Intrinsic capacity and its dynamic change associate with risk of cardiovascular disease: Evidence from multinational prospective cohorts

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality and disability in aging populations. Intrinsic capacity (IC) is a novel measure related to health outcomes. However, most previous studies focused on baseline IC within individual cohorts. We investigated IC and its longitudinal changes in relation to CVD across three prospective cohorts. METHODS: Participants (over 45 years) were from China Health and Retirement Longitudinal Study (CHARLS), Health and Retirement Study (HRS), and English Longitudinal Study of Ageing (ELSA). IC was calculated as a composite score of locomotion, cognition, psychological well-being, sensory function, and vitality. IC change was assessed as tertile transition over four years and as longitudinal trajectories based on latent class mixed model. Incident CVD included angina, myocardial infarction, arrhythmia, heart failure, and stroke. Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs). RESULTS: Analyses included 11,101, 6456, and 5761 participants from CHARLS, HRS, and ELSA for baseline IC; 7144, 4754, and 3979 for change-patterns; and 5428, 4754, and 2703 for trajectories. Higher IC was associated with lower CVD risk in all cohorts (CHARLS: HR 0.97, 95 % CI 0.97-0.98; HRS: HR 0.97, 95 % CI 0.96-0.97; ELSA: HR 0.98, 95 % CI 0.97-0.99). Among participants with low baseline IC, improvement to higher tertiles reduced risk. Compared with stable high-IC trajectory group, other groups showed higher risk. CONCLUSIONS: Baseline IC, tertile change patterns, and trajectories are consistently associated with long-term CVD risk across nations. Lower IC, declining tertiles, and adverse trajectories increase risk, whereas higher IC and favorable changes are protective.