Frailty index changes before and after incident cardiovascular disease

Area of Science:

• Gerontology
• Cardiology
• Public Health

Background:

• Cardiovascular disease (CVD) and frailty are common, interrelated conditions in aging populations.
• The dynamic temporal relationship between CVD and frailty is not well understood.
• This study examines longitudinal frailty trajectories around the time of incident CVD.

Purpose of the Study:

• To investigate the longitudinal changes in frailty trajectories before and after the onset of cardiovascular disease (CVD).
• To explore the temporal interplay between frailty and CVD across diverse multinational cohorts.
• To provide insights for integrating frailty assessment into CVD management strategies for older adults.

Main Methods:

• Utilized data from four large, multinational longitudinal cohorts (ELSA, HRS, CHARLS, SHARE; n = 66,537).
• Constructed the frailty index (FI) using age-related health deficits (40-44 items per cohort).
• Employed linear mixed models to assess FI changes pre- and post-CVD, adjusting for covariates; conducted sensitivity analyses.

Main Results:

• Frailty consistently increased before CVD onset across all cohorts (pre-CVD slope: β = 0.005-0.012, P < 0.001).
• An acute increase in frailty was observed at CVD diagnosis (post-CVD acute change: β = 0.024-0.046, P < 0.001).
• Frailty progression significantly accelerated after CVD onset (post-CVD slope: β = 0.005-0.017, P < 0.001).

Conclusions:

• This multinational study reveals a bidirectional acceleration of frailty around the time of CVD onset.
• The findings highlight a close temporal interplay between cardiovascular disease and frailty in aging individuals.
• Incorporating frailty assessment into CVD care may identify at-risk individuals and guide multidimensional interventions.