Kudos to Shamatree Shakya, PhD student, and her faculty sponsor Michael Cary, associate professor, for the submission of her Southern Nursing Research Society (SNRS) Dissertation Research Grant application entitled: "Identification of Cardiometabolic Indicator Clusters Associated with the Subsequent Development of Frailty in Older Adults." This proposal requests funds for a one-year period with a start date of May 1, 2021.

Nearly half (45.5%) of all US older adults are pre-frail and 15.3% are frail. Studies have found that cardiac risk factors and frailty co-exist. It is unknown, however, whether the profile of cardiometabolic indicators in non-frail older adults with or without cardiometabolic syndrome (CMS) predict the subsequent development of frailty. This study aims to: 1) identify subgroups of non-frail older adults (65 years and above) with distinct CMS indicators, covarying for clinical characteristics; 2) determine sociodemographic and clinical characteristics associated with each CMS subgroup, and 3) determine which CMS subgroups are at greater risk of developing frailty after four and eight years in this clinical subpopulation, covarying for sociodemographic characteristics. This prospective cohort study will use existing data from the Health and Retirement Study. The analysis will include 706 community-residing non-frail older adults with varying CMS indicators. Latent Class Analysis (LCA) methods will be used to identify distinct CMS subgroups; while multinomial logistic regression methods will be used to determine sociodemographic characteristics associated with each subgroup and binomial covariate-adjusted logistic regression will be employed to determine which subgroups have the greatest odds of developing frailty. Findings will inform the formulation of precision-based clinical interventions for early management of frailty.

The study goal is to identify subgroups of community-residing non-frail older adults (≥ 65 years) with distinct patterns of CMS indicators, compare the individual characteristics of each identified subgroup, and examine which CMS subgroups predict the subsequent development of frailty in this clinical subpopulation. Five baseline CMS indicator will be examined (1) high blood pressure, 2) low high-density lipoprotein, 3) high total cholesterol, 4) hyperglycemia, and 5) high waist circumference with each indicator coded as no or yes. A CMS diagnosis will not be required for inclusion and, thus, it is expected that the sample will have baseline indicator profiles ranging from zero to five indicators present. Frailty status at 4-years and 8-years post-baseline will be coded as non-frail, pre-fail, and frail; however, the primary outcome will be the presence of frailty. This study will be a secondary analysis of data from the Health and Retirement Study (N=706).