Heart 99:737-742 doi:10.1136/heartjnl-2012-302922
  • Epidemiology
  • Original article

Cardiovascular disease risk scores in identifying future frailty: the Whitehall II prospective cohort study

Open Access
  1. Mika Kivimäki1,5
  1. 1Department of Epidemiology and Public Health, University College London, London, UK
  2. 2Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
  3. 3INSERM U1018, Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France
  4. 4Centre de Gérontologie, Hôpital Ste Périne, AP-HP, Paris, France
  5. 5Finnish Institute of Occupational Health, Helsinki, Finland
  1. Correspondence to Dr Kim Bouillon, Department of Epidemiology and Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT, UK; kim.bouillon.09{at}
  • Received 17 August 2012
  • Revised 27 December 2012
  • Accepted 28 December 2012
  • Published Online First 16 March 2013


Objectives To examine the capacity of existing cardiovascular disease (CVD) risk algorithms widely used in primary care, to predict frailty.

Design Prospective cohort study. Risk algorithms at baseline (1997–1999) were the Framingham CVD, coronary heart disease and stroke risk scores, and the Systematic Coronary Risk Evaluation.

Setting Civil Service departments in London, UK.

Participants 3895 participants (73% men) aged 45–69 years and free of CVD at baseline.

Main outcome measure Status of frailty at the end of follow-up (2007–2009), based on the following indicators: self-reported exhaustion, low physical activity, slow walking speed, low grip strength and weight loss.

Results At the end of the follow-up, 2.8% (n=108) of the sample was classified as frail. All four CVD risk scores were associated with future risk of developing frailty, with ORs per one SD increment in the score ranging from 1.35 (95% CI 1.21 to 1.51) for the Framingham stroke score to 1.42 (1.23 to 1.62) for the Framingham CVD score. These associations remained after excluding incident CVD cases. For comparison, the corresponding ORs for the risk scores and incident cardiovascular events varied between 1.36 (1.15 to 1.61) and 1.64 (1.50 to 1.80) depending on the risk algorithm.

Conclusions The use of CVD risk scores in clinical practice may also have utility for frailty prediction.

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