-, 10-year- and 14-year-exposure lagged analyses, and after excluding participants with diabetes and CVD at baseline. CONCLUSIONS The HHS, based on a set of modifiable-lifestyle factors, is strongly associated with risk of frailty in older women.
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Affiliation(s)
- Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Ellen A Struijk
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Teresa T Fung
- Department of Nutrition, Simmons University, Boston, MA, USA
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Eric B Rimm
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Fernando Rodriguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Walter C Willett
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Frank B Hu
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham & Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Mone P, Gambardella J, Pansini A, Martinelli G, Minicucci F, Mauro C, Santulli G. Cognitive dysfunction correlates with physical impairment in frail patients with acute myocardial infarction. Aging Clin Exp Res 2022; 34:49-53. [PMID: 34101155 DOI: 10.1007/s40520-021-01897-w] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/28/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND To the best of our knowledge, the association of physical impairment and cognitive decline has never been investigated in frail patients with acute myocardial infarction. AIM The aim of our study is to assess the correlation between physical and cognitive dysfunction in frail patients with ST-elevation myocardial infarction (STEMI). METHODS We examined consecutive frail patients with first STEMI treated with primary percutaneous coronary intervention (PPCI). All patients were evaluated via Mini Mental State Examination (MMSE) and 5-m gait speed test after PPCI. RESULTS A total of 871 frail patients with suspected STEMI were admitted and 301 patients successfully completed the study. We found that the gait speed significantly correlated with the MMSE score (r: 0.771; p: < 0.001). The independent effects on MMSE score were confirmed in a linear multivariate analysis. CONCLUSIONS Taken together, our findings indicate that an assessment of both cognitive and physical conditions should be included in the comprehensive geriatric evaluation of hospitalized older STEMI patients.
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Palta P, Griswold M, Ranadive R, Bandeen-Roche K, Folsom AR, Petruski-Ivleva N, Burgard S, Kucharska-Newton A, Windham BG. Midlife Cardiovascular Health and Robust versus Frail Late-Life Status: The Atherosclerosis Risk in Communities (ARIC) Study. J Gerontol A Biol Sci Med Sci 2021; 77:1222-1229. [PMID: 34661638 DOI: 10.1093/gerona/glab310] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND We examined the relationship of midlife cardiovascular health (CVH) with late-life robustness among men and women and the impact of survivorship bias on sex-differences in robustness. METHODS Prospective analysis of 15,744 participants aged 45-64 (Visit 1 median age: 54 years, 55% female, 27% Black) in 1987-1989 from the population-based ARIC Study. CVH was operationalized according to the Life's Simple 7 (LS7) metric of health behaviors (smoking, weight, physical activity, diet, cholesterol, blood pressure, and glucose); each behavior was scored as ideal (2 points), intermediate (1 point), or poor (0 points) and summed. Late-life robust/pre-frail/frailty was defined at Visit 5 (2011-2013). Multinomial regression estimated relative prevalence ratios (RPR) of late-life robustness/pre-frailty/frailty/death across overall midlife LS7 score and components, for the full Visit 1 sample. Separate analyses considered Visit 5 survivors only. RESULTS For each one-unit greater midlife LS7 score, participants had a 37% higher relative prevalence of being robust versus frail (overall RPR=1.37, [95% CI: 1.30-1.44]; women=1.45 [1.36-1.54]; men=1.24 [1.13-1.36]). Among the full Visit 1 sample, women had a similar one-level higher robustness category prevalence (RPR=1.35 [95% CI: 1.32-1.39]) than men (RPR=1.31 [95% CI: 1.27-1.35]) for every one-unit higher midlife LS7 score. Among survivors, men were more likely to be robust than women at lower LS7 levels; differences were attenuated and not statistically different at higher midlife LS7 levels. CONCLUSIONS Midlife CVH is positively associated with robustness in late-life among men and women. Accounting for mortality in part explains documented sex-differences in robustness across all levels of LS7.
