Cardiovascular risk factors among older persons with cognitive frailty in middle income country

Table 1 Summary of parameters used in this study

	Parameters
Socio-demography, health, lifestyle	Gender, education level, marital status, total household income, smoking status, medical history based on self-report during the interview
Body composition	Waist circumference measured using Lufkin tape; weight, fat free mass and percentage body fat measured using Bio-electrical Impedance Analysis Inbody 270 (Biospace, Seoul, Korea) and height was measured using Leicester Height Measure (CMS Weighing Equipment, United Kingdom)
Blood pressure	Blood pressure was measured using Omron blood pressure monitor (Kyoto, Japan) and average values were recorded
Cognitive function & Frailty status	Clinical Dementia Rating Scale, FRIED criteria
Biochemical profile	A total of 20 mL fasting venous blood sample was taken and analyzed for fasting blood glucose, HbA1c and lipid profile using butterfly syringe by phlebotomist

Table 2 Sociodemographic, health, anthropometry, and biochemical characteristics of participants

	Non-cognitive frail (n = 275, 53.7%)	Cognitive frail (n = 237, 46.3%)	Total (n = 512)	P value
Sociodemographic
Age, mean ± SD	71.6 ± 4.7	71.4 ± 6.3	71.5 ± 5.5	0.57
Age group, n (%)b				0.53
60-69	109 (39.6)	101 (42.6)	210 (41)
≥ 70	166 (60.4)	136 (57.4)	302(59)
Gender, n (%)b				0.01
Men	134 (48.7)	88 (37.1)	222 (43.4)
Women	141 (51.3)	149 (62.9)	290 (56.6)
Marital Status, n (%)b				< 0.001
Single	50 (18.2)	104 (43.9)	154 (30.1)
Married	225 (81.8)	133 (56.1)	358 (69.9)
Smoking status, n (%)				0.17
Yes	21 (7.6)	27 (11.4)	48 (9.4)
No	254 (92.4)	210 (88.6)	464 (90.6)
Years of education, mean ± SDa	7.8 ± 4.5	5.8 ± 4.2	6.85 ± 4.47	< 0.001
Level education, n (%)b				0.001
Never attended	23 (8.4)	44 (18.6)	67 (13.1)
Primary school	252 (91.6)	193 (81.4)	445 (86.9)
Household income, n (%)b				< 0.001
< 1929 (RM)	177 (64.4)	191 (80.9)	368 (72)
≥ 1929 (RM)	98 (35.6)	45 (19.1)	143 (28)
Medical history, n (%)
Hypertensionb				0.01
Yes	148 (53.8)	154 (65.0)	302 (59)
No	127 (46.2)	83 (35.0)	210 (41)
Hypercholesterol
Yes	149 (54.2)	130 (54.9)	279 (54.5)	0.93
No	126 (45.8)	107 (45.1)	233 (45.5)
Diabetes				0.04
Yes	79 (28.7)	89(37.6)	168 (32.8)
No	196 (71.3)	148 (62.4)	344 (67.2)
Heart disease				0.59
Yes	31 (11.3)	31(13.1)	62 (12.1)
No	244 (88.7)	206(86.9)	450 (87.9)
Waist circumference (cm)a	88.6 ± 11.3	91.5 ± 12.8	89.95 ± 12.10	0.01
Fat free mass (kg)a	44.1 ± 22.7	39.3 ± 7.7	41.90 ± 17.60	< 0.001
