Pre-Frailty Phenotype and Arterial Stiffness in Older Adults Free of Cardiovascular Diseases

Abstract

Purpose: Arterial stiffness is a subclinical marker of cardiovascular disease (CVD). The pre-frailty phenotype is associated with a higher risk for CVD. This study investigated the association between the pre-frailty phenotype and arterial stiffness in community-dwelling older adults without diagnosed CVD. Methods: In total, 249 community-dwelling older adults aged 60–80 years were included in this cross-sectional study. The pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Participants with one or two standardized Fried criteria were classified as pre-frail and those with zero criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The data were analyzed using the generalized linear model. Results: From 249 participants (66.1 ± 5.3 years; 79.5% females), 61.8% (n = 154) were pre-frail and 38.2% (n = 95) robust. Pre-frail older adults had a higher aPWV (β = 0.19 m/s; p = 0.007) compared to their robust peers. Conclusions: The pre-frailty phenotype was associated with higher arterial stiffness in community-dwelling older adults aged 60–80 years. Pre-frail older adults may have a higher risk for CVD.

Endothelial Dysfunction as a Key Link between Cardiovascular Disease and Frailty: A Systematic Review

“…For instance, in a study conducted by Kannegieter [35] et al on the association between frailty and mobility, handgrip strength, and aortic stiffness, although possible confounders were identified, no specific methods were applied to address them, such as matching or stratifying participants or utilizing multivariate regression analysis. This limitation was also observed in similar studies conducted by Macedo [18] and Mone [29].…”

“…The methods used to measure vascular endothelial function and physical fragility were inconsistent across the included studies, with some studies using multiple measures. Of the 29 studies included in the review, carotid intima-media thickness (CIMT; n = 7 [22,26,28,33,[36][37][38]), the ankle-brachial pressure index (ABPI; n = 4 [22,36,37,45]), carotid-femoral pulse wave velocity (cfPWV; n = 7 [25,[36][37][38]41,44,45]), ankle-brachial pulse wave velocity (baPWV; n = 4 [20,21,26,32]), carotid distensibility (CD; n = 3 [36][37][38]), nitrite/nitric oxide (NO; n = 2 [23,31]), flow-mediated brachial dilatation (FMD; n = 2 [19,32]), the reactive hyperaemia index (RHI; n = 2 [34,38]), blood pressure complexity (n = 2 [20,21]), the heart-ankle vascular index (CAVI; n = 3 [22,26,27]), aortic pulse wave velocity (aPWV; n = 2 [18,35]), the aortic augmentation index (aAIx; n = 1 [38]), asymmetric dimethylarginine (ADMA; n = 1 [40]), homocysteine (Hcy; n = 2 [24,39]), the von Willebrand factor (vWF; n = 1…”

“…The included studies were published between 2014 and 2024. The studies were conducted in Brazil (n = 2 [18,19]), China (n = 3 [20][21][22]), Egypt (n = 1 [23]), France (n = 2 [24,25]), India (n = 1 [26]), Japan (n = 2 [26,27]), Iceland (n = 1 [28]), Italy (n = 3 [29][30][31]), Korea (n = 3 [32- A summary of the characteristics of the selected studies is presented in Table S2. The included studies were published between 2014 and 2024.…”

“…The included studies were published between 2014 and 2024. The studies were conducted in Brazil (n = 2 [18,19]), China (n = 3 [20][21][22]), Egypt (n = 1 [23]), France (n = 2 [24,25]), India (n = 1 [26]), Japan (n = 2 [26,27]), Iceland (n = 1 [28]), Italy (n = 3 [29][30][31]), Korea (n = 3 [32][33][34]), the Netherlands (n = 1 [35]), the United Kingdom (n = 2 [36,37]), Singapore (n = 1 [38]), Spain (n = 4 [39][40][41][42]), and the United States of America (n = 4 [43][44][45][46]). All of the studies that were selected were conducted in clinical settings; the included works consisted primarily of studies with a descriptive cross-sectional design.…”

Associations between physical activity and cardiorespiratory fitness with vascular health phenotypes in older adults: a cross-sectional study

“…Per manufacturer’s instructions, four measurements were collected with intervals of 1-min being the first used to calibrate the device, and the average of the following 3 used as aPWV in m/s. Recent investigations have shown that the aPWV assessment used in the present study is associated with steps per day ( Cabral et al, 2021 ) and frailty ( Macêdo et al, 2022 ) in older adults.…”