Cumulative Burden of Geriatric Conditions and Cardiovascular Outcomes in Older Adults: Analysis From ARIC.
Academic Article
Overview
abstract
BACKGROUND: Older adults face a high burden of cardiovascular disease that is exacerbated by geriatric conditions. The collective influence of geriatric conditions on outcomes remains unclear. OBJECTIVES: The authors aimed to determine whether the coexistence of multiple geriatric conditions confers a graded increase in risk of major adverse cardiovascular events (MACE). METHODS: The authors used data from the ARIC (Atherosclerosis Risk In Communities) study to examine the association between different numbers of geriatric conditions (0-1 vs 2 vs 3-4 vs ≥ 5) and cardiovascular events. Primary outcome was MACE, defined as all-cause death, acute myocardial infarction, or stroke. Logistic regression was used to assess the unadjusted and adjusted association between number of geriatric conditions and MACE. RESULTS: Among participants, 18% had 0 to 1, 19% had 2, 31% had 3 to 4, and 32% had ≥5 geriatric conditions. Those with ≥5 conditions were older, more often female, and more frequently hospitalized. Frailty, sarcopenia, and cognitive impairment were most prevalent. Multimorbidity contributed the highest odds for MACE. Compared with 0 to 1 conditions, ≥5 conditions conferred significantly greater risk of myocardial infarction (OR: 4.62; 95% CI: 2.92-7.72), stroke (OR: 6.03; 95% CI: 3.04-13.75), death (OR: 3.12; 95% CI: 2.12-4.74), and MACE overall (OR: 4.26; 95% CI: 3.17-5.83). Results were consistent in weighted analyses. CONCLUSIONS: In a community-based cohort, we observed a graded and synergistic association between the number of geriatric conditions and MACE. These findings highlight the need to integrate systematic geriatric assessment into cardiovascular risk models to improve stratification and personalize care in older adults.
