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This study aimed to determine whether visit-to-visit blood pressure (BP) variability (BPV) is associated with incident frailty. We included 1 394 nonfrail community-dwelling participants aged ≥70 years from the Multidomain Alzheimer Preventive Trial (MAPT) who underwent repeated clinical examinations, including BP and frailty, over a 5-year follow-up period. Systolic BPV (SBPV), diastolic BPV (DBPV), mean arterial pressure variability (MAPV), and pulse pressure variability (PPV) were evaluated using standard deviation (SD), coefficient of variation (CV), average real variability, successive variation, variation independent of mean, and residual SD. Incident frailty was assessed using the Fried phenotype. Cox proportional hazards models were used for the analyses. Higher SBPV was significantly associated with greater risk of frailty (1-SD increase of CV: hazard ratio [HR] = 1.18, 95% confidence interval [CI]: 1.02-1.36) after adjustment for demographics, systolic BP, antihypertensive drugs, body mass index, diabetes, ischemic heart disease, congestive heart failure, stroke, atrial fibrillation, MAPT randomization group, and frailty status. Similar results were observed with all indicators of variability. Higher PPV was associated with a greater risk of developing frailty over time (1-SD increase of CV: HR = 1.17, 95% CI: 1.01-1.35). DBPV and MAPV were not significantly associated with incident frailty. Higher SBPV and PPV were associated with greater risk of incident frailty. Our findings support the concept of BP physiological dysregulation underlying the frail state and suggest that BP instability could be an early marker of frailty.
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http://dx.doi.org/10.1093/gerona/glab112 | DOI Listing |
Biometrics
October 2024
Evidence Generation and Advanced Analytics Biogen Digital Health, Biogen, Cambridge, MA 02142, United States.
In many clinical contexts, the event of interest could occur multiple times for the same patient. Considerable advancement has been made on developing recurrent event models based on or that use biomarker information. However, less attention has been given to evaluating the prognostic accuracy of a biomarker or a composite score obtained from a fitted recurrent event-rate model.
View Article and Find Full Text PDFJACC Cardiovasc Interv
December 2024
Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Background: Survival after transcatheter aortic valve replacement (TAVR) has markedly increased. Thus, other comorbidities will intersect patient trajectories and challenge follow-up.
Objectives: The aim of this study was to describe patient characteristics and hospitalizations at end of life to further improve the quality of life for patients undergoing TAVR.
Lipids Health Dis
December 2024
Department of Cardiology, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences, 1 DaHua Road, Beijing, 100730, China.
Background: Frailty poses a considerable public health challenge because of its association with negative health consequences. Although obesity is recognized as a contributor to frailty, conventional measures fail to adequately account for the effects of visceral adiposity. The study aimed to investigate the associations between the visceral adiposity index (VAI) or lipid accumulation product (LAP) and frailty.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
Introduction: The retinal nerve fiber layer (RNFL) or ganglion cell-inner plexiform layer (GC-IPL) is associated with cognitive impairment. However, the relationship between retinal asymmetry and cognitive frailty (CF) remains unknown.
Methods: Two hundred twenty-two community-dwelling older adults were assessed starting in 2015 and underwent biennial cognitive and frailty evaluations until 2022.
J Am Med Dir Assoc
December 2024
School of Nursing, Peking University, Beijing, China. Electronic address:
Objectives: Malnutrition is generally studied to be involved in outlining hazard frailty trajectories, resulting in adverse outcomes. In view of frailty's multidimensional nature, we aimed to assess the contribution of nutritional items in existing frailty tools to adverse outcomes, and develop and validate a nutritional frailty phenotype based on machine learning.
Design: A population-based prospective cohort study.
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