Dataset Information

Mortality Risk Along the Frailty Spectrum: Data from the National Health and Nutrition Examination Survey 1999 to 2004.

ABSTRACT: OBJECTIVES:To determine the relationship between frailty and overall and cardiovascular mortality. DESIGN:Longitudinal mortality analysis. SETTING:National Health and Nutrition Examination Survey (NHANES) 1999-2004. PARTICIPANTS:Community-dwelling older adults aged 60 and older (N = 4,984; mean age 71.1 ± 0.19, 56% female). MEASUREMENTS:We used data from 1999-2004 cross-sectional NHANES and mortality data from the National Death Index, updated through December 2011. An adapted version of Fried's frailty criteria was used (low body mass index, slow walking speed, weakness, exhaustion, low physical activity). Frailty was defined as persons meeting 3 or more criteria, prefrailty as meeting 1 or 2 criteria, and robust (reference) as not meeting any criteria. The primary outcome was to evaluate the association between frailty and overall and cardiovascular mortality. Cox proportional hazard models were used to evaluate the association between risk of death and frailty category adjusted for age, sex, race, smoking, education, coronary artery disease, heart failure, nonskin cancer, diabetes, and arthritis. RESULTS:Half (50.4%) of participants were classified as robust, 40.3% as prefrail, and 9.2% as frail. Fully adjusted models demonstrated that prefrail (hazard ratio (HR) = 1.64, 95% confidence interval (CI) = 1.45-1.85) and frail (HR = 2.79, 95% CI = 2.35-3.30) participants had a greater risk of death and of cardiovascular death (prefrail: HR = 1.84, 95% CI = 1.45-2.34; frail: HR = 3.39, 95% CI = 2.45-4.70). CONCLUSION:Frailty and prefrailty are associated with increased risk of death. Demonstrating the association between prefrail status and mortality is the first step to identifying potential targets of intervention in future studies.

SUBMITTER: Crow RS

PROVIDER: S-EPMC5849536 | biostudies-literature | 2018 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Mortality Risk Along the Frailty Spectrum: Data from the National Health and Nutrition Examination Survey 1999 to 2004.

Crow Rebecca S RS Lohman Matthew C MC Titus Alexander J AJ Bruce Martha L ML Mackenzie Todd A TA Bartels Stephen J SJ Batsis John A JA

Journal of the American Geriatrics Society 20180125 3

<h4>Objectives</h4>To determine the relationship between frailty and overall and cardiovascular mortality.<h4>Design</h4>Longitudinal mortality analysis.<h4>Setting</h4>National Health and Nutrition Examination Survey (NHANES) 1999-2004.<h4>Participants</h4>Community-dwelling older adults aged 60 and older (N = 4,984; mean age 71.1 ± 0.19, 56% female).<h4>Measurements</h4>We used data from 1999-2004 cross-sectional NHANES and mortality data from the National Death Index, updated through December ...[more]

PMID: 29368330

Similar Datasets

Project description:BackgroundPotential associations between background environmental chemical exposures and autoimmunity are understudied.ObjectivesOur exploratory study investigated exposure to individual environmental chemicals and selected mixtures in relation to the presence of antinuclear antibodies (ANA), a widely used biomarker of autoimmunity, in a representative sample of the U.S.MethodsThis cross-sectional analysis used data on 4,340 participants from the National Health and Nutrition Examination Survey (1999-2004), of whom 14% were ANA positive, to explore associations between ANA and concentrations of dioxins, dibenzofurans, polychlorinated biphenyls, organochlorines, organophosphates, phenols, metals, and other environmental exposures and metabolites measured in participants' serum, whole blood, or urine. For dioxin-like compounds with toxic equivalency factors, we developed and applied a new statistical approach to study selected mixtures. Lognormal models and censored-data methods produced estimates of chemical associations with ANA in males, nulliparous females, and parous females; these estimates were adjusted for confounders and accommodated concentrations below detectable levels.ResultsSeveral associations between chemical concentration and ANA positivity were observed, but only the association in males exposed to triclosan remained statistically significant after correcting for multiple comparisons (mean concentration ratio = 2.8; 95% CI: 1.8, 4.5; p < 0.00001).ConclusionsThese data suggest that background levels of most xenobiotic exposures typical in the U.S. population are not strongly associated with ANA. Future studies should ideally reduce exposure misclassification by including prospective measurement of the chemicals of concern and should track changes in ANA and other autoantibodies over time.CitationDinse GE, Jusko TA, Whitt IZ, Co CA, Parks CG, Satoh M, Chan EKL, Rose KM, Walker NJ, Birnbaum LS, Zeldin DC, Weinberg CR, Miller FW. 2016. Associations between selected xenobiotics and antinuclear antibodies in the National Health and Nutrition Examination Survey, 1999-2004. Environ Health Perspect 124:426-436; http://dx.doi.org/10.1289/ehp.1409345.

Project description:Estimates of chronic kidney disease (CKD) in the United States using the continuous National Health and Nutrition Examination Survey (NHANES) data set 1999-2004 indicate that 13.1% of the population (26.3 million people based on the 2000 census) has CKD stages 1 to 4.We performed sensitivity analyses to highlight assumptions underlying these estimates and illustrate their robustness to varying assumptions.NHANES 1999-2004 was a nationally representative cross-sectional continuous survey of the civilian noninstitutionalized US population. Our sample included participants 20 years and older.Estimated glomerular filtration rate (GFR) less than 60 mL/min/1.73 m(2) defined from the 4-variable Modification of Diet in Renal Disease (MDRD) Study equation; albuminuria defined as persistence of urinary albumin-creatinine ratio greater than 30 mg/g.We compared prevalence estimates using the MDRD Study equation with 2 other GFR estimating equations (equation 5 by Rule et al from the Mayo Clinic Donors study; Cockcroft-Gault equation adjusted for body surface area and corrected for the bias in the MDRD Study sample), and sex-specific cutoff values to define albuminuria.We found CKD stages 1 to 4 prevalence estimates ranging from 11.7% to 24.9%, a more than 2-fold difference resulting in population estimates of 25.8 million to 54.0 million people using 2006 population estimates. Considering only stages 3 and 4, which are not affected by the choice of cutoff values to define albuminuria, prevalence estimates ranged from 6.3% to 18.6%, resulting in population estimates of 13.7 million to 40.3 million people, a nearly 3-fold difference.NHANES 1999-2004 is a cross-sectional survey and allows for GFR and albumin-creatinine ratio estimates at 1 point in time. NHANES does not account for seniors in long-term care facilities.Although CKD prevalence is high regardless of varying modeling assumptions, different assumptions yield large differences in prevalence estimates.

Dataset Information

Mortality Risk Along the Frailty Spectrum: Data from the National Health and Nutrition Examination Survey 1999 to 2004.

Publications

Mortality Risk Along the Frailty Spectrum: Data from the National Health and Nutrition Examination Survey 1999 to 2004.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets