Frailty and Cardiovascular Disease: Potential Role of Gait Speed in Surgical Risk Stratification in Older Adults

Overview

Journal J Geriatr Cardiol

Specialty Geriatrics

Date 2015 Feb 14

PMID 25678904

Citations 21

Authors

Michael A Chen

Affiliations

Soon will be listed here.

Abstract

Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. Gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies (e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis).

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References

Retornaz F, Monette J, Batist G, Monette M, Sourial N, Small D . Usefulness of frailty markers in the assessment of the health and functional status of older cancer patients referred for chemotherapy: a pilot study. J Gerontol A Biol Sci Med Sci. 2008; 63(5):518-22. DOI: 10.1093/gerona/63.5.518. View

Bernstein A, Parsonnet V . Bedside estimation of risk as an aid for decision-making in cardiac surgery. Ann Thorac Surg. 2000; 69(3):823-8. DOI: 10.1016/s0003-4975(99)01424-1. View

Cigolle C, Ofstedal M, Tian Z, Blaum C . Comparing models of frailty: the Health and Retirement Study. J Am Geriatr Soc. 2009; 57(5):830-9. DOI: 10.1111/j.1532-5415.2009.02225.x. View

Shahian D, OBrien S, Filardo G, Ferraris V, Haan C, Rich J . The Society of Thoracic Surgeons 2008 cardiac surgery risk models: part 3--valve plus coronary artery bypass grafting surgery. Ann Thorac Surg. 2009; 88(1 Suppl):S43-62. DOI: 10.1016/j.athoracsur.2009.05.055. View

Fried L, Tangen C, Walston J, Newman A, Hirsch C, Gottdiener J . Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001; 56(3):M146-56. DOI: 10.1093/gerona/56.3.m146. View

Khan H, Kalogeropoulos A, Georgiopoulou V, Newman A, Harris T, Rodondi N . Frailty and risk for heart failure in older adults: the health, aging, and body composition study. Am Heart J. 2013; 166(5):887-94. PMC: 3844525. DOI: 10.1016/j.ahj.2013.07.032. View

Speziale G, Nasso G, Barattoni M, Bonifazi R, Esposito G, Coppola R . Operative and middle-term results of cardiac surgery in nonagenarians: a bridge toward routine practice. Circulation. 2010; 121(2):208-13. DOI: 10.1161/CIRCULATIONAHA.108.807065. View

Rathore S, Weinfurt K, Foody J, Krumholz H . Performance of the Thrombolysis in Myocardial Infarction (TIMI) ST-elevation myocardial infarction risk score in a national cohort of elderly patients. Am Heart J. 2005; 150(3):402-10. PMC: 2790534. DOI: 10.1016/j.ahj.2005.03.069. View

Hubbard R, Woodhouse K . Frailty, inflammation and the elderly. Biogerontology. 2010; 11(5):635-41. DOI: 10.1007/s10522-010-9292-5. View

10.

Bossoni S, Mazziotti G, Gazzaruso C, Martinelli D, Orini S, Solerte S . Relationship between instrumental activities of daily living and blood glucose control in elderly subjects with type 2 diabetes. Age Ageing. 2007; 37(2):222-5. DOI: 10.1093/ageing/afm158. View

11.

Chou C, Hwang C, Wu Y . Effect of exercise on physical function, daily living activities, and quality of life in the frail older adults: a meta-analysis. Arch Phys Med Rehabil. 2012; 93(2):237-44. DOI: 10.1016/j.apmr.2011.08.042. View

12.

Yao X, Hamilton R, Weng N, Xue Q, Bream J, Li H . Frailty is associated with impairment of vaccine-induced antibody response and increase in post-vaccination influenza infection in community-dwelling older adults. Vaccine. 2011; 29(31):5015-21. PMC: 3129421. DOI: 10.1016/j.vaccine.2011.04.077. View

13.

Walston J, Hadley E, Ferrucci L, Guralnik J, Newman A, Studenski S . Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc. 2006; 54(6):991-1001. DOI: 10.1111/j.1532-5415.2006.00745.x. View

14.

Nashef S, Roques F, Sharples L, Nilsson J, Smith C, Goldstone A . EuroSCORE II. Eur J Cardiothorac Surg. 2012; 41(4):734-44. DOI: 10.1093/ejcts/ezs043. View

15.

Ekerstad N, Swahn E, Janzon M, Alfredsson J, Lofmark R, Lindenberger M . Frailty is independently associated with short-term outcomes for elderly patients with non-ST-segment elevation myocardial infarction. Circulation. 2011; 124(22):2397-404. DOI: 10.1161/CIRCULATIONAHA.111.025452. View

16.

Klein B, Klein R, Knudtson M, Lee K . Frailty, morbidity and survival. Arch Gerontol Geriatr. 2005; 41(2):141-9. DOI: 10.1016/j.archger.2005.01.002. View

17.

Morais J, Ross R, Gougeon R, Pencharz P, Jones P, Marliss E . Distribution of protein turnover changes with age in humans as assessed by whole-body magnetic resonance image analysis to quantify tissue volumes. J Nutr. 2000; 130(4):784-91. DOI: 10.1093/jn/130.4.784. View

18.

Ferrucci L, Guralnik J, Studenski S, Fried L, Cutler Jr G, Walston J . Designing randomized, controlled trials aimed at preventing or delaying functional decline and disability in frail, older persons: a consensus report. J Am Geriatr Soc. 2004; 52(4):625-34. DOI: 10.1111/j.1532-5415.2004.52174.x. View

19.

Dupuis J . Predicting outcomes in cardiac surgery: risk stratification matters?. Curr Opin Cardiol. 2008; 23(6):560-7. DOI: 10.1097/HCO.0b013e32831217ed. View

20.

Leng S, Xue Q, Tian J, Walston J, Fried L . Inflammation and frailty in older women. J Am Geriatr Soc. 2007; 55(6):864-71. DOI: 10.1111/j.1532-5415.2007.01186.x. View