title: Fatigue, general health, and ischemic heart disease in older adults.
abstract: BACKGROUND
  Fatigue has been shown to predict ischemic heart disease (IHD) and mortality in nonsmoking middle-aged men free of cardiovascular disease. The aim of this study was to investigate the predictive value of fatigue for IHD and general health in nondisabled individuals free of cardiovascular disease and older than 70 years.
  
  
  METHODS
  The study population was drawn from The Longitudinal Study of Aging Danish Twins. In total, 1,696 participants were followed up for 2-10 years by questionnaires and 10-16 years through registries. Kaplan Meier, Cox Proportional Hazard and logistic regression were used to analyze data. Fatigue was measured with the mobility-tiredness scale, and multivariable-adjusted models included age, sex, socioeconomic position, life style factors, and depression symptomatology. Good general health was defined as no hospitalization due to IHD, no self-reported IHD-related diagnoses, no use of heart medication, sustained good mobility, and participation at follow-up. IHD was defined as first hospitalization due to IHD (ICD10: I20-I25) or death due to IHD as primary cause.
  
  
  RESULTS
  Participants without fatigue had higher chances of a sustained good general health at 2 (odds ratio [OR] = 1.45 confidence interval [CI] 95%: 1.08-1.93) and 4 years of follow-up (OR = 1.55 CI 95%: 1.11-2.16), compared with participants with fatigue. Further, participants with fatigue had a significantly higher hazard of IHD during the 10-16 years of follow-up (hazard ratio [HR] = 1.47 CI 95%: 1.08-2.00) compared with participants without fatigue.
  
  
  CONCLUSIONS
  We concluded that fatigue in nondisabled older adults free of cardiovascular disease is an early predictor for development of subsequent poor general health and IHD.
authors.affiliation: Section of Social Medicine, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Postbox 2099, 1014 Copenhagen K, Denmark. anek@sund.ku.dk
authors.forename: Anette
authors.initials: A
authors.lastname: Ekmann
authors.forename: Inge
authors.initials: I
authors.lastname: Petersen
authors.forename: Minna
authors.initials: M
authors.lastname: Mänty
authors.forename: Kaare
authors.initials: K
authors.lastname: Christensen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Avlund
mesh_terms: D000368:Aged; D003718:Denmark / Q000453:epidemiology; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D017202:Myocardial Ischemia / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012042:Registries