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Joint Associations of Frailty and Cardiometabolic Diseases With Risk of All-Cause and Cardiac Mortality

Chen Zhu1, Tianqi Ma1, Lingfang He2

  • 1Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, P.R. China; Center of Coronary Circulation, Xiangya Hospital, Central South University, Changsha, P.R. China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China.

JACC. Asia
|July 16, 2025
PubMed

Insights

Frailty and cardiometabolic diseases (CMDs) significantly increase mortality risk in older adults. Managing both conditions together is crucial for reducing death rates.

Area of Science:

  • Gerontology
  • Cardiology
  • Public Health

Background:

  • Cardiometabolic diseases (CMDs) are prevalent in middle-aged and older adults.
  • The impact of frailty on CMD-related mortality risk remains unclear.

Purpose of the Study:

  • To investigate the combined effects of frailty and CMDs on mortality risk.
  • To examine the interaction between frailty and CMDs in predicting mortality outcomes.

Main Methods:

  • Prospective cohort study of 467,406 UK Biobank participants.
  • Frailty assessed using frailty phenotype and frailty index (FI).
  • CMD status categorized as none, single, or cardiometabolic multimorbidity (CMM).

Main Results:

  • Significant multiplicative and additive interactions between frailty and CMDs on mortality.
  • Coexisting frailty phenotype and CMM increased all-cause mortality 4.91-fold and cardiac mortality 8.33-fold.
  • Similar joint associations observed with FI measurements.

Conclusions:

  • Combined frailty and CMDs are associated with cumulatively increased mortality risk.
  • Comprehensive screening and management of frailty and CMDs are recommended for older populations.
Abstract

Keywords:
cardiovascular diseasesdiabetes mellitusfrailtymortalitymultimorbidity

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