Midlife Cardiovascular Health and Robust Versus Frail Late-Life Status: The Atherosclerosis Risk in Communities Study.
American Heart Association
Cohort study
Life’s Simple 7
Physical function
Journal
The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837
Informations de publication
Date de publication:
01 06 2022
01 06 2022
Historique:
received:
27
01
2021
pubmed:
19
10
2021
medline:
7
6
2022
entrez:
18
10
2021
Statut:
ppublish
Résumé
We examined the relationship of midlife cardiovascular health (CVH) with late-life robustness among men and women and the impact of survivorship bias on sex differences in robustness. Prospective analysis of 15 744 participants aged 45-64 (visit 1 median age: 54 years, 55% female, 27% Black) in 1987-1989 from the population-based Atherosclerosis Risk in Communities Study. CVH was operationalized according to the Life's Simple 7 (LS7) metric of health behaviors (smoking, weight, physical activity, diet, cholesterol, blood pressure, and glucose); each behavior was scored as ideal (2 points), intermediate (1 point), or poor (0 points) and summed. Late-life robust/prefrail/frailty was defined at visit 5 (2011-2013). Multinomial regression estimated relative prevalence ratios (RPRs) of late-life robustness/prefrailty/frailty/death across overall midlife LS7 score and components, for the full visit 1 sample. Separate analyses considered visit 5 survivors-only. For each 1-unit greater midlife LS7 score, participants had a 37% higher relative prevalence of being robust versus frail (overall RPR = 1.37 [95% confidence interval {CI}: 1.30-1.44]; women = 1.45 [1.36-1.54]; men = 1.24 [1.13-1.36]). Among the full visit 1 sample, women had a similar 1-level higher robustness category prevalence (RPR = 1.35 [95% CI: 1.32-1.39]) than men (RPR = 1.31 [95% CI: 1.27-1.35]) for every 1-unit higher midlife LS7 score. Among survivors, men were more likely to be robust than women at lower LS7 levels; differences were attenuated and not statistically different at higher midlife LS7 levels. Midlife CVH is positively associated with robustness in late life among men and women. Accounting for mortality in part explains documented sex differences in robustness across all levels of LS7.
Sections du résumé
BACKGROUND
We examined the relationship of midlife cardiovascular health (CVH) with late-life robustness among men and women and the impact of survivorship bias on sex differences in robustness.
METHODS
Prospective analysis of 15 744 participants aged 45-64 (visit 1 median age: 54 years, 55% female, 27% Black) in 1987-1989 from the population-based Atherosclerosis Risk in Communities Study. CVH was operationalized according to the Life's Simple 7 (LS7) metric of health behaviors (smoking, weight, physical activity, diet, cholesterol, blood pressure, and glucose); each behavior was scored as ideal (2 points), intermediate (1 point), or poor (0 points) and summed. Late-life robust/prefrail/frailty was defined at visit 5 (2011-2013). Multinomial regression estimated relative prevalence ratios (RPRs) of late-life robustness/prefrailty/frailty/death across overall midlife LS7 score and components, for the full visit 1 sample. Separate analyses considered visit 5 survivors-only.
RESULTS
For each 1-unit greater midlife LS7 score, participants had a 37% higher relative prevalence of being robust versus frail (overall RPR = 1.37 [95% confidence interval {CI}: 1.30-1.44]; women = 1.45 [1.36-1.54]; men = 1.24 [1.13-1.36]). Among the full visit 1 sample, women had a similar 1-level higher robustness category prevalence (RPR = 1.35 [95% CI: 1.32-1.39]) than men (RPR = 1.31 [95% CI: 1.27-1.35]) for every 1-unit higher midlife LS7 score. Among survivors, men were more likely to be robust than women at lower LS7 levels; differences were attenuated and not statistically different at higher midlife LS7 levels.
CONCLUSIONS
Midlife CVH is positively associated with robustness in late life among men and women. Accounting for mortality in part explains documented sex differences in robustness across all levels of LS7.
