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Lifestyle-based healthy heart score and risk of frailty in older women
Evidence on the comprehensive role of lifestyle in frailty risk is scarce. A paper published in the journal Age and Aging assessed 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.
The prospective cohort study used data from the Nurses’ Health Study in the US. 68,416 women aged ≥60 year with a follow-up from 1990 to 2014 were included. The Healthy Heart Score was computed based on 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%.
During 22 years of follow-up, 11,041 total incident cases of frailty were ascertained. Compared to women in the lowest quintile of the Healthy Heart Score (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). 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.
The study authors conclude that Healthy Heart Score, based on a set of modifiable-lifestyle factors, is strongly associated with risk of frailty in older women.
Source: Sotos-Prieto M, Struijk EA, Fung TT, Rimm EB, Rodriguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Association between a lifestyle-based healthy heart score and risk of frailty in older women: a cohort study. Age Ageing. 2022 Feb 2;51(2):afab268.
The prospective cohort study used data from the Nurses’ Health Study in the US. 68,416 women aged ≥60 year with a follow-up from 1990 to 2014 were included. The Healthy Heart Score was computed based on 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%.
During 22 years of follow-up, 11,041 total incident cases of frailty were ascertained. Compared to women in the lowest quintile of the Healthy Heart Score (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). 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.
The study authors conclude that Healthy Heart Score, based on a set of modifiable-lifestyle factors, is strongly associated with risk of frailty in older women.
Source: Sotos-Prieto M, Struijk EA, Fung TT, Rimm EB, Rodriguez-Artalejo F, Willett WC, Hu FB, Lopez-Garcia E. Association between a lifestyle-based healthy heart score and risk of frailty in older women: a cohort study. Age Ageing. 2022 Feb 2;51(2):afab268.
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