Associations between meat consumption and all-cause and cause-specific mortality in middle-aged and older adults with frailty.

OBJECTIVES: This study aimed to explore the associations between different types of meat consumption and mortality risk among people with frailty. DESIGN: Longitudinal study. SETTING AND PARTICIPANTS: We included 19,913 physically frail participants from the UK Biobank. MEASUREMENTS: We used the validated brief food frequency questionnaire (FFQ) to measure meat consumption. Baseline diet data from 2006 to 2010 were collected, and participants were followed up until March 23, 2021. Cox proportional hazards regression models were conducted to examine the associations of meat consumption with mortality risk. RESULTS: We identified 3,622 all-cause deaths, 1,453 cancer deaths, and 1,663 cardiovascular deaths during a median follow-up time of 11.2 years. Higher consumption of unprocessed poultry (per 25 g/day increment) was associated with a lower risk of all-cause mortality (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.75-0.88), cancer mortality (HR 0.84, 95% CI 0.74-0.96), and cardiovascular mortality (HR 0.72, 95% CI 0.63-0.81). Consumption of unprocessed red meat had a U-shaped relationship with mortality. Moderate consumption of unprocessed red meat 1.0-1.9 times/week was associated with a 14% (95% CI: 3 %-24%) lower risk of all-cause mortality than the lowest consumption frequency group (0-0.9 times/week). The hazard of cancer and CV mortality was also lower in the 1.0-1.9 times/week group, though the associations were not statistically significant. More frequent consumption of processed meat was associated with an increased risk of all-cause mortality (HR 1.20, 95% CI 1.07-1.34) and cardiovascular mortality (HR 1.20, 95% CI 1.02-1.42). Fish consumption was not associated with all types of mortality. CONCLUSIONS: Higher consumption of processed meat, not fish, was associated with increased all-cause and cardiovascular mortality. In contrast, higher consumption of unprocessed poultry and moderate consumption of unprocessed red meat was associated with reduced all-cause, cancer, and cardiovascular mortality. These findings warrant further investigation to establish optimal dietary patterns for frail individuals.

Associations between healthy lifestyle and mortality across different social environments: a study among adults with frailty from the UK Biobank.

BACKGROUND: Among people living with frailty, adherence to a healthy lifestyle may be a low-cost and effective strategy to decrease frailty-induced health risks across different social environments. METHODS: We included 15 594 frail participants at baseline from the UK Biobank study. We used four lifestyle factors to create a composite healthy lifestyle score and 17 social factors to construct a polysocial score. We classified the lifestyle score into two levels (unhealthy and healthy) and the polysocial score into three levels (low, intermediate and high). We used Cox regression to determine the association of each lifestyle factor and lifestyle score with all-cause mortality, respectively. We also examined the associations across polysocial score categories. We evaluated the joint association of the lifestyle score and the categorical polysocial score with all-cause mortality. RESULTS: During up to 14.41 follow-up years, we documented 3098 all-cause deaths. After multivariable adjustment, we found a significant association between not smoking and adequate physical activity with all-cause mortality across polysocial score categories, respectively. We also found a significant association between a healthy diet and all-cause mortality among frail participants living in an intermediate social environment. A healthy lifestyle was associated with a lower all-cause mortality risk across polysocial score categories, especially among those with a low polysocial score. CONCLUSIONS: Adherence to a healthy lifestyle, particularly not smoking, adequate physical activity and a healthy diet, may provide a feasible solution to decreasing mortality risk among frail adults across different social environments, especially for those in the socially disadvantaged group.

Joint Association of Physical Frailty and Self-Rated Health With Mortality Among Community-Dwelling Older Adults.

