April 16, 2025Frontiers in Public Health11 citationsOpen Access
Cardiometabolic multimorbidity and frailty in middle-aged and older adults: a cross-nationally harmonized study
Key Result
Cardiometabolic multimorbidity was significantly associated with increased frailty severity, with the presence of three cardiometabolic diseases increasing the frailty index by 28.79 points compared to no diseases.
Study Design
Type
Observational (n=403,609)
Multicenter
Yes
Structured PICO
Does the presence and cumulative number of cardiometabolic diseases increase frailty severity in middle-aged and older adults?
P
Population
403,609 adults aged 50 and older from four international cohorts were analyzed to evaluate the cumulative impact of cardiometabolic diseases on frailty severity.
E
Exposure
Presence of one or more cardiometabolic diseases (diabetes, heart disease, or stroke), categorized as single condition or cardiometabolic multimorbidity (≥2 conditions).
C
Comparator
Individuals without any cardiometabolic disease.
O
Outcome
Frailty severity assessed by a 30-item frailty index quantifying the cumulative burden of age-related health deficits.composite
Cardiometabolic multimorbidity exhibits a strong, dose-response relationship with frailty severity in older adults, emphasizing the need for early, integrated chronic disease management.
Main Result
Mean Difference: 28.79 (95% CI 28.41–29.17)
p-value: p=<0.05
Limitations
- Self-reported data for some health conditions and lifestyle factors may present biases such as social desirability bias and recall bias.
- Methodological differences in the data collection processes across the four cohorts may introduce biases during data integration.
- Statistical analysis may be influenced by unmeasured variables, such as dietary habits and socioeconomic factors.
- The use of cross-sectional data restricts the capacity to draw clear causal inferences between cardiometabolic multimorbidity and frailty.
Abstract
Background Cardiometabolic diseases are prevalent among ageing populations and have a close association with frailty. However, the cumulative impact multiple cardiometabolic diseases have on frailty remains underexplored. Methods This study used data from four international cohorts – HRS, CHARLS, ELSA and SHARE – to examine the correlation between frailty and cardiometabolic diseases (CMD). The frailty index was used for assessing frailty and statistical analyses were performed as a means of analysing the correlation between the number of cardiometabolic conditions and frailty severity. Linear regression models were employed to evaluate the associations between CMD and frailty severity. Results The study found that as the number of cardiometabolic diseases increased, the frailty index rose significantly one disease, β = 7.80 (95% CI: 7.70 to 7.90) p 0.05; two diseases, β = 17.92 (95% CI: 17.76 to 18.08) p 0.05; three diseases, β = 28.79 (95% CI: 28.41 to 29.17) p 0.05. Stroke was found to have the most pronounced impact on frailty ( β = 12.34 95%CI 12.20 to 12.48 p 0.05) and the coexistence of multiple conditions served to amplify the symptoms of frailty. Conclusion This study highlights the compounded impact multiple cardiometabolic diseases have on frailty and also emphasizes the necessity for early intervention.
Cite This Study
Zhou et al. (Wed,) conducted a observational in Cardiometabolic multimorbidity and frailty (n=403,609). Cardiometabolic multimorbidity (diabetes, heart disease, stroke) vs. No cardiometabolic diseases was evaluated on Frailty index (β = 28.79, 95% CI 28.41 to 29.17, p=<0.05). Cardiometabolic multimorbidity was significantly associated with increased frailty severity, with the presence of three cardiometabolic diseases increasing the frailty index by 28.79 points compared to no diseases.