scholarly journals Clinical Use of Acid Suppressants and Risk of Dementia in the Elderly: A Pharmaco-Epidemiological Cohort Study

2020 ◽  
Vol 17 (21) ◽  
pp. 8271
Author(s):  
Liang-Yu Chen ◽  
Huey-Juan Lin ◽  
Wen-Tung Wu ◽  
Yong-Chen Chen ◽  
Cheng-Li Chen ◽  
...  
Keyword(s):  
Cox Regression ◽  
The Elderly ◽  
Cumulative Exposure ◽  
Prior History ◽  
Research Database ◽  
Dementia Patients ◽  
Hazard Ratios ◽  
Dementia Risk ◽  
Potential Link ◽  
History Of

Background: Results of studies regarding the potential link between acid suppressant use and dementia risk are inconsistent. This study aimed to evaluate the association of cumulative exposure to histamine 2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs) with dementia risk in an Asian older cohort aged ≥65 years. Methods: Patients initiating H2RA (the H2RA user cohort, n = 21,449) or PPI (the PPI user cohort, n = 6584) and those without prescription for H2RA (the H2RA non-user cohort, n = 21,449) or PPI (the PPI non-user cohort, n = 6584) between 1 January 2000 and 31 December 2005 without a prior history of dementia were identified from Taiwan’s National Health Insurance Research Database (NHIRD). The outcome of interest was all-cause dementia. Patients’ exposure to H2RAs or PPIs was followed-up from dates of initial prescription to the earliest outcome of incident dementia, death, or the end of 2013. Potential associations between acid suppressant use and dementia risk were analyzed using time-dependent Cox regression estimated hazard ratios (HRs) and 95% confidence intervals (CIs). Results: After mutual adjustment for H2RA and PPI use and other potential confounders, patients with H2RA use had significantly higher risk of developing dementia as compared to those not treated with H2RAs (adjusted HR, 1.84; 95% CI, 1.49–2.20). Likewise, PPI users had significantly elevated risk of dementia compared to PPI non-users (adjusted HR, 1.42; 95% CI, 1.07–1.84). Conclusions: Our results indicate that exposures to H2RAs and PPIs are associated with increased dementia risk.

Abstract 14: The Influence of Provider Specialty on Anticoagulation Prescription Fills and Stroke Risk in Atrial Fibrillation Patients With History of Cancer

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Wesley T O’Neal ◽  
J’Neka Claxton ◽  
Richard MacLehose ◽  
Lin Chen ◽  
Lindsay G Bengtson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulant ◽  
Cox Regression ◽  
Prior History ◽  
Cancer Type ◽  
Patients With Cancer ◽  
Increased Risk ◽  
History Of ◽  
Reduced Risk ◽  
History Of Cancer

Background: Early cardiology involvement within 90 days of atrial fibrillation (AF) diagnosis is associated with greater likelihood of oral anticoagulant use and a reduced risk of stroke. Due to variation in cardiovascular care for patients with cancer, it is possible that a similar association does not exist for AF patients with cancer. Methods: We examined the association of early cardiology involvement with oral anticoagulation use among non-valvular AF patients with history of cancer (past or active), using data from 388,045 patients (mean age=68±15 years; 59% male) from the MarketScan database (2009-2014). ICD-9 codes in any position were used to identify cancer diagnosis prior to AF diagnosis. Provider specialty and filled anticoagulant prescriptions 3 months prior to and 6 months after AF diagnosis were obtained. Poisson regression models were used to compute the probability of an oral anticoagulant prescription fill and Cox regression was used to estimate the risk of stroke and major bleeding. Results: A total of 64,016 (17%) AF patients had a prior history of cancer. Cardiology involvement was less likely to occur among patients with history of cancer than those without (relative risk=0.92, 95% confidence interval (0.91, 0.93)). Similar differences were observed for cancers of the colon (0.90 (0.88, 0.92)), lung (0.76 (0.74, 0.78)), pancreas (0.74 (0.69, 0.80)), and hematologic system (0.88 (0.87, 0.90)), while no differences were observed for breast or prostate cancers. Patients with cancer were less likely to fill prescriptions for anticoagulants (0.89 (0.88, 0.90)) than those without cancer, and similar results were observed for cancers of the colon, lung, prostate, pancreas, and hematologic system. However, patients with cancer were more likely to fill prescriptions for anticoagulants (1.48 (1.45, 1.52)) if seen by a cardiology provider, regardless of cancer type. A reduced risk of stroke (hazard ratio=0.89 (0.81, 0.99)) was observed among all cancer patients who were seen by a cardiology provider than among those who were not, without an increased risk of bleeding (1.04 (0.95, 1.13)). Conclusion: AF patients with cancer were less likely to see a cardiologist, and less likely to fill an anticoagulant prescription than AF patients without cancer. However, cardiology involvement was associated with increased anticoagulant prescription fills and reduced risk of stroke, suggesting a beneficial role for cardiology providers to improve outcomes in AF patients with history of cancer.

