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Volume 2019, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Frailty is a state of vulnerability and a decreased physiological response to stressors. As the population ages, the prevalence of frailty is expected to increase. Thus, identifying tools and resources that efficiently predict frailty among the Saudi population is important. We aimed to describe the prevalence and predictors of frailty among Saudi patients referred for cardiac stress testing with nuclear imaging. We included 876 patients (mean age 60.3 ± 11 years, women 48%) who underwent clinically indicated cardiac nuclear stress testing between January and October 2016. Fried Clinical Frailty Scale was used to assess frailty. Patients were considered frail if they had a score of four or higher. Multivariate adjusted logistic regression models were used to determine the independent predictors of elderly frail patients. In this cohort, the median age of the included patients was 61 years, and the prevalence of frailty was 40%. The frail patients were older, more frequently women, and had a higher body mass index. Additionally, frailty was associated with a higher prevalence of cardiovascular risk factors: hypertension (85% vs. 70%) and diabetes (75% vs. 60%). In a fully adjusted logistic regression model, women, hypertension, and obesity (BMI ≥ 30 kg/m2) were independent predictors of elderly frail patients. With the aging of the Saudi population, frailty prevalence is expected to increase. Elderly, obesity, hypertension, and female gender are risk factors of frailty. Interventions to reduce frailty should be focused on this high-risk population.

© 2019 Ahmed, Ahmed, Alfaris, Holmes, Aljizeeri, Al-Mallah, licensee HBKU Press.
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2020-01-23
2024-04-19
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References

