Low CV risk profiles may reduce incidence of frailty in older age

Adults aged 60 to 69 years with near-ideal CV risk factors have lower incidence of geriatric conditions and frailty, according to recently published data.

Researchers also suggest that optimizing CVD risk factors may substantially reduce the burden of morbidity in later life.

“Evidence on the combined effects of cardiovascular disease risk factors on common conditions of older age is unclear, with few studies showing an association between cardiovascular risk and loss of functional status,” Janice L. Atkins, PhD, research fellow for the epidemiology and public health group at the University of Exeter Medical School, United Kingdom, and colleagues wrote in the study background. “We focused on common clinical geriatric outcomes that could be ascertained in the available data, predominantly from primary care and linked hospital electronic medical records diagnoses plus baseline self-reports. This is the first study to estimate geriatric outcomes in large cohorts of people with near-perfect or low cardiovascular risk.”

The researchers collected data from population representative medical records and healthy volunteers who were followed up to 10 years.

Smoking status, LDL, BP, BMI, fasting glucose and physical activity were used to group patients by CVD risk score: low (all factors near ideal), moderate or high.

Atkins and colleagues used logistic regression, Cox models, and Fine-Gray risk models to test the link between the CVD risk score and health outcomes.

The primary outcome was geriatric syndromes commonly diagnosed in older persons and secondary outcomes included all-cause mortality, CHD, stroke and cancer.

Low risk confers better health

It was found that participants with low CVD risk score had less chronic pain (UK Biobank baseline OR = 0.52; 95% CI, 0.5-0.54), lower incidence of incontinence (Clinical Practice Research Datalink sub-HR = 0.75; 95% CI, 0.63-0.91), falls (sub-HR = 0.82; 95% CI, 0.73-0.91), fragility fractures (sub-HR = 0.78; 95% CI, 0.65-0.93) and dementia (vs. high risks, UK Biobank sub-HR = 0.67; 95% CI, 0.5-0.89; Clinical Practice Research Datalink sub-HR = 0.79; 95% CI, 0.56-1.12).

A total of 5.4% of individuals in the Clinical Practice Research Datalink with low CVD risk score became frail (Rockwood index) compared with 24.2% with high CVD risk score.

The instance of all-cause mortality was significantly lower among those in the low CVD risk score group (HR = 0.4; 95% CI, 0.35-0.47).

New approach

According to the study, all associations showed dose-response relationships and results were similar in both cohorts.

“In the past, we viewed ageing and these common chronic diseases as being both inevitable and unrelated to each other. Now our growing body of scientific evidence on ageing shows what we have previously considered as inevitable might be prevented or delayed through earlier and better recognition and treatment of cardiac disease,” George Kuchel, MD, director of the UConn Center on Aging at UConn Health in Connecticut, said in a press release. "This overall approach working at the interface of ageing and varied chronic diseases could be transformative in helping adults to maintain function and independence in late life, adding life to their years as opposed to just years to their life." – by Dave Quaile

Disclosures: Atkins and Kuchel report no relevant financial disclosures.