Sustained frailty remission and future cardiovascular disease risk: a longitudinal study from the UK Biobank

Physical frailty has been recognized as reversible and an important risk factor for cardiovascular disease (CVD). However, little is known about sustained frailty remission and its impact on CVD. The study aimed to assess the association between sustained frailty remission and incident CVD.

Data were derived from the UK Biobank. Physical frailty was evaluated by the Fried frailty phenotype, and frailty transition patterns across three waves that is instance 0, instance 1, and instance 2 were defined. Incident CVD was defined by the International Classification of Diseases, 10th Revision (codes I00-I99). Cox proportional hazard models were used to calculate the hazard ratio (HR) and 95% confidence interval (95% CI), and stratified by age and sex.

A total of 2,391 participants from the UK Biobank (mean age: 54.97 years) were included. 1,513 participants remained robust and 351 participants experienced sustained frailty remission. Over a median follow-up duration of 4.6 years, 508 participants developed CVD. Compared with stable pre-frail or frail individuals, those with sustained frailty remission had a lower future CVD risk (HR = 0.72, 95% CI: 0.53-0.99). The association remained significant in middle-aged adults (< 65 years; HR = 0.69, 95% CI: 0.50-0.98), and a stronger, though non-significant, association was observed in females (HR = 0.64, 95% CI: 0.38-1.08) than in males (HR = 0.80, 95% CI: 0.53-1.21).

Sustained frailty remission was associated with a reduced risk of developing CVD. Physical frailty may serve as an early indicator of CVD risk and a potential target for intervention strategies.