"Successful aging": effect of subclinical cardiovascular disease.
BACKGROUND
Cardiovascular diseases are the primary cause of death in older adults. Among those without clinical disease, high levels of subclinical disease are associated with poor survival. The effect of the extent of subclinical cardiovascular disease on the quality of the remaining years has not been defined.


METHODS
In a longitudinal cohort study, 2932 men and women aged 65 years and older were followed up for 8 years to determine the likelihood of maintaining intact health and functioning. Successful aging was defined as remaining free of cardiovascular disease, cancer, and chronic obstructive pulmonary disease and with intact physical and cognitive functioning.


RESULTS
Younger age at study entry and a lower extent of subclinical cardiovascular disease were independently associated with the likelihood of maintaining successful aging. In age-stratified summaries, those with subclinical disease had a trajectory of decline similar to subjects 5 years older without subclinical vascular disease. Regression analyses showed that the decline associated with subclinical disease was equivalent to 6.5 (95% confidence interval, 6.4-6.6) years of aging for women and 5.6 (95% confidence interval, 5.4-5.8) years of aging for men. Individual measures of the extent of cardiovascular disease, diabetes mellitus, smoking, and higher C-reactive protein level were also independently predictive of fewer years of successful aging, but none of these factors substantially attenuated the effect of age itself.


CONCLUSIONS
There is a graded relationship between the extent of vascular disease measured noninvasively and the likelihood of maintaining intact health and function. Prevention of subclinical vascular disease may increase the quality and the quantity of years in late life.
Newman
Anne B
AB
Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA. anewman@pitt.edu
Arnold
Alice M
AM
Naydeck
Barbara L
BL
Fried
Linda P
LP
Burke
Gregory L
GL
Enright
Paul
P
Gottdiener
John
J
Hirsch
Calvin
C
O'Leary
Daniel
D
Tracy
Russell
R
D000368:Aged / Q000706:statistics & numerical data*; D000369:Aged, 80 and over; D000375:Aging; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors
D002097:C-Reactive Protein