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Affiliation(s)
- Priya Palta
- Departments of Medicine and Epidemiology, Columbia University Irving Medical Center, New York, NY
| | - Michael Griswold
- The MIND Center, Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Radhikesh Ranadive
- The MIND Center, Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Karen Bandeen-Roche
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Aaron R Folsom
- Divison of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | | | - Sheila Burgard
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Anna Kucharska-Newton
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY
| | - B Gwen Windham
- The MIND Center, Department of Medicine, University of Mississippi Medical Center, Jackson, MS
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Frailty and dementia: what can the body tell us about the brain? Int Psychogeriatr 2021; 33:1001-1003. [PMID: 34078500 DOI: 10.1017/s1041610220004160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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10
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Yuan L, Chang M, Wang J. Abdominal obesity, body mass index and the risk of frailty in community-dwelling older adults: a systematic review and meta-analysis. Age Ageing 2021; 50:1118-1128. [PMID: 33693472 DOI: 10.1093/ageing/afab039] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Indexed: 12/11/2022] Open
Abstract
Obese older people are more likely to be frail than those with a normal body mass index (BMI), but the results of individual studies have been inconsistent. We conducted a systematic review and meta-analysis to clarify the association between obesity and the risk of frailty, and whether there was a relationship between BMI and frailty, in community-dwelling older adults aged ≥60 years. Eight databases (PubMed/MEDLINE, EMBASE, EBSCO, CINAHL, Scopus, Cochrane Library and Web of Science) were systematically searched from inception to August 2020. Relative risks for incident frailty were pooled using a random-effects model. We found a positive association between abdominal obesity and frailty [relative risk (RR) = 1.57, 95% confidence interval (CI) 1.29-1.91, I2 = 48.1%, P = 0.086, six observational studies, 18,764 subjects]. People in the higher category of waist circumference had a pooled 57% higher risk of frailty than those with a normal waist circumference. In addition, a total of 12 observational studies comprising 37,985 older people were included in the meta-analysis on the relationship between BMI and the risk for frailty. Taking the normal BMI as the reference group, the pooled RR of frailty risk ranged from 1.45 (95% CI 1.10-1.90, I2 = 83.3%; P < 0.01) for the underweight group, to 0.93 (95% CI 0.85-1.02, I2 = 34.6%; P = 0.114) for the overweight group and to 1.40 (95% CI 1.17-1.67, I2 = 86.1%; P < 0.01) for the obese group. We have shown that obesity or underweight is associated with an increased risk of frailty in community-dwelling older adults.
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Affiliation(s)
- Linli Yuan
- Medical School, Nanjing University, Nanjing 210093, PR China
| | - Meilian Chang
- Pediatric Outpatient Clinic, Changzheng People's Hospital of Shangqiu City, Shangqiu 476000, PR China
| | - Jing Wang
- Fudan University School of Nursing, Shanghai 200032, PR China
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Oni E, Ogunmoroti O, Allen N, A-Mallah MH, Blankstein R, Martin SS, Zeb I, Cushman M, Joshi PH, Budoff MJ, Blaha MJ, Blumenthal RS, Veledar E, Nasir K. Life's Simple 7 and Nonalcoholic Fatty Liver Disease: The Multiethnic Study of Atherosclerosis. Am J Med 2021; 134:519-525. [PMID: 33285128 DOI: 10.1016/j.amjmed.2020.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The American Heart Association (AHA) has defined Life's Simple 7 (LS7) as a measure of overall cardiovascular health . Nonalcoholic fatty liver disease (NAFLD) has been involved as a risk factor for cardiovascular disease. We evaluated the association between LS7 and NAFLD. METHODS We evaluated participants form the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Cardiovascular health score was calculated from the Life's Simple 7 metrics. A score of 0-8 was considered inadequate, 9-10 average, and 11-14 optimal. NAFLD was defined using noncontrast cardiac computed tomography (CT) and a liver/spleen attenuation ratio (L/S) < 1. Multivariable regression were performed to evaluate the association. RESULTS Our cross-sectional analysis of 3901 participants showed 19% (n = 747) had optimal cardiovascular health, 33% (n = 1270) had average, and 48% (n = 1884) had inadequate. White participants were most likely to have an optimal score (51%, n = 378), whereas African American participants had the lowest proportion with optimal scores (16%, n = 120; P < 0.001). The overall prevalence of NAFLD was 18% with a distribution of 7%, 14%, and 25% in the optimal, average, and inadequate score categories, respectively (P < 0.001). Adjusted for risk factors, average and optimal health categories had lower odds of NAFLD compared to those with inadequate scores: odds ratio for average, 0.44 (95% confidence interval 0.36-0.54); optimal, odds ratio 0.19 (95% confidence interval 0.14-0.26). This association was similar across gender, race and age groups. CONCLUSION A more favorable cardiovascular health score was associated with a lower prevalence of NAFLD. This study may suggest a potential of Life's Simple 7 in the prevention of liver disease.
