Abstract
BackgroundMultidimensional frailty, including physical, psychological, and social components, is associated to disability, lower quality of life, increased healthcare utilization, and mortality. In order to prevent or delay frailty, more knowledge of its determinants is necessary; one of these determinants is lifestyle. The aim of this study is to determine the association between lifestyle factors smoking, alcohol use, nutrition, physical activity, and multidimensional frailty.MethodsThis cross-sectional study was conducted in two samples comprising in total 45,336 Dutch community-dwelling individuals aged 65 years or older. These samples completed a questionnaire including questions about smoking, alcohol use, physical activity, sociodemographic factors (both samples), and nutrition (one sample). Multidimensional frailty was assessed with the Tilburg Frailty Indicator (TFI).ResultsHigher alcohol consumption, physical activity, healthy nutrition, and less smoking were associated with less total, physical, psychological and social frailty after controlling for effects of other lifestyle factors and sociodemographic characteristics of the participants (age, gender, marital status, education, income). Effects of physical activity on total and physical frailty were up to considerable, whereas the effects of other lifestyle factors on frailty were small.ConclusionsThe four lifestyle factors were not only associated with physical frailty but also with psychological and social frailty. The different associations of frailty domains with lifestyle factors emphasize the importance of assessing frailty broadly and thus to pay attention to the multidimensional nature of this concept. The findings offer healthcare professionals starting points for interventions with the purpose to prevent or delay the onset of frailty, so community-dwelling older people have the possibility to aging in place accompanied by a good quality of life.
Highlights
Frailty is a concept that is in the spotlight of science and practice
Our study distinguishes itself from previous studies, because we aimed to determine the associations between smoking, alcohol use, nutrition, physical activity, and the physical, psychological and social domains of frailty separately in a large sample of community-dwelling older people
Studies focused on specific lifestyle factors as smoking [20], excessive alcohol use [24], poor dietary habits [26], and low physical activity [29], provided evidence that these individual factors had an effect on frailty
Summary
Frailty is a concept that is in the spotlight of science and practice. This is not surprising because frailty is closely related to ageing [1] and population aging is occurring all over the world [2]. Wellknown determinants of frailty are greater age [1, 12], gender (being a woman) [1, 13], lower education [14], low income [13, 15], and living without a partner [13, 14]. Another important determinant of frailty is having an unhealthy lifestyle [16,17,18,19]. The aim of this study is to determine the association between lifestyle factors smoking, alcohol use, nutrition, physical activity, and multidimensional frailty. Age_c Age2_c Gender (women) Not married‡ Divorced* Widowed* Education Income ΔR2 Lifestyle factors Smoking Smoking past Smoking ΔR2
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