Examining how frailty progresses to cardiovascular disease (CVD) events…

Doctor Aung Zaw Zaw Phyo, Monash University

Postdoctoral Fellowship

Years funded: 2026 - 2027

Examining how frailty progresses to cardiovascular disease (CVD) events and the influence of socioeconomic disparities on this progression among community-dwelling older people with no prior CVD events

Frailty is a common chronic condition in older people. It is characterised by the accumulation of age-related deteriorations in biological systems that increase vulnerability to diseases. Prior studies show evidence that pre-frail or frail individuals are more likely to develop cardiovascular disease (CVD). This positions frailty as a possible target for interventions to reduce CVD risk. However, frailty is a condition that progresses over time due to health conditions, ageing and lifestyles. So, understanding how frailty progresses preceding the CVD event can provide key insights into identifying at-risk individuals earlier and inform targeted intervention to reduce CVD risk. This project aims to examine (a) the frailty trajectories preceding CVD events and (b) the transition rates between different frailty states (non-frail, pre-frail and frail) and to CVD. Moreover, this project will assess how gender and socioeconomic disparities influence these frailty progressions and transition to CVD. The project will use data already collected from a large prospective cohort of 19,114 (87% Australians) community-dwelling older people with no prior CVD events (the ‘ASPREE’ study). Over 14 years, 2304 participants had an incident CVD event, verified by an international expert panel. Frailty has been assessed annually using widely recognised criteria (Fried Frailty Phenotype and the Deficit Accumulation Frailty Index). Frailty trajectories preceding CVD events (“cases”) will be compared to those of matched controls who do not develop CVD. Next, Multi-state Markov modelling will be used to examine the most common transition states between non-frail, pre-frail, and frail and to CVD. The findings will help healthcare professionals better understand the relationship between frailty and CVD and inform clinical guidelines and the integration of routine frailty screening into clinical practice. The influence of gender and socioeconomic disparities on these frailty trajectories and transition to CVD will be determined, providing important information for the early identification of individuals at risk and enabling targeted interventions to reduce the burden of CVD. Findings will be disseminated through publications in clinical journals, presentations at major conferences targeting clinicians (e.g. the World Congress of Cardiology), media press releases, and engagement with the community and advocacy groups, which include working with the Heart Foundation, the Australian Association of Gerontology and the Royal Australian College of General Practitioners. Further, findings will be shared through Medical Journal of Australia InSight and ASPREE’s Newsletter (reaching 2,000+ General Practitioners) to engage healthcare professionals and policymakers in translating research into health policy and strategies and clinical practice.