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Affiliation(s)
- Ebenezer Oni
- Division of Cardiology, Heart and Vascular Institute, Albert Einstein Medical Center, Philadelphia, Penn.
| | - Oluseye Ogunmoroti
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Md
| | - Norrina Allen
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Ill
| | - Mouaz H A-Mallah
- Preventive Cardiology, Houston Methodist DeBakey Cardiology Associates, Houston Tex
| | - Ron Blankstein
- Departments of Medicine (Cardiovascular Division) and Radiology, Brigham and Women's Hospital, Boston, Mass
| | - Seth S Martin
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Md
| | - Irfan Zeb
- Division of Cardiology, Heart and Vascular Institute at West Virginia University Hospital, Morgantown, WVa
| | - Mary Cushman
- Departments of Medicine and Pathology and Laboratory Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vt
| | - Parag H Joshi
- Department of Internal Medicine, Division of Cardiology, UT Southwestern Medical Center, Dallas, Tex
| | - Matthew J Budoff
- Division of Cardiology, Harbor-UCLA Medical Center, Torrance, Calif
| | - Michael J Blaha
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Md
| | - Roger S Blumenthal
- The Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Baltimore, Md
| | - Emir Veledar
- Corporate Clinical Administration, Baptist Health South Florida, Miami, Fla
| | - Khurram Nasir
- Preventive Cardiology, Houston Methodist DeBakey Cardiology Associates, Houston Tex
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12
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Han X, Jiang Z, Li Y, Wang Y, Liang Y, Dong Y, Tang S, Du Y, Qiu C. Sex disparities in cardiovascular health metrics among rural-dwelling older adults in China: a population-based study. BMC Geriatr 2021; 21:158. [PMID: 33663413 PMCID: PMC7934439 DOI: 10.1186/s12877-021-02116-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 02/24/2021] [Indexed: 02/06/2023] Open
Abstract
Background Cardiovascular health (CVH) metrics among Chinese older adults are poorly understood. We investigated sex disparities in CVH metrics and their management among rural-dwelling older adults in China. Methods This community-based study included 5026 participants (age ≥ 65 years; 57.2% women) in the baseline survey of a multimodal intervention study in rural China. In March–September 2018, data were collected through face-to-face interviews, clinical examinations, and laboratory tests. We defined six CVH metrics (three behavioral factors—smoking, body mass index, and physical activity; three biological factors—blood pressure, total cholesterol, and blood glucose) following the modified American Heart Association’s recommendations. We performed descriptive analysis separately for men and women. Results Of all participants, only 0.8% achieved ideal levels in all six CVH metrics. Men were more likely than women to have ideal levels in all CVH metrics but smoking. Women had higher prevalence of ideal global (9.7% vs. 7.8%) and behavioral (18.3% vs. 9.5%) CVH metrics (p < 0.001), whereas men had higher prevalence of ideal biological CVH metrics (5.4% vs. 3.5%, p < 0.001). The prevalence of ideal global and behavioral CVH metrics increased with age in both women and men (p for trend< 0.001). Women were more likely to be aware of their hypertension and diabetes, and to receive antihypertensive treatment, while men were more likely to achieve the goal of high cholesterol treatment (p < 0.05). Conclusions The CVH metrics among older adults living in the rural communities in China are characterized by an extremely low proportion of optimal global CVH metrics and distinct sex differences, alongside poor management of major biological risk factors. Trial registration ChiCTR1800017758 (Aug 13, 2018). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02116-x.
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Affiliation(s)
- Xiaolei Han
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China
| | - Ziying Jiang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China
| | - Yuanjing Li
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Yajun Liang
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China. .,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, People's Republic of China.
