Cardiovascular-kidney-metabolic syndrome predicted the risks of geriatric syndromes and mortality of major chronic diseases

Abstract Background The American Heart Association (AHA) has introduced the cardiovascular-kidney-metabolic (CKM) syndrome as a systemic health disorder affecting nearly all organ systems. However, evidence supporting CKM syndrome health-related effects remains scarce, and its effects beyond its components are not studied. Methods Here, we used data from the China Health and Retirement Longitudinal Study (CHARLS) to investigate the associations of CKM syndrome with adverse health outcomes, including functional disability, physical frailty, falls, hospitalization and mortality. Then, we examined the associations between CKM syndrome and all-cause and cause-specific mortalityusing data from the US National Health and Nutrition Examination Survey (NHANES). Results CKM syndrome stages were independently associated with incident geriatric syndromes, including incident disability (OR, 1.2, 95% CI, 1.11-1.29), frailty (OR, 1.28, 95% CI, 1.15-1.42), falls (OR, 1.11, 95% CI, 1.06-1.17), and hospitalization (OR, 1.19, 95% CI, 1.14-1.25). Moreover, CKM syndrome stages independently predicted all-cause mortality (CHARLS: HR, 1.12 95% CI, 1.06-1.18; NHANES: HR, 1.34 95% CI, 1.29-1.40), and cause-specific mortality, including CVD (HR, 1.62, 95% CI, 1.50-1.75), malignant neoplasm (HR, 1.20, 95% CI, 1.10-1.30), respiratory disease (HR, 1.26, 95% CI, 1.07-1.49). After adjusting for CKM components, the positive associations of CKM syndrome with geriatric syndrome and mortality were persisted, indicating that CKM syndrome has health implications beyond those of its component disorders. There were dose-effect relationships between CKM stages and risks of geriatric syndromes and mortality. Especially, advanced CKM syndrome (stage 3-4) exhibited higher risks of adverse outcomes along the CKM staging spectrum. Conclusion The findings revealed that CKM syndrome significantly impacted the overall health among middle-aged and older adults, advocating its application from CVD to geriatric community and multidiscipline clinical settings. It suggested the need for CKM syndrome assessment to predict and prevent geriatric syndromes and major chronic conditions, thereby reducing social and healthcare burdens. Moreover, these results provided empirical evidence for the validity and robustness of the CKM staging classification.