scholarly journals A population-wide analysis of the familial risk of suicide in Utah, USA

2021 ◽  
pp. 1-10
Author(s):  
Amanda V. Bakian ◽  
Danli Chen ◽  
Chong Zhang ◽  
Heidi A. Hanson ◽  
Anna R. Docherty ◽  
...  
Keyword(s):  
Suicide Risk ◽  
Cox Regression ◽  
Familial Risk ◽  
Risk Groups ◽  
Population Based ◽  
Unified Framework ◽  
Population Database ◽  
First Degree Relatives ◽  
Hazard Ratios ◽  
History Of

Abstract Background The degree to which suicide risk aggregates in US families is unknown. The authors aimed to determine the familial risk of suicide in Utah, and tested whether familial risk varies based on the characteristics of the suicides and their relatives. Methods A population-based sample of 12 160 suicides from 1904 to 2014 were identified from the Utah Population Database and matched 1:5 to controls based on sex and age using at-risk sampling. All first through third- and fifth-degree relatives of suicide probands and controls were identified (N = 13 480 122). The familial risk of suicide was estimated based on hazard ratios (HR) from an unsupervised Cox regression model in a unified framework. Moderation by sex of the proband or relative and age of the proband at time of suicide (<25 v. ⩾25 years) was examined. Results Significantly elevated HRs were observed in first- (HR 3.45; 95% CI 3.12–3.82) through fifth-degree relatives (HR 1.07; 95% CI 1.02–1.12) of suicide probands. Among first-degree relatives of female suicide probands, the HR of suicide was 6.99 (95% CI 3.99–12.25) in mothers, 6.39 in sisters (95% CI 3.78–10.82), and 5.65 (95% CI 3.38–9.44) in daughters. The HR in first-degree relatives of suicide probands under 25 years at death was 4.29 (95% CI 3.49–5.26). Conclusions Elevated familial suicide risk in relatives of female and younger suicide probands suggests that there are unique risk groups to which prevention efforts should be directed – namely suicidal young adults and women with a strong family history of suicide.

Abstract P668: Clinically Meaningful Weight Gain Before Menopause and Risk of Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Maria D Zambrano Espinoza ◽  
Emma Kersey ◽  
Amelia K Boehme ◽  
Joshua Willey ◽  
Eliza C Miller
Keyword(s):  
Weight Gain ◽  
Weight Change ◽  
Stroke Risk ◽  
Cox Regression ◽  
Reference Group ◽  
Weight Changes ◽  
Younger Women ◽  
Hazard Ratios ◽  
History Of ◽  
Using Data

Background: Obesity is an independent risk factor for stroke. Weight gain has been associated with a higher risk of cardiovascular diseases in postmenopausal women. It is unclear, however, if weight changes before menopause have similar effects. We hypothesized that clinically meaningful premenopausal weight gain, defined as Body Mass Index (BMI) change >5%, would be associated with a higher stroke risk later in life. Methods: Using data from the California Teachers Study, we identified women aged < 55 with no history of stroke. We used weight changes between 1995-2006 as proxy for premenopausal weight gain. We defined weight change as modest or moderate using BMI changes of 5-10% and >10% respectively. Stroke outcomes were obtained from linkage to California hospitalization records. We used Cox regression models to calculate hazard ratios with 95% confidence intervals for the association of weight change and future stroke, adjusting for vascular risk factors. Results: Of 17,295 women included in the study, 113 had a stroke. In comparison to women who maintained a stable weight, women with moderate weight gain during premenopausal years had 2.0 times the risk of stroke. In the adjusted analysis, women with moderate weight gain had 89.6% higher risk of stroke, compared to the reference group. We found no significant association with stroke in women who had modest weight changes. Conclusion: Moderate premenopausal weight gain significantly increased stroke risk in women. Younger women should be educated about the effects of weight gain on future brain health. Count: 1836/1950

