Key result
Progression from a robust to a pre-frail or frail status significantly increased the risk of incident cardiometabolic diseases (HR 1.67) compared to remaining robust.
Why the study?
Cardiometabolic diseases and cardiometabolic multimorbidity have been associated with frailty, but studies examining these associations and changes in frailty are limited.
Does progression of frailty status or a higher frailty index increase the risk of cardiometabolic disease and cardiometabolic multimorbidity in adults?
Cohort (n=10,022)
Yes
Does progression of frailty status or a higher frailty index increase the risk of cardiometabolic disease and cardiometabolic multimorbidity in adults?
Hazard Ratio: 1.67 (95% CI 1.46–1.92)
p-value: p=<0.001
Progression of frailty and higher frailty index are significantly associated with increased risks of incident cardiometabolic disease and multimorbidity, highlighting the importance of frailty assessment in risk stratification.
FI and frailty changes may stratify CMD/CMM risk; hypothesis-generating for interventional trials.
BACKGROUND: Cardiometabolic diseases (CMD) include coronary heart disease, stroke, and diabetes. Patients who have ≥2 CMD are defined as cardiometabolic multimorbidity (CMM). CMD and CMM have been associated with frailty, but studies are limited. OBJECTIVES: The aim of this study was to examine the association between frailty index (FI), changes in frailty, and risks of CMD and CMM. METHODS: Data were obtained from the China Health and Retirement Longitudinal Study. Frailty status was classified into 3 categories: robust (FI ≤0.1), pre-frail (FI 0.1-0.25), and frail (FI ≥0.25). Total FI and change in FI (ΔFI) were divided into 3 tertiles. Mendelian randomization was used to clarify the relationship between FI and CMD from a genetic perspective. RESULTS: A total of 10,022 patients were included (female: 54.0%, median age: 57 years). Robust subjects who progressed to pre-frail/frail status had significantly increased risks of CMD (HR: 1.67, 95% CI: 1.46-1.92) and CMM (HR: 1.80, 95% CI: 1.30-2.50). Participants in the tertile 2 (HR: 1.48, 95% CI: 1.31-1.66) and tertile 3 of the total FI group (HR: 2.11, 95% CI: 1.87-2.37) had increased risks of developing CMD, compared with tertile 1. Participants in the upper tertile of the ΔFI group had higher risks of CMD (HR: 1.61, 95% CI: 1.44-1.80) and CMM (HR: 2.07, 95% CI: 1.61-2.66) than those in the first tertile. CONCLUSIONS: Progression of frailty status elevates CMD and CMM risks. Higher total FI and ΔFI were also related to increased risks of CMD and CMM.
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Wang et al. (2025) conducted a cohort in Cardiometabolic diseases and multimorbidity (n=10,022). Progression to pre-frail or frail status vs. Stable robust status was evaluated on Incident cardiometabolic disease (CMD) (HR 1.67, 95% CI 1.46-1.92, p=<0.001). Progression from a robust to a pre-frail or frail status significantly increased the risk of incident cardiometabolic diseases (HR 1.67) compared to remaining robust.
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