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

BackgroundFrailty is associated with greater mortality; however, whether frail patients primarily die of cardiovascular disease (CVD) or non‐CVD causes is unknown. Methods and ResultsWe assessed the cause of death in relation to frailty status, measured at baseline, among 3135 community‐dwelling old...

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Autores principales:	Selcuk Adabag, Tien N. Vo, Lisa Langsetmo, John T. Schousboe, Peggy M. Cawthon, Katie L. Stone, James M. Shikany, Brent C. Taylor, Kristine E. Ensrud
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2018
Materias:	cardiovascular disease cardiovascular disease risk factors functional capacity impairment mortality Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/551fb0513c8241278918a7fba10a27a6
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spelling	oai:doaj.org-article:551fb0513c8241278918a7fba10a27a62021-11-12T17:01:53ZFrailty as a Risk Factor for Cardiovascular Versus Noncardiovascular Mortality in Older Men: Results From the MrOS Sleep (Outcomes of Sleep Disorders in Older Men) Study10.1161/JAHA.118.0089742047-9980https://doaj.org/article/551fb0513c8241278918a7fba10a27a62018-05-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.118.008974https://doaj.org/toc/2047-9980BackgroundFrailty is associated with greater mortality; however, whether frail patients primarily die of cardiovascular disease (CVD) or non‐CVD causes is unknown. Methods and ResultsWe 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. ConclusionsAmong 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.Selcuk AdabagTien N. VoLisa LangsetmoJohn T. SchousboePeggy M. CawthonKatie L. StoneJames M. ShikanyBrent C. TaylorKristine E. EnsrudWileyarticlecardiovascular diseasecardiovascular disease risk factorsfunctional capacity impairmentmortalityDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 7, Iss 10 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	cardiovascular disease cardiovascular disease risk factors functional capacity impairment mortality Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	cardiovascular disease cardiovascular disease risk factors functional capacity impairment mortality Diseases of the circulatory (Cardiovascular) system RC666-701 Selcuk Adabag Tien N. Vo Lisa Langsetmo John T. Schousboe Peggy M. Cawthon Katie L. Stone James M. Shikany Brent C. Taylor Kristine E. Ensrud 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
description	BackgroundFrailty is associated with greater mortality; however, whether frail patients primarily die of cardiovascular disease (CVD) or non‐CVD causes is unknown. Methods and ResultsWe 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. ConclusionsAmong 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	article
author	Selcuk Adabag Tien N. Vo Lisa Langsetmo John T. Schousboe Peggy M. Cawthon Katie L. Stone James M. Shikany Brent C. Taylor Kristine E. Ensrud
author_facet	Selcuk Adabag Tien N. Vo Lisa Langsetmo John T. Schousboe Peggy M. Cawthon Katie L. Stone James M. Shikany Brent C. Taylor Kristine E. Ensrud
author_sort	Selcuk Adabag
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_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_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_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
publisher	Wiley
publishDate	2018
url	https://doaj.org/article/551fb0513c8241278918a7fba10a27a6
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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

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