Journal Article Ppublish 4 citations
PubMed: 39894445 DOI: 10.1016/j.jtha.2025.01.006
Frailty and risk of venous thromboembolism in older adults: the Atherosclerosis Risk in Communities Study.
J Thromb Haemost 23(5):1531-1538
Authors: Tobyn S Chiu, James S Pankow, Mary Cushman, B Gwen Windham, Kunihiro Matsushita, Yejin Mok, Anna M Kucharska-Newton, Weihong Tang, Pamela L Lutsey
Affiliations
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
- Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont, USA.
- Department of Medicine, MIND Center, University of Mississippi Medical Center, Jackson, Mississippi, USA.
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
- Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA; Department of Epidemiology, University of Kentucky, Lexington, Kentucky, USA.
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
Abstract
BACKGROUND
Frailty may be a marker of risk for developing venous thromboembolism (VTE).
OBJECTIVES
To examine the relationship of frailty and its components with risk of incident VTE among older adults.
METHODS
We examined 5551 participants of the Atherosclerosis Risk in Communities Study without a history of VTE, using visit 5 (2011-2013) as baseline (mean age, 75.4 years; 57.8% female; 21.5% Black race). Frailty status (frail, prefrail, or robust) was defined as having ≥3 components, 1 to 2 components, or no components, respectively, from assessments of weight loss, low grip strength, exhaustion, slow walking speed, and low physical activity. VTE events were identified from hospitalization records and adjudicated by physicians.
RESULTS
In total, 182 incident VTE events accrued over a median follow-up of 7.2 years. Participants who were frail, vs robust, had a hazard ratio (HR) for incident VTE of 2.20 (95% CI, 1.30-3.71) after accounting for demographics. Further adjustment for potential confounders only slightly attenuated the association (HR, 2.09; 95% CI, 1.23-3.55). When analyzed separately, frailty was associated with a fully adjusted HR of 2.46 (95% CI, 1.26-4.80) for provoked VTE and 1.56 (95% CI, 0.66-3.69) for unprovoked VTE. Of the frailty components, exhaustion, slow walking speed, and low physical activity were significantly associated with increased risk of incident VTE.
CONCLUSION
Among this sample of older adults, frail participants had a 2-fold greater risk of incident VTE than robust participants. Exhaustion, slow walking speed, and low physical activity were frailty components identified as being predictors of incident VTE. Frailty status may be a means for identifying older adults at elevated VTE risk.
MeSH
Exercise, Thromboembolism, Walking Speed, Walking, Atherosclerosis, Venous Thromboembolism, Thrombosis, Frailty