ReviewRole of Frailty in Patients With Cardiovascular Disease
Section snippets
Methods
The approach used to identify, select, and appraise relevant studies for this systematic review is outlined in the following and was in accordance with the standards put forth by the Quality of Reporting of Meta-Analyses statement.4
We searched Ovid MEDLINE from 1966 to December 2007, using a hierarchical search strategy with the following search terms: “frail,” “frailty,” “elderly,” “frail elderly,” “aged,” “80 and over,” “health services for the aged,” and “cardiovascular diseases.” We
Results
We identified 9 studies meeting our selection criteria (Figure 2), encompassing 54,250 patients with a mean weighted follow-up of 6.2 years. Patients were aged ≥60 years and living in the community (with the exception of 1 study that included hospitalized patients). All cohorts were recruited prospectively, although 5 of the 9 studies were secondary analyses of the initial cohorts. Criteria used to define frailty varied by study and are listed in Table 1. Study characteristics are listed in
Discussion
Our systematic review has shown that there exists a relation between frailty and CVD; frailty may lead to CVD, just as CVD may lead to frailty. The relation may also be collinear, because these entities share common biologic pathways. Consensus groups have yet to agree on 1 universal definition of frailty from among the domains of strength, function, nutrition, mobility, and cognition. Using the most often cited construct, frailty is associated with a two- to threefold increase in the
Acknowledgment
We would like to thank Dr. Jean-Francois Boivin (Department of Epidemiology, McGill University) for his diligent review of this report.
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