Abstract 16083: Risk of Preserved versus Reduced Ejection Fraction in Women With and Without History of Breast Cancer: The Pathways Heart Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jamal S Rana ◽  
Heather Greenlee ◽  
Richard Cheng ◽  
Cecile A Laurent ◽  
Hanjie Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Ejection Fraction ◽  
Endocrine Therapy ◽  
White Women ◽  
Cox Regression ◽  
Prior History ◽  
Reduced Ejection Fraction ◽  
Increased Risk ◽  
History Of

Introduction: Incidence of heart failure (HF), specifically with preserved ejection fraction (HFpEF), is rising in the general population, yet is understudied. To provide a population-based estimate of HF in breast cancer (BC) survivors, we compared risk of HF in women with and without BC history in the Kaiser Permanente Northern California (KPNC) integrated health system. Methods: Data were extracted from KPNC electronic health records. All invasive BC cases diagnosed from 2005-2013 were identified and matched 1:5 with non-BC controls on birth year, race/ethnicity, and KPNC membership at BC diagnosis. Cox regression models assessed the hazard of HF by EF status: HFpEF (EF ≥ 45%), HF with reduced EF (HFrEF; EF < 45%), and unknown EF. Women with prior history of HF were excluded. Models were adjusted for factors known to affect BC risk or CVD and for prevalent CVD at BC diagnosis. We also examined case subgroups who received cardiotoxic chemotherapy, left-sided radiation therapy, and/or endocrine therapy, versus their controls. Results: A total of 14,804 women diagnosed with invasive BC and with no history of HF were identified and matched to 74,034 women without BC history. Women were on average 61 years at BC diagnosis and 65% white. Women with HFpEF were older and more likely to have hypertension (p<0.05). Among all cases vs. controls, there was increased risk of HFrEF (HR: 1.5, 95% CI: 1.18, 1.98) but not HFpEF or unknown EF (figure). Compared to their controls, women treated with chemotherapy were more than 3-times likely to develop HFrEF (HR: 3.26, 95% CI: 2.2, 4.8) and more than 1.5-times likely to develop HFpEF (HR=1.61, 95% CI: 1.15, 2.24). Women who received left-sided radiation therapy had nearly double the risk of developing HFrEF (HR=1.85, 95% CI: 1.20, 2.84). No associations were found among women who received endocrine therapy. Conclusions: Increased surveillance is warranted for women with BC receiving cardiotoxic chemotherapy for development of both HFrEF and HFpEF.

Abstract P283: Resistance Exercise Reduces the Risk of Developing Excess Body Fat and Abdominal Obesity

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Angelique G Brellenthin ◽  
Duck-chul Lee ◽  
Xuemei Sui ◽  
Steven Blair
Keyword(s):  
Resistance Exercise ◽  
Aerobic Exercise ◽  
Body Fat ◽  
Abdominal Obesity ◽  
Cox Regression ◽  
Physical Activity Guidelines ◽  
Specific Effects ◽  
Hazard Ratios ◽  
History Of ◽  
Skinfold Measurements

