Frailty, an Independent Risk Factor in Progression Trajectory of Cardiometabolic Multimorbidity: A Prospective Study of UK Biobank

Abstract

Background Although frailty was associated with cardiometabolic diseases (CMDs, including coronary heart disease, stroke, and diabetes here), there was no systematic analyses estimating its role in incidence, progression, and prognosis of cardiometabolic multimorbidity (CMM). Methods We included 351,205 participants without CMDs at baseline in UK Biobank. Occurrences of first CMD, CMM, and death were recorded. We used multi-state models to assess transition-specific role of baseline frailty measured by frailty phenotype and frailty index in CMM progression trajectory from no disease to single CMD, CMM, and death. Association between changes in frailty and outcomes was investigated among 17,264 participants. Results Among 351,205 participants (44.0% male, mean age 56.55 years), 8,190 (2.3%) had frail phenotype, and 13,615 (3.9%) were moderate/severe frail according to frailty index. During median follow-up of 13.11 years, 41,558 participants experienced ≥1 CMD, 4,952 had CMM, and 20,670 died. In multi-state models, frail phenotype-related hazard ratios were 1.94 and 2.69 for transitions from no CMD to single disease and death, 1.63 and 1.67 for transitions from single CMD to CMM and death, and 1.57 for transitions from CMM to death (all P <0.001). Consistent results were observed for frailty index. Improvement of frailty reduced the risk of CMD progression and death. Conclusions Frailty is an independent risk factor for all transitions of CMM progression trajectory. Frailty-targeted management is a potential strategy for primary and secondary prevention of CMM beyond chronological age.

Association of possible sarcopenia with major chronic diseases and multimorbidity among middle‐aged and older adults: Findings from a national cross‐sectional study in China

“…It has been reported to associate with a number of adverse outcomes, such as lower quality of life, higher medical expenses, functional impairment, depression and all-cause mortality. [10][11][12] Although previous studies showed an inverse relationship between a person's muscle mass, handgrip strength and the number of chronic diseases, the overall association between multimorbidity and sarcopenia has received relatively little attention. [13][14][15] Possible sarcopenia (PSA) is a new concept proposed by the AWGS 2019, characterized by a decrease in muscle strength and physical performance, which is usually assessed by using the handgrip strength and the five-time chair stand test.…”