title: Frailty, Physical Activity, and Mobility in Patients With Cardiac Implantable Electrical Devices.
abstract: This study aimed to demonstrate the feasibility of measuring frailty in patients with cardiac implantable electrical devices while validating the physiologic significance of device-detected physical activity by evaluating its association with frailty and mobility.
  
  
  
  Outpatients with cardiac implantable electrical devices compatible with physical activity analysis with at least 7 days of data were eligible. Office testing included frailty status (Study of Osteoporotic Fractures instrument), gait speed (m/s), mobility according to the Timed Up and Go (TUG) test (seconds), and daily physical activity (h/d) as measured by cardiac implantable electrical device. Among 219 patients, Study of Osteoporotic Fractures testing found 39.7% to be robust, 47.5% prefrail, and 12.8% frail. The mean gait speed for the cohort was 0.8±0.3 m/s, mean TUG time was 10.9±4.4 seconds, and mean activity was 2.8±1.9 h/d. Frail patients were markedly more likely to have gait speeds <0.8 m/s (OR 6.25, 95% CI 1.79-33.3). In unadjusted analyses each 1-hour increase in mean daily activity was associated with a 46% reduction of frail phenotype (OR 0.54, 95% CI 0.40-0.74) versus robust and with a 27% reduction in the odds of having the prefrail phenotype (OR 0.73, 95% CI 0.62-0.86). After adjustment this association per hour of activity persisted, with an adjusted OR for frailty of 0.71 (95% CI 0.51-0.99) and adjusted OR for prefrailty of 0.81 (95% CI 0.67-0.99).
  
  
  
  Frailty and mobility limitation are common among cardiac implantable electrical device patients and are correlated to device-detected physical activity.
authors.affiliation: Hebrew SeniorLife Institute for Aging Research, Boston, MA dkramer@bidmc.harvard.edu.|Harvard Medical School, Boston, MA.|Division of Cardiology, Department of Medicine, Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Kramer
authors.affiliation: Hebrew SeniorLife Institute for Aging Research, Boston, MA.
authors.forename: Timothy
authors.initials: T
authors.lastname: Tsai
authors.affiliation: Harvard Medical School, Boston, MA.|Division of Cardiology, Department of Medicine, Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Poorna
authors.initials: P
authors.lastname: Natarajan
authors.affiliation: Harvard Medical School, Boston, MA.|Division of Cardiology, Department of Medicine, Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Elise
authors.initials: E
authors.lastname: Tewksbury
authors.affiliation: Hebrew SeniorLife Institute for Aging Research, Boston, MA.|Harvard Medical School, Boston, MA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Mitchell
authors.affiliation: Hebrew SeniorLife Institute for Aging Research, Boston, MA.|Harvard Medical School, Boston, MA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Travison
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000534:rehabilitation* / Q000628:therapy; D003430:Cross-Sectional Studies; D017147:Defibrillators, Implantable; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D000073496:Frailty / Q000453:epidemiology / Q000534:rehabilitation*; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D051346:Mobility Limitation; D010045:Outpatients; D010138:Pacemaker, Artificial; D012307:Risk Factors; D013997:Time Factors; D016138:Walking / Q000502:physiology*
keywords: aging; defibrillation; pacemaker; physical exercise