Abstract P122: Life’s Simple 7 and Psychosocial Health Predict Physical Frailty, Hospital Frailty, and Comprehensive Frailty Index 10 Years Later

Abstract

Introduction: Life’s Simple 7 (LS7) is a metric for cardiovascular health (CVH). Evidence has shown that LS7 in late life was linked to late-life physical frailty, while the association of LS7 in midlife with multidimensional frailty indicators in late life remains unclear. In addition, there might be synergistic interactions between cardiovascular health and psychosocial health factors on risk of frailty. Hypothesis: Based on the bio-psycho-social medical model, we hypothesized that midlife LS7 status might be related to late life multidimensional frailty indicators (physical frailty, hospital frailty, and comprehensive frailty index), and psychosocial health (social isolation and loneliness) might interact the association between LS7 and frailty. Methods: We used cohort data from UK Biobank. CVH was measured by LS7. A higher score indicated better CVH. Psychosocial health status was measured by social isolation and loneliness and divided into good or poor. Frailty was assessed using physical Frailty Phenotype (FP), a validated Hospital Frailty Risk Score (HFRS) and a comprehensive Frailty Index (FI). Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) on the association between the LS7 score, psychosocial health, and frailty. The synergistic effects of LS7 and psychosocial health on frailty were also analyzed. All HRs were adjusted for sex, age at last follow-up, race, education level, alcohol drinking, and income. Results: For the association of LS7 with FP and FI, 39,047 individuals who attended baseline and visit 2 were included. After a median follow-up of 9.0 years, FP identified 1,329 (3.4%) people with frailty, and FI identified 5,699 (14.6%) with frailty. For association of LS7 with HFRS, 366,570 people were included. After a median follow-up of 12.0 years, 18,737 (5.1%) people were identified as with hospital frailty. Compared to people with poor LS7 score, those with intermediate (FP:HR=0.64, 0.54-0.77; FI: HR=0.77, 0.69-0.86; HFRS: HR=0.60, 0.58-0.62) and optimal LS7 score (FP: HR=0.31, 0.25-0.39; FI: HR=0.62, 0.55-0.69; HFRS: HR=0.39, 0.37-0.41) were associated with lower risk of frailty. Poor psychosocial health was associated with an increased risk of frailty (FP: 1.87, 1.44-2.43; FI: 1.46, 1.24-1.71; HFRS: 1.53, 1.44-1.62). We observed synergistic effects of LS7 and psychosocial health on frailty. People who had good psychosocial status and optimal LS7 score had the lowest risk of frailty (FP: 0.30, 0.24-0.38; FI: 0.63, 0.56-0.70; HFRS: 0.38, 0.36-0.41). Conclusions: Higher LS7 score or good psychosocial health in midlife was associated with reduced risk of physical frailty, hospital frailty, and overall frailty. Psychosocial status interacted with LS7 on frailty. Individuals who had good psychosocial health and optimal LS7 score were associated with the lowest risk of frailty.