Mortality and heart rate in the elderly: Role of cognitive impairment

被引:6
作者
Cacciatore, Francesco
Mazzella, Francesca
Abete, Pasquale
Viati, Luisa
Galizia, Gianluigi
D'Ambrosio, Daniele
Gargiulo, Gaetano
Russo, Salvatore
Visconti, Claudia
Della Morte, David
Ferrara, Nicola
Rengo, Franco
机构
[1] Univ Naples Federico II, Dipartimento Med Clin Sci Cardiovasc & Immunol, Cattedra Geriatr, I-80136 Naples, Italy
[2] IRCCS, Ist Sci Campoli Telese, Fdn Salvatore Maugeri, Benevento, Italy
关键词
D O I
10.1080/03610730601166372
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Mortality related to heart rate ( HR) increase in the elderly has not yet been well established. To ascertain the relationships among cognitive impairment ( CI), mortality, and HR increase, the authors prospectively studied a random sample of elderly subjects stratified according to presence or absence of CI. Elderly subjects randomly selected in 1991 ( n = 1332) were followed up for 12 years. Mortality was established in 98.1% of the subjects. When HR was stratified in quartiles (< 69,70-75,76-80, and > 80 bpm), mortality was linearly associated with increased HR in all ( from 47.7 to 57.0; r(2) = .43, p = .019) and in subjects without ( from 41.7 to 51.1%; r(2) = .50, p = .043) but not in those with CI ( from 57.5 to 66.1; r(2) = .20, p = .363). Cox regression analysis, adjusted for several variables, shows that HR doesn't predict mortality in all subjects ( RR 0.69; 95% CI = 0.27-1.73) or in those with CI ( RR 0.91; 95% CI = 0.81-1.02). In contrast, HR predicts mortality in subjects without CI ( RR 1.10; 95% CI = 1.00-1.22). Hence, HR increase is a predictor of mortality in elderly subjects without CI. However, when considering all elderly subjects and those with CI, HR increase seems to have no effect on mortality. Thus, CI should be considered when focusing on HR increase as risk factor for mortality in the elderly.
引用
收藏
页码:127 / 144
页数:18
相关论文
共 42 条
[1]   Association of average heart rate on 24-hour ambulatory electrocardiograms with incidence of new coronary events at 48-month follow-up in 1,311 patients (mean age 81 years) with heart disease and sinus rhythm [J].
Aronow, WS ;
Ahn, C ;
Mercando, AD ;
Epstein, S .
AMERICAN JOURNAL OF CARDIOLOGY, 1996, 78 (10) :1175-&
[2]  
ARONSON MK, 1991, ARCH INTERN MED, V151, P989, DOI 10.1001/archinte.1991.00400050129024
[3]  
Bassuk SS, 2000, AM J EPIDEMIOL, V151, P676
[4]   Pain reactivity in Alzheimer patients with different degrees of cognitive impairment and brain electrical activity deterioration [J].
Benedetti, F ;
Arduino, C ;
Vighetti, S ;
Asteggiano, G ;
Tarenzi, L ;
Rainero, I .
PAIN, 2004, 111 (1-2) :22-29
[5]   Pain threshold and tolerance in Alzheimer's disease [J].
Benedetti, F ;
Vighetti, S ;
Ricco, C ;
Lagna, E ;
Bergamasco, B ;
Pinessi, L ;
Rainero, I .
PAIN, 1999, 80 (1-2) :377-382
[6]   Influence of heart rate on mortality in a French population - Role of age, gender, and blood pressure [J].
Benetos, A ;
Rudnichi, A ;
Thomas, F ;
Safar, M ;
Guize, L .
HYPERTENSION, 1999, 33 (01) :44-52
[7]   Resting heart rate in older people: A predictor of survival to age 85 [J].
Benetos, A ;
Thomas, F ;
Bean, K ;
Albaladejo, P ;
Guize, L ;
Palatini, P .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2003, 51 (02) :284-285
[8]   Predictors of mortality in patients diagnosed with probable Alzheimer's disease [J].
Bowen, JD ;
Malter, AD ;
Sheppard, L ;
Kukull, WA ;
McCormick, WC ;
Teri, L ;
Larson, EB .
NEUROLOGY, 1996, 47 (02) :433-439
[9]   FACTORS AFFECTING SURVIVAL IN ALZHEIMERS-DISEASE [J].
BURNS, A ;
LEWIS, G ;
JACOBY, R ;
LEVY, R .
PSYCHOLOGICAL MEDICINE, 1991, 21 (02) :363-370
[10]   The role of blood pressure in cognitive impairment in an elderly population [J].
Cacciatore, F ;
Abete, P ;
Ferrara, N ;
Paolisso, G ;
Amato, L ;
Canonico, S ;
Maggi, S ;
Rengo, F .
JOURNAL OF HYPERTENSION, 1997, 15 (02) :135-142