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May 22, 2025Postgraduate Medicine1 citationsOpen Access

Treatment burden and its impact on residual cardiovascular risk in community-dwelling older adults with cardiometabolic multimorbidity: an exploratory cross-sectional study

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YLYang LiHJHua Jiang

Key Result

Higher treatment burden in older adults with cardiometabolic multimorbidity was associated with elevated inflammatory indicators, including MLR (β=0.01), NLR (β=0.11), and SII (β=18.76).

Study Design

Type

Cross-Sectional (n=170)

Multicenter

No

Structured PICO

Is high treatment burden associated with increased inflammatory indicators of residual cardiovascular risk in older adults with cardiometabolic multimorbidity?

P
Population
170 community-dwelling older adults (age ≥60 years) with cardiometabolic multimorbidity from a Shanghai community.
E
Exposure
High treatment burden (Treatment Burden Questionnaire [TBQ] >59)
C
Comparator
Low treatment burden (TBQ ≤59)
O
Outcome
Inflammatory indicators including monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII)surrogate

High treatment burden in older adults with cardiometabolic multimorbidity is associated with elevated inflammatory markers, suggesting a link to residual cardiovascular risk.

Main Result

Effect estimate: β = 0.01 for MLR, β = 0.11 for NLR, β = 18.76 for SII

Abstract

BACKGROUND AND AIMS: Cardiometabolic multimorbidity (CMM), defined as ≥ 2 coexisting cardiometabol ic diseases, contributes significantly to global disease burden in older adults. Treatment burden and inflammation-related residual cardiovascular risk in this population remain poorly characterized. This study aimed to quantify treatment burden in community-dwelling older adults with CMM and explore its association with inflammatory indicators. METHODS: A random sample of 170 CMM patients (age ≥60 years) from a Shanghai community completed questionnaires, such as the Treatment Burden Questionnaire (TBQ), and underwent laboratory tests. The participants were stratified according to their treatment burden and then compared in terms of demographics, lifestyle, number of cardiometabolic diseases, medication usage, and cardiometabolic and inflammatory indicators (monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII)). Linear regression models and restricted cubic splines were employed to examine the associations of treatment burden with inflammatory indicators. RESULTS: Among participants, 37.65% (64/170) reported high treatment burden (TBQ >59). The high TBQ group exhibited poorer medication adherence (39.06% vs. 24.53%) and higher inflammatory indicators (MLR: 0.24 vs. 0.19; NLR: 1.86 vs. 1.43; SII: 352.55 vs. 276.26). No significant differences were observed in cardiometabolic indicators (except for creatinine) or medication counts. Each 10-point TBQ increase was associated with higher MLR (β = 0.01), NLR (β = 0.11), and SII (β = 18.76) in adjusted models. Non-linear associations were observed between TBQ and NLR/SII. CONCLUSION: Over one-third of elderly CMM patients experience high treatment burden linked to inflammation-driven residual cardiovascular risk. Early treatment burden assessment and anti-inflammatory strategies may improve their prognosis in primary care.

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Cite This Study

Li et al. (2025) conducted a cross-sectional in Cardiometabolic multimorbidity (n=170). High treatment burden vs. Low treatment burden was evaluated on Inflammatory indicators (MLR, NLR, and SII) (β = 0.01 for MLR, β = 0.11 for NLR, β = 18.76 for SII). Higher treatment burden in older adults with cardiometabolic multimorbidity was associated with elevated inflammatory indicators, including MLR (β=0.01), NLR (β=0.11), and SII (β=18.76).

synapsesocial.com/papers/6a896ad0de8e7079c6f7cd32https://doi.org/10.1080/00325481.2025.2510894
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