Association of frailty and pre-frailty with all-cause and cardiovascular mortality in diabetes: Three prospective cohorts and a meta-analysis

IF 12.5 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2025-02-17 DOI:10.1016/j.arr.2025.102696

Lin Wen , Yanhui Lu , Xin Li , Yu An , Xiao Tan , Liangkai Chen

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引用次数: 0

Abstract

Objective

To investigate the association of frailty status with all-cause and cardiovascular disease (CVD) mortality in individuals with diabetes.

Methods

Data was sourced from the Third National Health and Nutrition Examination Survey (NHANES III, 1988–1994), NHANES (1999–2006), and the UK Biobank. Frailty status was assessed using the Fried phenotype and classified as non-frailty, pre-frailty, and frailty. We further performed a meta-analysis involving 19 prospective cohort studies (753,480 patients) to summarize the existing evidence.

Results

We included 31,225 diabetes patients from NHANES III (mean age 63.3 ± 0.8, 56.4 % female), NHANES 1999–2006 (mean age 61.6 ± 0.4, 49.7 % female), and the UK Biobank (mean age 59.6 ± 7.2, 39.5 % female). The prevalence of frailty was 9.9 %, 10.7 %, and 12.1 % across respective cohorts. During a follow-up period exceeding 13 years, we observed consistent results that frailty and pre-frailty were significantly associated with increased risks of all-cause and CVD mortality in diabetes. Notably, of the five domains used to assess frailty phenotypes, low gait speed showed the strongest association with all-cause and CVD mortality risks. Meta-analysis showed that, compared to non-frailty, frailty in patients with diabetes was associated with a 1.8-fold higher risk of all-cause mortality and a 2.0-fold higher risk of CVD mortality. Similarly, pre-frailty was associated with a 1.3-fold higher risk of all-cause mortality and a 1.4-fold higher risk of CVD mortality.

Conclusions

This study established a strong association between frailty, pre-frailty, and increased all-cause and CVD-related mortality in diabetes. Integrating frailty assessment into routine practice to identify frail and pre-frail status early on is recommended, followed by the implementation of targeted healthy lifestyle interventions to mitigate adverse outcomes.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.