Cardiovascular risk factors and frailty in a cross-sectional study of older people: implications for prevention.

Objectiveto examine the associations of cardiovascular disease (CVD) and cardiovascular risk factors with frailty.Designa cross-sectional study.Settingthe Irish Longitudinal Study on Ageing (TILDA).Participantsfrailty measures were obtained on 5,618 participants and a subset of 4,330 participants with no prior history of CVD.Exposures for observational studycardiovascular risk factors were combined in three composite CVD risk scores (Systematic Coronary Risk Evaluation [SCORE], Ideal Cardiovascular Health [ICH] and Cardiovascular Health Metrics [CHM]).Main outcome measuresa frailty index (40-items) was used to screen for frailty.Methodsthe associations of CVD risk factors with frailty were examined using logistic regression.Resultsoverall, 16.4% of participants had frailty (7.6% at 50-59 years to 42.5% at 80+ years), and the prevalence was higher in those with versus those without prior CVD (43.0% vs. 10.7%). Among those without prior CVD, mean levels of CVD risk factors were closely correlated with higher frailty index scores. Combined CVD risk factors, assessed using SCORE, were linearly and positively associated with frailty. Compared to low-to-moderate SCOREs, the odds ratio (OR) (95% confidence interval, CI) of frailty for those with very high risk was 3.18 (2.38-4.25). Conversely, ICH was linearly and inversely associated with frailty, with an OR for optimal health of 0.29 (0.21-0.40) compared with inadequate health.Conclusionsthe concordant positive associations of SCORE and inverse associations of ICH and CHM with frailty highlight the potential importance of optimum levels of CVD risk factors for prevention of disability in frail older people.