Cardiovascular risk factors and frailty in a cross-sectional study of older people: implications for prevention
Professor Robert Clarke, Professor of Epidemiology and Public Health Medicine, University of Oxford and Angel Wong, MSc student in Global Health Science, examined the relevance of cardiovascular disease (CVD) risk factors for frailty in a recent report in Age and Ageing.
This report adds to the growing body of evidence linking CVD risk factors with an increased risk of frailty.
A frailty index questionnaire (40-items) was used to screen for frailty. CVD risk factors were combined using three composite risk scores: European Cardiovascular Disease Risk Score (SCORE), American Heart Association Ideal Cardiovascular Health (ICH) and Cardiovascular Health Metrics (CHM).
Overall about 1 in 6 people in the study population had frailty, but the prevalence was 4-fold higher in those with, versus those without, prior CVD.
Among those without prior CVD, mean levels of CVD risk factors were closely correlated with higher frailty index scores.
The concordant strong associations of the different CVD risk scores with frailty highlight the importance of achieving optimum levels of CVD risk factors for prevention of frailty.
The revised contract for General Practitioners in the UK for 2017-2018 includes advice to screen older people for frailty using the electronic frailty questionnaire and advocates strategies to review medication of frail older people each year.
Hence, screening older people to identify frailty could include opportunities to review lifestyle advice and medication to optimise levels of CVD risk factors for prevention of disability and death in frail older people.
However, more evidence is needed about the effects of lowering blood pressure or cholesterol in high-risk older people with frailty before recommending specific drug treatments in all such individuals.
Read the Age and Ageing paper Cardiovascular risk factors and frailty in a cross-sectional study of older people: implications for prevention