Biopsychosocial frailty and the incident risk of cardio- and cerebrovascular diseases: an 8-year follow-up of the italian longitudinal study on aging.

Biopsychosocial frailty, a new construct combining modifiable physical, psychological, and social domains, was associated with increased risk of dementia, mild cognitive impairment, and their subtypes. The aim of the present study was to estimate the role of biopsychosocial frailty on the incident risk of cardio- and cerebrovascular disease, i.e., myocardial infarction, peripheral artery disease (PAD), and definite stroke. From the eight municipalities of the population-based Italian Longitudinal Study on Aging, we examined 2410 older individuals in a longitudinal analysis with an 8-year follow-up. Biopsychosocial frailty operationalization was based on the results of a previous comprehensive geriatric assessment and the presence of physical frailty. Generalized estimating equation models assessed the independent contribution at three different follow-ups of baseline individuals with biopsychosocial frailty on occurring new events of myocardial infarction, PAD, and stroke. The prevalence of biopsychosocial frailty in older individuals with myocardial infarction was 10.9%, in older subjects with PAD was 8.9%, and in older individuals with definite stroke was 23.7%. After 8 years of follow-up, participants with biopsychosocial frailty showed an increased odds ratio (OR) of definite stroke [OR 2.67; 95% confidence interval 1.11-6.40]. No statistically significant associations between biopsychosocial frailty and myocardial infarction or PAD were observed. Over an 8-year follow-up, in a large, older cohort, a biopsychosocial frailty phenotype was associated with incident cerebrovascular disease, in particular with definite stroke. This complex phenotype of frailty has several modifiable components and could be an optimal target for potential interventions and prevention strategies.