The effectiveness of a multidomain intervention on cardiovascular health among older persons with cognitive frailty

Abstract

Cardiovascular health influences the risk of dementia; however, such risk among predemented state, i.e. cognitive frailty is yet to be investigated. Multidomain intervention has been reported to improve or maintain cognitive function among at-risk older persons. However, its effectiveness on cardiovascular outcomes, especially among cognitive frailty (CF) older persons are lacking. Therefore, this study aimed to determine the association between cardiovascular risk factors with CF and evaluate the effectiveness of multidomain intervention on cardiovascular health related physical, physiological and blood parameters among older persons with CF. Phase I involves scoping review to identify cardiovascular-related blood parameters to be used in an intervention study. Phase 2 is to develop predictive equation to estimate cardiorespiratory fitness as assessed using VO2 max via physical performance test (two minutes step test, two minutes walk and one minute chair stand test) involving 32 older persons with cognitive frailty. Phase 3 investigates the relationships between cardiovascular risk factors and older persons with CF involving 512 older persons from two cohorts (i.e. AGELESS and LRGS TUA). Phase 4 involves the assessment of the effectiveness of one-year multidomain intervention on cardiovascular health among 106 older persons with CF through a randomized controlled trial. Results indicated that cardiovascular risk factors namely hypertension, high fasting blood glucose, low fat free mass, high percentage body fat, high waist circumference, high body mass index and high Framingham risk score, and sociodemographic variables (marital status and household income) were found to be associated with CF (p<0.05 for all parameters). While, repeated measure ANOVA indicated that a significant interaction effect of multidomain intervention on two-minutes step test, heart rate variability, low-density lipid, and HOMA-IR. In conclusion, cardiovascular and sociodemographic factors were associated with CF. A one-year multidomain intervention has yielded improvements in several cardiovascular health related parameters and biomarkers. Lifestyle changes deem necessary to improve cardiovascular health and reduce risk of dementia among older persons with CF.