Among 150 geriatric outpatients in Swabi, Pakistan, 56.7% were physically inactive and 50.7% carried a cardiovascular disease (CVD) diagnosis. Active participants showed 58% lower odds of CVD versus inactive peers (OR = 0.42, 95% CI: 0.21–0.84, p = 0.014). Mean Mini Nutritional Assessment scores of 8.83 ± 1.98 placed much of the cohort in malnutrition-risk territory, and nutritional vulnerability independently associated with higher CVD prevalence (p < 0.05).
The direction of these findings aligns firmly with decades of global cardiovascular epidemiology — physical activity and adequate nutrition are among the most consistently documented protective factors in older adults. What this small Pakistani cohort adds is regional granularity: geriatric populations in lower-middle-income settings face compounding vulnerabilities that Western-centric datasets underrepresent. However, critical limitations temper enthusiasm. At 150 participants, the wide confidence interval (0.21–0.84) the authors themselves flag signals imprecision; the true protective effect could range from modest to substantial. Crucially, cross-sectional design cannot establish causality — reverse causation is plausible, as CVD may cause inactivity and appetite loss rather than the reverse. Selection bias from an outpatient clinic setting further limits generalizability. This is a preprint posted on medRxiv and has not yet undergone peer review, meaning findings and statistical interpretations may change. Overall, this is confirmatory rather than paradigm-shifting work — useful for regional health policy but requiring larger longitudinal replication before clinical inference.
