The association between lifestyle and overall health, using the frailty index.

OBJECTIVE: To evaluate the associations of four individual lifestyle factors with frailty.

METHODS: We used cross-sectional data from 11,539 participants of the Rotterdam Study, a population-based cohort, running from 1990 till now. A frailty index was used with a range from 0 to 100 (higher values indicating increasing frailty). We examined physical activity, dietary quality, alcohol intake, and smoking and calculated a sum-score of these, with a range from 0 (lowest) to 8 (highest). The associations between each lifestyle factor and the lifestyle score with frailty were evaluated.

RESULTS: Each lifestyle factor was independently associated with frailty. Participants with high physical activity levels had lower frailty scores than participants with low physical activity (β = -4.70,95%CI = -5.10,-4.30). High diet quality, compared to low diet quality was associated with less frailty (β=-0.88,95%CI = -1.35,-0.42). Low alcohol intake was associated more frailty (β = 0.84, 95%CI = 0.39, 1.29). Never-smokers or former smokers had on average 1.15 (95%CI = -1.60,-0.69) and 1.28 (95%CI = -1.78,-0.79) better frailty scores than smokers. A one-unit increment of the lifestyle score was associated with lower frailty (β = -0.62;95%CI = -0.84,-0.53).

CONCLUSIONS: The prevention of frailty can lead to lower health care costs and a higher quality of life among the growing group of elderly people. Our results emphasize that there is an urgent need for preventions that combine several lifestyle factors to improve healthy ageing.