Abstract
Only a few studies have examined the impacts of environmental exposure on frailty. This study investigated the association between phthalates and frailty among community-dwelling older adults. The Korean Elderly Environmental Panel II (KEEP II) study is a repeated panel data study of 800 community-dwelling older adults in South Korea. Frailty was measured with five items defined by Fried and colleagues. Environmental pollutants in the form of two types of metabolites for Di-ethylhexyl phthalate (DEHPs)—Mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and Mono (2-ethyl-5-oxohexyl) phthalate (MEOHP)—were obtained from urine specimens. Analyses were performed using repeated linear mixed models. The concentration levels of both MEOHP and MEHHP in urine were significantly higher in the pre-frail or frail group than its counterparts. While adjusting for covariates, MEOHP level was positively associated with the likelihood of being pre-frail or frail in both males and females; the concentration level of MEHHP also had a positive impact on the likelihood of being pre-frail or frail in females. The DEHP metabolite concentrations were significantly lower among adults with daily fruit consumption in both males and females. DEHPs, measured by metabolite concentrations, may increase the risk of frailty among older men and women; further studies are necessary. The preventive effects of nutrition on DEHP risk should also be further investigated.
Highlights
Global aging has accelerated, and countries have been paying more attention to strategies to promote healthy aging [1]
Health condition-related variables were associated with frailty; those with more drugs, a lower body mass index (BMI), and/or more chronic diseases were more likely to be frail
Few empirical studies have assessed the effects of phthalate exposure on frailty, and this is an initial study on the effects of phthalate exposure on the frailty of older adults
Summary
Countries have been paying more attention to strategies to promote healthy aging [1]. As a clinical syndrome that can exacerbate physiological vulnerability, frailty is known to be a precursor to serious disability and disease, but it can be prevented and delayed [3,4]. The syndrome indicates older adults are at a high risk for functional aggravation, and noticing it allows room to intervene to prevent and/or delay the onset of such irreversible functional decline, unlike disease and disability [3,4,5]. But there has been pretty consistent evidence in the literature across countries on its socio-demographic and behavioral determinants. Researchers have investigated a wide variety of factors associated with frailty, including socio-demographic characteristics, marital status, social support, experience of fall, number of comorbid diseases, and medications [3,6].
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