Cargando…
Frailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study
BACKGROUND: Frailty is associated with greater mortality; however, whether frail patients primarily die of cardiovascular disease (CVD) or non‐CVD causes is unknown. METHODS AND RESULTS: We assessed the cause of death in relation to frailty status, measured at baseline, among 3135 community‐dwelling...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015334/ https://www.ncbi.nlm.nih.gov/pubmed/29728373 http://dx.doi.org/10.1161/JAHA.118.008974 |
_version_ | 1783334388631601152 |
---|---|
author | Adabag, Selcuk Vo, Tien N. Langsetmo, Lisa Schousboe, John T. Cawthon, Peggy M. Stone, Katie L. Shikany, James M. Taylor, Brent C. Ensrud, Kristine E. |
author_facet | Adabag, Selcuk Vo, Tien N. Langsetmo, Lisa Schousboe, John T. Cawthon, Peggy M. Stone, Katie L. Shikany, James M. Taylor, Brent C. Ensrud, Kristine E. |
author_sort | Adabag, Selcuk |
collection | PubMed |
description | BACKGROUND: Frailty is associated with greater mortality; however, whether frail patients primarily die of cardiovascular disease (CVD) or non‐CVD causes is unknown. METHODS AND RESULTS: We assessed the cause of death in relation to frailty status, measured at baseline, among 3135 community‐dwelling older men in the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) study. Absolute probability and risk of CVD mortality associated with frailty status were estimated with traditional methods that used censoring and newer methods that considered non‐CVD mortality as a competing risk. Of the 3135 men (mean age: 76.4±5.6 years), 475 (15.2%) were frail. During an average follow‐up of 9.2 years, 1275 (40.7%) men died, including 445 (34.9%) from CVD and 828 (64.9%) from non‐CVD causes (2 deaths unadjudicated). Both CVD and non‐CVD mortality risk increased with frailty. Cumulative absolute probability of CVD death at 10 years among frail men was 23.8% (20.2–27.6%) using the competing risk method versus 32.5% (27.3–37.8%) using the traditional Kaplan–Meier method (41.5% [95% confidence interval, 36.9–45.9%] and 48.6% [95% confidence interval, 43.6–53.4%], respectively, for non‐CVD mortality). The multivariable‐adjusted risk of CVD death among frail versus robust men was 1.38 (95% confidence interval, 0.99–1.92) using the competing risk method versus 1.84 (95% confidence interval, 1.35–2.51) using the traditional Cox proportional hazards method. CONCLUSIONS: Among community‐dwelling older men, ≈35% of the deaths were due to CVD. Frail men were at increased risk of CVD death, but ignoring the competing risk of non‐CVD mortality overestimated their long‐term probability and relative risk of CVD death. |
format | Online Article Text |
id | pubmed-6015334 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-60153342018-07-05 Frailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study Adabag, Selcuk Vo, Tien N. Langsetmo, Lisa Schousboe, John T. Cawthon, Peggy M. Stone, Katie L. Shikany, James M. Taylor, Brent C. Ensrud, Kristine E. J Am Heart Assoc Original Research BACKGROUND: Frailty is associated with greater mortality; however, whether frail patients primarily die of cardiovascular disease (CVD) or non‐CVD causes is unknown. METHODS AND RESULTS: We assessed the cause of death in relation to frailty status, measured at baseline, among 3135 community‐dwelling older men in the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) study. Absolute probability and risk of CVD mortality associated with frailty status were estimated with traditional methods that used censoring and newer methods that considered non‐CVD mortality as a competing risk. Of the 3135 men (mean age: 76.4±5.6 years), 475 (15.2%) were frail. During an average follow‐up of 9.2 years, 1275 (40.7%) men died, including 445 (34.9%) from CVD and 828 (64.9%) from non‐CVD causes (2 deaths unadjudicated). Both CVD and non‐CVD mortality risk increased with frailty. Cumulative absolute probability of CVD death at 10 years among frail men was 23.8% (20.2–27.6%) using the competing risk method versus 32.5% (27.3–37.8%) using the traditional Kaplan–Meier method (41.5% [95% confidence interval, 36.9–45.9%] and 48.6% [95% confidence interval, 43.6–53.4%], respectively, for non‐CVD mortality). The multivariable‐adjusted risk of CVD death among frail versus robust men was 1.38 (95% confidence interval, 0.99–1.92) using the competing risk method versus 1.84 (95% confidence interval, 1.35–2.51) using the traditional Cox proportional hazards method. CONCLUSIONS: Among community‐dwelling older men, ≈35% of the deaths were due to CVD. Frail men were at increased risk of CVD death, but ignoring the competing risk of non‐CVD mortality overestimated their long‐term probability and relative risk of CVD death. John Wiley and Sons Inc. 2018-05-04 /pmc/articles/PMC6015334/ /pubmed/29728373 http://dx.doi.org/10.1161/JAHA.118.008974 Text en © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Research Adabag, Selcuk Vo, Tien N. Langsetmo, Lisa Schousboe, John T. Cawthon, Peggy M. Stone, Katie L. Shikany, James M. Taylor, Brent C. Ensrud, Kristine E. Frailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study |
title | Frailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study |
title_full | Frailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study |
title_fullStr | Frailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study |
title_full_unstemmed | Frailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study |
title_short | Frailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study |
title_sort | frailty as a risk factor for cardiovascular versus noncardiovascular mortality in older men: results from the mros sleep (outcomes of sleep disorders in older men) study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6015334/ https://www.ncbi.nlm.nih.gov/pubmed/29728373 http://dx.doi.org/10.1161/JAHA.118.008974 |
work_keys_str_mv | AT adabagselcuk frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy AT votienn frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy AT langsetmolisa frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy AT schousboejohnt frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy AT cawthonpeggym frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy AT stonekatiel frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy AT shikanyjamesm frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy AT taylorbrentc frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy AT ensrudkristinee frailtyasariskfactorforcardiovascularversusnoncardiovascularmortalityinoldermenresultsfromthemrossleepoutcomesofsleepdisordersinoldermenstudy |