Mercedes Sotos-Prieto1,2,3,4, Ellen A Struijk1,2, Teresa T Fung5,6, Eric B Rimm6,7, Fernando Rodriguez-Artalejo1,2,4, Walter C Willett6,7, Frank B Hu6,7, Esther Lopez-Garcia1,2,4. 1. Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, and IdiPaz (Instituto de Investigación Sanitaria Hospital Universitario La Paz), Madrid, Spain. 2. CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain. 3. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 4. IMDEA-Food Institute, CEI UAM+CSIC, Madrid, Spain. 5. Department of Nutrition, Simmons University, Boston, MA, USA. 6. Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA. 7. Channing Division of Network Medicine, Department of Medicine, Brigham & Women's Hospital and Harvard Medical School, Boston, MA, USA.
Abstract
BACKGROUND: Evidence on the comprehensive role of lifestyle in frailty risk is scarce. To assess the association between a lifestyle-based Healthy Heart Score (HHS), which estimates the 20-year risk of cardiovascular disease (CVD), and risk of frailty among older women. METHODS: Prospective cohort study in 121,700 nurses from the USA participating at the Nurses' Health Study. This study included 68,416 women aged ≥60 year with a follow-up from 1990 to 2014. The HHS was computed using the gender-specific beta-coefficients of the nine lifestyle factors, including current smoking, high body mass index, low physical activity, lack of moderate alcohol intake and unhealthy diet. Frailty incidence was assessed every 4 years from 1992 to 2014 as having ≥3 of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses and weight loss ≥5%. RESULTS: During 22 years of follow-up, 11,041 total incident cases of frailty were ascertained. Compared to women in the lowest quintile of the HHS (lowest estimated CVD risk), the multivariable-adjusted hazard ratio of frailty across quintiles was: Q2:1.67 (95% confidence interval 1.53, 1.82); Q3: 2.34 (2.15, 2.53); Q4: 3.54 (3.28, 3.83) and Q5: 5.92 (5.48, 6.38); P-trend > 0.001. Results were consistent for each frailty criterion, among participants with 0 frailty criteria at baseline, when using only baseline exposure or in 6-year-, 10-year- and 14-year-exposure lagged analyses, and after excluding participants with diabetes and CVD at baseline. CONCLUSIONS: The HHS, based on a set of modifiable-lifestyle factors, is strongly associated with risk of frailty in older women.
BACKGROUND: Evidence on the comprehensive role of lifestyle in frailty risk is scarce. To assess the association between a lifestyle-based Healthy Heart Score (HHS), which estimates the 20-year risk of cardiovascular disease (CVD), and risk of frailty among older women. METHODS: Prospective cohort study in 121,700 nurses from the USA participating at the Nurses' Health Study. This study included 68,416 women aged ≥60 year with a follow-up from 1990 to 2014. The HHS was computed using the gender-specific beta-coefficients of the nine lifestyle factors, including current smoking, high body mass index, low physical activity, lack of moderate alcohol intake and unhealthy diet. Frailty incidence was assessed every 4 years from 1992 to 2014 as having ≥3 of the following five criteria from the FRAIL scale: fatigue, low strength, reduced aerobic capacity, having ≥5 illnesses and weight loss ≥5%. RESULTS: During 22 years of follow-up, 11,041 total incident cases of frailty were ascertained. Compared to women in the lowest quintile of the HHS (lowest estimated CVD risk), the multivariable-adjusted hazard ratio of frailty across quintiles was: Q2:1.67 (95% confidence interval 1.53, 1.82); Q3: 2.34 (2.15, 2.53); Q4: 3.54 (3.28, 3.83) and Q5: 5.92 (5.48, 6.38); P-trend > 0.001. Results were consistent for each frailty criterion, among participants with 0 frailty criteria at baseline, when using only baseline exposure or in 6-year-, 10-year- and 14-year-exposure lagged analyses, and after excluding participants with diabetes and CVD at baseline. CONCLUSIONS: The HHS, based on a set of modifiable-lifestyle factors, is strongly associated with risk of frailty in older women.
Authors: Mercedes Sotos-Prieto; Josiemer Mattei; Frank B Hu; Andrea K Chomistek; Eric B Rimm; Walter C Willett; A Heather Eliassen; Stephanie E Chiuve Journal: Circ Cardiovasc Qual Outcomes Date: 2016-02
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Authors: Esther Lopez-Garcia; Kaitlin A Hagan; Teresa T Fung; Frank B Hu; Fernando Rodríguez-Artalejo Journal: Am J Clin Nutr Date: 2018-05-01 Impact factor: 7.045
Authors: A M Wolf; D J Hunter; G A Colditz; J E Manson; M J Stampfer; K A Corsano; B Rosner; A Kriska; W C Willett Journal: Int J Epidemiol Date: 1994-10 Impact factor: 7.196
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Authors: Mercedes Sotos-Prieto; Josiemer Mattei; Nancy R Cook; Frank B Hu; Walter C Willett; Stephanie E Chiuve; Eric B Rimm; Howard D Sesso Journal: J Am Heart Assoc Date: 2018-11-06 Impact factor: 5.501