Midlife Cardiovascular Health and Robust Versus Frail Late-Life Status: The Atherosclerosis Risk in Communities Study. Issue 6 (18th October 2021)

• Record Type: Journal Article
• Authors: Palta, Priya; Griswold, Michael; Ranadive, Radhikesh; Bandeen-Roche, Karen; Folsom, Aaron R; Petruski-Ivleva, Natalia; Burgard, Sheila; Kucharska-Newton, Anna; Windham, B Gwen
• Editors: Lipsitz, Lewis A
• Is Part Of: Journals of gerontology. Volume 77:Issue 6(2022)
• Page Start: 1222
• Page End: 1229
• Publication Date: 2021-10-18
• Subjects: American Heart Association -- Cohort study -- Life's Simple 7 -- Physical function; Geriatrics -- Periodicals; Gerontology -- Periodicals; 618.97
• DOI: 10.1093/gerona/glab310
• Languages: English
• ISSNs: 1079-5006

Abstract

Abstract: 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.