Table.
Summary of studies on the association between frailty and cardiovascular mortality
| Study (author, year) | Country, dataset | Study type | Sample size | Population characteristics |
Frailty definition | CVD Mortality definition | Outcome |
|---|---|---|---|---|---|---|---|
| Dumurgier et al 2009 [51] | France, Dijon centre (Three-City study) | Prospective cohort study | 3,208 | 65% women, mean age 73 | Gait speed | Trained adjudicators | Lower third walking pace vs upper third: HR 2.92 (1.46–5.84) |
| Sanchis et al 2014 [52] | Spain, patients hospitalized after ACS in Spain | Prospective cohort study | 342 | Age ≥65 after ACS | Fried and Green scores | Trained adjudicators | Compared to nonfrail, all-cause death after MI HR 1.19 (1.02–1.39) CV mortality reported as HR 4.80 in separate manuscript (Veronese, et al 2017) |
| Sergi et al 2015 [53] | Italy, Progretto Veneto Anziani Pro V.A. study | Prospective cohort study (Pro Veneti Anziani [VA]) | 1,567 | Age 65–86, community-dwelling individuals, pre-frail patients (frail patients were excluded) | Fried (pre-frailty; 1 or 2 positive modified Fried criteria) | ICD-9 codes (390–459) | Compared to nonfrail, +2 Fried criteria = HR 1.79 (1.27–2.52) of CVD (composite of CAD, HF, stroke, PAD, or CV mortality). CV mortality reported as HR 3.41 in separate manuscript (Veronese, et al 2017) |
| Veronese et al 2017 [54] | Multi-national | Meta-analysis of 18 studies | 31,343 | Mean age ≥65 | Variable | Variable: adjudicated, self-report, medical records | Pooled HR for frail vs robust: 3.89 (2.40–6.34) |
| Adabag et al 2018 [13] | United States, Outcomes of Sleep Disorders in Older Men (MrOS) study | Prospective cohort study | 3,135 | 100% men, 90% white, 35% prior CVD | Fried | Trained adjudicators | Frail vs non-frail Cox model HR 2.73 (2.03–3.68); subdistribution model HR 1.98 (1.45–2.71) |
| Farooqi et al 2020 [55] | Multi-national | Meta-analysis of 14 multicenter clinical CVD trials | 154,696 | 37% women; mean age, 70.8 years; 70% white with CVD or at risk for CVD | Frailty Index | Trained adjudicators | Per 0.1 unit increase in FI HR 1.44 (1.40–1.46); Frail vs non-frail HR 2.86 (2.64–3.10) |
| Dewan et al 2020 [56] | Multi-National | Pooled analysis of PARADIGM-HF and ATMOSPHERE trial data | 13,625 | HF patients enrolled in either trial; 22% female, mean age 63, with or without CVD | Frailty Index | Trained adjudicators | Frail vs non-frail HR 1.75 (1.56–1.96) |
| Hoogendjik et al 2020 [14] | Italy Aging in the Chianti area; InCHIANTI study | Prospective cohort study | 1,129 | Mean age 75, 57% women | Frailty Index | Vital status, ICD-9 | HR range per 0.01 FI increase = 1.03–1.07, all p < 0.001 |
| Fan 2020 [57] | China | Prospective cohort study | 512,723 | Adults age 30–79 | Frailty index (28 baseline variables) | Mortality caused by IHD, cerebrovascular diseases (ICD-10 codes) | Compared to nonfrail pts, dose-dependent response: • IHD mortality; HR per 0.1 frailty incremement 1.89 (1.83–1.94) • Cerebrovascular mortality; HR per 0.1 frailty increment 1.84 (1.79–1.89) |
| Shrauner et al 2022 [42] | United States, Veterans Health Administration | Retrospective cohort study | 3,068,439 | US Veterans, 98% male; mean age 75, 90% white with or at risk for CVD | Frailty Index | National Death Index, ICD-9 | Compared to nonfrail, HR for mild frail 2.7 (2.1–3.3) Moderate frail 4.3 (3.3–5.6) Severe frail 7.9 (6.2–10.3) |