Key Laboratory of Biopharmaceuticals, Postdoctoral Scientific Research Workstation, Shandong Academy of Pharmaceutical Science, Jinan, 250098, China.
Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.
BMC Geriatr. 2024 Oct 30;24(1):894. doi: 10.1186/s12877-024-05482-4.
Smoking has been recognized as a contributing factor to frailty in older adults. Nevertheless, it remains uncertain whether the degree of smoking has a discernible impact on frailty among older smokers. This cross-sectional study was conducted to investigate the correlation between serum cotinine levels, a biomarker reflecting tobacco exposure, and the presence of frailty within a nationally representative cohort of older adults.
A total of 1626 individuals aged ≥ 60 who identified as smokers were included in the analysis. Participants were selected based on self-reported current smoking status. According to the Fried Phenotype, frailty is assessed through five dimensions: unintentional weight loss, slow walking speed, weakness, self-reported exhaustion, and low physical activity. Participants with three or more of these conditions were categorized as frailty, those with at least one but less than three as pre-frailty, and those with none as robust. Multinomial logistic regression models were employed to explore the relationship between serum cotinine level quartiles, with the lowest quartile as the reference group, and the various frailty statuses, with robustness as the reference category. These models were adjusted for covariates, including age, sex, race/ethnicity, alcohol drinking, daily protein intake, systolic blood pressure, serum albumin level, depressive symptoms, and cognitive function. The data used for this analysis were sourced from the National Health and Nutrition Examination Survey for the years 2011 to 2014.
The median age of the participants was 69.0 years. The majority were male (62.2%) and non-Hispanic White (49.0%). The distribution of frailty statuses among the participants revealed that the highest proportion had pre-frailty (50.7%), followed by robustness (41.1%), and frailty (8.2%). Multinomial logistic regression showed that participants in the 4 quartile of serum cotinine level exhibited a higher probability of pre-frailty versus robustness (Odds ratio [OR] 1.599, 95% confidence interval [CI] 1.017, 2.513, P = 0.042). Participants in the 3 quartile of serum cotinine level had higher odds of frailty versus robustness (OR 2.403, 95% CI 1.125, 5.134, P = 0.024). Moreover, participants whose serum cotinine levels were higher than the literature cutoffs (≥ 15 ng/ml) were more likely to be pre-frail (Odds ratio [OR] 1.478, 95% confidence interval [CI] 1.017, 2.150, P = 0.035) or frail (Odds ratio [OR] 2.141, 95% confidence interval [CI] 1.054, 4.351, P = 0.041).
A higher serum cotinine level is linked to an elevated probability of pre-frailty and frailty among older smokers. Initiatives geared towards assisting older smokers in reducing or quitting their smoking habits might possibly play a crucial role in preventing pre-frailty and frailty.
吸烟已被公认为导致老年人虚弱的一个因素。然而，吸烟程度是否对老年吸烟者的虚弱状况有明显影响仍不确定。本横断面研究旨在调查血清可替宁水平（反映烟草暴露的生物标志物）与全国代表性老年人群中虚弱状况之间的相关性。
共纳入 1626 名年龄≥60 岁且自我报告为吸烟者的参与者。参与者是根据当前吸烟状况的自我报告选择的。根据 Fried 表型，通过五个维度评估虚弱：非有意体重减轻、缓慢步行速度、虚弱、自我报告的疲劳和低体力活动。有三个或更多这些情况的参与者被归类为虚弱，有一个或少于三个的被归类为前期虚弱，没有这些情况的被归类为健壮。采用多分类逻辑回归模型探讨血清可替宁水平四分位组（最低四分位组为参考组）与各种虚弱状态（健壮为参考类别）之间的关系。这些模型根据年龄、性别、种族/民族、饮酒、每日蛋白质摄入量、收缩压、血清白蛋白水平、抑郁症状和认知功能等因素进行了调整。本分析使用的数据来自 2011 年至 2014 年的全国健康和营养调查。
参与者的中位年龄为 69.0 岁。大多数为男性（62.2%）和非西班牙裔白人（49.0%）。参与者虚弱状态的分布显示，大多数人处于前期虚弱（50.7%），其次是健壮（41.1%）和虚弱（8.2%）。多分类逻辑回归显示，血清可替宁水平第 4 四分位组的参与者出现前期虚弱的可能性高于健壮（比值比[OR]1.599，95%置信区间[CI]1.017，2.513，P=0.042）。血清可替宁水平第 3 四分位组的参与者出现虚弱的可能性高于健壮（OR 2.403，95% CI 1.125，5.134，P=0.024）。此外，血清可替宁水平高于文献截定点（≥15ng/ml）的参与者更容易出现前期虚弱（OR 1.478，95% CI 1.017，2.150，P=0.035）或虚弱（OR 2.141，95% CI 1.054，4.351，P=0.041）。
较高的血清可替宁水平与老年吸烟者前期虚弱和虚弱的概率增加有关。旨在帮助老年吸烟者减少或戒烟的措施可能在预防前期虚弱和虚弱方面发挥关键作用。
