You probably know someone who used to breeze up the stairs and now stops at the landing to catch their breath.
Most of us chalk it up to getting older. For some people, that gradual slowdown may be telling a different story.
A large new study in JAMA Cardiology has found that measurable physical decline often shows up years, sometimes a full decade, before a heart attack, heart failure or stroke.
Researchers from Monash University in Melbourne analyzed 12,015 older adults from the ASPREE trial.
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They compared 2,403 people who later had a cardiovascular event with 9,612 matched controls who did not.
People in the first group had worse frailty scores, lower overall body function and poorer physical quality of life up to ten years before the event. The gap widened sharply in the last five years.
What the Monash team actually measured
The team tracked four things once a year. Two were frailty scores, which measure how fit and resilient a person is.
The others covered overall body capacity and how well people were functioning physically in daily life.
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Participants who later had a cardiovascular event showed a noticeable drop in their ability to do routine tasks like walking, climbing stairs and carrying groceries.
The slide got steeper in the five years before the event, rather than appearing suddenly.
The gap was clearest for heart failure and fatal coronary heart disease, where the differences were visible at least ten years earlier.
For heart attack and stroke, they emerged closer to the event.
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Why a pattern over time matters more than one bad day
"Some decline in physical function is expected as we age," said lead author Aung Zaw Zaw Phyo in a statement from Monash University. "But we found the trajectory was different among people who later experienced a cardiovascular event."
A single tired afternoon says little on its own. "It is progressive and accelerated decline over time, rather than one isolated measurement, that may warrant closer attention," Phyo said.
Joanne Ryan, another researcher on the study, said people whose everyday abilities are declining faster than expected for their age should bring the change up with their doctor.
Warning signs the CDC says people often miss
Classic heart attack signs are chest pain or discomfort, but the CDC also lists unusual tiredness, shortness of breath, lightheadedness and cold sweats among signals people often overlook.
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Women are more likely to feel these quieter symptoms.
The agency urges anyone with sudden chest discomfort, breathlessness or pain spreading to the jaw, neck or arm to call 911 right away.
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This article is made and published by Ida-Marie Palm Varbæk, who may have used AI in the preparation.