In older patients, the complex interplay between muscle deterioration, cognitive decline, and vascular dysfunction represents a crucial triad of health challenges associated with aging.1 Despite its known associations, the incremental prognostic value of vascular impairment in older patients with low muscle mass areas (MMAs) remains unclear. This study aimed to evaluate whether the aortic tortuosity index (ATI) provides incremental prognostic value over muscle mass areas (MMAs) for predicting ad…