  1. Lauer MS. Advancing cardiovascular research. Chest. 2012; 141:2:500–505.
     [Google Scholar]
  2. Williams KJ, Feig JE, Fisher EA. Rapid regression of atherosclerosis: insights from the clinical and experimental literature. Nat Clin Pract Cardiovasc Med. 2008; 5::91–102.
     [Google Scholar]
  3. Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, et al.  From vulnerable plaque to vulnerable patient a call for new definitions and risk assessment strategies: part I. Circulation. 2003; 108::1664–1672.
     [Google Scholar]
  4. Task Force Members, Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, et al.  ESC guidelines on the management of stable coronary artery disease. Eur Heart J. 2013; 34:38:2949–3003.
     [Google Scholar]
  5. Authors/Task Force Members, Hamm CW, Bassand J-P, Agewall S, Bax J, Boersma E, et al.  ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2011; 32:23:2999–3054.
     [Google Scholar]
  6. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Drazner MH, et al.  ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; 62:16:e147–e239.
     [Google Scholar]
  7. Graham DJ, Reichman ME, Wernecke M, Zhang R, Southworth MR, Levenson M, et al.  Cardiovascular, bleeding, and mortality risks in elderly medicare patients treated with dabigatran or warfarin for nonvalvular atrial fibrillation. Circulation. 2015; 131:157–164.
     [Google Scholar]
  8. Cannon CP, Harrington RA, James S, Ardissino D, Becker RC, Emanuelsson H, et al.  Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised double-blind study. Lancet. 2010; 375:9711:283–293.
     [Google Scholar]
  9. Heidenreich PA, Lee TT, Massie BM. Effect of beta-blockade on mortality in patients with heart failure: a meta-analysis of randomized clinical trials 1. J Am Coll Cardiol. 1997; 30:1:27–34.
     [Google Scholar]
  10. Fonarow GC, Wright RS, Spencer FA, Fredrick PD, Dong W, Every N, et al.  Effect of statin use within the first 24 hours of admission for acute myocardial infarction on early morbidity and mortality. Am J Cardiol. 2005; 96:5:611–616.
     [Google Scholar]
  11. Lakoski S, Cushman M, Siscovick D, Blumenthal R, Palmas W, Burke G, et al.  The relationship between inflammation, obesity and risk for hypertension in the Multi-Ethnic Study of Atherosclerosis (MESA). J Hum Hypertens. 2011; 25::73–79.
     [Google Scholar]
  12. Kim F, Nichol G, Maynard C, Hallstrom A, Kudenchuk PJ, Rea T, et al.  Effect of prehospital induction of mild hypothermia on survival and neurological status among adults with cardiac arrest: a randomized clinical trial. JAMA. 2014; 311:1:45–52.
     [Google Scholar]
  13. Cleveland JC. Frailty, aging, and cardiac surgery outcomes: the stopwatch tells the story. J Am Coll Cardiol. 2010; 56:20:1677–1678.
     [Google Scholar]
  14. Afilalo J, Alexander KP, Mack MJ, Maurer MS, Green P, Allen LA, et al.  Frailty assessment in the cardiovascular care of older adults. J Am Coll Cardiol. 2014; 63:8:747–762.
     [Google Scholar]
  15. Van Kan GA, Rolland Y, Bergman H, Morley J, Kritchevsky S, Vellas B, The IANA. Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging. 2008; 12:1:29–37.
     [Google Scholar]
  16. Casale-Martínez RI, Navarrete-Reyes AP, Ávila-Funes JA. Social determinants of frailty in elderly Mexican community-dwelling adults. J Am Geriatr Soc. 2012; 60:4:800–802.
     [Google Scholar]
  17. Bunt S, Steverink N, Olthof J, van der Schans C, Hobbelen J. Social frailty in older adults: a scoping review. Eur J Ageing. 2017; 14:3:323–334.
     [Google Scholar]
  18. Hulten E, Bittencourt MS, Ghoshhajra B, O'Leary D, Christman MP, Blaha MJ, et al.  Incremental prognostic value of coronary artery calcium score versus CT angiography among symptomatic patients without known coronary artery disease. Atherosclerosis. 2014; 233:1:190–195.
     [Google Scholar]
  19. Fukushima K, Javadi MS, Higuchi T, Lautamaki R, Merrill J, Nekolla SG, et al.  Prediction of short-term cardiovascular events using quantification of global myocardial flow reserve in patients referred for clinical 82Rb PET perfusion imaging. J Nucl Med. 2011; 52:5:726–732.
     [Google Scholar]
  20. Government of Saudi Arabia. Saudi Vision 2030 [Internet]. 2016 (cited 21 May 2019). Available from: https://vision2030.gov.sa/download/file/fid/417 .
  21. Dilsizian V, Bacharach SL, Beanlands RS, Bergmann SR, Delbeke D, Dorbala S, et al.  ASNC imaging guidelines/SNMMI procedure standard for positron emission tomography (PET) nuclear cardiology procedures. J Nucl Cardiol. 2016; 23:5:1187–1226.
     [Google Scholar]
  22. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al.  Frailty in older adults evidence for a phenotype. J Gerontol A: Biol Sci Med Sci. 2001; 56:3:M146–M156.
     [Google Scholar]
  23. McNallan SM, Singh M, Chamberlain AM, Kane RL, Dunlay SM, Redfield MM, et al.  Frailty and healthcare utilization among patients with heart failure in the Community. JACC Heart Fail. 2013; 1:2:135–141.
     [Google Scholar]
  24. Rockwood K, Song X, MacKnight C, Bergman H, Hogan DB, McDowell I, et al.  A global clinical measure of fitness and frailty in elderly people. CMAJ. 2005; 173:5:489–495.
     [Google Scholar]
  25. Murali-Krishnan R, Iqbal J, Rowe R, Hatem E, Parviz Y, Richardson J, et al.  Impact of frailty on outcomes after percutaneous coronary intervention: a prospective cohort study. Open Heart. 2015; 2:1:e000294.
     [Google Scholar]
  26. Song X, Mitnitski A, Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. J Am Geriatr Soc. 2010; 58:4:681–687.
     [Google Scholar]
  27. Rockwood K, Stadnyk K, MacKnight C, McDowell I, Hebert R, Hogan DB. A brief clinical instrument to classify frailty in elderly people. Lancet. 1999; 353:9148:205–206.
     [Google Scholar]
  28. Lupón J, González B, Santaeugenia S, Altimir S, Urrutia A, Más D, et al.  Prognostic implication of frailty and depressive symptoms in an outpatient population with heart failure. Rev Esp Cardiol. 2008; 61:8:835–842.
     [Google Scholar]
  29. Pittman JG, Cohen P. The pathogenesis of cardiac cachexia. N Engl J Med. 1964; 271::403–409.
     [Google Scholar]
  30. von Haehling S, Anker SD, Doehner W, Morley JE, Vellas B. Frailty and heart disease. Int J Cardiol. 2013; 168:3:1745–1747.
     [Google Scholar]
  31. Goff JDC, Lloyd-Jones DM, Bennett G, Coady S, D'Agostino SRB, Gibbons R, et al.  2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol. 2014; 63:25 Part B:2935–2959.
     [Google Scholar]
  32. Selvarajah S, Kaur G, Haniff J, Cheong KC, Hiong TG, van der Graaf Y, et al.  Comparison of the Framingham Risk Score, SCORE and WHO/ISH cardiovascular risk prediction models in an Asian population. Int J Cardiol. 2014; 176::211–218.
     [Google Scholar]
  33. Sergi G, Veronese N, Fontana L, De Rui M, Bolzetta F, Zambon S, et al.  Pre-frailty and risk of cardiovascular disease in elderly men and women: the Pro.V.A. study. J Am Coll Cardiol. 2015; 65:10:976–983.
     [Google Scholar]
  34. Uchmanowicz I, Łoboz-Rudnicka M, Szeląg P, Jankowska-Polańska B, Łoboz-Grudzień K. Frailty in heart failure. Curr Heart Fail Rep. 2014; 11:3:266–273.
     [Google Scholar]
  35. Moorhouse P, Rockwood K. Frailty and its quantitative clinical evaluation. J R Coll Physicians Edinb. 2012; 42::333–340.
     [Google Scholar]
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Prevalence and predictors of frailty in a high-income developing country: A cross-sectional study
Qatar Medical Journal 2019, 20 (2020); https://doi.org/10.5339/qmj.2019.20
/content/journals/10.5339/qmj.2019.20
/content/journals/10.5339/qmj.2019.20
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  • Article Type: Research Article
Keyword(s): cardiac nuclear stress testing, cardiovascular predictors, frail elderly and Fried clinical frailty scale

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