Life's Crucial 9 and its influence on frailty and survival in patients with cancer: Insights from NHANES.

INTRODUCTION

This study aims to examine the effect of Life's Crucial 9 (LC9), a comprehensive health measure, on frailty status and its association with all-cause, cancer-related, and non-cancer-related mortality in patients with cancer.

MATERIALS AND METHODS

A prospective cohort study was conducted with 2466 patients with cancer aged 20 years or older (weighted population: 16,222,181) from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. The LC9 score was calculated by averaging the Life's Essential 8 (LE8) and depression scores, which reflect psychological well-being. Multivariable logistic regression models were used to examine the relationship between LC9 and frailty in patients with cancer, while Cox proportional hazards models evaluated the associations between LC9 and all-cause, cancer-specific, and non-cancer mortality.

RESULTS

At baseline, 664 deaths were recorded among the 2466 patients with cancer, including 229 from cancer, 138 from heart disease, and 297 from other causes. Higher LC9 scores were linked to a lower risk of frailty and reduced hazard ratios for all-cause and non-cancer mortality, but not for cancer-specific mortality, compared to those with lower scores. Kaplan-Meier survival curves stratified by LC9 quartiles showed that participants in the highest quartile (Q4) had significantly lower risks of death from all causes (P < 0.001), cancer-specific causes (P = 0.01), and non-cancer causes (P < 0.001).

DISCUSSION

In patients with cancer in the United States, higher LC9 scores were independently associated with reduced risks of frailty, all-cause mortality, and non-cancer-related mortality. This health measure may serve as an effective secondary prevention strategy to mitigate mortality in this population.