Wang Laureen Y T, Lim Wee Shiong, Tan Ru-San, Teo Louis L Y, Tan Shu Yun, Ooi Chun How, Ong Alvin Cong Wei, Kovalik Jean-Paul, Goh Jorming, Gao Fei, Koh Angela S
Alexandra Hospital, National University Health System, Singapore, Singapore.
Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore, Singapore.
Sci Rep. 2025 May 5;15(1):15679. doi: 10.1038/s41598-025-00657-4.
While cardiovascular aging and frailty are strongly associated in older adults, their mechanistic relationship and how physical activity, through its frequency, intensity, and duration, may influence their association remains unclear. A prospective community cohort of older adults without cardiovascular disease were studied cross-sectionally for cardiac structure and function via echocardiogram, dynamometer-derived handgrip strength, skeletal muscle measurements and physical activity questionnaires. Based on handgrip strength and cardiac aging, we derived four phenotypic groups: Normal, Physical frailty without cardiac aging, Cardiac aging without physical frailty, and Physical frailty and cardiac aging. Multinomial logistic regression was used to examine factors associated with cardiac frailty phenotypes, adjusting for physical activity characteristics, physical measurements, demographics, and cardiovascular risk factors. Amongst 592 participants, the prevalence in the four groups were 44.9%, 20.6%, 18.8%, and 15.7% respectively. Participants in group 1 were the youngest (64, IQR 22), while those in group 4 were the oldest (75, IQR 4.7). Higher frequencies of physical activity (once a week: RRR = 8.922, 95%CI 1.799, 44.250, p = 0.007; and 2-3 times a week: RRR = 3.873, 95%CI 1.036, 14.478, p = 0.044) were associated with Group 4 category. Higher intensity of physical activity indicated by heavy breath and sweat or near exhaustion (RRR = 0.081, 95%CI 0.017, 0.380, p = 0.001), and longer duration (> 1 h: RRR = 0.261, 95%CI 0.079, 0.869, p = 0.029) were associated with Group 4 category as well. More than half of community older adults had physical frailty with or without cardiac aging. Higher intensity and longer physical activity duration were associated with lower risks of cardiac aging in the presence of physical frailty, although frequency of once and two to three times a week was associated with higher odds. Physical activity frequency showed no significant association with risks of isolated cardiac aging or physical frailty. These results highlight the importance of tailoring physical activity characteristics based on cardiac frailty phenotypes for developing individualized preventive interventions. Trial registration: ClinicalTrials.gov Identifier: NCT02791139 (06/06/2016).
虽然心血管衰老和身体虚弱在老年人中密切相关，但它们之间的机制关系以及身体活动如何通过其频率、强度和持续时间影响它们之间的关联仍不清楚。对一个无心血管疾病的老年人群前瞻性社区队列进行横断面研究，通过超声心动图、测力计测量的握力、骨骼肌测量和身体活动问卷来评估心脏结构和功能。根据握力和心脏衰老情况，我们划分出四个表型组：正常组、无心脏衰老的身体虚弱组、无身体虚弱的心脏衰老组、身体虚弱且心脏衰老组。采用多项逻辑回归分析与心脏虚弱表型相关的因素，并对身体活动特征、身体测量指标、人口统计学和心血管危险因素进行校正。在592名参与者中，四组的患病率分别为44.9%、20.6%、18.8%和15.7%。第一组参与者最年轻（64岁，四分位距22），而第四组参与者最年长（75岁，四分位距4.7）。较高的身体活动频率（每周一次：相对风险降低率RRR = 8.922，95%置信区间CI 1.799, 44.250，p = 0.007；每周2 - 3次：RRR = 3.873，95%CI 1.036, 14.478，p = 0.044）与第四组类别相关。由呼吸急促、出汗或接近疲惫所表明的较高身体活动强度（RRR = 0.081，
