Association between a lifestyle-based healthy heart score and risk of frailty in older women: a cohort study.
Association between a lifestyle-based healthy heart score and risk of frailty in older women: a cohort study.
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基于生活方式的健康心脏评分与老年女性虚弱风险之间的关联：一项队列研究。
DOI：
10.1093/ageing/afab268
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发表时间：
2022
期刊：
影响因子：
6.7
通讯作者：
Lopez-Garcia,Esther
中科院分区：
文献类型：
--
作者：
Sotos-Prieto,Mercedes;Struijk,EllenA;Fung,TeresaT;Rimm,EricB;Rodriguez-Artalejo,Fernando;Willett,WalterC;Hu,FrankB;Lopez-Garcia,Esther
背景 关于生活方式对衰弱风险的综合作用的证据很少。旨在评估基于生活方式的健康心脏评分 (HHS)（可估计 20 年心血管疾病 (CVD) 风险）与老年女性虚弱风险之间的关联。方法对参加护士健康研究的 121,700 名美国护士进行前瞻性队列研究。这项研究纳入了 68,416 名 60 岁以上的女性，并于 1990 年至 2014 年进行了随访。HHS 是使用九种生活方式因素的性别特异性 β 系数计算的，包括当前吸烟、高体重指数、低体力活动、缺乏适量酒精摄入和不健康饮食。从 1992 年到 2014 年，每 4 年评估一次衰弱发生率，符合 FRAIL 量表中以下 5 个标准中的 3 条以上：疲劳、低强度、有氧能力降低、患有 ≥ 5 种疾病和体重减轻 ≥ 5%。 结果在 22 年的随访期间，共确定了 11,041 例衰弱事件。与 HHS 最低五分位数（估计 CVD 风险最低）的女性相比，五分位数的衰弱风险比经多变量调整后为： Q2:1.67（95% 置信区间 1.53, 1.82）； Q3：2.34（2.15，2.53）； Q4: 3.54 (3.28, 3.83) 和 Q5: 5.92 (5.48, 6.38)；P-趋势 > 0.001。在基线时衰弱标准为 0 的参与者中，仅使用基线暴露或在 6 年、10 年和 14 年暴露滞后分析中，以及在排除基线时患有糖尿病和 CVD 的参与者后，每个衰弱标准的结果都是一致的。结论基于一组可改变的生活方式因素的 HHS 与老年女性的衰弱风险密切相关。
BackgroundEvidence 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.MethodsProspective 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%.ResultsDuring 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.ConclusionsThe HHS, based on a set of modifiable-lifestyle factors, is strongly associated with risk of frailty in older women.