Abstract
BACKGROUND: Intrinsic capacity (IC) is defined as the combination of all physical and mental (including psychosocial) capacities that an individual can rely on at any given time. Previous studies have shown that a decline in IC is linked to an increased mortality rate. Thus, this study aimed to evaluate the impact of IC on the 5-year mortality of older people with cardiovascular disease. METHODS: This was a prospective cohort study conducted at a tertiary-level A hospital in China between September 2018 and April 2019, with a follow-up period of 5 years. We applied a proposed IC score to assess the baseline IC of each participant. The primary clinical outcome was 5-year all-cause mortality. RESULTS: A total of 524 older patients (mean age, 75.2 ± 6.5 years; 51.7% men) were enrolled from the cardiology ward. A total of 86 patients (16.5%) experienced all-cause mortality over the 5-year follow-up period. Compared with the survival group, patients in the mortality group were older (81.1 ± 5.7 vs. 74.0 ± 6.0; p < 0.01), showed a higher male proportion (61.6% vs. 49.8%; p = 0.04), had a lower intrinsic score [7.0 (6.0, 8.0) vs. 8.0 (7.0, 9.0); p < 0.01], and a higher prevalence rates of atrial fibrillation or atrial flutter (34.9% vs. 20.1%; p < 0.01), heart failure (44.2% vs.11.2%; p < 0.01), diabetes (48.8% vs. 33.1%; p < 0.01), and chronic kidney disease (19.8% vs. 4.3%; p < 0.01). After adjusting for covariates, multivariate Cox regression showed that the IC score was associated with a lower hazard ratio of 5-year all-cause mortality (hazard ratio (HR) = 0.79, 95% confidence interval (CI): 0.69-0.92, p < 0.01). CONCLUSIONS: Among these older aged patients with cardiovascular disease, the IC score is independently associated with 5-year all-cause mortality, with a lower IC score indicating a poorer prognosis. CLINICAL TRIAL REGISTRATION: ChiCTR1800017204; date of registration: 07/18/2018. URL: https://www.chictr.org.cn/showproj.html?proj=28931.