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      Frailty in Patients with Cardiovascular Disease: Why, When, and How to Measure

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      Publication date (Electronic):
      Journal: Current Cardiovascular Risk Reports
      Publisher: Current Science Inc.
      Keywords: Aging, Frailty, Cardiovascular diseases, Cardiac surgery

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          Abstract

          Frailty is a geriatric syndrome of impaired resistance to stressors due to a decline in physiologic reserve. Frailty and cardiovascular disease (CVD) share a common biological pathway, and CVD may accelerate the development of frailty. Frailty is identified in 25% to 50% of patients with CVD, depending on the frailty scale used and the population studied. Frail patients with CVD, especially those undergoing invasive procedures or suffering from coronary artery disease and heart failure, are more likely to suffer adverse outcomes as compared to their non-frail counterparts. Five-meter gait speed is a simple and effective way of objectively measuring frailty in patients with CVD and should be incorporated in risk assessment.

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          Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care.

          Linda P Fried, Luigi Ferrucci, Jonathan Darer … (2004)
          Three terms are commonly used interchangeably to identify vulnerable older adults: comorbidity, or multiple chronic conditions, frailty, and disability. However, in geriatric medicine, there is a growing consensus that these are distinct clinical entities that are causally related. Each, individually, occurs frequently and has high import clinically. This article provides a narrative review of current understanding of the definitions and distinguishing characteristics of each of these conditions, including their clinical relevance and distinct prevention and therapeutic issues, and how they are related. Review of the current state of published knowledge is supplemented by targeted analyses in selected areas where no current published data exists. Overall, the goal of this article is to provide a basis for distinguishing between these three important clinical conditions in older adults and showing how use of separate, distinct definitions of each can improve our understanding of the problems affecting older patients and lead to development of improved strategies for diagnosis, care, research, and medical education in this area.
          Article 0 comments Cited 356 times – based on 0 reviews     Review now
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            Physical performance measures in the clinical setting.

            Stephanie Studenski, Subashan Perera, Dennis H. Wallace … (2003)
            To assess the ability of gait speed alone and a three-item lower extremity performance battery to predict 12-month rates of hospitalization, decline in health, and decline in function in primary care settings serving older adults. Prospective cohort study. Primary care programs of a Medicare health maintenance organization (HMO) and Veterans Affairs (VA) system. Four hundred eighty-seven persons aged 65 and older. Lower extremity performance Established Population for Epidemiologic Studies of the Elderly (EPESE) battery including gait speed, chair stands, and tandem balance tests; demographics; health care use; health status; functional status; probability of repeated admission scale (Pra); and primary physician's hospitalization risk estimate. Veterans had poorer health and higher use than HMO members. Gait speed alone and the EPESE battery predicted hospitalization; 41% (21/51) of slow walkers (gait speed 1.0 m/s) (P <.0001). The relationship was stronger in the HMO than in the VA. Both performance measures remained independent predictors after accounting for Pra. The EPESE battery was superior to gait speed when both Pra and primary physician's risk estimate were included. Both performance measures predicted decline in function and health status in both health systems. Performance measures, alone or in combination with self-report measures, were more able to predict outcomes than self-report alone. Gait speed and a physical performance battery are brief, quantitative estimates of future risk for hospitalization and decline in health and function in clinical populations of older adults. Physical performance measures might serve as easily accessible "vital signs" to screen older adults in clinical settings.
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              Frailty in older adults: evidence for a phenotype

              LP Fried, C. TANGEN, J Walston … (2001)
              Article 0 comments Cited 285 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                : +1-514-3408222 , +1-514-2213785 , jonathan@afilalo.com
                Journal
                Journal ID (nlm-ta): Curr Cardiovasc Risk Rep
                Title: Current Cardiovascular Risk Reports
                Publisher: Current Science Inc. (New York )
                ISSN (Print): 1932-9520
                ISSN (Electronic): 1932-9563
                Publication date (Electronic): 2 August 2011
                Publication date PMC-release: 2 August 2011
                Publication date (Print): October 2011
                Volume: 5
                Issue: 5
                Pages: 467-472
                Affiliations
                Divisions of Cardiology and Clinical Epidemiology, Department of Medicine, SMBD-Jewish General Hospital, McGill University, 3755 Cote Ste Catherine, Montreal, Quebec H3T 1E2 Canada
                Article
                Publisher ID: 186
                DOI: 10.1007/s12170-011-0186-0
                PMC ID: 3165117
                PubMed ID: 21949560
                SO-VID: bf7d83cb-ccd4-46f4-9411-898afeffc914
                Copyright © © The Author(s) 2011
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                Subject: Article
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                issue-copyright-statement © Springer Science+Business Media, LLC 2011

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: cardiovascular diseases,cardiac surgery,aging,frailty
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: cardiovascular diseases, cardiac surgery, aging, frailty

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