Spectrum of cardiovascular diseases with increasing age and its association with geriatric syndromes

ABSTRACT

Objective: The burden of cardiovascular diseases (CVDs) is highest among the older adults, who are often carriers of various geriatric syndromes. Studies evaluating CVDs among the old adults in the low? and middle?income countries are limited. This study was conducted to assess the frequency of CVDs and their risk factors among the older population and their association with geriatric syndromes. Subjects and Methods: In this cross?sectional study, 200 health?care seeking adults aged ?75 years were subjected to routine comprehensive geriatric assessment (assessment for functionality, cognition, depression, frailty, and various geriatric syndromes) and a detailed cardiovascular evaluation using electrocardiography, chest X?ray, echocardiogram, HbA1c level, fasting lipid profile, thyroid function test, serum homocysteine level, and serum NT?pro?BNP. Results: The overall frequency of CVDs in this study was 76%. Polypharmacy, multi-morbidity, cognitive impairment, depression, frailty, and impairment of basic and instrumental activities of daily living were present in 50.5%, 91.5%, 6.5%, 10%, 30.5%, 24.5%, and 55% individuals, respectively. CVDs were significantly associated with increased risk of geriatric syndromes (multi?morbidity [odds ratio (OR) 3.61, confidence interval (CI) 1.13 – 11.54, P = 0.030], polypharmacy [OR 5.46, CI 2.23 – 13.34, P = 0.001] and frailty [OR 3.29, CI 1.01 – 10.64, P = 0.047]). Conclusion: The prevalence of CVDs and their risk factors among the older population was high and significantly associated with increased risk of geriatric syndromes. These observations further strengthen the need for routine geriatric assessment and integrated management of geriatric syndromes in older patients with CVDs.