Lorentzen Loomis (pepperice5)

Older adults with coronary artery disease (CAD) are at risk for frailty. However, little is known regarding transition in frailty measures over time or its impact on outcomes. We sought to determine the association of temporal change in frailty with long-term outcome in older adults with CAD. We re-assessed for phenotypic frailty using the Fried index (0 = not frail; 1-2 = pre-frail; ≥ 3 frail) in a cohort of CAD patients ≥ 65 years old at 2 time points 5 years apart. Factors associated with frailty worsening were assessed with scatterplots and outcomes estimated using the Kaplan-Meier method. Cox models were used to assess the risk of worsening frailty on outcome. There were 45 subjects that completed both baseline and 5-year Fried frailty assessment. Mean age was 74.6 ± 5.9 and 30 (67%) were men. Frailty incidence increased over time baseline (3% frail, 37% pre-frail); 5 years (10% frail, 40% pre-frail). Baseline factors were not predictors of worsening frailty score, while both slower walk time ( = 0.46; = 0.004) and diminishing grip strength ( = -0.39; = 0.01) were associated with worsening frailty transitions. In follow-up (median 5.2 years), long-term major adverse cardiac event (MACE) free survival ( = 0.12) or hospitalization ( = 0.98) was not different for those with worsening frailty score (referent improved/unchanged frailty). Frailty worsening had a trend towards increased risk of MACE (HR = 1.86; 95% CI 0.65-5.27, = 0.25). Frailty transitions, specifically, declines in walk time and grip strength, were strongly associated with worsening frailty score in a cohort of older adults with CAD than were baseline indices, though frailty change status was not independently associated with MACE outcomes. Frailty transitions, specifically, declines in walk time and grip strength, were strongly associated with worsening frailty score in a cohort of older adults with CAD than were baseline indices, though frailty change status was not independently associated with MACE outcomes. To examine the association of baseline waist circumference (WC) and changes in WC with cardiovascular disease (CVD) and all-cause mortality among elderly people. A total of 30,041 eligible participants were included from a retrospective cohort in China. The same questionnaire, anthropometric and laboratory measurements were performed at baseline (2010) and the first follow-up (2013). The percent change in WC between baseline and the first follow-up was calculated to evaluate three years change of WC. We collected the occurrence of CVD and all-cause death from the first follow-up to December 31, 2018. Restricted cubic splines and Cox proportional-hazards regression models were used to evaluate the relationship between baseline WC/ changes in WC and mortality. The dose-response relationships between baseline WC and CVD mortality were U- or J-shaped. In low WC group, compared with stable group, the fully adjusted hazard ratio (aHR) for CVD mortality was 1.60 (95% CI 1.24-2.06) in WC gain group among men. In normal WC group, the CVD mortality risk increased with WC gain (men aHR = 1.86, 95% CI 1.36-2.56; women aHR = 1.83, 95% CI 1.29-2.58). In moderate-high WC group, the CVD mortality risk increased with WC gain (men aHR = 1.76, 95% CI 1.08-2.88; women aHR = 1.46, 95% CI 1.04-2.05) and risk decreased with WC loss (men aHR = 0.54, 95% CI 0.30-0.98; women aHR = 0.59, 95% CI 0.37-0.96). For the elderly population, WC gain may increase CVD mortality risk regardless of baseline WC, whereas WC reduction could decrease the risk only in the moderate-high WC group. For the elderly population, WC gain may increase CVD mortality risk regardless of baseline WC, whereas WC reduction could decrease the risk only in the moderate-high WC group. Moderate to vigorous physical activity is recommended to prevent hypertension according to