BACKGROUND: The relationship between subjective and objective health is complex and not always matched. Although frailty and self-rated health (SRH) have been separately associated with adverse outcomes, their joint effects remained unclear. METHODS: Participants were 5 300 adults ≥60 years from the China Health and Retirement Longitudinal Study in 2011. Frailty, measured by the validated physical frailty phenotype approach, was classified as nonfrail, prefrail, and frail. SRH was categorized into 3 groups: excellent/very good/good, fair, and poor/very poor. We used the Cox models to examine the independent and joint association of frailty and SRH with mortality. We used the interaction approach to determine whether the association of SRH with mortality differed by frailty. Subgroup analyses were conducted by depression and cognitive impairment. RESULTS: About 8.1% of frail participants reported excellent/very good/good health; 21.2% of the nonfrail reported poor/very poor health. Prefrailty and frailty were associated with a 1.63- and 2.38-fold increase in the hazard of mortality than the nonfrail, respectively, after adjusting for SRH. Reporting fair and poor/very poor health was associated with a 29% and 100% increase in the hazard of mortality, respectively, after adjusting for frailty. No significant interaction was found. Prefrail and frail older adults with excellent/very good/good health had a similar mortality as the nonfrail with poor/very poor SRH. The association of SRH with mortality was less pronounced among individuals with depression or cognitive impairment. CONCLUSIONS: SRH is a potential marker of resilience among people living with frailty that may be a target for ameliorating health risks induced by frailty.

Examining racial and ethnic differences in disability among older adults: A polysocial score approach.

OBJECTIVES: Racial and ethnic disparities in disability in activities of daily living (ADL) continue to be a public concern. We evaluated whether the polysocial score approach could provide a more comprehensive method for modifying racial and ethnic differences in such disability. STUDY DESIGN: Cohort study. MAIN OUTCOME MEASURES: We included 5833 participants from the Health and Retirement Study, who were aged 65 years or more and were initially free of ADL disability. We considered six ADLs: bathing, eating, using the toilet, dressing, walking across a room, and getting in/out of bed. We included 20 social factors spanning economic stability, neighborhood and physical environment, education, community and social context, and health system. We used forward stepwise logistic regression to derive a polysocial score for ADL disability. We created a polysocial score using 12 social factors and categorized the score as low (0-19), intermediate (20-30), and high (31+). We used multivariable logistic regression to estimate the incident risk of ADL disability and examine additive interactions between race/ethnicity and polysocial score. RESULTS: A higher polysocial score is associated with a lower incidence of ADL disability among older adults in the United States. We found additive interactions between race/ethnicity and polysocial score categories. In the low polysocial score category, White and Black/Hispanic participants had a 18.5 % and 24.4 % risk of ADL disability, respectively. Among White participants, the risk of ADL disability decreased to 14.1 % and 12.1 % in the intermediate and high polysocial score categories, respectively; among Black/Hispanic participants, those in the intermediate and high categories had a 11.9 % and 8.7 % risk of ADL disability, respectively. CONCLUSIONS: The polysocial score approach provides a new opportunity for explaining racial/ethnic disparities in functional capacity among older adults.

Association of Joint Genetic and Social Environmental Risks With Incident Myocardial Infarction: Results From the Health and Retirement Study.

Background Myocardial infarction (MI) is a significant clinical and public health problem worldwide. However, little research has assessed the interplay between genetic susceptibility and social environment in the development of MI. Methods and Results Data were from the HRS (Health and Retirement Study). The polygenic risk score and polysocial score for MI were classified as low, intermediate, and high. Using Cox regression models, we assessed the race-specific association of polygenic score and polysocial score with MI and examined the association between polysocial score and MI in each polygenic risk score category. We also examined the joint effect of genetic (low, intermediate, and high) and social environmental risks (low/intermediate, high) on MI. A total of 612 Black and 4795 White adults aged ≥65 years initially free of MI were included. We found a risk gradient of MI across the polygenic risk score and polysocial score among White participants; no significant risk gradient across the polygenic risk score was found among Black participants. A disadvantaged social environment was associated with a higher risk of incident MI among older White adults with intermediate and high genetic risk but not those with low genetic risk. We revealed the joint effect of genetics and social environment in the development of MI among White participants. Conclusions Living in a favorable social environment is particularly important for people with intermediate and high genetic risk for MI. It is critical to developing tailored interventions to improve social environment for disease prevention, especially among adults with a relatively high genetic risk.