Identifiants
pubmed: 34661638
pii: 6400010
doi: 10.1093/gerona/glab310
pmc: PMC9159655
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
1222-1229Subventions
Organisme : NHLBI NIH HHS
ID : U01 HL096812
Pays : United States
Organisme : HHS
ID : HHSN268201700001I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700002I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700005I
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700003I
Pays : United States
Organisme : NIH HHS
Pays : United States
Organisme : NIA NIH HHS
ID : R00 AG052830
Pays : United States
Organisme : NIA NIH HHS
ID : P30AG021334
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG021334
Pays : United States
Organisme : NHLBI NIH HHS
ID : HHSN268201700004I
Pays : United States
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Références
J Am Geriatr Soc. 2006 Jun;54(6):991-1001
pubmed: 16776798
Health Serv Res. 2002 Aug;37(4):849-84
pubmed: 12236388
J Gerontol A Biol Sci Med Sci. 2015 Nov;70(11):1427-34
pubmed: 26297656
Circulation. 2011 Nov 8;124(19):2145-54
pubmed: 22064958
J Gerontol A Biol Sci Med Sci. 2017 Mar 1;72(3):382-388
pubmed: 27470301
J Am Coll Cardiol. 2011 Apr 19;57(16):1690-6
pubmed: 21492767
J Am Coll Surg. 2010 Jun;210(6):901-8
pubmed: 20510798
Circulation. 2010 Feb 2;121(4):586-613
pubmed: 20089546
J Gerontol A Biol Sci Med Sci. 2006 Mar;61(3):262-6
pubmed: 16567375
Clin Chem. 1983 Jun;29(6):1075-80
pubmed: 6851096
Multivariate Behav Res. 2011 May;46(3):399-424
pubmed: 21818162
J Am Heart Assoc. 2016 Apr 06;5(4):e003192
pubmed: 27053058
J Am Geriatr Soc. 2014 Oct;62(10):1860-8
pubmed: 25283337
Arch Intern Med. 2011 Jun 27;171(12):1119-21
pubmed: 21709116
Am J Clin Nutr. 1982 Nov;36(5):936-42
pubmed: 7137077
J Am Geriatr Soc. 2012 Aug;60(8):1487-92
pubmed: 22881367
Stat Methods Med Res. 2013 Jun;22(3):278-95
pubmed: 21220355
CMAJ. 2021 Mar 15;193(11):E361-E370
pubmed: 33722827
Med Sci Sports Exerc. 2011 Aug;43(8):1575-81
pubmed: 21681120
Lancet. 2013 Mar 2;381(9868):752-62
pubmed: 23395245
J Gerontol A Biol Sci Med Sci. 2007 Jul;62(7):744-51
pubmed: 17634322
Am J Epidemiol. 1989 Apr;129(4):687-702
pubmed: 2646917
J Gerontol A Biol Sci Med Sci. 2017 Nov 09;72(12):1710-1716
pubmed: 28184412
Eur Heart J. 1987 Sep;8(9):1007-14
pubmed: 3665952
Stroke. 2013 Jul;44(7):1909-14
pubmed: 23743971
J Am Heart Assoc. 2015 Feb 12;4(2):
pubmed: 25677566
J Am Geriatr Soc. 2015 Jul;63(7):1459-62
pubmed: 26179067
Exp Gerontol. 2017 Mar;89:30-40
pubmed: 28043934
J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56
pubmed: 11253156
Am J Med. 2015 Sep;128(9):970-6.e2
pubmed: 25908393
J Am Geriatr Soc. 2017 May;65(5):1012-1018
pubmed: 28165626
J Am Coll Cardiol. 2015 Oct 6;66(14):1633-1634
pubmed: 26429090
Circ Cardiovasc Qual Outcomes. 2016 May;9(3):239-45
pubmed: 27166207