Key result
Incident CVD linked to increased short-term physical frailty and faster annual functional decline in older adults.
Why the study?
The study was conducted to capture temporal patterns of physical function frailty before and after incident cardiovascular disease, including heart disease and stroke, among older adults.
Does an incident cardiovascular disease event accelerate the trajectory of physical function frailty in older adults?
Cohort (n=23,307)
Yes
Does an incident cardiovascular disease event accelerate the trajectory of physical function frailty in older adults?
Incident cardiovascular events are associated with an acute worsening and an accelerated long-term decline in physical function among older adults, highlighting the need for targeted rehabilitation.
May warrant frailty monitoring around CVD events in older adults; extends trajectory data but leaves causal questions open.
To capture temporal pattern of physical function frailty before and after cardiovascular disease (CVD), including heart disease and stroke incidence event, among older adults. A total of 23,307 participants aged over 50 years from three cohorts: English Longitudinal Study of Ageing (ELSA), and Health and Retirement Study (HRS) and China Health and Retirement Longitudinal Study (CHARLS) were studied. Physical function frailty was assessed by mobility and daily function scores. Higher scores indicated more severe physical function frailty. CVD was ascertained by self-reported physician-diagnosed heart disease or stroke. Four subtypes of heart disease including angina, heart attack, coronary heart disease and heart failure were also assessed. In participants who experienced a CVD event, physical function frailty (measured by the mobility and daily function scores) were already present prior to the event and worsened thereafter. Short-term increase of mobility scores following the CVD diagnosis were observed (ELSA: β = 4.40, 95% CI 3.34, 5.45; HRS: β = 4.73, 95% CI 3.95, 5.50; CHARLS: β = 3.08, 95% CI 1.01, 5.14). The post-annual increase of physical function frailty after the event was significantly faster than that before the event. These patterns were consistent for both heart disease and stroke incidence events, as well as for the four subtypes of heart disease. Prior to CVD onset, participants who developed CVD exhibited higher levels of physical function frailty at baseline compared with CVD-free participants. Following the incidence of CVD, participants experienced a short-term increase and a faster annual rate of increase in physical function frailty. We recommend that integrating routine screening for physical function frailty into primary care for older adults to identify high-risk individuals for targeted CVD prevention. Tailored cardiac rehabilitation programs should be developed for CVD survivors.
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Zhou et al. (2026) conducted a cohort in Cardiovascular disease and physical function frailty (n=23,307). Incident cardiovascular disease (CVD) vs. Pre-CVD event period and CVD-free participants was evaluated on Short-term change in mobility score after incident CVD diagnosis (ELSA cohort) (β 4.40, 95% CI 3.34-5.45). Following the incidence of cardiovascular disease, older adults experienced a significant short-term increase in physical function frailty (ELSA mobility score β 4.40) and a faster annual rate of decline.
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