Zhong Wen-Fang, Wang Xiao-Meng, Song Wei-Qi, Chen Huan, Xie Jia-Hao, Yan Hao, Wang Jun-Jie, Lv Yue-Bin, Li Zhi-Hao, Shi Xiao-Ming, Mao Chen
Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China; Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Clin Nutr. 2025 Jul;50:29-37. doi: 10.1016/j.clnu.2025.04.033. Epub 2025 May 13.
The association between change in lifestyle in late-life and frailty mediated by genetic risk is yet to be elucidated. This study aimed to investigate the associations of change in lifestyle in late-life and genetic risk with frailty among older adults.
6945 participants aged 65 or older were included from the Chinese Longitudinal Healthy Longevity Survey. Three-year lifestyle changes were assessed by comparing the first survey (2002, 2005, 2008, 2011) with the second survey (2005, 2008, 2011, 2014), evaluating changes in overall lifestyle scores, lifestyle combinations, and four factors (smoking, alcohol use, physical activity, and diet). A weighted polygenic risk score was constructed using 25 frailty-associated Single Nucleotide Polymorphism in a subsample of 4346 participants. Frailty was defined as a frailty index ≥0.25. Cox proportional hazards regression models, with age as the time scale and stratified by 5-year age groups, were used to estimate the interaction between genetic and lifestyle factors on frailty risk.
During a median follow-up time of 5.7 years [interquartile range (IQR): 3.1-8.9), 2525 participants developed frailty. Compared to consistently unhealthy lifestyles, the hazard ratios (HRs) for frailty were 0.64 [95 % confidence interval (CI): 0.54-0.75] for healthy-to-healthy, 0.80 (95 % CI: 0.68-0.93) for moderate-to-moderate, and 0.83 (95 % CI: 0.70-0.99) for moderate-to-healthy changes. Participants with a high genetic risk group suffered from 87 % (95%CI: 1.68-2.08) higher risk of frailty. Notably, the highest frailty risk was observed in individuals with high genetic risk who changed from a healthy to an unhealthy lifestyle (HR: 2.86, 95%CI: 1.89-4.34).
Improving or maintaining a healthy lifestyle over three years, even in late life, was associated with a lower risk of frailty. This underscores the importance of a healthy lifestyle in preventing frailty, particularly for individuals with a high genetic risk.
晚年生活方式的改变与由遗传风险介导的衰弱之间的关联尚待阐明。本研究旨在调查老年人晚年生活方式的改变和遗传风险与衰弱之间的关联。
纳入来自中国老年健康长寿纵向调查的6945名65岁及以上的参与者。通过比较第一次调查（2002年、2005年、2008年、2011年）和第二次调查（2005年、2008年、2011年、2014年）来评估三年的生活方式变化，评估总体生活方式得分、生活方式组合以及四个因素（吸烟、饮酒、身体活动和饮食）的变化。在4346名参与者的子样本中，使用25个与衰弱相关的单核苷酸多态性构建加权多基因风险评分。衰弱定义为衰弱指数≥0.25。以年龄为时间尺度并按5岁年龄组分层的Cox比例风险回归模型用于估计遗传和生活方式因素对衰弱风险的相互作用。
在中位随访时间5.7年[四分位间距（IQR）：3.1 - 8.9]期间，2525名参与者出现衰弱。与始终保持不健康生活方式相比，从健康到健康、从中度到中度以及从中度到健康变化的衰弱风险比（HR）分别为0.64[95%置信区间（CI）：0.54 - 0.75]、0.80（95%CI：0.68 - 0.93）和0.83（95%CI：0.70 - 0.99）。高遗传风险组的参与者患衰弱的风险高87%（95%CI：1.68 - 2.08）。值得注意的是，从健康生活方式转变为不健康生活方式的高遗传风险个体中观察到最高的衰弱风险（HR：2.86，95%CI：1.89 - 4.34）。
即使在晚年，在三年时间里改善或保持健康的生活方式与较低的衰弱风险相关。这突出了健康生活方式在预防衰弱中的重要性，特别是对于高遗传风险的个体。
