Geriatrics

Two years of aerobic exercise and intensive vascular control did not improve global cognition in high‑risk elders

In this 24‑month randomized trial, 513 adults aged 60–85 years with vascular risk or subjective decline were assigned to aerobic exercise, intensive vascular risk reduction (IRVR), both, or usual care. Global cognition, measured by the Preclinical Alzheimer Cognitive Composite, improved modestly in all groups, with no significant differences between interventions and usual care. Neither exercise, IRVR, nor their combination produced superior cognitive outcomes despite blood pressure and lipid targets in the IRVR arms. These data suggest that, over two years, standard aerobic prescriptions and pharmacologic vascular optimization may not translate into measurable cognitive benefit in high‑risk but dementia‑free elders. 1

Higher protein intake predicts better function and survival in community-dwelling older adults

This English Longitudinal Study of Ageing analysis followed 532 adults aged ≥65 years for six years. Protein intakes ≥0.8–1.0 g/kg/day or ≥18% of energy were associated with lower risks of falls, mobility limitation, ADL disability, frailty, slower walking, and mortality. Animal-derived, high‑quality protein partly mediated the beneficial mobility effects of Mediterranean and WHO‑quality dietary patterns. Results support targeting at least 1.0 g/kg/day protein, with attention to protein quality, when counseling older adults on preserving function and independence. 2

Certain multimorbidity patterns drive faster 15‑year physical performance decline

This Swedish cohort study followed 3,112 dementia‑free adults aged ≥60 years for 15 years, assessing walking speed and chair‑stand performance. Latent class analysis identified four multimorbidity patterns: psychiatric–respiratory–musculoskeletal, anemia–sensory, cardiometabolic–inflammatory, and an unspecific pattern. All multimorbidity patterns showed faster physical performance decline versus ≤1 chronic disease, with the steepest decline in the cardiometabolic–inflammatory group. Associations persisted after adjusting for number of chronic conditions, suggesting pattern rather than simple disease count is critical for mobility prognosis. 3

Frailty independently heightens cardiovascular risk across CKM stages

Among 408,163 UK Biobank adults without baseline cardiovascular disease, frailty was classified as robust, pre‑frail, or frail via Fried phenotype. Over 15.1 years, cardiovascular disease incidence was substantially higher in pre‑frail and frail participants than in robust peers. Adjusted hazard ratios for incident CVD were 1.24 for pre‑frailty and 1.85 for frailty versus robustness. Frailty predicted cardiovascular risk across all cardiovascular‑kidney‑metabolic (CKM) stages, indicating it adds prognostic information beyond traditional CKM risk factors. 4