Geriatric syndromes and intrinsic capacity in older adults with coronary heart disease: a cross-sectional study in China
Background Geriatric syndromes (GS) are highly prevalent among community-dwelling older adults with self-reported physician-diagnosed coronary heart disease (CHD), but their association with intrinsic capacity (IC) remains poorly characterized. Methods We analyzed cross-sectional data from 5,835 community-dwelling Chinese older adults with self-reported physician-diagnosed CHD (mean age 74.4 years; 65.8% women). GS burden (0 to ≥4) and specific comorbidities were examined against overall IC impairment and its five domains (locomotion, cognition, sensory, vitality, psychological). Adjusted prevalence ratios (PR) were estimated using multivariable modified Poisson regression models. Sensitivity analyses accounted for frailty, disability, and conceptual overlap between exposure and outcome domains, and the exclusion of severe end-stage deficits. Results Overall, 69.6% of participants had ≥1 GS. IC impairment prevalence increased progressively with GS burden, from 35.6% (0 GS) to 84.7% (≥4 GS). Compared to those with 0 GS, participants with ≥4 GS had a substantially higher prevalence of overall IC impairment (PR = 2.00; 95% CI: 1.76–2.27), locomotion difficulties (PR = 6.52), and psychological problems (PR = 6.68; all p < 0.001). Individually, delirium symptoms showed the strongest association with cognitive (PR = 4.09) and overall IC impairment (PR = 1.48). Specific dyadic GS combinations (e.g., anxiety paired with chronic constipation) remained independently associated with IC impairment even after adjusting for the total concurrent GS burden. Sensitivity analyses confirmed that cumulative GS associations remained stable after adjusting for physical vulnerability (≥4 GS PR = 1.73) and excluding severe deficits. No significant interactions were observed by age, sex, or region. Conclusion In community-dwelling older adults with self-reported physician-diagnosed CHD, a higher GS burden is strongly and independently associated with IC impairment, reflecting a functional continuum from early capacity declines to advanced physical vulnerability. This graded relationship persists even when accounting for physical vulnerability, highlighting the critical value of identifying high-risk GS clusters to proactively manage IC.