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The association between frailty and incident cardiovascular disease events in community-dwelling healthy older adults
Journal article   Open access   Peer reviewed

The association between frailty and incident cardiovascular disease events in community-dwelling healthy older adults

A.R.M. Saifuddin Ekram, Andrew M. Tonkin, Joanne Ryan, Lawrence Beilin, Michael E. Ernst, Sara E. Espinoza, John J. McNeil, Mark R. Nelson, Christopher M. Reid, Anne B. Newman, …
American heart journal plus, Vol.28, 100289
04/2023
DOI: 10.1016/j.ahjo.2023.100289
PMCID: PMC10168683
PMID: 37168270
url
https://doi.org/10.1016/j.ahjo.2023.100289View
Published (Version of record) Open Access

Abstract

This study examined the association between frailty and incident cardiovascular disease (CVD) events, major adverse cardiovascular events (MACE), and CVD-related mortality. Longitudinal cohort study. The ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial in Australia and the United States. 19,114 community-dwelling older adults (median age 74.0 years; 56.4 % females). Pre-frailty and frailty were assessed using a modified Fried phenotype and a deficit accumulation Frailty Index (FI) at baseline. CVD was defined as a composite of CVD death, non-fatal myocardial infarction, non-fatal stroke, and hospitalization for heart failure; MACE included all except heart failure. Cox proportional hazards regression was used to analyze the association between frailty and CVD outcomes over a median follow-up of 4.7 years. Baseline pre-frail and frail groups had a higher risk of incident CVD events (Hazard Ratio (HR): 1.31; 95 % Confidence Interval (CI): 1.14–1.50 for pre-frail and HR: 1.63; 95 % CI: 1.15–2.32 for frail) and MACE (pre-frail HR: 1.26; 95 % CI: 1.08–1.47 and frail HR: 1.51; 95 % CI: 1.00–2.29) than non-frail participants according to Fried phenotype after adjusting for traditional CVD risk factors. Effect sizes were similar or larger when frailty was assessed with FI; similar results for men and women. Frailty increases the likelihood of developing CVD, including MACE, in community-dwelling older men and women without prior CVD events. Screening for frailty using Fried or FI method could help identify community-dwelling older adults without prior CVD events who are more likely to develop CVD, including MACE, and may facilitate targeted preventive measures to reduce their risk. •Fried phenotype/FI-defined pre-frail/frail older adults have a higher CVD event risk than non-frail persons.•Frail individuals have a double to triple likelihood of CVD mortality even after accounting for traditional CVD risk factors.•Addressing frailty in older adults, a novel CVD risk factor, may improve prevention strategies.
 Cardiovascular Disease Heart Failure Stroke Frailty Mortality Myocardial infarction

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