Association of physical function with cardiovascular risk in middle-aged and older patients with schizophrenia

Cardiovascular disease is a leading cause of mortality among patients with schizophrenia. Impaired physical function may contribute to the elevated cardiovascular risk in this population. This study aimed to examine the association between physical function and cardiovascular risk, and to identify optimal functional test cut-offs for detecting high cardiovascular risk in middle-aged and older patients with schizophrenia.

In this cross-sectional study, physical function was assessed using grip strength, the Timed Up and Go Test (TUGT), the 30-s sit-to-stand test, and the Short Physical Performance Battery (SPPB). The 10-year cardiovascular risk was estimated using the China-PAR model, with high risk defined as ≥10%. Associations were analyzed using binary logistic regression. Receiver Operating Characteristic curve analyses were performed to determine the optimal cut-off values.

A total of 202 patients aged ≥45 years with schizophrenia were included (55.45% female). Patients at high cardiovascular risk exhibited significantly poorer physical function (p < 0.05). After full adjustment, grip strength (odds ratio [OR] = 0.86, 95% confidence interval [CI] 0.75-0.97) and SPPB score (OR = 0.71, 95% CI 0.51-0.95) were inversely associated with high cardiovascular risk, while TUGT duration was positively associated (OR = 1.38, 95% CI 1.06-1.84). The SPPB score demonstrated the strongest discriminative ability for identifying high cardiovascular risk (area under the curve = 0.76, 95% CI 0.70-0.82).

Physical function is significantly associated with cardiovascular risk in middle-aged and older patients with schizophrenia. The SPPB may serve as a practical and effective screening tool for identifying individuals at high cardiovascular risk.