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, No. 324 Jingwuweiqi Road, Jinan, 250021, Shandong, People's Republic of China.,Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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13
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Ultra-Processed Food Consumption Is Associated with Abdominal Obesity: A Prospective Cohort Study in Older Adults. Nutrients 2020; 12:nu12082368. [PMID: 32784758 PMCID: PMC7468731 DOI: 10.3390/nu12082368] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Ultra-processed food (UPF) consumption has been associated with increased incidence of cardiovascular disease and its risk factors. The aim of this study was to assess, for the first time in the literature, the prospective association between UPF consumption and the incidence of abdominal obesity (AO) in older adults. METHODS The study sample consists of 652 participants in the Seniors Study on Nutrition and Cardiovascular Risk in Spain: Seniors-ENRICA-1 study, (mean age 67, 44% women). At baseline, standardized anthropometric measurements were collected (including abdominal circumference). After a median follow-up of six years, the abdominal circumference was measured again, and the incidence of abdominal obesity (AO) was calculated, defined as an abdominal perimeter ≥102 cm in men and ≥88 cm in women. At baseline, dietary information was collected using a computerized and validated dietary history. Information was obtained on the usual diet in the previous year. A total number of 880 foods were classified according to their degree of processing following the NOVA classification. Foods or drinks formulated mostly or entirely from substances derived from foods, with little or no presence of the unaltered original food were classified as UPF. For each participant, the percentage of energy from UPF was derived and sex-specific tertiles were calculated. Logistic regression models were built and adjusted for sociodemographic, lifestyle, morbidity, and drug treatment variables. RESULTS Among those participants without AO at baseline, 177 developed AO during follow-up. The average consumption of UPF was 17% of total energy (7% in the first tertile; 29% in the third tertile). The odds ratio (95% confidence interval) for incident AO risk when compared to the lowest tertile was: 1.55 (0.99-2.44) for the second tertile of UPF consumption and 1.62 (1.04-2.54) for the third tertile; p for linear trend: 0.037. Results remained statistically significant after adjusting for potential dietary confounding factors such as fiber consumption, the intake of very long chain omega-3 fatty acids and adherence to the Mediterranean diet. CONCLUSIONS A higher UPF consumption is positively associated with incident AO in older adults in Spain. These findings extend the current evidence of the detrimental effect of UPF consumption on cardiometabolic health.
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14
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Rempe HM, Calvani R, Marzetti E, Picca A, Sieber CC, Freiberger E, Landi F. Are Health Behaviors and Self-Rated Health Related to Cardiovascular Health and Functional Performance? Results from the Lookup 7+ Cross-Sectional Survey among Persons Aged 65+. J Nutr Health Aging 2020; 24:379-387. [PMID: 32242205 DOI: 10.1007/s12603-020-1342-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Cardiovascular health (CVH) and physical performance (PP) are key factors of successful ageing. This study investigated whether self-reported CVH behaviours and self-rated health (SRH) are related to ideal CVH and PP. DESIGN Cross-sectional survey. SETTING Public places in Italy (e.g. exhibitions, malls, health promotion campaigns), outside of conventional healthcare settings. PARTICIPANTS 1415 community-living persons aged 65+ years (mean age 72.2 ± 5.4; 58.4% female). MEASUREMENTS Three ideal CVH behaviors [regular physical activity (PA), healthy diet, no smoking] and SRH (1 excellent - 4 poor) were assessed through a brief questionnaire. Four ideal CVH factors [iBMI ≤ 25 kg/m2, untreated random total blood cholesterol ≤200 mg/dl, absence of diabetes (untreated random blood glucose ≤200 mg/dl), untreated blood pressure (iBP) <140/90mmHg] and two ideal PP factors [grip strength (iGrip), 5-repetition chair-stand test <10 seconds (iStand)] were measured. RESULTS Adjusted for age and gender, regular PA was positively related to CVH factor score (β = 0.1; p = < .001), iBMI (OR = 1.8; 95% CI = 1.5-2.3), iBP (OR = 1.3; 95% CI = 1.1-1.6) and iStand (OR = 1.6; 95% CI = 1.3-2.1). Healthy diet was positively related to CVH factor score (β = 0.1; p = < .05) and iGrip (OR = 1.4; 95% CI = 1.1-1.8). Participants rating SRH as "good" (OR = 2.0; 95% CI = 1.1-3.9) and "not so good" (OR = 2.3; 95% CI = 1.2-4.5) met iDiabetes more often than those with poor SRH. Moreover, iStand (OR = 3.2; 95% CI = 1.6-6.6) and iGrip (OR = 4.2; 95% = CI 2.0-8.8) were more prevalent among participants with excellent SRH compared with those with poor SRH. CONCLUSIONS Physical activity, diet and self-rated health may provide quick and easy-to-assess metrics to identify persons aged 65+ years at risk of cardiovascular events and functional impairment, who could particularly benefit from engaging in health promotion programs.
