Cardiovascular Dysfunction and Frailty among Older Adults in the Community: The ARIC Study

Wilson Nadruz, Dalane Kitzman, Beverly Gwen Windham, Anna Kucharska-Newton, Kenneth Butler, Priya Palta, Michael E. Griswold, Lynne E. Wagenknecht, Gerardo Heiss, Scott D. Solomon, Hicham Skali, Amil M. Shah

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Background: The contribution of cardiovascular dysfunction to frailty in older adults is uncertain. This study aimed to define the relationship between frailty and cardiovascular structure and function, and determine whether these associations are independent of coexisting abnormalities in other organ systems. Methods: We studied 3,991 older adults (mean age 75.6 - 5.0 years; 59% female) from the Atherosclerosis Risk in Communities (ARIC) Study in whom the following six organ systems were uniformly assessed: cardiac (by echocardiography), vascular (by ankle-brachial-index and pulse-wave-velocity), pulmonary (by spirometry), renal (by estimated glomerular filtration rate), hematologic (by hemoglobin), and adipose (by body mass index and bioimpedance). Frailty was defined by the presence of ?3 of the following: low strength, low energy, slowed motor performance, low physical activity, or unintentional weight loss. Results: Two hundred eleven (5.3%) participants were frail. In multivariable analyses adjusted for demographics, diabetes, hypertension, and measures of other organ system function, frailty was independently and additively associated with left ventricular hypertrophy (odds ratio [OR] = 1.72; 95% confidence interval [CI] = 1.30-2.40), reduced global longitudinal strain (reflecting systolic function; OR = 1.68; 95% CI = 1.16-2.44), and greater left atrial volume index (reflecting diastolic function; OR = 1.60; 95% CI = 1.13-2.27), which together demonstrated the greatest association with frailty (OR = 2.10; 95% CI = 1.57-2.82) of the systems studied. Lower magnitude associations were observed for vascular and pulmonary abnormalities, anemia, and impaired renal function. Cardiovascular abnormalities remained associated with frailty after excluding participants with prevalent cardiovascular disease. Conclusions: Abnormalities of cardiac structure and function are independently associated with frailty, and together show the greatest association with frailty among the organ systems studied.

Original languageEnglish
Pages (from-to)958-964
Number of pages7
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number7
StatePublished - Jul 1 2017

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute (NHLBI) contracts (HHSN268201100005C, HHSN268201100006C, HHSN268201100007C, HHSN268201100008C, HHSN268201100009C, HHSN268201100010C, HHSN268201100011C, and HHSN268201100012C). This work was also supported by NHLBI (K08-HL-116792 to A.M.S.), American Heart Association (14CRP20380422 to A.M.S.), NHLBI cooperative agreement (NHLBI-HC-11-08 to S.D.S.), and the Brazilian National Council for Scientific and Technological Development Grant (249481/2013-8 to W.N.J.).

Publisher Copyright:
© The Author 2016.


  • Echocardiography
  • Elderly
  • Frailty
  • Systolic function

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


Dive into the research topics of 'Cardiovascular Dysfunction and Frailty among Older Adults in the Community: The ARIC Study'. Together they form a unique fingerprint.

Cite this