Heart Diseases Can Predict Incident Frailty: A 20-Year Cohort Study in 3,998 Older Adults

AIM: This community-based cohort study aimed to examine whether baseline heart diseases predict incident frailty over 20 years. METHODS: A total of 3,998 non-frail adults (2,000 men, 1,998 women) aged ≥65 years were included at study entry. Heart disease was defined as self-reported, medication-verified chronic heart failure, myocardial infarction, or angina pectoris. Frailty was assessed at interval using the FRAIL scale (score ≥3 defining frailty) at baseline and was repeated at: 2-years, 4-years, 14-years, 18-years and finally 20-years follow-up. Cox proportional hazards models, stratified by sex and adjusted for age, diabetes, hypertension, smoking, and BMI, analysed the association between heart disease and time to incident frailty. RESULTS: At baseline, heart disease prevalence was 18.3% in men and 16.5% in women. Over a total follow-up duration of 62,012 person-years, baseline heart disease was demonstrated to be a significant independent predictor of frailty after adjustment for confounders. The risk was greater in men (adjusted hazard ratio [aHR] 1.77, 95% confidence interval [CI]: 1.26-2.48, p 0.001) than in women (aHR 1.34, 95% CI: 1.00 - 1.80; p=0.048) CONCLUSIONS: Heart diseases, apart from being a primary driver of mortality, are significant independent predictors of incident frailty in older adults, with a stronger effect observed in men. This highlights the need for frailty screening and preventive strategies in older patients with heart disease.