Introduction: Excess body fat and abdominal obesity have been associated with cardiovascular diseases. While aerobic exercise is often recommended to prevent fat accumulation, less evidence exists detailing the specific effects of resistance exercise, independent of or combined with aerobic exercise, on the development of excess body fat and abdominal obesity. Hypothesis: We hypothesized that resistance exercise would be associated with a lower incidence of developing excess body fat and abdominal obesity. Methods: Participants were 7,685 men and women aged 18 to 89 years (mean age, 46) who received a preventive medical examination during 1987-2005 in the Aerobics Center Longitudinal Study. Participants with a history of myocardial infarction, stroke, cancer, excess body fat, or abdominal obesity at baseline were excluded. Resistance exercise (RE) and meeting the 2008 US Physical Activity Guidelines (RE ≥2 days/week) for RE were determined by self-reported leisure-time exercise. Excess body fat was defined as % body fat (≥25 in men, ≥30 in women) based on underwater weighing or skinfold measurements and abdominal obesity as waist girth (>102 cm in men, >88 cm in women). Cox regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident excess body fat and abdominal obesity by RE levels after adjusting for baseline age, sex, examination year, body weight, current smoking, heavy alcohol drinking, and meeting aerobic exercise (AE) guidelines (≥500 MET-minutes per week). Results: During an average follow-up of 5 years, 1517 (20%) developed excess body fat and 552 (14%) developed abdominal obesity. Individuals meeting the RE guidelines (30%; 2323 of 7685) had a 26% and 25% lower risk of developing excess body fat (HR: 0.74; 95% CI: 0.65 to 0.84) and abdominal obesity (HR: 0.75; 95% CI: 0.61 to 0.92), respectively, after adjusting for potential confounders including AE. The HRs (95% CIs) of incident abdominal obesity were 0.70 (0.48-1.01), 0.62 (0.44-0.87), 0.98 (0.67-1.42), and 0.62 (0.42-0.91), while the HRs (95% CIs) of incident excess body fat were 0.84 (0.69-1.03), 0.71 (0.59-0.86), 0.75 (0.59-0.96), and 0.56 (0.43-0.72), in weekly RE time of 1-59, 60-119, 120-179, and ≥180 minutes/week, respectively, compared with no RE. In the combined analysis of RE and AE, HRs (95% CIs) of incident excess body fat and abdominal obesity were 0.71 (0.53-0.95) and 0.62 (0.37-1.04) in meeting RE guidelines only, 0.86 (0.77-0.97) and 0.80 (0.66-0.97) in meeting AE guidelines only, and 0.65 (0.56-0.75) and 0.62 (0.49-0.79) in meeting both RE and AE guidelines, respectively, compared with meeting none of the guidelines. Conclusions: We found that RE, independent of and combined with AE, is associated with a reduced risk of developing excess body fat and abdominal obesity.

scholarly journals Pregnancy, pregnancy loss and the risk of diabetes in Chinese women: findings from the China Kadoorie Biobank

2019 ◽  
Vol 35 (3) ◽  
pp. 295-303
Author(s):  
Sanne A. E. Peters ◽  
◽  
Ling Yang ◽  
Yu Guo ◽  
Yiping Chen ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Cox Regression ◽  
Chinese Women ◽  
Later Life ◽  
Induced Abortion ◽  
Hazard Ratios ◽  
Increased Risk ◽  
History Of ◽  
Incident Cases

AbstractPregnancy and pregnancy loss may be associated with increased risk of diabetes in later life. However, the evidence is inconsistent and sparse, especially among East Asians where reproductive patterns differ importantly from those in the West. We examined the associations of pregnancy and pregnancy loss (miscarriage, induced abortion, and still birth) with the risk of incident diabetes in later life among Chinese women. In 2004–2008, the nationwide China Kadoorie Biobank recruited 302 669 women aged 30–79 years from 10 (5 urban, 5 rural) diverse localities. During 9.2 years of follow-up, 7780 incident cases of diabetes were recorded among 273,383 women without prior diabetes and cardiovascular disease at baseline. Cox regression yielded multiple-adjusted hazard ratios (HRs) for the risk of diabetes associated with pregnancy and pregnancy loss. Overall, 99% of women had been pregnant, of whom 10%, 53%, and 6% reported having a history of miscarriage, induced abortion, and stillbirth, respectively. Among ever pregnant women, each additional pregnancy was associated with an adjusted HR of 1.04 (95% CI 1.03; 1.06) for diabetes. Compared with those without pregnancy loss, women with a history of pregnancy loss had an adjusted HR of 1.07 (1.02; 1.13) and the HRs increased with increasing number of pregnancy losses, irrespective of the number of livebirths; the adjusted HR was 1.03 (1.00; 1.05) for each additional pregnancy loss. The strength of the relationships differed marginally by type of pregnancy loss. Among Chinese women, a higher number of pregnancies and pregnancy losses were associated with a greater risk of diabetes.

scholarly journals Pre-eclampsia and risk of later kidney disease: nationwide cohort study

BMJ ◽  
2019 ◽  
pp. l1516 ◽  
Author(s):  
Jonas H Kristensen ◽  
Saima Basit ◽  
Jan Wohlfahrt ◽  
Mette Brimnes Damholt ◽  
Heather A Boyd
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Outcome Measure ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Hazard Ratios ◽  
Gestational Age At Delivery ◽  
History Of

