TL;DR
A study published in JAMA Cardiology found that people who later experienced cardiovascular disease events had worse frailty, intrinsic capacity and physical health-related quality of life than matched controls up to a decade beforehand. The differences widened in the five years before events, but the study does not establish that functional decline causes cardiovascular disease or that it can predict an individual event.
A study published online Sept. 23 in JAMA Cardiology found that people who later experienced cardiovascular disease events had worse measures of physical function and aging than matched peers as far as 10 years before the events. The analysis of 12,015 participants suggests that changes in frailty, physical capacity and quality of life may offer a prolonged period for closer clinical evaluation, but it does not show that those changes cause cardiovascular disease or can predict an event for an individual.
Aung Zaw Zaw Phyo of Monash University in Melbourne and colleagues examined participants in the Aspirin in Reducing Events in the Elderly cohort. The nested case-control analysis compared 2,403 people who had a cardiovascular event with 9,612 matched controls. Researchers tracked functional performance in the years leading up to events, rather than testing a method for predicting or preventing them.
Compared with controls, participants who experienced an event had higher frailty, lower intrinsic capacity and poorer physical health-related quality of life in assessments extending up to a decade before the event. The gap widened markedly during the five years before the event. Across the study period, the event group showed greater increases in frailty and steeper declines in intrinsic capacity and physical quality-of-life scores.
The researchers reported similar broad patterns across components of the cardiovascular disease composite, though timing differed. Differences appeared at least 10 years before heart failure and fatal coronary heart disease, while divergence before myocardial infarction or stroke was not reported as occurring as early. The paper, titled “Multidimensional Aging Trajectories Preceding Cardiovascular Events,” was published in JAMA Cardiology in 2026.
A Longer Window for Clinical Review
The findings place functional aging measures on a timeline that may begin well before a cardiovascular event becomes clinically apparent. If further research confirms the pattern and establishes how to use it, changes in frailty, physical capacity and daily health could help clinicians identify people who warrant a closer review of cardiovascular risk and overall health.
That possibility should not be mistaken for a screening recommendation. This study compared past trajectories between groups; it did not test whether acting on functional decline prevents heart attacks, strokes or heart failure. Nor does the reported group-level difference mean that an individual with frailty will develop cardiovascular disease. The findings matter as evidence of an association and a potential period for study, not as a stand-alone diagnostic tool.
How Researchers Tracked Decline
The analysis used the Aspirin in Reducing Events in the Elderly cohort and matched participants who experienced cardiovascular events with controls. Researchers assessed several dimensions of functional aging, including two frailty measures, intrinsic capacity and physical health-related quality of life. This multidimensional approach let the team compare patterns over time rather than rely on a single measurement close to diagnosis.
The study reports that event cases had worse profiles well before the event and that their decline accelerated relative to controls, particularly in the five years beforehand. Because the analysis is observational, it can identify differences and timing but cannot determine whether functional decline contributed to cardiovascular disease, resulted from other health changes, or reflected shared underlying processes. The authors described the pattern as potentially reflecting progressive multisystem aging.
“Declines in functional aging markers were prominent before clinically apparent CVD.”
— Aung Zaw Zaw Phyo and colleagues, in the study
What the Study Cannot Establish
The results do not establish that functional decline causes cardiovascular disease, or that changing frailty or physical capacity would prevent an event. The study also does not show whether these measures can accurately distinguish which individuals will later experience a heart attack, stroke, heart failure or fatal coronary disease. Prediction accuracy, useful clinical thresholds and intervention effects are not provided in the source report.
The analysis included people from a particular cohort, and the supplied report does not give details needed to judge how well the findings apply to other populations. It also does not specify the participants’ ages, the duration of follow-up for each person, or the number of events by cardiovascular subtype. Those limits leave open how the trajectory findings should be interpreted in routine care.
Testing the Findings in Care
The reported study identifies a pattern that warrants further testing, rather than a new clinical protocol. Future research would need to establish whether functional measures add useful information to existing cardiovascular risk assessments, whether the pattern holds across different populations, and whether earlier evaluation or intervention based on those measures changes outcomes.
For now, the findings support attention to the association between functional aging and later cardiovascular events, while leaving clinical decisions to established assessment and individual medical advice. The source report does not describe a planned follow-up trial or a specific next research milestone.
Key Questions
What did the study find?
People who later had cardiovascular events had worse frailty, intrinsic capacity and physical health-related quality of life than matched controls, with differences visible years beforehand and widening in the five years before the event.
How many people were included?
The analysis included 12,015 participants: 2,403 people 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 found an association between worse functional aging measures and later events, but cannot show whether one caused the other or whether shared factors contributed to both.
Can these measures predict an individual’s heart event?
The report does not establish that frailty or other functional measures can predict an event for a particular person. It does not provide individual prediction accuracy or clinical thresholds.
When did differences appear before events?
Overall differences were reported up to a decade before cardiovascular events and widened in the final five years. Divergence appeared at least 10 years before heart failure and fatal coronary heart disease; the report did not describe equally early divergence for myocardial infarction or stroke.
Source: rss
