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- Title
Predictors of Mortality in Home-Dwelling Patients with Cardiovascular Disease Aged 75 and Older.
- Authors
Strandberg, Timo E.; Pitkala, Kaisu H.; Tilvis, Reijo S.
- Abstract
OBJECTIVES: To compare the predictive value of biomarkers commonly measured in older patients with cardiovascular disease (CVD) with an indicator of cognitive function. DESIGN: Prospective cohort study. SETTING: Helsinki, Finland. PARTICIPANTS: Three hundred ninety-eight home-dwelling older persons (261 women, mean age 80) with stable CVD and without a diagnosis of clinical dementia. MEASUREMENTS: Simple laboratory and clinical measurements (including the Mini Mental State Examination (MMSE, maximum score 30 points) and New York Heart Association (NYHA) classification) were used to predict mortality. A MMSE score between 18 and 24 points was considered to indicate cognitive impairment. RESULTS: At baseline, median MMSE score was 27 (interquartile range 25–28), with 59 individuals having a score below 24 points. During a mean follow-up of 6.0 years, 129 participants died. In the fully adjusted Cox proportional hazards model, low MMSE score was the strongest predictor of mortality, with a relative hazard of 2.38 (95% confidence interval=1.52–3.74; P<.001). Of the various clinical and laboratory variables, only creatinine, C-reactive protein, and history of congestive heart failure were significant independent predictors, whereas conventional risk factors were not. CONCLUSION: Only a few clinical variables independently predicted 6-year mortality in older home-living patients with CVD. The strongest predictor was impaired cognitive function assessed using MMSE.
- Subjects
BIOMARKERS; MEDICAL care for older people; CARDIOVASCULAR diseases in old age; CARDIOVASCULAR diseases; DISEASES in older people
- Publication
Journal of the American Geriatrics Society, 2009, Vol 57, Issue 2, p279
- ISSN
0002-8614
- Publication type
Article
- DOI
10.1111/j.1532-5415.2008.02112.x