A gradual decline in physical function – including a person’s ability to walk, climb stairs, carry groceries and manage other everyday tasks independently – could be an early warning sign of a major cardiovascular event years before it occurs, Monash University researchers have found.
The study, published in JAMA Cardiology, tracked functional health in more than 12,000 adults, aged 65 and older using 14 years of data from the Monash-led ASPREE trial.
While participants had no history of heart disease at the start of the study, those who later experienced a cardiovascular event showed a noticeable decline in their ability to carry out everyday physical activities, with the decline accelerating sharply in the five years before the event.
For some outcomes, including heart failure and coronary heart disease death, differences in physical function were apparent at least a decade beforehand, while they emerged later for heart attack and stroke.
Lead author Dr Aung Zaw Zaw Phyo, from the Monash School of Public Health and Preventive Medicine, said physical decline could be an early warning sign, but needed to be considered against normal signs of ageing.
“Some decline in physical function is expected as we age, but we found the trajectory was different among people who later experienced a cardiovascular event,” Dr Phyo said.
“It is progressive and accelerated decline over time, rather than one isolated measurement, that may warrant closer attention,” Dr Phyo said.
Researchers assessed four measures of functional health annually, capturing frailty, overall physical and mental abilities, and how physical health affected participants’ everyday functioning.
Professor Joanne Ryan, head of Monash University’s Biological Neuropsychiatry and Dementia research unit in the School of Public Health and Preventive Medicine, said cardiovascular events can appear sudden, despite underlying health changes potentially developing for years in the background.
“We often think of a heart attack or heart failure as something that happens suddenly, but there can be biological and physiological changes occurring well beforehand,” Professor Ryan said.
“If someone’s ability to do their usual activities is progressively declining, particularly more than expected for their age, it may be worth discussing that change with their GP.”
While detailed assessments of physical function can be difficult to fit into a time-poor GP appointment, the study found that a simple questionnaire completed in just a few minutes could help identify changes in a person’s physical health and ability to carry out everyday activities.
The researchers said the questionnaire could potentially provide a low-burden way to track changes in physical function over time.
“Tracking changes in physical function among older people could complement established cardiovascular risk assessment and help guide earlier intervention,” Dr Phyo said.
Read the research paper: https://doi.org/10.1001/jamacardio.2026.3597
