Associations of Baseline and Changes in Intrinsic Capacity With Incident Cardiovascular Disease: A Multicohort Study

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality worldwide. Intrinsic capacity (IC) represents a composite measure of physical and mental capacities. However, the relationships among baseline IC status, changes in IC over time, and the risk of incident CVD remain unclear. METHODS: This multicohort study used data from 4 nationally representative aging cohorts: the CHARLS (China Health and Retirement Longitudinal Study), the HRS (Health and Retirement Study), the MHAS (Mexican Health and Aging Study), and the SHARE (Survey of Health, Aging, and Retirement in Europe). Participants were aged ≥50 years. IC was assessed across 5 domains (locomotion, cognition, vitality, sensory, and psychology). Changes in IC status were categorized as robust, decline, improve, or stable impaired. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% CIs. RESULTS: A total of 4548 participants from CHARLS, 8420 from HRS, 8165 from MHAS, and 19 111 from SHARE were included in baseline IC status analyses. Compared with no IC decline, individuals with impairment in 2 or more domains had a significantly higher risk of incident CVD (CHARLS, HR=1.33, 95% CI: 1.12-1.58; HRS, HR=1.73, 95% CI: 1.48-2.02; MHAS, HR=1.31, 95% CI: 1.03-1.65; SHARE, HR=1.32, 95% CI: 1.19-1.46). A total of 2825 participants from CHARLS, 7981 from HRS, 6932 from MHAS, and 17 631 from SHARE were included in changes in IC status analyses. Participants with stable impaired (CHARLS, HR=1.65, 95% CI: 1.27-2.15; HRS, HR=1.57, 95% CI: 1.36-1.82; MHAS, HR=1.53, 95% CI: 1.09-2.14; SHARE, HR=1.53, 95% CI: 1.36-1.72) showed elevated CVD risks compared with the robust group. CONCLUSIONS: Baseline IC impairments and sustaining impairments are associated with higher CVD risk. Routine assessment and monitoring of IC may prevent CVD.