ABSTRACTObjectiveTo investigate associations between pre-eclampsia and later risk of kidney disease.DesignNationwide register based cohort study.SettingDenmark.PopulationAll women with at least one pregnancy lasting at least 20 weeks between 1978 and 2015.Main outcome measureHazard ratios comparing rates of kidney disease between women with and without a history of pre-eclampsia, stratified by gestational age at delivery and estimated using Cox regression.ResultsThe cohort consisted of 1 072 330 women followed for 19 994 470 person years (average 18.6 years/woman). Compared with women with no previous pre-eclampsia, those with a history of pre-eclampsia were more likely to develop chronic renal conditions: hazard ratio 3.93 (95% confidence interval 2.90 to 5.33, for early preterm pre-eclampsia (delivery <34 weeks); 2.81 (2.13 to 3.71) for late preterm pre-eclampsia (delivery 34-36 weeks); 2.27 (2.02 to 2.55) for term pre-eclampsia (delivery ≥37 weeks). In particular, strong associations were observed for chronic kidney disease, hypertensive kidney disease, and glomerular/proteinuric disease. Adjustment for cardiovascular disease and hypertension only partially attenuated the observed associations. Stratifying the analyses on time since pregnancy showed that associations between pre-eclampsia and chronic kidney disease and glomerular/proteinuric disease were much stronger within five years of the latest pregnancy (hazard ratio 6.11 (3.84 to 9.72) and 4.77 (3.88 to 5.86), respectively) than five years or longer after the latest pregnancy (2.06 (1.69 to 2.50) and 1.50 (1.19 to 1.88). By contrast, associations between pre-eclampsia and acute renal conditions were modest.Conclusions Pre-eclampsia, particularly early preterm pre-eclampsia, was strongly associated with several chronic renal disorders later in life. More research is needed to determine which women are most likely to develop kidney disease after pre-eclampsia, what mechanisms underlie the association, and what clinical follow-up and interventions (and in what timeframe post-pregnancy) would be most appropriate and effective.

scholarly journals Mortality in Patients with Diabetic Foot Ulcers: Causes, Risk Factors, and Their Association with Evolution and Severity of Ulcer

2020 ◽  
Vol 9 (9) ◽  
pp. 3009
Author(s):  
José Antonio Rubio ◽  
Sara Jiménez ◽  
José Luis Lázaro-Martínez
Keyword(s):  
Diabetic Foot ◽  
Cox Regression ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
History Of

Background: This study reviews the mortality of patients with diabetic foot ulcers (DFU) from the first consultation with a Multidisciplinary Diabetic Foot Team (MDFT) and analyzes the main cause of death, as well as the relevant clinical factors associated with survival. Methods: Data of 338 consecutive patients referred to the MDFT center for a new DFU during the 2008–2014 period were analyzed. Follow-up: until death or until 30 April 2020, for up to 12.2 years. Results: Clinical characteristics: median age was 71 years, 92.9% had type 2 diabetes, and about 50% had micro-macrovascular complications. Ulcer characteristics: Wagner grade 1–2 (82.3%), ischemic (49.2%), and infected ulcers (56.2%). During follow-up, 201 patients died (59.5%), 110 (54.7%) due to cardiovascular disease. Kaplan—Meier curves estimated a reduction in survival of 60% with a 95% confidence interval (95% CI), (54.7–65.3) at 5 years. Cox regression analysis adjusted to a multivariate model showed the following associations with mortality, with hazard ratios (HRs) (95% CI): age, 1.07 (1.05–1.08); HbA1c value < 7% (53 mmol/mol), 1.43 (1.02–2.0); active smoking, 1.59 (1.02–2.47); ischemic heart or cerebrovascular disease, 1.55 (1.15–2.11); chronic kidney disease, 1.86 (1.37–2.53); and ulcer severity (SINBAD system) 1.12 (1.02–1.26). Conclusion: Patients with a history of DFU have high mortality. Two less known predictors of mortality were identified: HbA1c value < 7% (53 mmol/mol) and ulcer severity.

