Heart diseases and physical frailty in community-dwelling older populations

概要

Background: Heart diseases have been associated with an increased risk of physical frailty. However, the association remains ambiguous and both directions are plausible. This study set out to examine the direct association by a cross-sectional study and a longitudinal study between heart diseases and physical frailty in community-dwe11ing older populations.

Methods: Both studies recruited the participants from the septuagenarians, octogenarians, nonagenarians investigation with centenarians study (SONIC study) in three age groups including 70, 80, and 90 years old, respectively. The survey site assessed questionnaires on medical history, social factors, blood test, and physical examination. Physical frailty was defined base on slow gait speed or weak grip strength. Consequently, the first study was a cross-sectional study to examine the association between heart diseases, social factors, and physical frailty. A total 1,882 participants were recruited to the study. Associations were analyzed using multiple logistic regression with adjustments for covariate factors.
The second study was a longitudinal study to examine the association of walking speed and handgrip strength with coronary heart disease (CHD). A total 1272 older people free from heart diseases at the baseline. Any new case of CHD was obtained based on a self-reported doctor's diagnosis. Cox-proportion hazard models were adjusted for covariate factors to examine the CHD risk.

Results: First study indicated that heart diseases were associated with a slow gait speed. Frequency of going outdoors and direct interaction with relatives or friends were associated
with a slow gait speed. Living alone and frequency of direct interaction with relatives or friends were associated with physical frailty in subjects with heart disease. The second study indicated that walking speed was strongly associated with CHD risk after adjusting for all confounding factors in the total participants and women.

Conclusion： In this study, the result revealed that heart diseases were associated with physical frailty based on slow walking speed, and on the other hand, walking speed is a strong surrogate predictor of CHD risk among older people. Our findings emphasize the need to improve physical function in order to prevent frailty and heart disease among older populations.