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Association between measures of and prognostic significance of cardiorespiratory fitness in community-dwelling older adults

Yazdanyar, Ali (2011) Association between measures of and prognostic significance of cardiorespiratory fitness in community-dwelling older adults. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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The age structure of the U.S. population is expected to change with the segment of the population aged over 65 years experiencing the largest increase in size. Given the expected change in the U.S. population, efforts aimed at screening and diagnosis, in addition to the prevention and treatment of diseases with a significant burden in older adults should be at the forefront of public health efforts. Accordingly, in order to obtain an appreciation of the significance of cardiovascular diseases in older adults we initially performed a literature review of the burden and prevention of cardiovascular diseases, the leading cause of morbidity and mortality in older adults. Subsequently, we focused our research efforts on cardiorespiratory fitness in older adults. Cardiorespiratory fitness is a determinant of morbidity and mortality in middle-aged and older adults which can be measured objectively by either exercise testing or walk-based tests. Few studies of community-dwelling older adults have characterized the relationship between fitness as assessed by exercise testing versus walk-based testing, with subclinical cardiovascular, or the prognostic significance of walk-based test performance. We sought to characterize these relationships among community-dwelling adults participating in the Cardiovascular Health Study (CHS). In an analysis of the Arterial Calcification in the Elderly (ACE-CHS), 6 Minute Walk test (6 MWT) performance was a useful measure of treadmill test capability and performance. A second analysis of ACE-CHS failed to identify subclinical cardiovascular disease as quantified by the coronary artery calcification score as a significant determinant of exercise duration in exercise treadmill testing. However, the coronary artery calcification score was associated with ischemia as detected by electrocardiographic changes during exercise testing. Finally, in the full CHS cohort, the 6 MWT performance was independently associated with all-cause mortality, demonstrating a prognostic value for submaximal fitness assessment using the 6 MWT across a wide range of function present in community-dwelling older adults. The public health relevance of these finding is the potential clinical utility of the 6 MWT, a quick, safe and inexpensive alternative to exercise treadmill testing, in the assessment of cardiorespiratory fitness and the prediction of mortality in community-dwelling older adults.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairNewman, Anne Bnewmana@edc.pitt.eduANEWMAN
Committee MemberEdmundowicz,
Committee MemberSutton-Tyrrell,
Committee MemberKuller, Lewiskullerl@edc.pitt.eduKULLER
Committee MemberBoudreau, Robertboudreaur@edc.pitt.eduROB21
Date: 29 June 2011
Date Type: Completion
Defense Date: 28 March 2011
Approval Date: 29 June 2011
Submission Date: 4 April 2011
Access Restriction: 5 year -- Restrict access to University of Pittsburgh for a period of 5 years.
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: cardiovascular disease; mortality; six minute walk test
Other ID:, etd-04042011-171221
Date Deposited: 10 Nov 2011 19:34
Last Modified: 15 Nov 2016 13:38


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