Poststroke depression in elderly, a review

2011 ◽  
Vol 26 (S2) ◽  
pp. 826-826 ◽  
Author(s):  
M. Samakouri ◽  
S. Arseniou ◽  
F.-G. Keskeridou ◽  
M. Gymnopoulou ◽  
M. Livaditis
Keyword(s):  
Negative Impact ◽  
The Elderly ◽  
Prior History ◽  
First Year ◽  
Functional Impairments ◽  
Motor Abilities ◽  
Significant Burden ◽  
History Of ◽  
Death Wishes ◽  
Early Diagnose

IntroductionMood disturbances are often found in stroke patients and have a negative impact both on the recovery and the outcome of the stroke. Depression is the most common neuropsychiatric complication in the poststroke population, affecting nearly 30%–50% of patients within the first year. PSD implies a significant burden on both patients and their caregivers.Material and methodsUsing the search engines Pubmed and Scopus, 20 papers regarding the elderly dated from 2002–2010 were reviewed using the keywords depression, poststroke, recovery after stroke.ResultsThe core features of PSD include but are not limited to: persistent sadness, feelings of hopelessness, helplessness and worthlessness, guilt and sense of being a burden on the caregiver, lack of motivation, loss of interest, death wishes and suicidal ideation. Various cerebrovascular risk factors, including hypertension, atherosclerotic heart disease, hyperlipidemia and diabetes mellitus have been implicated as risks for depression in late life.Other predisposing factors are: prior history of depression or anxiety disorder, certain personality traits, baseline dementia but also, social isolation, living alone, physical functional impairments or a history of other psychiatric disorder.ConclusionDepression may impede recovery from stroke and impair outcome by affecting social functioning, motor abilities, cognitive functions and quality of life, thus it is important to early diagnose and prevent PSD.

New-onset congestive heart failure (CHF) and cardiovascular disease (CVD) in older colorectal cancer (CRC) survivors: A population-based study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10011-10011
Author(s):  
Kelly Kenzik ◽  
Courtney Balentine ◽  
Smita Bhatia ◽  
Grant Richard Williams
Keyword(s):  
Cumulative Incidence ◽  
Cox Regression ◽  
The Elderly ◽  
Population Based ◽  
Diabetic Patients ◽  
Cumulative Incidence Functions ◽  
Increased Risk ◽  
History Of ◽  
Incidence Functions ◽  
New Onset

10011 Background: CRC is primarily a disease of the elderly. The high burden of pre-existing comorbidities alone or in concert with cancer treatment place the older patients with CRC at increased risk of new-onset morbidities, specifically, CVD and CHF. However, the magnitude of risk of new-onset morbidity, and its association with pre-existing comorbidities or treatment remain unknown. Methods: Using SEER-Medicare data, we evaluated individuals diagnosed with incident stage I-III CRC at age ≥66y between 1/1/2000 and 12/31/2011 who had survived ≥2y after diagnosis (n = 57,256; 77% with colon cancer). We compared these to an age, sex-, and race-frequency matched comparison group of non-cancer Medicare patients (n = 104,731). We evaluated new-onset CHF and CVD using competing risk cumulative incidence functions and multivariable Cox regression models. Results: The median age at diagnosis was 77y (66-106y); 45% males; and 85% non-Hispanic white. Median follow-up was 8y (2-14y) from diagnosis of CRC. Treatment included surgery for 99%, chemotherapy for 31%, and radiation for 12%. New-onset morbidity: The 10y cumulative incidence of new-onset CHF and CVD were 43.6% and 58.9%, respectively. After controlling for pre-cancer comorbidities, CRC survivors were at increased risk of new-onset CHF (HR 1.29) and CVD (HR 1.74) (all p < 0.001) compared to controls. Patients receiving radiation (HR 1.29) or 5-FU+oxaliplatin (HR 1.09) were at increased risk of CVD compared to those without those therapies (p < 0.001). Pre-existing diabetes (HR 1.16) and CHF (HR 1.21) independently increased the risk of CVD (p < 0.001). While 5FU+oxaliplatin did not increase the risk of CHF independently (HR 0.97), diabetic patients treated with 5-FU+oxaliplatin were at 1.71-fold increased risk of developing CHF (p < 0.001) when compared with those without pre-existing diabetes. Conclusions: Older CRC survivors are at increased of developing CHF and CVD. Monitoring survivors with a history of exposure to 5FU+oxaliplatin or radiation, and improving management of pre-existing comorbidities may reduce the burden of long-term morbidity for older CRC survivors.

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