Intrinsic capacity trajectories and cardiovascular disease incidence among Chinese older adults: a population-based prospective cohort study

Abstract Background Intrinsic capacity (IC), a composite of physical and mental capacities, is a marker of healthy aging. However, the association between changes in IC and trajectories in older adults and the onset of cardiovascular diseases (CVD) remains unclear. Objective To identify IC trajector...

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Main Authors: Zhiting Guo, Yuling Chen, Binu Koirala, Jiaying Li, Yingying Jia, Cheryl R. Dennison Himmelfarb, Jingfen Jin
Format: Article
Language:English
Published: BMC 2025-04-01
Series:BMC Geriatrics
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Online Access:https://doi.org/10.1186/s12877-025-05910-z
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author Zhiting Guo
Yuling Chen
Binu Koirala
Jiaying Li
Yingying Jia
Cheryl R. Dennison Himmelfarb
Jingfen Jin
author_facet Zhiting Guo
Yuling Chen
Binu Koirala
Jiaying Li
Yingying Jia
Cheryl R. Dennison Himmelfarb
Jingfen Jin
author_sort Zhiting Guo
collection DOAJ
description Abstract Background Intrinsic capacity (IC), a composite of physical and mental capacities, is a marker of healthy aging. However, the association between changes in IC and trajectories in older adults and the onset of cardiovascular diseases (CVD) remains unclear. Objective To identify IC trajectories over time and assess the associations between IC trajectories and the incidence of CVD among older adults. Methods The prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2020. To determine IC trajectory during 2011–2015, we included adults aged 60 years or older without CVD at baseline, who completed the follow-up visits in 2013 and 2015. We assessed IC through five domains (locomotion, sensory, vitality, cognition, and psychology) using the WHO framework. We determined the onset of CVD by self-reported diagnoses of heart disease or stroke. We performed a group-based trajectory model to identify IC trajectory, and cox proportional hazard models to estimate the adjusted hazard ratio (HR) for CVD incident across different IC trajectory groups, adjusting for sociodemographic factors, lifestyle health behaviors, and cardiovascular metabolic factors. Results The study included 3 336 adults without CVD at baseline, with the mean age of 66.64 (SD:5.53) years, and 49.4% were male. The baseline mean IC score was 5.40 (SD:1.70). We identified three IC trajectory: (1) moderate IC with subsequent increase (61.3%), (2) low IC with slow decline (27.61%), and (3) high IC with subsequent decline (11.09%). During the average follow-up of 6.78 years, we identified 1,351 cases of incident CVD. After adjusting for covariates, adults who in the low IC with slow decline group were 1.68 (95% CI: 1.38–2.04) times more likely to develop CVD, compared to adults in the high IC with subsequent decline group. Conclusion IC trajectory among Chinese older adults is heterogeneous. Low IC with slow declining is associated with an increased risk of CVD incidence.
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spelling doaj-art-ec4ef4f88d2e4635bd2cd9909fcd9d3b2025-08-20T02:19:57ZengBMCBMC Geriatrics1471-23182025-04-0125111110.1186/s12877-025-05910-zIntrinsic capacity trajectories and cardiovascular disease incidence among Chinese older adults: a population-based prospective cohort studyZhiting Guo0Yuling Chen1Binu Koirala2Jiaying Li3Yingying Jia4Cheryl R. Dennison Himmelfarb5Jingfen Jin6The Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU)Johns Hopkins University School of NursingJohns Hopkins University School of NursingJohns Hopkins University School of NursingThe Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU)Johns Hopkins University School of NursingThe Second Affiliated Hospital of Zhejiang University School of Medicine (SAHZU)Abstract Background Intrinsic capacity (IC), a composite of physical and mental capacities, is a marker of healthy aging. However, the association between changes in IC and trajectories in older adults and the onset of cardiovascular diseases (CVD) remains unclear. Objective To identify IC trajectories over time and assess the associations between IC trajectories and the incidence of CVD among older adults. Methods The prospective cohort study used data from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2020. To determine IC trajectory during 2011–2015, we included adults aged 60 years or older without CVD at baseline, who completed the follow-up visits in 2013 and 2015. We assessed IC through five domains (locomotion, sensory, vitality, cognition, and psychology) using the WHO framework. We determined the onset of CVD by self-reported diagnoses of heart disease or stroke. We performed a group-based trajectory model to identify IC trajectory, and cox proportional hazard models to estimate the adjusted hazard ratio (HR) for CVD incident across different IC trajectory groups, adjusting for sociodemographic factors, lifestyle health behaviors, and cardiovascular metabolic factors. Results The study included 3 336 adults without CVD at baseline, with the mean age of 66.64 (SD:5.53) years, and 49.4% were male. The baseline mean IC score was 5.40 (SD:1.70). We identified three IC trajectory: (1) moderate IC with subsequent increase (61.3%), (2) low IC with slow decline (27.61%), and (3) high IC with subsequent decline (11.09%). During the average follow-up of 6.78 years, we identified 1,351 cases of incident CVD. After adjusting for covariates, adults who in the low IC with slow decline group were 1.68 (95% CI: 1.38–2.04) times more likely to develop CVD, compared to adults in the high IC with subsequent decline group. Conclusion IC trajectory among Chinese older adults is heterogeneous. Low IC with slow declining is associated with an increased risk of CVD incidence.https://doi.org/10.1186/s12877-025-05910-zCardiovascular diseaseOlder adultsIntrinsic capacityTrajectoryBiomarkers
spellingShingle Zhiting Guo
Yuling Chen
Binu Koirala
Jiaying Li
Yingying Jia
Cheryl R. Dennison Himmelfarb
Jingfen Jin
Intrinsic capacity trajectories and cardiovascular disease incidence among Chinese older adults: a population-based prospective cohort study
BMC Geriatrics
Cardiovascular disease
Older adults
Intrinsic capacity
Trajectory
Biomarkers
title Intrinsic capacity trajectories and cardiovascular disease incidence among Chinese older adults: a population-based prospective cohort study
title_full Intrinsic capacity trajectories and cardiovascular disease incidence among Chinese older adults: a population-based prospective cohort study
title_fullStr Intrinsic capacity trajectories and cardiovascular disease incidence among Chinese older adults: a population-based prospective cohort study
title_full_unstemmed Intrinsic capacity trajectories and cardiovascular disease incidence among Chinese older adults: a population-based prospective cohort study
title_short Intrinsic capacity trajectories and cardiovascular disease incidence among Chinese older adults: a population-based prospective cohort study
title_sort intrinsic capacity trajectories and cardiovascular disease incidence among chinese older adults a population based prospective cohort study
topic Cardiovascular disease
Older adults
Intrinsic capacity
Trajectory
Biomarkers
url https://doi.org/10.1186/s12877-025-05910-z
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