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Multidimensional frailty increases cardiovascular risk in older people: An 8-year longitudinal cohort study in the
Nicola Veronese1, Ai Koyanagi2, Lee Smith3
1Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy; Department Geriatric Care, Orthogeriatrics and Rehabilitation, Frailty Area, E.O. Galliera Hospital, Genova, Italy.
Insights
Frailty, assessed using the Multidimensional Prognostic Index (MPI), is linked to a higher risk of cardiovascular diseases (CVDs). Comprehensive geriatric assessment (CGA) can help predict CVD risk in older adults.
Area of Science:
- Gerontology
- Cardiology
- Public Health
Background:
- Cardiovascular diseases (CVDs) are a leading cause of mortality and disability.
- Frailty is associated with increased cardiovascular risk, yet multidimensional frailty assessment is under-researched.
- The Multidimensional Prognostic Index (MPI) offers a comprehensive geriatric assessment (CGA) approach to frailty.
Purpose of the Study:
- To investigate the association between the MPI, derived from CGA, and CVD risk.
- To determine if MPI predicts CVD incidence in individuals at risk for or with knee osteoarthritis.
Main Methods:
- Longitudinal study of 4211 community-dwelling adults followed for 8 years.
- MPI calculated using a modified CGA, assessing functional, nutritional, mood, comorbidities, medications, quality of life, and co-habitation.
- Logistic regression analyses adjusted for confounders to assess CVD risk associated with MPI scores.
Main Results:
- Individuals with incident CVD had significantly higher baseline MPI scores (0.44 ± 0.17) compared to those without CVD (0.39 ± 0.17).
- Higher MPI scores (0.34–0.66 and >0.66) were associated with increased odds of CVD.
- A 0.10-point increase in MPI score correlated with a 1.16 times higher odds of incident CVD.
Conclusions:
- Elevated MPI scores are significantly associated with an increased risk of developing CVD.
- CGA, as integrated into the MPI, is a valuable tool for predicting CVD risk in older populations.
- The findings underscore the importance of multidimensional frailty assessment in cardiovascular risk stratification.
Background:
Cardiovascular diseases (CVDs) are the most important cause of mortality and an important cause of disability. Frailty seems to be associated with higher cardiovascular risk, but limited research has been done using a multidimensional approach to frailty. Thus, the present study aimed to investigate whether the multidimensional prognostic index (MPI), based on comprehensive geriatric assessment (CGA), is associated with CVD risk in the Osteoarthritis Initiative (OAI) study.
Methods:
Community-dwellers affected by knee OA or at high risk for this condition were followed for 8 years. A standardized CGA including information on functional, nutritional, mood, comorbidities, medications, quality of life and co-habitation status was used to calculate a modified version of the MPI (range 0-1), with higher scores representing greater risk of mortality. CVDs were recorded using self-reported information. Logistic regression analyses, adjusting for potential confounders, were conducted.
Results:
The final sample consisted of 4211 individuals (mean age 60.8 years, females = 58.6%). People with incident CVD had a significant higher baseline MPI value than those without CVD (0.44 ± 0.17 vs. 0.39 ± 0.17). People with an MPI between 0.34 and 0.66 (OR = 1.31; 95%CI: 1.03-1.67) and over 0.66 (OR = 1.91; 95%CI: 1.26-2.89) experienced a higher risk of CVD (vs. MPI score < 0.34). A 0.10 points increase in the MPI score at baseline was associated with a 1.16 (95%CI: 1.09-1.24) times higher odds for incident CVD.
Conclusions And Implications:
Higher MPI values at baseline were associated with an increased risk of CVD, reinforcing the importance of CGA in predicting CVD risk in older people.
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