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Affiliation(s)
- H M Rempe
- Hanna M. Rempe, Kobergerstraße 60, 90408 Nürnberg, Germany, E-mail:
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15
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Kehler DS, Theou O. The impact of physical activity and sedentary behaviors on frailty levels. Mech Ageing Dev 2019; 180:29-41. [PMID: 30926562 DOI: 10.1016/j.mad.2019.03.004] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 03/12/2019] [Accepted: 03/25/2019] [Indexed: 12/17/2022]
Abstract
Heterogeneity in aging can be explained by frailty. Lifestyle behaviors such as physical activity can help manage frailty levels. Conversely, sedentary behaviours are associated with frailty independently of physical activity. Here, we summarize epidemiological and clinical trial evidence concerning the impact of physical activity and sedentary behaviors on frailty levels. We also analysed the National Health and Nutrition Examination Survey (NHANES) data to describe physical activity and sedentary behavior accumulation patterns across frailty levels and their impact on mortality risk. The few prospective and intervention studies demonstrate that higher physical activity levels are associated with a lower incidence of frailty. There are no interventions published which limit sedentary behaviors to manage frailty. Using the NHANES data we demonstrate that individuals are less likely to meet physical activity guidelines and are more likely to accumulate sedentary time in prolonged bouts. Prolonged sedentary bouts and total sedentary time were associated with a higher mortality risk in frail individuals but not in the fit group. Non-bouted sedentary time was not associated with mortality risk. Our review and novel data suggest that there is a need for more intervention studies which focus on increasing physical activity or minimizing sedentary time to manage frailty levels.
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Affiliation(s)
| | - Olga Theou
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
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16
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Poorer cardiovascular health is associated with psychiatric comorbidity: results from the ELSA-Brasil Study. Int J Cardiol 2019; 274:358-365. [DOI: 10.1016/j.ijcard.2018.06.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/05/2018] [Accepted: 06/11/2018] [Indexed: 02/08/2023]
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17
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Peng TC, Wang YC, Chiu CH, Wang CC, Chen WL, Yang HF. Association between Cardiovascular Health Metrics and Frailty in a Taiwanese Population. JOURNAL OF MEDICAL SCIENCES 2019. [DOI: 10.4103/jmedsci.jmedsci_19_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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18
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Peng Y, Cao S, Yao Z, Wang Z. Prevalence of the cardiovascular health status in adults: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2018; 28:1197-1207. [PMID: 30360955 DOI: 10.1016/j.numecd.2018.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The American Heart Association has outlined seven cardiovascular health (CVH) metrics, including smoking, body mass index, physical activity, dietary pattern, total cholesterol, and fasting plasma glucose, to define and monitor CVH status. Our study was to evaluate the global CVH in adults. METHODS AND RESULTS We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and reference lists of relevant articles for studies published between 1 January 2010 and 30 June 2018. Included studies should report the proportions of ideal status for the seven CVH metrics and/or provide the prevalence of overall poor (having 0-2 ideal metrics) or ideal (having 5-7 ideal metrics) CVH status in adults. 88 articles were identified: 75 for the prevalence of ideal CVH metrics, 58 for the proportion of overall poor CVH status, and 55 for the proportion of overall ideal CVH status. Smoking had the highest prevalence of ideal status (69.1%) while dietary pattern has the lowest (12.1%). 32.2% and 19.6% of participants had overall poor and ideal CVH, respectively. Females and young adults had better CVH status when compared to males and older adults. There existed regional variations in ideal CVH metrics and overall CVH status. The overall CVH status had improved over study time. CONCLUSION The prevalence of ideal status was low for some metrics, such as dietary pattern, and the overall CVH status was still unsatisfactory. We should continue to measure the CVH status and carry out lifestyle interventions to improve the CVH status in the whole population.
