This nested case-control study (within the ASPREE cohort) tracked 14-year trajectories of frailty (64-item Frailty Index and Fried phenotype), intrinsic capacity (IC), and physical health-related quality of life (HRQOL) in adults aged ≥70 years, comparing 2,403 people who later had a CVD event with 9,612 matched CVD-free controls, followed through December 2024.
Future CVD cases had consistently worse frailty, IC, and physical HRQOL up to a decade before their event, with differences widening sharply in the final 5 years; cases showed faster frailty increase (FI β = 0.78, 95% CI 0.66–0.91), steeper IC decline (β = −0.34, 95% CI −0.44 to −0.24), and greater HRQOL decline (β = −0.55, 95% CI −0.70 to −0.40), with heart failure and fatal coronary heart disease diverging earlier (≥10 years) than MI or stroke.
Case-control design limits causal inference; the cohort enrolled relatively healthy older adults (no prior CVD, dementia, or significant disability), which may underestimate decline severity in frailer real-world populations; full text was not available for detailed methodological review.
Serial monitoring of frailty and functional aging markers in older adults may signal rising CVD risk years before a clinical event, offering a prolonged window for closer evaluation and early intervention—particularly for heart failure and fatal coronary heart disease.
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