Association of intrinsic capacity with incidence and mortality of cardiovascular disease: Prospective study in UK Biobank

被引:17
|
作者
Ramirez-Velez, Robinson [1 ,2 ]
Iriarte-Fernandez, Maria [1 ]
Santafe, Guzman [3 ,4 ]
Malanda, Armando [5 ]
Beard, John R. [6 ]
Garcia-Hermoso, Antonio [1 ]
Izquierdo, Mikel [1 ,2 ]
机构
[1] Univ Publ Navarra UPNA, Hosp Univ Navarra HUN, IdiSNA, Navarrabiomed, Pamplona, Spain
[2] Inst Salud Carlos III, CIBER Frailty & Hlth Aging CIBERFES, Madrid, Spain
[3] Univ Publ Navarra UPNA, Dept Stat Comp Sci & Math, Pamplona, Spain
[4] Univ Publ Navarra UPNA, InaMat, Pamplona, Spain
[5] Univ Publ Navarra UPNA, Dept Elect & Elect Engn, Pamplona, Spain
[6] Columbia Univ, Columbia Aging Ctr, New York, NY USA
关键词
biological ageing; biomarkers; incident pathologies; intrinsic capacity; mortality; GRIP STRENGTH; EPIDEMIOLOGY; HEALTH; RISK;
D O I
10.1002/jcsm.13283
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
BackgroundThe World Health Organization proposed the concept of intrinsic capacity (IC; the composite of all the physical and mental capacities of the individual) as central for healthy ageing. However, little research has investigated the interaction and joint associations of IC with cardiovascular disease (CVD) incidence and CVD mortality in middle- and older-aged adults. MethodsUsing data from 443 130 UK Biobank participants, we analysed seven biomarkers capturing the level of functioning of five domains of IC to calculate a total IC score (ranging from 0 [better IC] to +4 points [poor IC]). Associations between IC score and incidence of six long-term CVD conditions (hypertension, stroke/transient ischaemic attack stroke, peripheral vascular disease, atrial fibrillation/flutter, coronary artery disease and heart failure), and grouped mortality from these conditions were estimated using Cox proportional models, with a 1-year landmark analysis to triangulate the findings. ResultsOver 10.6 years of follow-up, CVD morbidity grouped (n = 384 380 participants for the final analytic sample) was associated with IC scores (0 to +4): mean hazard ratio (HR) [95% confidence interval, CI] 1.11 [1.08-1.14], 1.20 [1.16-1.24], 1.29 [1.23-1.36] and 1.56 [1.45-1.59] in men (C-index = 0.68), and 1.17 [1.13-1.20], 1.30 [1.26-1.36], 1.52 [1.45-1.59] and 1.78 [1.67-1.89] in women (C-index = 0.70). In regard to mortality, our results indicated that the higher IC score (+4 points) was associated with a significant increase in subsequent CVD mortality (mean HR [95% CI]: 2.10 [1.81-2.43] in men [C-index = 0.75] and 2.29 [1.85-2.84] in women [C-index = 0.78]). Results of all sensitivity analyses by full sample, sex and age categories were largely consistent independent of major confounding factors (P < 0.001). ConclusionsIC deficit score is a powerful predictor of functional trajectories and vulnerabilities of the individual in relation to CVD incidence and premature death. Monitoring an individual's IC score may provide an early-warning system to initiate preventive efforts.
引用
收藏
页码:2054 / 2063
页数:10
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