Frailty and risk of venous thromboembolism in older adults

Aaron R. Folsom, Lori L. Boland, Mary Cushman, Susan R. Heckbert, Wayne D. Rosamond, Jeremy D. Walston

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Background. Frailty is a common risk factor for morbidity and mortality in elderly persons. Recent evidence links frailty to activation of coagulation and inflammatory pathways. We aimed to determine whether frailty in community-dwelling older adults is a risk factor for venous thromboembolism (VTE). Methods. We conducted a prospective cohort study in four U.S. communities involving 4859 participants 65 years old and older. At baseline, in 1989-1993, we assessed frailty based on weight loss, grip strength, feelings of exhaustion, walk time, and physical activity. Incident VTE (deep vein thrombosis or pulmonary embolus) through 2002 was identified by review of hospital records. Results. Fifty-two percent of the sample was classified as having intermediate or definite frailty. After adjustment for age, race, sex, body mass index, and diabetes, the relative risk of total VTE (n = 150) for people who were frail compared with no frailty was 1.31 (95% confidence interval [CI], 0.93-1.84). The comparably adjusted relative risk for idiopathic VTE (n = 58) was 1.79 (95% CI, 1.02-3.13). Conclusions. The incidence rates of idiopathic VTE was higher in community-dwelling older adults with baseline frailty compared with no frailty. Further studies of the clotting process in frailty may allow the development of an improved strategy to determine VTE risk in this vulnerable subset of older adults.

Original languageEnglish (US)
Pages (from-to)79-82
Number of pages4
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume62
Issue number1
DOIs
StatePublished - Jan 2007

Bibliographical note

Funding Information:
ACKNOWLEDGMENTS The Cardiovascular Health Study (CHS) was funded by contracts N01-HC-85079 through N01-HC-85086, N01-HC-75150, N01-HC-45133, N01-HC-35129, and N01 HC-15103 from the National Heart, Lung, and Blood Institute. A full list of participating CHS investigators and institutions can be found at http://www.chs-nhlbi.org. The Longitudinal Investigation of Thromboembolism Etiology (LITE) study was funded by grant R01 HL59367 from the National Heart, Lung, and Blood Institute.

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