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Affiliation(s)
- Y Peng
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia.
| | - S Cao
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Herston, Australia
| | - Z Yao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Z Wang
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia
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Landi F, Calvani R, Picca A, Tosato M, D'Angelo E, Martone AM, Serafini E, Ortolani E, Savera G, Salini S, Acampora N, Bernabei R, Marzetti E. Relationship between cardiovascular health metrics and physical performance in community-living people: Results from the Longevity check-up (Lookup) 7+ project. Sci Rep 2018; 8:16353. [PMID: 30397361 PMCID: PMC6218517 DOI: 10.1038/s41598-018-34746-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/22/2018] [Indexed: 11/09/2022] Open
Abstract
Cardiovascular health metrics (CHMs) may predict disability independent of vascular events. Though, the link between CHMs and physical performance is unclear. This relationship was explored using data from the Longevity check-up (Lookup) 7+ project. Lookup 7+ is an ongoing cross-sectional survey conducted in unconventional settings across Italy. People who are at least 18-year-old and provide written informed consent are eligible. CHMs [i.e., smoking status, healthy diet, body mass index (BMI), blood pressure, blood cholesterol, and diabetes status] are assessed through closed questions and objective measurements. Physical performance is measured via the 5-repetition chair-stand test. Analyses included 7446 participants (55.5 ± 14.9 years; 56% women). Physical performance positively correlated with CHMs scores, such that participants who scored higher (6-7 points) completed the chair-stand test about 2 s faster than those scoring lower (1-2 points). In fully adjusted analysis, better physical performance was more frequently observed in younger, non-smoking, physically active men, with ideal BMI, and no diabetes. Our findings indicate a gradient of better physical function with increasing CHMs scores. Future investigations should establish the longitudinal effect of unhealthy behaviours and cardiovascular risk factors on physical performance and verify whether implementation of large-scale primordial cardiovascular prevention may positively impact physical fitness.
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Affiliation(s)
- Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Riccardo Calvani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Anna Picca
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy.
| | - Matteo Tosato
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Emanuela D'Angelo
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Anna Maria Martone
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Elisabetta Serafini
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Elena Ortolani
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Giulia Savera
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Sara Salini
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Nicola Acampora
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Roberto Bernabei
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, 00168, Italy
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20
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Wong TY, Massa MS, O'Halloran AM, Kenny RA, Clarke R. Cardiovascular risk factors and frailty in a cross-sectional study of older people: implications for prevention. Age Ageing 2018; 47:714-720. [PMID: 29796607 PMCID: PMC6108388 DOI: 10.1093/ageing/afy080] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Indexed: 12/13/2022] Open
Abstract
Objective to examine the associations of cardiovascular disease (CVD) and cardiovascular risk factors with frailty. Design a cross-sectional study. Setting the Irish Longitudinal Study on Ageing (TILDA). Participants frailty measures were obtained on 5,618 participants and a subset of 4,330 participants with no prior history of CVD. Exposures for observational study cardiovascular risk factors were combined in three composite CVD risk scores (Systematic Coronary Risk Evaluation [SCORE], Ideal Cardiovascular Health [ICH] and Cardiovascular Health Metrics [CHM]). Main outcome measures a frailty index (40-items) was used to screen for frailty. Methods the associations of CVD risk factors with frailty were examined using logistic regression. Results overall, 16.4% of participants had frailty (7.6% at 50-59 years to 42.5% at 80+ years), and the prevalence was higher in those with versus those without prior CVD (43.0% vs. 10.7%). Among those without prior CVD, mean levels of CVD risk factors were closely correlated with higher frailty index scores. Combined CVD risk factors, assessed using SCORE, were linearly and positively associated with frailty. Compared to low-to-moderate SCOREs, the odds ratio (OR) (95% confidence interval, CI) of frailty for those with very high risk was 3.18 (2.38-4.25). Conversely, ICH was linearly and inversely associated with frailty, with an OR for optimal health of 0.29 (0.21-0.40) compared with inadequate health. Conclusions the concordant positive associations of SCORE and inverse associations of ICH and CHM with frailty highlight the potential importance of optimum levels of CVD risk factors for prevention of disability in frail older people.
