The frailty risk trajectory associated with kidney and cardiovascular morbidities among patients with incident diabetes: A population-based study

Wang, Jui; Lee, Szu-Ying; Chao, Chia‐Ter; Huang, Jenq‐Wen; Chien, Kuo‐Liong

doi:10.1016/j.atherosclerosis.2022.06.1010

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…40 Using a nationwide cohort, we recently discovered that coronary and cerebral vasculopathy increased the risk of incident frailty by 21% and 41% over time, respectively. 41 Along the same lines, we showed that VC in the form of aortic calcification elevated the risk of incident prefrailty or frailty by 5-to 10-fold. 13 On the other hand, a few reports have suggested that vasculitis increases the risk of frailty, partly due to systemic inflammation and the immunomodulatory agents used for treatment.…”

Section: Vasculopathy As a Contributor To Frailty And Vascular Tissue...mentioning

confidence: 66%

“…In addition, vascular calcification (VC) without or with increasing vascular stiffness can be observed in a large proportion of healthy elderly individuals 40 . Using a nationwide cohort, we recently discovered that coronary and cerebral vasculopathy increased the risk of incident frailty by 21% and 41% over time, respectively 41 . Along the same lines, we showed that VC in the form of aortic calcification elevated the risk of incident prefrailty or frailty by 5‐ to 10‐fold 13 .…”

Section: The Origin Of Frailty: Interplay Between Different Pathologiesmentioning

confidence: 82%

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Vascular frailty, a proposal for new frailty type: A narrative review

Chao

Hung

2023

The Kaohsiung J of Med Scie

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Frailty is the incremental accumulation of minute defects that progressively impair health and performance. Frailty is commonly observed in older adults; however, secondary frailty may also occur in patients with metabolic disorders or major organ failure. In addition to physical frailty, several distinct types of frailty have been identified, including oral, cognitive, and social frailty, each of which is of practical importance. This nomenclature suggests that detailed descriptions of frailty can potentially advance relevant researches. In this narrative review, we first summarize the clinical value and plausible biological origin of frailty, as well as how to appropriately assess it using physical frailty phenotypes and frailty indexes. In the second part, we discuss the issue of vascular tissue as a relatively underappreciated organ whose pathologies contribute to the development of physical frailty. Moreover, when vascular tissue undergoes degeneration, it exhibits vulnerability to subtle injuries and manifests a unique phenotype amenable to clinical assessment prior to or accompanying physical frailty development. Finally, we propose that vascular frailty, based on an extensive set of experimental and clinical evidence, can be considered a new frailty type that requires our attention. We also outline potential methods for the operationalization of vascular frailty. Further studies are required to validate our claim and sharpen the spectrum of this degenerative phenotype.

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Section: Vasculopathy As a Contributor To Frailty And Vascular Tissue...mentioning

confidence: 66%

Section: The Origin Of Frailty: Interplay Between Different Pathologiesmentioning

confidence: 82%

Vascular frailty, a proposal for new frailty type: A narrative review

Chao

Hung

2023

The Kaohsiung J of Med Scie

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“…DPP4i has been credited for its beneficial effects of hypoglycemia compared to sulfonylurea in frail adults [ 39 ]. However, a prior clinical trial showed that DPP4i increased the risk of hospitalization for heart failure among older adults with DM [ 40 ], and heart failure may well increase the risk of frailty in this population through multiple mechanisms [ 11 ]. A population-based study compared the cardiovascular risk between metformin and DPP4i users with DM, finding that DPP4i use was associated with a higher risk of cardiovascular events than metformin [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several risk factors modulate the risk of frailty in patients with DM. Wang et al revealed that diabetic complications such as chronic kidney disease (CKD) and vascular morbidities affected the risk of incident frailty at different timings following DM onset [11]. Oral function integrity and its associated factors, including chewing capacity, choking probability, and tooth brushing habits, also play a role in determining the risk of frailty in patients with DM [12].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Glucose-Lowering Strategy on the Risk of Increasing Frailty Severity among 49,519 Patients with Diabetes Mellitus: A Longitudinal Cohort Study

Chi¹,

Wang²,

Lee³

et al. 2023

Aging and disease

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Patients with diabetes mellitus (DM) have a higher risk of incident and aggravating frailty over time. Frailty-initiating risk factors have been identified, but modulators of frail severity over time remain poorly defined. We aimed to explore the influences of glucose-lowering drug (GLD) strategy on DM patients' risk of increasing frail severity. We retrospectively identified type 2 DM patients between 2008 and 2016, dividing them into "no GLD", oral GLD (oGLD) monotherapy, oGLD combination, and those receiving insulin without or with oGLD at baseline. Increasing frail severity, defined as ≥1 FRAIL component increase, was the outcome of interest. Cox proportional hazard regression was utilized to analyze the risk of increasing frail severity associated with GLD strategy, accounting for demographic, physical data, comorbidities, medication, and laboratory panel. After screening 82,208 patients with DM, 49,519 (no GLD, 42.7%; monotherapy, 24.0%; combination, 28.5%; and insulin user, 4.8%) were enrolled for analysis. After 4 years, 12,295 (24.8%) had increasing frail severity. After multivariate adjustment, oGLD combination group exhibited a significantly lower risk of increasing frail severity (hazard ratio (HR) 0.90, 95% confidence interval (CI) 0.86 -0.94), while the risk of insulin users increased (HR 1.11, 95% CI 1.02 -1.21) than no GLD group. Users receiving more oGLD exhibited a trend of less risk reduction relative to others. In conclusion, we discovered that the strategy of oral glucose lowering drugs combination might reduce the risk of frail severity increase. Accordingly, medication reconciliation in frail diabetic older adults should take into account their GLD regimens.

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Combinations of valvular calcification and serum alkaline phosphatase predict cardiovascular risk among end-stage kidney disease patients

Chao,

Liao,

2024

IJC Heart & Vasculature

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The frailty risk trajectory associated with kidney and cardiovascular morbidities among patients with incident diabetes: A population-based study

Cited by 5 publications

References 34 publications

Vascular frailty, a proposal for new frailty type: A narrative review

Vascular frailty, a proposal for new frailty type: A narrative review

The Impact of Glucose-Lowering Strategy on the Risk of Increasing Frailty Severity among 49,519 Patients with Diabetes Mellitus: A Longitudinal Cohort Study

Combinations of valvular calcification and serum alkaline phosphatase predict cardiovascular risk among end-stage kidney disease patients

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