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"Successful aging": effect of subclinical cardiovascular disease
Anne B Newman1, Alice M Arnold, Barbara L Naydeck
1Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. anewman@pitt.edu
Insights
Subclinical cardiovascular disease significantly reduces healthy aging years in older adults. Preventing early vascular disease may improve both quality and quantity of life in later years.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Public Health
Background:
- Cardiovascular diseases (CVD) are a leading cause of mortality in older adults.
- Subclinical CVD, even without overt symptoms, is linked to reduced survival.
- The impact of subclinical CVD extent on quality of life in aging is not well-defined.
Purpose of the Study:
- To investigate the association between the extent of subclinical cardiovascular disease and successful aging in older adults.
- To quantify the impact of subclinical CVD on the duration and quality of remaining healthy years.
Main Methods:
- Longitudinal cohort study of 2932 individuals aged 65+ followed for 8 years.
- Successful aging defined as absence of CVD, cancer, COPD, and preserved physical/cognitive function.
- Vascular disease extent measured noninvasively.
Main Results:
- Younger age and less subclinical CVD independently predicted successful aging.
- Subclinical CVD accelerated functional decline, equivalent to 5.6-6.5 years of aging.
- Individual risk factors (diabetes, smoking, CRP) predicted decline but did not fully explain the age-related effect.
Conclusions:
- A direct, graded relationship exists between vascular disease extent and health/function maintenance.
- Preventing subclinical vascular disease is crucial for enhancing longevity and quality of life in older age.
Background:
Cardiovascular diseases are the primary cause of death in older adults. Among those without clinical disease, high levels of subclinical disease are associated with poor survival. The effect of the extent of subclinical cardiovascular disease on the quality of the remaining years has not been defined.
Methods:
In a longitudinal cohort study, 2932 men and women aged 65 years and older were followed up for 8 years to determine the likelihood of maintaining intact health and functioning. Successful aging was defined as remaining free of cardiovascular disease, cancer, and chronic obstructive pulmonary disease and with intact physical and cognitive functioning.
Results:
Younger age at study entry and a lower extent of subclinical cardiovascular disease were independently associated with the likelihood of maintaining successful aging. In age-stratified summaries, those with subclinical disease had a trajectory of decline similar to subjects 5 years older without subclinical vascular disease. Regression analyses showed that the decline associated with subclinical disease was equivalent to 6.5 (95% confidence interval, 6.4-6.6) years of aging for women and 5.6 (95% confidence interval, 5.4-5.8) years of aging for men. Individual measures of the extent of cardiovascular disease, diabetes mellitus, smoking, and higher C-reactive protein level were also independently predictive of fewer years of successful aging, but none of these factors substantially attenuated the effect of age itself.
Conclusions:
There is a graded relationship between the extent of vascular disease measured noninvasively and the likelihood of maintaining intact health and function. Prevention of subclinical vascular disease may increase the quality and the quantity of years in late life.
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