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A study of 12,015 older adults found that participants who later experienced cardiovascular disease events had worse functional-aging measures than matched controls as far as 10 years beforehand. Differences widened in the five years before an event, but the observational findings do not establish that functional decline causes cardiovascular disease or show that screening based on these measures prevents events.
A study published online September 23 in JAMA Cardiology found that older adults who later experienced a cardiovascular event had worse measures of frailty, physical capacity and physical health-related quality of life than matched peers as far as a decade before the event. The results point to a long period in which functional differences may be detectable, but do not show that decline causes cardiovascular disease or that monitoring it prevents an event.
Researchers led by Aung Zaw Zaw Phyo of Monash University analyzed data from 12,015 participants in the Aspirin in Reducing Events in the Elderly cohort. The analysis compared 2,403 participants who experienced a cardiovascular event with 9,612 matched controls. The study examined how several measures of functional aging changed in the years before the event.
Before an event, the case group had higher frailty, lower intrinsic capacity and poorer physical health-related quality of life than controls. The researchers reported that the gap widened markedly during the five years before an event, with the group that later had an event showing faster worsening across the measured indicators. These are group-level patterns; they do not establish that every person who experiences functional decline will develop cardiovascular disease.
The timing also differed by event type. The reported divergence appeared at least 10 years before heart failure and fatal coronary heart disease, while the source says it occurred later for myocardial infarction and stroke. The available report does not provide enough detail to translate the study’s statistical estimates into an individual’s risk or a clinical threshold.
A Longer Window for Clinical Attention
The findings matter because cardiovascular risk is often discussed in relation to diagnosed disease and conventional risk factors, while this study tracks changes in how people function before a clinical event. If the pattern is confirmed and made useful in practice, functional measures could help clinicians recognize changes that warrant a closer review of a person’s overall health. The researchers describe a prolonged window for clinical evaluation, not a proven screening program.
The results may also support a broader view of cardiovascular health in older adults: frailty, physical capacity and quality of life can change alongside other aspects of aging. But the study does not establish that these measures add predictive value beyond existing assessments, identify which interventions should follow, or show that acting on them would avert heart attacks, strokes, heart failure or death. Readers should not interpret ordinary changes in strength or stamina as evidence that a cardiovascular event is imminent; personal concerns should be discussed with a health professional.
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How the Cohort Was Compared
The analysis was a nested case-control study within the Aspirin in Reducing Events in the Elderly cohort. Researchers compared participants who experienced a cardiovascular event with matched participants who did not, then examined trajectories of functional-aging measures leading up to the event. This design allows researchers to study differences that appeared before diagnosis, but it is observational and cannot by itself establish cause and effect.
The publication, titled Multidimensional Aging Trajectories Preceding Cardiovascular Events, appeared in JAMA Cardiology in 2026. The Medical Xpress report, citing the journal study, identifies frailty, intrinsic capacity and physical health-related quality of life as the measures assessed. The report gives statistical estimates for changes over time but does not explain them in a way that supports using them as individual predictions.
“Declines in functional aging markers were prominent before clinically apparent CVD.”
— Aung Zaw Zaw Phyo and colleagues, in the study
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Limits of Risk Prediction
The report does not establish whether functional decline contributes to cardiovascular disease, results from early but unrecognized disease, reflects other health conditions, or arises through a combination of factors. Because the analysis is observational, it cannot determine cause and effect. It also does not show that measuring these indicators in routine care would improve prediction beyond current tools or lead to better outcomes.
Further details needed to judge clinical usefulness include how the measures performed for individual risk prediction, whether the findings apply to populations beyond this cohort, and what assessment or intervention would be appropriate. The report does not provide a specific threshold for concern, nor does it describe a tested program for acting on the changes. The reported earlier divergence for heart failure and fatal coronary heart disease also does not mean that these outcomes can be reliably forecast a decade ahead for an individual.
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Testing Clinical Usefulness
The study’s results leave the next step at the level of further research: determine whether these functional measures improve cardiovascular risk assessment and whether clinical responses to changes can help patients. The provided report does not announce a follow-up trial, new guideline or recommended screening schedule. Clinicians and researchers would need evidence on prediction, practical thresholds and outcomes before the findings could support a change in routine care.
For now, the study adds evidence that differences in functional aging can precede diagnosed cardiovascular events in this cohort. People should continue to seek individualized advice from their health-care providers rather than use the findings as a self-diagnosis or substitute for established cardiovascular evaluation.
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Key Questions
What did the study find?
Participants who later had a cardiovascular event showed worse frailty, intrinsic capacity and physical health-related quality of life than matched controls, with differences evident years before the event and widening in the five years beforehand.
How many people were included?
The analysis included 12,015 participants from the Aspirin in Reducing Events in the Elderly cohort: 2,403 who experienced a cardiovascular event and 9,612 matched controls.
Does functional decline cause cardiovascular disease?
The study does not establish cause and effect. It reports that functional measures differed before events, but it cannot determine whether decline contributes to disease, reflects early disease or is related to other factors.
Does the finding mean functional measures should be used to predict an individual’s risk?
Not on the evidence described in the report. It does not establish an individual risk threshold or show that adding these measures to clinical assessment improves prediction or prevents events. Discuss health changes and cardiovascular concerns with a health professional.
Source: rss
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