Scientific Reports · Oct 21, 2026
A descriptive three-domain limitation count is associated with incident cardiovascular disease across three longitudinal ageing cohorts
By Shou R, Li L, Zhu S
Ageing populations experience functional and psychological limitations, but their accumulated cardiovascular relevance across settings is uncertain. We analysed 31,535 adults aged ≥ 50 years without baseline cardiovascular disease in three cohorts. A descriptive three-domain analytic count (0–3) comprised daily-function, walking-distance mobility and elevated depressive-symptom limitations. Cohort-specific Cox models used a common adjustment set across cohorts; estimates were pooled using random effects. During follow-up, 8,950 participants developed cardiovascular disease. Each additional domain was associated with incident cardiovascular disease; the pooled hazard ratio was 1.214 (95% confidence interval 1.109–1.330; 95% prediction interval 1.043–1.414). Compared with no domains, pooled hazard ratios were 1.250 for one domain and 1.517 for ≥ 2 domains. After expanded adjustment for available socioeconomic, behavioural and multimorbidity-related factors, the pooled hazard ratio attenuated to 1.163 (95% confidence interval 1.064–1.271). Findings were similar in sensitivity analyses using common comparable ADL/IADL items and leave-one-cohort-out analyses. Competing-risk estimates differed in HRS, and findings at ≥ 75 years were heterogeneous. The primary estimate is not independent of broader measured factors; the descriptive count is not intended for causal inference, clinical prediction or decision-making.