Joint Associations of Frailty and Cardiometabolic Diseases With Risk of All-Cause and Cardiac Mortality

Figures

• 

  Figure 1. Distribution of Frailty Levels Stratified by CMD Status (A) Distribution of fulfilled phenotype criteria numbers according to cardiometabolic disease (CMD) status. (B) Density map of FI according to CMD status. CMM = cardiometabolic multimorbidity; FI = frailty index.

• 

  Figure 2. Joint Association of Frailty and CMD Status on Mortality Outcomes (A and B) Joint association of frailty phenotype and CMD status on all-cause/cardiac mortality; (C and D) joint association of frailty assessed by FI and CMD status on all-cause/cardiac mortality. In the model, follow-up year is included as the timescale, participants without CMD and frailty status at baseline are considered as the reference group. Overall HR and 95% CI estimates from flexible parametric survival models with hazard scale are presented. Baseline restricted cubic splines with 4 internal knots (df: 5, positions: 20%, 40%, 60%, and 80%) and 3 internal knots (df: 4, default positions: 25%, 50%, 75%) were used for all-cause and cardiac morality as outcomes, respectively. Covariates including age, sex, race, Townsend Deprivation Index, body mass index, healthy diet, smoking status, alcohol consumption, physical activity, sleep duration, and hypertension at baseline were adjusted. Abbreviations as in Figure 1.

• 

  Central Illustration. The Joint Association of Frailty and Cardiometabolic Disease on All-Cause and Cardiac Mortality In this study, 467,406 participants from UK Biobank were included. Cardiometabolic disease (CMD) status at baseline was categorized into no CMD, single CMD, or cardiometabolic multimorbidity (CMM) (the coexistence of ≥2 CMDs in an individual). Frailty status was evaluated by frailty phenotype and frailty index. The joint association between CMM and frailty on all-cause or cardiac mortality was observed, for their coexistence generated higher risk of mortality compared with individually exposure of CMM or frailty. CHD = coronary heart disease.