基于生活方式的健康心脏评分与老年女性衰弱风险的关系：一项队列研究。
Association between a lifestyle-based healthy heart score and risk of frailty in older women: a cohort study.
机构信息
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.
CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
出版信息
Age Ageing. 2022 Feb 2;51(2). doi: 10.1093/ageing/afab268.
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.
背景
关于生活方式在衰弱风险中的综合作用的证据很少。评估基于生活方式的健康心脏评分（HHS）与老年女性衰弱风险之间的关联，HHS 可估计心血管疾病（CVD）的 20 年风险。
方法
这是一项在美国护士健康研究中进行的前瞻性队列研究，共纳入 121700 名护士。该研究包括 68416 名年龄≥60 岁的女性，随访时间从 1990 年至 2014 年。HHS 通过九个生活方式因素的性别特异性β系数计算得出，包括当前吸烟、高体重指数、低身体活动量、缺乏适度饮酒和不健康饮食。从 1992 年至 2014 年，每 4 年评估一次衰弱的发生率，使用 FRAIL 量表中的以下五个标准中的≥3 项来确定衰弱：疲劳、低力量、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 11041 例衰弱总发病例。与 HHS 最低五分位数（最低估计 CVD 风险）的女性相比，HHS 五分位数的多变量调整后的衰弱风险比为：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。在基线时具有 0 个衰弱标准的参与者中，当仅使用基线暴露或在 6 年、10 年和 14 年的滞后暴露分析中，以及在排除基线患有糖尿病和 CVD 的参与者后，结果对于每个衰弱标准都是一致的。
结论
基于一组可改变的生活方式因素的 HHS 与老年女性衰弱风险密切相关。
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