Frailty Risk After a Cardiovascular Event Among Community-Dwelling Older People: Influence of Sociodemographic, Polypharmacy, and Pre-event Frailty

BACKGROUND: Frailty is a significant concern for older adults and can increase after a major health event. This study examined the risk of incident frailty after a cardiovascular disease (CVD) event among community-dwelling older people aged ≥ 65 years and explored whether sociodemographic factors, polypharmacy, and pre-event frailty influence their risk of developing frailty after a CVD event. METHODS: This study included a cohort of 738 participants (38.5% women) from the ASPREE study who were not classified as frail before their CVD event. Frailty was measured annually using the 64-item deficit-accumulation frailty index. RESULTS: Over an average 2.6 years after a CVD event, 333 individuals had incident frailty. In logistic regression models, increased chronological age, being a woman, and having polypharmacy were associated with 4% to 83% increased odds of developing frailty after a CVD event. Individuals with CVD residing in the inner regional area had about 50% higher odds of having frailty than those living in cities. This association was more evident among stroke survivors, with both inner regional (adjusted odds ratio [OR] 2.13) and outer regional or remote residents (adjusted OR 2.37) having greater odds of frailty. Individuals who were classified as pre-frail before their CVD event, had notably higher odds of progressing to frailty after the CVD event (adjusted OR 3.41). CONCLUSIONS: Our community-based study provides robust evidence that individuals who were women, older, pre-frail, with polypharmacy, and living in regional or remote areas have a markedly greater odds of developing frailty after a CVD event.