Improving Heart Health Could Prevent Frailty in Old Age

Senior man controlling his blood pressure at home. (Getty Images)
Many think frailty is an inevitable consequence of aging, but a new study found that severe frailty was far less likely in those with low heart disease risk factors. (Getty Images)

New research has shown that older people with very low heart disease risk also have very little frailty, raising the possibility that frailty could be prevented by earlier and better recognition and treatment of cardiac disease.

The study, led by the University of Exeter, UK, found that even small reductions in risk factors helped to reduce frailty, as well as dementia, chronic pain, and other disabling conditions of old age.

Many perceive frailty to be an inevitable consequence of ageing – but the study, published in the Journal of Gerontology: Medical Sciences, found that severe frailty was 85 percent less likely in those with near ideal cardiovascular risk factors.

It also found that those with fewer heart disease risk factors were much less likely to have other conditions unrelated to the heart – including chronic pain, incontinence, falls, fractures, and dementia.

Dr. João Delgado of the University of Exeter Medical School, joint lead author of the study, says: “This study indicates that frailty and other age-related diseases could be prevented and significantly reduced in older adults. Getting our heart risk factors under control could lead to much healthier old ages. Unfortunately, the current obesity epidemic is moving the older population in the wrong direction. However, our study underlines how even small reductions in risk are worthwhile.”

The study, the largest of its kind, analysed data from more than 421,000 people aged 60 to 69 in both general practitioner medical records and in the UK Biobank research study. Participants were followed over a 10-year period.

The researchers analysed six factors that could affect heart health. They looked at uncontrolled high blood pressure, cholesterol and glucose levels, plus being overweight, doing little physical activity, and being a current smoker.

The international research team involved U.S. collaborators the UConn Center on Aging at UConn Health, and the National Institute on Aging.

The project was funded by the Medical Research Council and the National Institute for Health Research in the UK. They analysed data from participants using general practitioner (GP) medical records (Clinical Practice Research Datalink) and healthy volunteers (UK Biobank).

Dr. Janice Atkins of the University of Exeter Medical School, joint lead author of the study, says:A quarter (26 percent) of participants from UK Biobank, made up of predominantly healthy volunteers, had near perfect cardiovascular risk factors, compared to only 2.4 percent of the population via GP records. This highlights the huge potential for improvement in cardiovascular risk factors of the general population in the UK.”

This is the first large-scale study to show that older people with near-ideal cardiovascular risk factor profiles have better outcomes on a number of factors that are not directly linked to heart disease.

Dr. George Kuchel, director of the UConn Center on Aging at UConn Health and a co-researcher on the study, says: “Individuals with untreated cardiovascular disease or other common chronic diseases appear to age faster and with more frailty. In the past, we viewed ageing and these common chronic diseases as being both inevitable and unrelated to each other. Now our growing body of scientific evidence on ageing shows that what we have previously considered as inevitable might be prevented or delayed through earlier and better recognition and treatment of cardiac disease.

“This overall approach working at the interface of aging and varied chronic diseases could be transformative in helping adults to maintain function and independence in late life,” he continues, “adding life to their years as opposed to just years to their life.”

The study, “Impact of low cardiovascular risk profiles on geriatric outcomes: evidence from 421,000 subjects in two cohorts,” is published in the Journal of Gerontology: Medical Sciences. Authors are Janice L. Atkins, João Delgado, Luke C. Pilling, Kirsty Bowman, Jane A.H. Masoli, George A. Kuchel, Luigi Ferrucci, and David Melzer.