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Affiliation(s)
- Tsz Yan Wong
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - M Sofia Massa
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Rose Ann Kenny
- TILDA, Department of Medical Gerontology, Trinity College, Dublin, Ireland
| | - Robert Clarke
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
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21
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Arias-Fernández L, Machado-Fragua MD, Graciani A, Guallar-Castillón P, Banegas JR, Rodríguez-Artalejo F, Lana A, Lopez-Garcia E. Prospective Association Between Nut Consumption and Physical Function in Older Men and Women. J Gerontol A Biol Sci Med Sci 2018; 74:1091-1097. [DOI: 10.1093/gerona/gly171] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Indexed: 12/17/2022] Open
Affiliation(s)
- Lucía Arias-Fernández
- Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, IdiPAZ, Universidad Autónoma de Madrid, Spain
| | - Marcos D Machado-Fragua
- Department of Preventive Medicine and Public Health, School of Medicine, IdiPAZ, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Auxiliadora Graciani
- Department of Preventive Medicine and Public Health, School of Medicine, IdiPAZ, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Pilar Guallar-Castillón
- Department of Preventive Medicine and Public Health, School of Medicine, IdiPAZ, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, IdiPAZ, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, IdiPAZ, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
| | - Alberto Lana
- Department of Medicine, Preventive Medicine and Public Health Area, School of Medicine and Health Sciences, Universidad de Oviedo, Spain
- Department of Preventive Medicine and Public Health, School of Medicine, IdiPAZ, Universidad Autónoma de Madrid, Spain
| | - Esther Lopez-Garcia
- Department of Preventive Medicine and Public Health, School of Medicine, IdiPAZ, Universidad Autónoma de Madrid, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain
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Affiliation(s)
- Waleed T Kayani
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Christie M Ballantyne
- Department of Medicine, Baylor College of Medicine, Houston, TX .,Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, TX
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Sinclair AJ, Abdelhafiz AH, Rodríguez-Mañas L. Frailty and sarcopenia - newly emerging and high impact complications of diabetes. J Diabetes Complications 2017; 31:1465-1473. [PMID: 28669464 DOI: 10.1016/j.jdiacomp.2017.05.003] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 05/04/2017] [Accepted: 05/06/2017] [Indexed: 12/14/2022]
Abstract
Diabetes increases the risk of physical dysfunction and disability. Diabetes-related complications and coexisting morbidities partially explain the deterioration in physical function. The decline in muscle mass, strength and function associated with diabetes leads to sarcopenia, frailty and eventually disability. Frailty acts as a mediator in the pathogenesis of disability in older people with diabetes and its measurement in routine daily practice is recommended. Frailty is a dynamic process which progresses from a robust condition to a pre-frail stage then frailty and eventually disability. Therefore, a multimodal intervention which includes adequate nutrition, exercise training, good glycaemic control and the use of appropriate hypoglycemic medications may help delay or prevent the progression to disability.
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Affiliation(s)
- Alan J Sinclair
- University of Aston and Foundation for Diabetes Research in Older People, Diabetes Frail Ltd, Droitwich Spa, WR9 0QH, UK.
| | - Ahmed H Abdelhafiz
- Department of Elderly Medicine, Rotherham General Hospital, Moorgate Road, Rotherham, UK
| | - Leocadio Rodríguez-Mañas
- Hospital Universitario de Getafe, Department of Geriatrics and School of Health Sciences, Universidad Europea de Madrid, Spain
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Fuentes F, Palomo I, Fuentes E. Platelet oxidative stress as a novel target of cardiovascular risk in frail older people. Vascul Pharmacol 2017; 93-95:14-19. [PMID: 28705733 DOI: 10.1016/j.vph.2017.07.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/18/2017] [Accepted: 07/10/2017] [Indexed: 12/13/2022]
Abstract
The average lifespan of humans and the percentage of people entering the 65 and older age group are growing rapidly. Within this age group, cardiovascular diseases (CVD) increase steeply and are the most common cause of death. During aging, experimental and clinical studies support the pivotal role played by reactive oxidant species in the mechanism of platelet activation. Frailty has been implicated as a causative and prognostic factor in patients with CVD. Oxidative stress is increased in frail older people, and may lead to accelerated aging and higher incidence of oxidative diseases such as CVD. The present article aims to highlight the relative contribution of platelet oxidative stress as a key target of frailty in elderly people with CVD.
