Document Detail

Relationships of cardiac, pulmonary, and muscle reserves and frailty to exercise capacity in older women.
MedLine Citation:
PMID:  19822621     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A decline in exercise capacity (EC) is a characteristic of frailty. We hypothesized that decline is the effect of decrements in several physiological systems. We assessed whether the relationship of three main physiological systems-cardiac, pulmonary, and musculoskeletal-to EC is independent or interactive and whether their effect on EC varies with respect to frailty status.
METHODS: Observational study of 547 disabled women aged 65 years and older (Women's Health and Aging Study I) including 131 frail who participated in a test of EC. EC (seated step test), cardiac function (chronotropic index), pulmonary function (forced vital capacity, FVC), musculoskeletal function (quadriceps strength, QS), and frailty status were measured and interactive effects were modeled using linear regression and differentiation.
RESULTS: Each physiological system had a direct relationship with EC, which was lower in frail compared with nonfrail. The relationship between FVC and EC was positive and increased with increasing QS in nonfrail subjects. The effect of QS on EC was positive and increased with increasing FVC regardless of frailty. In subjects with low QS, frailty status was associated with lower EC and this effect became stronger with increasing FVC. Discussion Findings suggest but do not show that frailty status modifies the effects of physiological function in several systems on EC. Approaches to understanding emergent properties such as vulnerability to illness and death and clinical efforts to prevent and treat frailty should evaluate and possibly intervene on several physiological systems to be maximally effective.
Carlos O Weiss; Helen H Hoenig; Ravi Varadhan; Eleanor M Simonsick; Linda P Fried
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2009-10-12
Journal Detail:
Title:  The journals of gerontology. Series A, Biological sciences and medical sciences     Volume:  65     ISSN:  1758-535X     ISO Abbreviation:  J. Gerontol. A Biol. Sci. Med. Sci.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-03-18     Revised Date:  2014-09-22    
Medline Journal Info:
Nlm Unique ID:  9502837     Medline TA:  J Gerontol A Biol Sci Med Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  287-94     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Exercise Tolerance / physiology*
Frail Elderly*
Heart / physiopathology*
Heart Rate / physiology
Longevity / physiology*
Lung / physiopathology*
Muscle Strength / physiology*
Muscle, Skeletal / physiopathology*
Vital Capacity / physiology
Women's Health
Grant Support
5R37AG019905-08/AG/NIA NIH HHS; M01 RR000052/RR/NCRR NIH HHS; M01 RR000052-44/RR/NCRR NIH HHS; M01-RR00052/RR/NCRR NIH HHS; N01 AG012112/AG/NIA NIH HHS; N01AG12112/AG/NIA NIH HHS; P30 AG021334/AG/NIA NIH HHS; P30 AG021334-04/AG/NIA NIH HHS; P30AG021334-04/AG/NIA NIH HHS; R01 AG011703/AG/NIA NIH HHS; R01 AG011703-05/AG/NIA NIH HHS; R37 AG019905/AG/NIA NIH HHS; R37 AG019905-08/AG/NIA NIH HHS; T32 AG000247/AG/NIA NIH HHS; T32 AG000247-03/AG/NIA NIH HHS
Comment In:
J Gerontol A Biol Sci Med Sci. 2010 Mar;65(3):255-6; discussion 257   [PMID:  19887535 ]

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