Percentage body fat (%)a	32.6 ± 9.4	36.8 ± 10.1	34.51 ± 9.94	< 0.001
Body mass index (kg/m2), mean ± SDa	25.5 ± 4.4	26.5 ± 4.9	25.9 ± 4.7	0.02
Body mass index, n (%)a				0.10
Underweight (< 24 kg/m2)	110 (40.0)	73 (30.8)	183 (35.7)
Normal (24-27 kg/m2)	76 (27.6)	75 (31.6)	151 (29.5)
Overweight (> 27 kg/m2)	89 (32.4)	89 (37.6)	178 (34.8)
Blood pressure systolic, mmHg (mean ± SD)	143.5 ± 19.3	141.8 ± 21.9	142.7 ± 20.6	0.38
Blood pressure systolic, n (%)				0.41
Normal (< 120 mmHg)	29 (10.5)	31 (13.2)	60 (11.8)
Elevated (≥ 120 mmHg)	246 (89.5)	203 (86.8)	449 (88.2)
Blood pressure diastolic, mmHg (mean ± SD	75.3 ± 10.5	75.3 ± 11.3	75.3 ± 10.9	0.97
Blood pressure diastolic, n (%)				.64
Normal (< 80 mmHg)	181 (65.8)	149 (63.7)	330 (64.8)
Elevated (≥ 80 mmHg)	94 (34.2)	85 (36.3)	179 (35.2)
Biochemical
Fasting blood glucose (mmol/L), mean ± SDa	5.8 ± 1.5	6.2 ± 2.0	6.0 ± 1.8	0.03
Fasting blood Glucose, n (%)b				0.01
Normal (4.1-6.1 mmol/L)	203 (75.5)	151 (65.1)	354 (70.7)
Elevated (> 6.1 mmol/L)	66 (24.5)	81 (34.9)	147 (29.3)
HbA1c%, mean ± SD	6.6 ± 1.1	6.6 ± 4.0	6.4 ± 2.3	0.07
HbA1c%, n (%)				0.11
Normal (< 5.6 mmol/L)	67 (24.4)	43 (18.1)	110 (21.5)
Elevated (≥ 5.6 mmol/L)	208 (75.6)	194 (81.9)	402 (78.5)
Total cholesterol (mmol/L), mean ± SD	5.1 ± 1.18	5.1 ± 1.1	5.1 ± 1.1	0.43
Total cholesterol, n (%)				0.66
Normal (< 5.2 mmol/L)	149 (54.2)	123 (51.9)	272 (53.1)
Elevated (≥ 5.2 mmol/L)	126 (45.8)	114 (48.1)	240 (46.9)
High density lipid (mmol/L), mean ± SD	1.47 ± 0.37	1.47 ± 0.39	1.47 ± 0.38	0.89
Low density lipid (mmol/L), mean ± SD	3.0 ± 1.00	3.0 ± 1.0	3.0 ± 1.0	0.70
Framingham risk score, mean ± SDa	18.1 ± 3.4	21.0 ± 8.4	19.8 ± 8.9	0.01
Framingham risk score, n (%)b				0.01
Low (< 10)	26 (24.5)	18 (11.4)	44 (16.7)
Intermediate (10-19)	34 (32.1)	52 (32.9)	86 (32.6)
High (≥ 20)	46 (43.4)	88 (55.7)	134 (50.8)

^aP < 0.05 using independent t-test.

^bP < 0.05 using chi-square.

Table 3 Binary logistic regression cardiovascular risk factors and cognitive function

Risk factor	Beta	P value	OR	95%CI
Gender	0.34	0.07	1.41	0.98-2.13
Marital statusa	1.22	< 0.001	3.38	2.26-5.05
Household incomea	0.78	< 0.001	2.18	1.44-3.30
Hypertensiona	0.47	0.01	1.60	1.12-2.30
FFMa	-0.04	< 0.001	0.96	0.94-0.98
PBFa	0.04	< 0.001	1.04	1.02-1.06
Waist circumferencea	0.02	0.01	1.02	1.01-1.04
Fasting blood glucosea	0.50	0.01	1.64	1.11-2.43
Body mass index	-0.20	0.31	0.82	0.56-1.21
Framingham risk scorea	0.50	0.01	1.65	1.17-2.31

^aP < 0.05. FFM: Fat free mass; PBF: Percentage body fat; Adjusted for level of education.