Contributors: Epidémiologie cardiovasculaire et mort subite; Université Paris-Sud - Paris 11 (UP11)-Institut National de la Santé et de la Recherche Médicale (INSERM); Epidémiologie et Biostatistique Bordeaux; Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM); Neuroépidémiologie; Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM); Epidémiologie des maladies chroniques : impact des interactions gène environnement sur la santé des populations; Institut Pasteur de Lille; Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé; Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC); Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM); Institut National de la Santé et de la Recherche Médicale, Victor Segalen-Bordeaux II University, Sanofi-Aventis, Fondation pour la Recherche Médicale , Caisse Nationale Maladie des Travailleurs Salariés, Direction Générale de la Santé, MGEN, Institut de la Longévité, Conseils Régionaux Aquitaine et Bourgogne, Fondation de France, Ministère de la Recherche -INSERM Programme "Cohortes et collections de données biologiques."
نبذة مختصرة : International audience ; OBJECTIVES: To prospectively assess the association between disability and incident fatal and nonfatal coronary heart disease (CHD) in older adults free of cardiovascular disease (CVD). DESIGN: A French multicenter prospective population-based cohort of 9,294 subjects, aged 65 and older at baseline, recruited between 1999 and 2001 and followed for 6 years. SETTING: Three cities in France: Bordeaux in the southwest, Dijon in the northeast, and Montpellier in the southeast. PARTICIPANTS: Seven thousand three hundred fifty-four participants with no history of CVD and with available information on disability status. Subjects were categorized at baseline as having no disability, mild disability (mobility only), and moderate or severe disability (mobility plus activities of daily living or instrumental activities of daily living). MEASUREMENTS: Incident fatal and nonfatal coronary events (angina pectoris, myocardial infarction, revascularization procedures, and CHD death). RESULTS: At baseline, the mean level of the risk factors increased gradually with the severity of disability. After a median follow-up of 5.2 years, 264 first coronary events, including 55 fatal events, occurred. After adjustment for cardiovascular risk factors, participants with moderate or severe disability had a 1.7 times (95% confidence interval (CI)=1.0-2.7) greater risk of overall CHD than nondisabled subjects, whereas those with mild disability were not at greater CHD risk. An association was also found with fatal CHD, for which the risk increased gradually with the severity of disability (hazard ratio (HR)(mild disability)=1.7, 95% CI=0.8-3.6; HR(moderate/severe disability)=3.5, 95% CI=1.3-9.3; P for trend=.01). CONCLUSION: In older community-dwelling adults, the association between disability and incident CHD is mostly due to an association with fatal CHD.
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