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Aging and Disease    2018, Vol. 9 Issue (3) : 489-497     DOI: 10.14336/AD.2017.1125
Orginal Article |
Frailty in Older Adults with Cardiovascular Disease: Cause, Effect or Both?
Emma EF. Kleipool1,Emiel O. Hoogendijk2,Marijke C. Trappenburg1,M. Louis Handoko3,Martijn Huisman2,4,Mike JL. Peters1,Majon Muller1,*
1Department of Internal medicine and Geriatrics, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
2Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
3Department of Cardiology, VU University Medical Center, 1081 HV Amsterdam, The Netherlands
4Department of Sociology, VU University, 1081 HV Amsterdam, The Netherlands
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Abstract  

Cardiovascular disease (CVD) has been associated with an increased risk of frailty, but the direction of the association remains unclear. This study set out to examine the bidirectional longitudinal association between CVD and frailty over an extended period of time. Data are from 1432 older adults (aged 65-88yrs) of the Longitudinal Aging Study Amsterdam (LASA), who were followed for 17 years. At baseline and follow-up, CVD was assessed through self-report, medication use and medical records, and classified as angina pectoris, myocardial infarction, heart failure (HF), stroke, and peripheral artery disease. Throughout the study, frailty was assessed using Fried’s frailty criteria. Cox regression models showed that patients with HF had an increased frailty risk (HR 2.7; 95%CI: 1.5-5.1) after a median follow-up of 8.4 yrs. This finding was independent of potential confounders (age, sex, several comorbidities). Examinations of the reverse association revealed that frail older adults were not at risk of incident CVD. Of all older adults with CVD, those with HF have an increased risk of frailty and frail older adults do not have an increased risk of CVD. Our findings emphasize the need for cardiac rehabilitation programs evaluating the effect of physical exercise programs in order to prevent frailty and therewith improve quality of life and independence of care in CVD patients.

Keywords Frailty      older adults      cardiovascular disease      heart failure     
Corresponding Authors: Majon Muller   
Issue Date: 05 June 2018
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Emma EF. Kleipool
Emiel O. Hoogendijk
Marijke C. Trappenburg
M. Louis Handoko
Martijn Huisman
Mike JL. Peters
Majon Muller
Cite this article:   
Emma EF. Kleipool,Emiel O. Hoogendijk,Marijke C. Trappenburg, et al. Frailty in Older Adults with Cardiovascular Disease: Cause, Effect or Both?[J]. A&D, 2018, 9(3): 489-497.
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http://www.aginganddisease.org/EN/10.14336/AD.2017.1125     OR     http://www.aginganddisease.org/EN/Y2018/V9/I3/489
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