University of Oulu

Nicola Veronese, Emanuele Cereda, Brendon Stubbs, Marco Solmi, Claudio Luchini, Enzo Manzato, Giuseppe Sergi, Peter Manu, Tamara Harris, Luigi Fontana, Timo Strandberg, Helene Amieva, Julien Dumurgier, Alexis Elbaz, Christophe Tzourio, Monika Eicholzer, Sabine Rohrmann, Claudio Moretti, Fabrizio D’Ascenzo, Giorgio Quadri, Alessandro Polidoro, Roberto Alves Lourenço, Virgilio Garcia Moreira, Juan Sanchis, Valeria Scotti, Stefania Maggi, Christoph U. Correll, Risk of cardiovascular disease morbidity and mortality in frail and pre-frail older adults: Results from a meta-analysis and exploratory meta-regression analysis, Ageing Research Reviews, Volume 35, 2017, Pages 63-73, ISSN 1568-1637,

Risk of cardiovascular disease morbidity and mortality in frail and pre-frail older adults : results from a meta-analysis and exploratory meta-regression analysis

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Author: Veronese, Nicola1,2,3; Cereda, Emanuele4; Stubbs, Brendon5,6,7;
Organizations: 1Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy
2Institute for Clinical Research and Education in Medicine (IREM), Padova, Italy
3National Research Council, Neuroscience Institute—Aging Branch, Padova, Italy
4Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
5Physiotherapy Department, South London and Maudsley NHS FoundationTrust, Denmark Hill, London SE5 8AZ, United Kingdom
6Health Service and Population Research Department, Institute of Psychiatry, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
7Health, Social Care and Education, Anglia Ruskin University, Chelmsford, United Kingdom
8Department of Neurosciences, University of Padova, Padova, Italy
9National Health Care System, Monselice, Padova Local Unit ULSS 17, Italy
10Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy
11Surgical Pathology Unit, Santa Chiara Hospital, Trento, Italy
12South Oaks Hospital, Northwell Health,400 Sunsrise Highway, Amityville, NY 11701, USA
13Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
14Division of Geriatrics and Nutritional Sciences and Center for Human Nutrition, Washington University School of Medicine, St. Louis, MO, USA
15Department of Clinical and Experimental Sciences, Brescia University, Brescia, Italy
16CEINGE Biotecnologie Avanzate, Napoli, Italy
17University of Helsinki and Helsinki University Hospital, Helsinki, Finland
18University of Oulu, Center for Life Course Health Research, Oulu, Finland
19Centre de Recherche Inserm, Bordeaux, France
20University Victor Segalen Bordeaux 2, Bordeaux, France
21CMRR Paris Nord AP-HP, Groupe Hospitalier Lariboisière Fernand-Widal Saint-Louis, INSERM, U942, Université Paris Diderot, Sorbonne Paris Cité, UMRS 942, Paris, France
22CESP, Univ. Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France
23University of Bordeaux, Neuroepidemiology, UMR897, Bordeaux, France
24University of Zurich, Epidemiology, Biostatistics and Prevention Institute, Division of Chronic Disease Epidemiology, Hirschengraben 84, CH-8001 Zurich, Switzerland
25Division of Cardiology, Department of Science, Città della Salute e della Scienza, Turin, Italy
26Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
27Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil
28Department of Cardiology, Hospital Clínico Universitario, School of Medicine, University of Valencia, Valencia, (CIBER-CV), Spain
29Clinical Epidemiology and Biometric Unit, IRCCS Policlinico S. Matteo Foundation, Pavia, Italy
30The Zucker Hillside Hospital, Psychiatry Research, Northwell Health, Glen Oaks, New York, USA
31Hofstra Northwell School of Medicine, Hempstead, NY, USA
32The Feinstein Institute for Medical Research, Manhasset, NY, USA
33Albert Einstein College of Medicine, Bronx, NY, USA
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.8 MB)
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Language: English
Published: Elsevier, 2017
Publish Date: 2019-09-19


Frailty is common and associated with poorer outcomes in the elderly, but its role as potential cardiovascular disease (CVD) risk factor requires clarification. We thus aimed to meta-analytically evaluate the evidence of frailty and pre-frailty as risk factors for CVD. Two reviewers selected all studies comparing data about CVD prevalence or incidence rates between frail/pre-frail vs. robust. The association between frailty status and CVD in cross-sectional studies was explored by calculating and pooling crude and adjusted odds ratios (ORs) ±95% confidence intervals (CIs); the data from longitudinal studies were pooled using the adjusted hazard ratios (HRs). Eighteen cohorts with a total of 31,343 participants were meta-analyzed. Using estimates from 10 cross-sectional cohorts, both frailty and pre-frailty were associated with higher odds of CVD than robust participants. Longitudinal data were obtained from 6 prospective cohort studies. After a median follow-up of 4.4 years, we identified an increased risk for faster onset of any-type CVD in the frail (HR = 1.70 [95%CI, 1.18–2.45]; I² = 66%) and pre-frail (HR = 1.23 [95%CI, 1.07–1.36]; I² = 67%) vs. robust groups. Similar results were apparent for time to CVD mortality in the frail and pre-frail groups. In conclusion, frailty and pre-frailty constitute addressable and independent risk factors for CVD in older adults.

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Series: Ageing research reviews
ISSN: 1568-1637
ISSN-E: 1872-9649
ISSN-L: 1568-1637
Volume: 35
Pages: 63 - 73
DOI: 10.1016/j.arr.2017.01.003
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3142 Public health care science, environmental and occupational health
Copyright information: © 2017 Elsevier B.V. Allr ights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license