Prevalence of frailty in patients with lower extremity peripheral arterial disease: A systematic review and meta-analysis

Wang, Yuxin; Wu, Xinyue; Hu, Xinhua; Yang, Yu

doi:10.1016/j.arr.2022.101748

Cited by 6 publications

(3 citation statements)

References 33 publications

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“…Although certain studies may carry a risk of bias, frailty is commonly observed in individuals with acute stroke, regardless of the specific measurement method used. Two meta-analyses [ 9 , 31 ] have demonstrated a significantly higher prevalence of frailty among individuals with PAD. Additionally, research has shown an independent association between subclinical cardiovascular diseases, such as carotid artery atherosclerosis and femoral artery sclerosis, and frailty, irrespective of the presence of coronary heart disease, stroke, or myocardial infarction [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Frail populations often exhibit a range of chronic conditions, such as coronary heart disease, heart failure, and ischemic stroke, which can result in varying degrees of physical disability. Observational studies have consistently linked frailty with coronary heart disease [ 5 , 6 ], ischemic stroke [ 7 , 8 ], and peripheral arterial disease [ 9 ] (PAD), all of which are associated with the underlying pathology of atherosclerosis. However, observational studies are susceptible to confounding bias and reverse causal associations, and whether a bidirectional association exists between frailty and systemic atherosclerosis with lipids remains uncertain.…”

Section: Introductionmentioning

confidence: 99%

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Frailty and risk of systemic atherosclerosis: A bidirectional Mendelian randomization study

Xu,

Wang,

et al. 2024

PLoS ONE

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Background Numerous observational studies have reported an association between frailty and atherosclerosis. However, the causal relationship between frailty and the occurrence of atherosclerosis in different anatomical sites remains unclear. we conducted a bidirectional Mendelian randomization (MR) study to evaluate the causal relationship between the frailty index (FI), and both systemic atherosclerosis and lipids. Methods We obtained summary statistics from large-scale genome-wide association studies (GWAS) of various phenotypes, including frailty (n = 175,226), coronary atherosclerosis (n = 56,685), cerebral atherosclerosis (n = 150,765), peripheral arterial disease (PAD) (n = 361,194), atherosclerosis at other sites (n = 17,832), LDL-C (n = 201,678), HDL-C (n = 77,409), and triglycerides (n = 78,700). The primary MR analysis employed the inverse variance weighted (IVW) method. Furthermore, to assess reverse causality, we employed inverse MR and multivariate MR analysis. Results Genetically predicted FI showed positive associations with the risk of coronary atherosclerosis (OR = 1.47, 95% CI 1.12–1.93) and cerebral atherosclerosis (OR = 1.99, 95% CI 1.05–3.78), with no significant association (p >0.05) applied to peripheral arterial disease and atherosclerosis at other sites. Genetically predicted FI was positively associated with the risk of triglycerides (OR = 1.31, 95% CI 1.08–1.59), negatively associated with the risk of LDL-C (OR = 0.87, 95% CI 0.78–0.97), and showed no significant association with the risk of HDL-C (p >0.05). Furthermore, both reverse MR and multivariate MR analyses demonstrated a correlation between systemic atherosclerosis, lipids, and increased FI. Conclusion Our study elucidated that genetically predicted FI is associated with the risk of coronary atherosclerosis and cerebral atherosclerosis by the MR analysis method, and they have a bidirectional causal relationship. Moreover, genetically predicted FI was causally associated with triglyceride and LDL-C levels. Further understanding of this association is crucial for optimizing medical practice and care models specifically tailored to frail populations.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frailty and risk of systemic atherosclerosis: A bidirectional Mendelian randomization study

Xu,

Wang,

et al. 2024

PLoS ONE

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“…Around half had frailty at baseline, consistent with previous research. 27 Frailty was strongly associated with comorbidity, polypharmacy, cognitive impairment, No frailty (CFS 1-4) 27…”

Section: Discussionmentioning

confidence: 99%

Single-centre prospective cohort study investigating the associations and one-year trends of frailty, cognition, disability and quality of life pre- and post-intervention for chronic limb-threatening ischaemia

Houghton,

Essop-Adam,

Nduwayo

et al. 2024

J.Vasc.Soc.G.B.Irel

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Background: Half of people with chronic limb-threatening ischaemia (CLTI) have frailty. This study aimed to describe the associations of frailty with cognition, disability and quality of life (QoL) among CLTI patients over 1 year following surgical or endovascular procedures. Methods: A single-centre prospective cohort study was undertaken. Patients undergoing a procedure for CLTI between May 2019 and May 2021 were eligible (minimum age >65 initially; >50 from November 2019). Participants underwent preoperative assessments for frailty, physical and cognitive function, disability, mood, disease-specific QoL (Vascular QoL questionnaire (VascuQoL)) and generic health-related QoL (EuroQoL EQ-5D-5L). Follow-up was at 3 months (clinic or telephone) and 12 months (telephone). Baseline frailty was assessed using both the Edmonton frail scale (EFS) and the clinical frailty scale (CFS). Frailty during follow-up was re-assessed at 3 and 12 months using the CFS as it can be performed via telephone. Associations of baseline frailty with disability, QoL and mood scores during follow-up were investigated using repeated measures mixed models. Results: Ninety-nine patients completed the baseline assessments. Forty-five (45%) were classified as frail by the EFS. Frailty was associated with a higher prevalence of cognitive impairment based on the Montreal cognitive assessment (52% vs 17%; p<0.001). Eighty-seven patients were eligible for follow-up. Baseline frailty (EFS) was associated with worse QoL scores at all timepoints (VascuQoL p=0.001; EQ-5D-5L p<0.001). Both those with and without frailty at baseline (EFS) had modest improvement in QoL scores at 12 months (VascuQoL p<0.001; EQ-5D-5L p=0.001). Barthel index (disability) scores were lower for those with frailty at baseline (EFS) (p<0.001) and decreased slightly over 12 months for both groups (p=0.007). Five patients (12%) transitioned from frailty to non-frailty at 12 months based on the CFS. However, 10 patients (23%) transitioned from non-frailty to frailty. Conclusions: CLTI patients with frailty have worse QoL and greater disability both pre- and post-intervention. However, they demonstrate similar QoL benefit to those without frailty at 1 year following intervention. Baseline frailty assessment is important to inform prognostic discussions, expectations and shared decision making in CLTI.

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Pathology, Progression, and Emerging Treatments of Peripheral Artery Disease–Related Limb Ischemia

Golledge

2023

Clinical Therapeutics

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Prevalence of frailty in patients with lower extremity peripheral arterial disease: A systematic review and meta-analysis

Cited by 6 publications

References 33 publications

Frailty and risk of systemic atherosclerosis: A bidirectional Mendelian randomization study

Frailty and risk of systemic atherosclerosis: A bidirectional Mendelian randomization study

Single-centre prospective cohort study investigating the associations and one-year trends of frailty, cognition, disability and quality of life pre- and post-intervention for chronic limb-threatening ischaemia

Pathology, Progression, and Emerging Treatments of Peripheral Artery Disease–Related Limb Ischemia

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