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Affiliation(s)
- Francisco Fuentes
- Becario Obstetricia y Ginecología Universidad Católica del Maule, Talca, Chile
| | - Iván Palomo
- Platelet Research Center, Department of Clinical Biochemistry and Immunohaematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca, Talca, Chile.
| | - Eduardo Fuentes
- Platelet Research Center, Department of Clinical Biochemistry and Immunohaematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca, Talca, Chile; Núcleo Científico Multidisciplinario, Universidad de Talca, Talca, Chile.
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García-Esquinas E, Andrade E, Martínez-Gómez D, Caballero FF, López-García E, Rodríguez-Artalejo F. Television viewing time as a risk factor for frailty and functional limitations in older adults: results from 2 European prospective cohorts. Int J Behav Nutr Phys Act 2017; 14:54. [PMID: 28446189 PMCID: PMC5406978 DOI: 10.1186/s12966-017-0511-1] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Accepted: 04/10/2017] [Indexed: 12/14/2022] Open
Abstract
Background Sedentariness is an important risk factor for poor health. The main objective of this work was to examine the prospective association between television viewing time and indicators of physical function, mobility, agility, and frailty. Methods Data came from two independent cohorts of community-dwelling older adults: the Seniors-ENRICA (n = 2392, 3.5 year follow-up), and the ELSA (n = 3989, 3.9 year follow-up). At baseline, television viewing and other sedentary behaviors were ascertained using interviewer-administered questionnaires. In the Seniors-ENRICA cohort overall physical function at baseline and follow-up was assessed using the physical component summary (PCS) of the SF-12 Health Survey. Measures for incident mobility and agility limitations in both cohorts were based on standardized questions, and incident frailty was measured with the Fried criteria. Analyses were adjusted for the main confounders, including physical activity at baseline. Results across cohorts were pooled using a random effects model. Results Lower (worse) scores in the PCS were observed among those in the highest (vs. the lowest) tertile of television viewing time (b-coefficient:-1.66; 95% confidence interval:-2.81,-0.52; p-trend = 0.01). Moreover, the pooled odds ratios (95% CIs) for mobility limitations for the second and third (vs. the lowest) tertile of television viewing were 1.00 (0.84, 1.20) and 1.17 (1.00, 1.38); p-trend = 0.12, respectively. The corresponding results for agility limitations were 1.18 (0.97, 1.44) and 1.25 (1.03, 1.51); p-trend = 0.02. Results for incident frailty were 1.10 (0.80, 1.51) and 1.47 (1.09, 1.97); p-trend = 0.03. No association between other types of sedentary behavior (time seated at the computer, while commuting, lying in the sun, listening to music/reading, internet use) and risk of functional limitations was found. Conclusions Among older adults, longer television viewing time is prospectively associated with limitations in physical function independently of physical activity. Electronic supplementary material The online version of this article (doi:10.1186/s12966-017-0511-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Esther García-Esquinas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.
| | - Elena Andrade
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain
| | - David Martínez-Gómez
- Department of Physical Education, Sport and Human Movement, Faculty of Teacher Training and Education, Universidad Autónoma de Madrid, Madrid, Spain
| | - Francisco Félix Caballero
- Department of Psychiatry, Universidad Autónoma de Madrid and CIBER of Mental Health (CIBERSAM), Madrid, Spain
| | - Esther López-García
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.,IMDEA-Food Institute. CEI UAM+CSIC, Madrid, Spain
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Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation 2017; 135:e146-e603. [PMID: 28122885 PMCID: PMC5408160 DOI: 10.1161/cir.0000000000000485] [Citation(s) in RCA: 6039] [Impact Index Per Article: 862.7] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Affiliation(s)
- Jonathan Afilalo
- Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
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