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A JAMA Cardiology study found that people who later experienced cardiovascular disease events had worse frailty, intrinsic capacity and physical health measures than matched controls as far as a decade beforehand. The differences widened in the five years before an event, but the study does not show that functional decline causes cardiovascular disease or that these measures can predict an individual’s risk.
A study in JAMA Cardiology found that older adults who later experienced cardiovascular disease events had worse measures of frailty, physical capacity and physical health than matched peers as far as a decade before the events. The differences grew more marked during the five years before an event, suggesting a long period in which clinicians may be able to assess declining function alongside other health information.
Researchers led by Aung Zaw Zaw Phyo of Monash University analyzed data from 12,015 participants in the Aspirin in Reducing Events in the Elderly cohort. The nested case-control analysis compared 2,403 people who experienced a cardiovascular event with 9,612 matched controls. The report was published online Sept. 23, 2026.
In the years before an event, the case group had higher frailty, lower intrinsic capacity and poorer physical health-related quality of life than controls. The researchers reported faster deterioration over time among those who later had an event: increases in scores on two frailty measures and declines in intrinsic capacity and physical health-related quality of life. These reported statistical estimates describe group trajectories, not an individual’s expected change or personal risk.
The overall pattern appeared across components of the cardiovascular disease composite, but timing varied. Differences emerged at least 10 years beforehand for heart failure and fatal coronary heart disease; the report says divergence for myocardial infarction and stroke occurred later. The study examined associations preceding recorded events, not whether functional decline itself caused them.
A Longer Window to Assess Function
The findings point to functional measures as a possible part of a broader view of health in older adults. Because differences were present well before a diagnosed event and widened closer to it, tracking changes in frailty and physical ability may give clinicians additional information to discuss with patients and consider alongside established cardiovascular risk factors.
The authors describe the pattern as a potential opportunity for closer clinical evaluation and early intervention. That is an interpretation of the results, not evidence that a particular screening approach or intervention prevents heart attacks, strokes or other events. The study also does not establish that functional measures can reliably forecast which person will develop cardiovascular disease.
For readers, the practical message is limited but relevant: changes in strength, mobility or day-to-day function may be worth discussing with a qualified health professional, especially as part of routine care. The research does not support self-diagnosis or replacing established medical assessment with a frailty score.
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How Researchers Tracked Aging
The analysis used the Aspirin in Reducing Events in the Elderly cohort, a study of older adults. Researchers compared participants who experienced a cardiovascular event with matched controls and examined measures collected in the years before the event. This design allowed the team to describe how group-level functional trajectories differed over time.
The study, titled Multidimensional Aging Trajectories Preceding Cardiovascular Events, was published in JAMA Cardiology and has DOI 10.1001/jamacardio.2026.3597. The source report does not provide detailed participant demographics, the exact event definitions, or a breakdown of results by age and other health conditions, so those details cannot be assessed from the report alone.
“Declines in functional aging markers were prominent before clinically apparent CVD.”
— Aung Zaw Zaw Phyo and colleagues
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Prediction and Cause Remain Unproven
The findings show differences between groups before events, but do not establish cause and effect. The report does not show whether functional decline contributes to cardiovascular disease, reflects underlying illness or aging, or is associated with other factors that influence both function and event risk.
It is also unclear from the available report how accurately these measures would identify an individual at elevated risk, or whether using them in routine screening would improve health outcomes. The researchers’ reported estimates reflect changes in group trajectories; they are not thresholds for diagnosis or predictions for a particular person. Further research would be needed to test clinical use and the effect of interventions.
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Testing Clinical Use in Future Studies
The study identifies a pattern for further research, but the source report does not announce a next trial or a change to clinical guidance. Future work would need to establish whether functional measures add useful information to existing cardiovascular assessments and whether acting on that information changes outcomes.
For now, the reported findings are observational evidence from the analyzed cohort. Any clinical decisions about cardiovascular risk or changes in physical function should be made with a qualified health professional, using a person’s full medical history and appropriate assessment.
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Key Questions
What did the study find?
People who later experienced cardiovascular events had worse frailty, intrinsic capacity and physical health measures than matched controls, with differences reported as far as a decade beforehand and widening near the event.
How many people were included?
The analysis included 12,015 participants: 2,403 who experienced a cardiovascular event and 9,612 matched controls.
Does functional decline cause heart disease?
The study does not establish causation. It describes associations and changes over time before recorded events, but does not determine why the groups’ trajectories differed.
Can these measures predict an individual’s heart event?
The report does not establish that the measures can accurately predict an individual’s risk. Its results describe group-level patterns, not a validated personal prediction tool.
When were the findings published?
The study appeared online in JAMA Cardiology on Sept. 23, 2026. A report about the research was dated Oct. 1, 2026.
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