Abstract Background With the intensification of global population aging, frailty and sarcopenia pose a significant public health burden for aging societies. The prevalence and incidence of cardiovascular disease (CVD) increase with age. Purpose Frailty and sarcopenia are closely related conditions, but the mechanisms through which they jointly contribute to the development of CVD remain unclear. This study aimed to investigate their combined effects in a representative sample. Methods This study utilized data from four waves of the China Health and Retirement Longitudinal Study (CHARLS). Frailty status was assessed using the Rockwood frailty index, categorizing participants into three groups: robust (FI ≤ 0.10), pre-frail (0.10 FI 0.25), and frail (FI ≥ 0.25). Sarcopenia status was classified according to the Asia Working Group for Sarcopenia 2019 criteria. Results A total of 6,460 participants aged 45 years and older (49.80% male; mean age 57.00 ± 8.52 years) were enrolled in 2011. Over the seven-year study period, both frailty and sarcopenia independently increased the risk of CVD. Notably, there might be a significant interaction for CVD between frailty and sarcopenia status (p for interaction = 0.009). Furthermore, frailty status mediated 40% of the association between sarcopenia and CVD (Figure 1). After adjusting for potential confounders, the coexistence of frailty and sarcopenia was associated with the highest risk of incident CVD (HR: 2.14, 95% CI 1.72-2.65) compared to individuals who were robust and non-sarcopenic. Additionally, pre-frail individuals without sarcopenia, pre-frail individuals with sarcopenia, and frail individuals without sarcopenia were independently associated with a 61.0% (adjusted HR aHR, 1.61; 95% CI 1.39–1.85), 93.0% (aHR, 1.93; 95% CI 1.64–2.26), and 97.0% (aHR, 1.97; 95% CI 1.53–2.53) increased risk of incident CVD, respectively, compared to those who were robust and non-sarcopenic (Figure 2). Conclusions These findings demonstrate that frailty and sarcopenia status have a significant and independent effect on the risk of incident CVD in middle-aged and older populations. These results underscore the importance of early health monitoring to identify and address frailty and sarcopenia to reduce the burden of CVD.
Liu et al. (Sat,) studied this question.