Interplay between frailty and cardiometabolic disorders: from pathophysiology to clinical implications

Cardiovasc Diabetol. 2025 Dec 8;25(1):1. doi: 10.1186/s12933-025-03022-x.

Abstract

Frailty and cardiometabolic disorders are highly prevalent in the aging population and frequently coexist, amplifying each other's adverse effects. Frailty, defined by decreased physiological reserves and heightened vulnerability to stressors, often occurs alongside cardiometabolic conditions such as diabetes, hypertension, and cardiovascular disease. The intersection of these conditions poses substantial clinical challenges, impacting morbidity, mortality, and quality of life. Understanding the shared pathophysiological mechanisms underlying frailty and cardiometabolic disorders is critical for guiding effective prevention and management strategies. This systematic review, registered in PROSPERO (CRD420251164236), documents current knowledge on the definitions, epidemiology, and pathophysiology of frailty in the context of cardiometabolic disorders and highlights the main clinical implications of their coexistence. Additionally, we discuss evidence-based strategies for assessment, prevention, and management, emphasizing the importance of an integrated approach to improve outcomes in older adults. These insights aim to inform about targeted interventions that can mitigate risk, enhance resilience, and optimize patient care.

Keywords: Geriatrics; Homeostenosis; Inflammaging; Multimorbidity; Polypharmacy; Resilience; Sarcopenia.

Publication types

  • Systematic Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging*
  • Cardiometabolic Risk Factors
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Cardiovascular Diseases* / physiopathology
  • Cardiovascular Diseases* / therapy
  • Comorbidity
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / epidemiology
  • Diabetes Mellitus* / physiopathology
  • Diabetes Mellitus* / therapy
  • Female
  • Frail Elderly*
  • Frailty* / diagnosis
  • Frailty* / epidemiology
  • Frailty* / physiopathology
  • Frailty* / therapy
  • Geriatric Assessment
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / epidemiology
  • Hypertension* / physiopathology
  • Hypertension* / therapy
  • Male
  • Metabolic Syndrome* / diagnosis
  • Metabolic Syndrome* / epidemiology
  • Metabolic Syndrome* / physiopathology
  • Metabolic Syndrome* / therapy
  • Prevalence
  • Prognosis
  • Risk Assessment