ABSTRACT
BACKGROUND: Vascular function (VF) is a general term used to describe the regulation of blood flow, arterial pressure, capillary recruitment, filtration and central venous pressure, it´s well known that age has direct effects on the VF, and this may affect the frailty status. OBJECTIVES: To analyse the association between Frailty Trait Scale 5 (FTS 5) with VF and its changes at values below and above a nadir. DESIGN: Prospective population-based cohort study. SETTING AND PARTICIPANTS: Data from 1.230 patients were taken from the first wave (2006-2009) of the Toledo Study for Healthy Aging. MEASUREMENTS: Frailty was evaluated using FTS 5, which evaluates 5 items: Body mass index, progressive Romberg, physical activity, usual gait speed and hand grip strength. VF was assessed using the ankle-brachial index (ABI) as an indirect measure of VF. Screening for cardiovascular and cerebrovascular disease was also performed by self-reporting and by searching medical records, and was used as exclusion criteria. RESULTS: The optimal ABI cut-off point that maximized the adjusted R2 was 1.071. We observed a statistically significant association for FTS 5 score above and below the ABI cut-off points. For every tenth that the ABI decreased below the cut-off point the patient had an increase in the FTS 5 score of 0.47 points and in every tenth that increased above the cut-off point the increase in the FTS 5 score was 0.41 points. Of all FTS 5 items, the gait speed was the only item that showed a significant association with an ABI changes 0.28 and 0.21 points for every tenth below and above the cut-off point, respectively. CONCLUSIONS: Frailty is highly associated with VF. In addition, FTS 5 and its gait speed criteria are useful to detect VF impairments, via changes in ABI.
Subject(s)
Frailty , Healthy Aging , Humans , Ankle Brachial Index , Frailty/diagnosis , Cohort Studies , Prospective Studies , Hand StrengthABSTRACT
INTRODUCTION: The executive function is a complex set of skills affected during the aging process and translate into subclinical cerebrovascular disease. Postural instability or motor slowness are some clinical manifestations, being consubstantial with the frailty phenotype, genuine expression of aging. Executive dysfunction is also considered a predictor of adverse health events in the elderly. AIM: To study whether the executive dysfunction can be used as an early marker for frailty and the viability of use as a predictor of mortality, hospitalization and/or disability in a Mediterranean population. DESIGN: A population-based cohort study using data from the Toledo Study for Healthy Aging (TSHA). METHODS: 1690 Spanish elders aged ≥65 years underwent a neuropsychological evaluation in order to measure executive function. To assess whether the accumulation of dysfunctions (in severity and amplitude) could increase the predictive value of adverse health events in relation to each dimension separately an executive dysfunction cumulative index was constructed. Cox proportional hazards model was used to examine mortality and hospitalization over 5.02 and 3.1 years of follow-up, respectively. RESULTS: Executive dysfunction is a powerful predictor of mortality, frailty and disability. Cumulative differences in executive function are associated with high risk of frailty and disability, thus, for each one point increment in the executive function index, the risk of death increased by 7 %, frailty by 13% and disability by 11% (P<0.05). Moreover, the executive impairment exhibits a strong positive tendency with age, comorbidity and mortality. CONCLUSIONS: Cumulative differences in four executive dimensions widely used in clinical practice improves the ability to predict frailty and disability compared to each dimension separately.
Subject(s)
Disabled Persons , Executive Function/physiology , Frailty/diagnosis , Aged , Cohort Studies , Comorbidity , Female , Frail Elderly , Humans , Male , Risk FactorsABSTRACT
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