medRxiv · Mar 31, 2026
Risk Factors for Cardiovascular Disease in Community-Dwelling Older Adults: The Potential Role of Dual Screening for Chronic Kidney Disease and Sarcopenia
By Nishida T, Hanamura I, Honda S et al.
Abstract Objectives Cardiovascular disease (CVD) is a leading cause of mortality and disability in older populations. This study aimed to identify CVD risk factors in community-dwelling older adults and to examine whether frailty-related factors (sarcopenia and nutritional status) interact with chronic kidney disease (CKD). Methods This cross-sectional study included 307 community-dwelling Japanese adults aged ≥65 years between September 2024 and March 2025. CVD history was assessed based on self-reported physician diagnoses obtained through a structured questionnaire. Lifestyle-related factors included hypertension, diabetes, dyslipidemia, and body mass index (BMI). Frailty-related factors included sarcopenia (Asian Working Group for Sarcopenia 2019 criteria), nutritional status (Mini Nutritional Assessment–Short Form), and physical activity (International Physical Activity Questionnaire–Short Form). CKD was defined using the estimated glomerular filtration rate (eGFR): non-CKD (≥60 mL/min/1.73 m²) and CKD (<60 mL/min/1.73 m²). Multivariable logistic regression identified independent correlates of CVD, and interactions between CKD and frailty-related factors were tested. Results The prevalence of CVD was 17.9%. Independent correlates included CKD (aOR 5.0), hypertension (aOR 4.0), male sex (aOR 3.1), undernutrition (aOR 2.7), sarcopenia (aOR 2.7), and low physical activity (aOR 2.5). No significant interactions were observed between CKD and sarcopenia (p = 0.70) or nutritional status (p = 0.40). Conclusions CKD, sarcopenia, undernutrition, and low physical activity were independently associated with CVD, with no interaction between CKD and frailty factors. These findings suggest that integrated management addressing both renal function and frailty-related factors may be important for CVD prevention in older adults.