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Cumulative Burden of Geriatric Conditions and Cardiovascular Outcomes in Older Adults: Analysis From ARIC

Kehinde Tom-Ayegunle1, Yasser Jamil2, Justin B Echouffo-Tcheugui1

  • 1Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

JACC. Advances
|November 13, 2025
PubMed

Insights

The number of geriatric conditions in older adults significantly increases the risk of major adverse cardiovascular events (MACE), including heart attack, stroke, and death. A graded, synergistic association highlights the need for integrated geriatric assessments in cardiovascular risk models.

Area of Science:

  • Geriatric Medicine
  • Cardiovascular Disease Epidemiology
  • Clinical Risk Stratification

Background:

  • Older adults experience a high burden of cardiovascular disease (CVD).
  • Geriatric conditions significantly exacerbate CVD outcomes.
  • The cumulative impact of multiple geriatric conditions on CVD events is not well understood.

Purpose of the Study:

  • To investigate the association between the number of geriatric conditions and major adverse cardiovascular events (MACE).
  • To determine if multiple coexisting geriatric conditions confer a graded increase in MACE risk.

Main Methods:

  • Utilized data from the Atherosclerosis Risk In Communities (ARIC) study.
  • Examined associations between 0-1, 2, 3-4, and ≥5 geriatric conditions and MACE (all-cause death, myocardial infarction, stroke).
  • Employed logistic regression for unadjusted and adjusted analyses.

Main Results:

  • 32% of participants had ≥5 geriatric conditions; these individuals were older, more often female, and frequently hospitalized.
  • Frailty, sarcopenia, and cognitive impairment were the most common conditions.
  • ≥5 conditions showed significantly higher odds for myocardial infarction (OR 4.62), stroke (OR 6.03), death (OR 3.12), and overall MACE (OR 4.26) compared to 0-1 conditions.

Conclusions:

  • A graded and synergistic association exists between the number of geriatric conditions and MACE in a community-based cohort.
  • Findings underscore the importance of integrating geriatric assessments into cardiovascular risk models.
  • Personalized care and improved risk stratification for older adults with CVD are needed.
Abstract

Keywords:
agedcardiovascular diseasescognitive impairmentcomorbidityfrailtypolypharmacy

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