Abstract
Objectives
To assess the short- and long-term association of 6 healthy behaviors (not smoking,
vigorous to moderate physical activity, healthy diet, adequate sleeping duration,
not being sedentary, and daily social interaction) with incident frailty and disability.
Design
Prospective population-based study.
Settings and Participants
In 2001, 4008 community-dwelling individuals aged ≥60 years in Spain were recruited.
Participants were followed up until 2003, when a short-term phone interview of the
remaining 3235 individuals was performed. Then, the participants were followed up
until 2009, when a long-term phone interview was conducted with 1309 participants.
Measures
At baseline, a home interview and a physical examination were conducted to assess
healthy behaviors. At baseline and at follow-ups, we ascertained frailty and 4 domains
of disability: limitation in instrumental activities of daily living, restriction
in daily activities, limitation in mobility, and self-care limitation.
Results
In the short-term analyses, vigorous to moderate physical activity and not being sedentary
were associated with a reduction in frailty, multivariable odds ratios (OR) (95% confidence
interval) 0.55 (0.35-0.85) and 0.43 (0.26-0.72). Vigorous to moderate physical activity
and adequate sleeping duration decreased instrumental activities of daily living limitation
OR 0.63 (0.44–0.91) and 0.69 (0.53–0.89) as well as self-care limitation OR 0.62 (0.41–0.92)
and 0.65 (0.45-0.94). Adequate sleep duration and not being sedentary decreased restriction
in daily activities OR 0.67 (0.49–0.90) and 0.57 (0.36–0.91). Vigorous to moderate
physical activity and healthy diet decreased limitation in mobility OR 0.58 (0.35–0.96)
and 0.73 (0.54–0.97). Considering these 5 healthy behaviors, participants who scored
5 (vs ≤ 2) in the combined score had a lower risk of frailty and disability. In the
long-term analyses, results showed the same direction as in short-term analyses.
Conclusions and Implications
The combination of healthy behaviors is associated with a substantial reduction in
the risk of frailty and of most disability outcomes in older adults.
Keywords
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Article info
Publication history
Published online: October 19, 2019
Footnotes
Data collection was funded by the following grants: FIS PI09/1626, PI16/00609, PI16/01460, PI17/1709 (State Secretary of R+D and FEDER/FSE), the ATHLOS project (EU H2020-Project ID: 635316), CIBERESP, Instituto de Salud Carlos III. Madrid, Spain, and the ‘Cátedra UAM de Epidemiología y Control del Riesgo Cardiovascular’[Universidad Autónoma of Madrid Chair in Epidemiology and Cardiovascular Risk Control]
Study participants gave written informed consent. The Clinical Research Ethics Committee of “La Paz” University Hospital in Madrid, Spain approved both, the baseline and follow-up studies.
The datasets analyzed during the current study are not publicly available. However, it can be made available from the corresponding author on reasonable request.
The authors declare no conflicts of interest.
Identification
Copyright
© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
