Association of frailty with non-laboratory based cardiovascular disease risk score among older adults and elderly population: insights from longitudinal aging study in India (LASI-1st wave)

Introduction: Frailty is an inevitable part of ageing, which is also associated with a variety of chronic diseases, the most common of which are cardiovascular diseases. The WHO non-laboratory-based CVD risk scores are reliable predictors of cardiovascular events and are used in treatment decision-making in primary health-care settings. The current study aims to find the association between the non-laboratory-based CVD risk scores and frailty scores.

Methods: The association between frailty and CVD risk scores of 56,450 older adults was estimated using nationally representative survey (Longitudinal Aging Study in India -LASI-1st Wave). Separate multivariable logistic regression was performed after adjusting for socio-economic, demographic and health related variables. Restricted cubic splines were also estimated to explore the association between probability of frailty and non-lab-based CVD risk score.

Results: The mean age of the participants was 59.3 ± 10.3 years. The prevalence of frailty was 15.6% in the participants above 45 years and 25.5% among participants aged more than 60 years. There was a significant association between the CVD risk scores and frailty in the participants and an increasing trend across the age groups (aOR = 1.3 (1.1-1.4), 2.3 (1.1-2.6), 3.6 (3.1-4.2) and 5.0 (2.9-8.6)) for CVD scores of 5-9, 10-19, 20-29 and > 30 respectively compared to a CVD risk score of < 5. The strength of association of frailty with CVD risk score when adjusted for both socioeconomic, demographic and health variables (model 2), was greater for females and ≥ 60 years age groups (aOR = 19.9 (CVD score > 30) and 4.6 (CVD score 20-29), respectively).

Conclusion: Screening for frailty should be performed in individuals with high non-laboratory-based CVD risk scores as a method of primary prevention to plan targeted interventions as a form of secondary prevention with more focusing on females and ≥ 60 years elderly population.