Functional Decline Precedes Cardiovascular Disease Events by Many Years

THURSDAY, Oct. 1, 2026 (HealthDay News) — Functional decline begins many years before clinically apparent cardiovascular disease (CVD) events, according to a study published online Sept. 23 in JAMA Cardiology.

Aung Zaw Zaw Phyo, Ph.D., from Monash University in Melbourne, Australia, and colleagues examined how functional performance trajectories change in the years preceding a CVD event. The analysis included data from 12,015 participants (2,403 cases and 9,612 matched controls) in the Aspirin in Reducing Events in the Elderly cohort.

The researchers found that individuals who experienced a CVD event had consistently worse profiles up to a decade beforehand, including higher frailty, lower intrinsic capacity, and poorer physical health-related quality of life (QOL), compared with controls. In the five years preceding the event, these differences widened markedly. Over time, cases showed faster deterioration, with greater increases in frailty (Frailty Index: β = 0.78; Fried phenotype frailty: β = 0.05) and steeper declines in intrinsic capacity (β = −0.34) and physical health-related QOL (β = −0.55). Similar patterns were seen across components of the CVD composite, with the exception that divergence occurred earlier for heart failure and fatal coronary heart disease (≥10 years before the event) than for myocardial infarction or stroke.

“Results of this nested case-control study show that declines in functional aging markers were prominent before clinically apparent CVD, suggesting that they may represent the culmination of progressive multisystem aging and indicating a prolonged window of opportunity for closer clinical evaluation and early intervention,” the authors write.

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