Ueno Kensuke, Ko Toshiyuki, Suzuki Yuta, Kaneko Hidehiro, Kamiya Kentaro, Okada Akira, Fujiu Katsuhito, Takeda Norifumi, Morita Hiroyuki, Node Koichi, Yasunaga Hideo, Takeda Norihiko
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Kanagawa, Japan.
Geriatr Gerontol Int. 2025 Sep;25(9):1239-1246. doi: 10.1111/ggi.70139. Epub 2025 Aug 5.
Although frailty is the result of multifactorial vulnerability, such as physical, cognitive, and socio-psychological factors, the association of multifactor-defined frailty and its components with cardiovascular disease (CVD) has not been investigated. The goal of this paper is to clarify the association between multifactor-defined frailty and its components and CVD in older adults.
Using a nationwide claims database, we included 66 948 participants aged ≥65 years without a history of CVD who were assessed using a simple questionnaire-based approach covering physical, cognitive, oral, nutritional, and social aspects of frailty. The primary outcome was composite CVD events, including ischemic heart disease, heart failure, and stroke.
During a mean follow-up period of 280 ± 153 days, 3721 CVD events were observed. Compared with robust individuals, frailty was associated with an increased risk of developing CVD (adjusted hazard ratio [HR] 1.41, 95% confidence interval [CI] 1.31-1.52). This association was consistent across CVD subtypes. All components of comprehensive measures of frailty, such as physical function (HR 2.32, 95% CI 1.85-2.91), nutritional status (HR 1.46, 95% CI 1.10-1.93), oral function (HR 1.18, 95% CI 1.05-1.32), cognitive function (HR 1.44, 95% CI 1.30-1.60), and social aspects (HR 1.39, 95% CI 1.13-1.72), were also associated with an increased risk of developing CVD.
The multifactorial assessment of frailty significantly stratifies CVD risk in Japanese older adults. Moreover, each component of frailty independently contributes to the likelihood of CVD, underscoring the importance of comprehensive frailty evaluations in preventive care for the aging population. Geriatr Gerontol Int 2025; 25: 1239-1246.
尽管衰弱是多种因素导致的易损性结果，如身体、认知和社会心理因素，但多因素定义的衰弱及其组成部分与心血管疾病（CVD）之间的关联尚未得到研究。本文的目的是阐明多因素定义的衰弱及其组成部分与老年人CVD之间的关联。
利用全国性的理赔数据库，我们纳入了66948名年龄≥65岁且无CVD病史的参与者，这些参与者通过一份基于问卷的简单方法进行评估，该方法涵盖了衰弱的身体、认知、口腔、营养和社会方面。主要结局是复合CVD事件，包括缺血性心脏病、心力衰竭和中风。
在平均280±153天的随访期内，观察到3721例CVD事件。与健康个体相比，衰弱与发生CVD的风险增加相关（调整后的风险比[HR]为1.41，95%置信区间[CI]为1.31-1.52）。这种关联在CVD各亚型中是一致的。衰弱综合测量的所有组成部分，如身体功能（HR 2.32，95%CI 1.85-2.91）、营养状况（HR 1.46，95%CI 1.10-1.93）、口腔功能（HR 1.18，95%CI 1.05-1.32）、认知功能（HR 1.44，95%CI 1.30-1.60）和社会方面（HR 1.39，95%CI 1.13-1.72），也与发生CVD的风险增加相关。
对衰弱的多因素评估显著分层了日本老年人的CVD风险。此外，衰弱的每个组成部分都独立地增加了CVD的发生可能性，强调了在老年人群预防保健中进行全面衰弱评估的重要性。《老年医学与老年病学国际杂志》2025年；25: 1239-1246。
