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Cross-sectional study links CKD, sarcopenia, and undernutrition to CVD history in older Japanese adults

Cross-sectional study links CKD, sarcopenia, and undernutrition to CVD history in older Japanese adu…
Photo by Bioscience Image Library by Fayette Reynolds / Unsplash
Key Takeaway
Consider integrated assessment of CKD and frailty factors in CVD risk evaluation for older adults.

This cross-sectional study examined 307 community-dwelling Japanese adults aged 65 years or older. It assessed the association between chronic kidney disease (CKD, defined as eGFR <60 mL/min/1.73 m²), frailty-related factors (sarcopenia, nutritional status, physical activity), and a history of cardiovascular disease (CVD). The study also tested for interactions between CKD and these frailty factors.

CKD, hypertension, male sex, undernutrition, sarcopenia, and low physical activity were identified as independent correlates of CVD history. The adjusted odds ratios were 5.0 for CKD, 4.0 for hypertension, 3.1 for male sex, 2.7 for undernutrition, 2.7 for sarcopenia, and 2.5 for low physical activity. No significant statistical interaction was found between CKD and sarcopenia (p=0.70) or between CKD and nutritional status (p=0.40).

Safety and tolerability data were not reported. The primary limitation is the cross-sectional design, which can identify associations but cannot establish causation or temporal sequence. The findings are specific to a community-dwelling Japanese older adult population.

For practice, this observational evidence suggests that in older adults, CKD, sarcopenia, undernutrition, and low physical activity may cluster with CVD history. The lack of interaction suggests these factors contribute independently. An integrated clinical approach addressing both renal function and frailty-related factors could be considered for comprehensive CVD risk assessment, though causality cannot be inferred from this study design.

Study Details

EvidenceLevel 5
PublishedMar 2026
View Original Abstract ↓
ObjectivesCardiovascular 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). MethodsThis cross-sectional study included 307 community-dwelling Japanese adults aged [&ge;]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 ([&ge;]60 mL/min/1.73 m{superscript 2}) and CKD (<60 mL/min/1.73 m{superscript 2}). Multivariable logistic regression identified independent correlates of CVD, and interactions between CKD and frailty-related factors were tested. ResultsThe 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). ConclusionsCKD, 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.
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