Background: Frailty may accelerate disease progression but is often overlooked in clinical practice, possible due to limited evidence. This study investigated the association of frailty with cardiometabolic multimorbidity (CMM) progression and its potential mediation. Multimorbidity, particularly one of the most replicable profiles—cardiometabolic multimorbidity (CMM), poses a major public health challenge. Previous studies concentrated on the associations of frailty with either specific cardiometabolic diseases (CMDs) or mortality, without considering the dynamics and integrity of CMM, it also remains unclear whether inflammation is a potential mediator.

Methods: We constructed a 36-item frailty index (FI). Causes of incidence and death were identified from hospitalization data, record linkage, and follow-up information. A total of 22,754 participants aged 50+ years were included. Cox regression and multistate models were used to assess associations of frailty with CMM progression, and the mediating role of inflammation was evaluated.

Results: After adjustment for confounders, participants with frailty (5.7%) exhibited significantly higher risks of incident CMDs (hazard ratios (HRs) range: 1.94–4.17), CMM (HR=3.05), and all-cause mortality (HR=1.66) compared to robust individuals. Inflammatory biomarkers mediated the associations, with mediation proportions ranging from 0.98% to 3.79%. Multistate models revealed that frailty (per 0.1 increment in FI) was positively associated with the risks of transitions from baseline health to first CMD (FCMD), FCMD to CMM, and CMM to death (adjusted HR (95% CI) 1.48 (1.43-1.54), 1.14 (1.07-1.22), and 1.17 (1.05-1.31), respectively).

Conclusion: Frailty increased risks of CMM progression, and the associations could be partly mediated through inflammation.

Authors:
Lin Xu, Sun Yat-sen University, China

About the Presenter(s)
Prof. Lin Xu is a Professor at Sun Yat-sen University, specializing in epidemiology, NCD prevention, and health surveillance. Her research focuses on data-driven public health strategies, and she is currently working on NCD surveillance and precision

Connect on Linkedin
https://www.linkedin.com/in/linxu1019

See this presentation on the full schedule – Friday Schedule

Bookmark

---

A Note to Presenters

To enhance academic profiles and showcase research, we encourage all presenters and co-presenters to include links to their public LinkedIn, ResearchGate profile, and research websites. Presenters may update their bio for their presentation by completing the form linked below by June 10, 2025.
- Presenter Information Update Form
Submitted changes will be reflected on June 20, 2025

Additionally, presenters should also update their IAFOR account details if there have been any changes to affiliations or biographies.
- https://submit.iafor.org/my-account/edit-account