Lifestyles of Older Adults: Can We Influence Cardiovascular Risk
Lifestyles of Older Adults: Can We Influence Cardiovascular Risk
Influences of lifestyle habits on cardiovascular disease risk among older adults are not well established. The authors present evidence from the Cardiovascular Health Study that dietary, physical activity, and smoking habits assessed late in life are associated with cardiovascular disease risk among adults aged 65 years or older. Persons consuming fatty fish twice per week had a 47% lower risk of coronary death compared with those who consumed fatty fish less than once per month, while cereal fiber intake (about two whole-grain bread slices per day) was associated with a 14% lower risk of myocardial infarction or stroke. Modest alcohol intake (1-6 drinks per week) predicted the fewest subclinical cerebrovascular abnormalities. Compared with little activity, moderate and high leisure-time activity predicted 28% and 44% lower mortality, respectively, while compared with nonexercisers, low, moderate, and high exercise intensity predicted 30%, 37%, and 53% more years of healthy life, respectively. Former and current smokers had 25% and 44% fewer years of healthy life than those who never smoked; lifetime smoking (pack-years) predicted higher mortality. Clinical practice and public health implications, gaps in knowledge, and future research directions are summarized.
There are 35 million persons aged 65 years or older in the United States, comprising approximately 13% of the population. These older adults are the fastest-growing segment of the population; by 2030, 70 million persons, or one in every five, will be ≥65 years old. Cardiovascular disease (CVD) is the leading cause of death and disability among older adults, who account for a large share of the $200 billion annual US health care expenditures for CVD. Better understanding of factors influencing CVD risks and outcomes in this population is clearly of merit. Because atherosclerotic disease is often more advanced late in life, risk factors for CVD may be different among older individuals compared with young or middle-aged adults. Furthermore, risk factors may receive less attention when years of remaining life are diminished. This may be particularly true for lifestyle factors such as diet, physical activity, and smoking. We present evidence from the Cardiovascular Health Study (CHS), a population-based, longitudinal cohort study of determinants of cardiovascular events among adults aged ≥65 years, and review other studies for the associations of lifestyle habits, assessed late in life, with CVD risk among older adults. We also summarize gaps in knowledge, directions for future research, and implications for clinical practice and public health.
Influences of lifestyle habits on cardiovascular disease risk among older adults are not well established. The authors present evidence from the Cardiovascular Health Study that dietary, physical activity, and smoking habits assessed late in life are associated with cardiovascular disease risk among adults aged 65 years or older. Persons consuming fatty fish twice per week had a 47% lower risk of coronary death compared with those who consumed fatty fish less than once per month, while cereal fiber intake (about two whole-grain bread slices per day) was associated with a 14% lower risk of myocardial infarction or stroke. Modest alcohol intake (1-6 drinks per week) predicted the fewest subclinical cerebrovascular abnormalities. Compared with little activity, moderate and high leisure-time activity predicted 28% and 44% lower mortality, respectively, while compared with nonexercisers, low, moderate, and high exercise intensity predicted 30%, 37%, and 53% more years of healthy life, respectively. Former and current smokers had 25% and 44% fewer years of healthy life than those who never smoked; lifetime smoking (pack-years) predicted higher mortality. Clinical practice and public health implications, gaps in knowledge, and future research directions are summarized.
There are 35 million persons aged 65 years or older in the United States, comprising approximately 13% of the population. These older adults are the fastest-growing segment of the population; by 2030, 70 million persons, or one in every five, will be ≥65 years old. Cardiovascular disease (CVD) is the leading cause of death and disability among older adults, who account for a large share of the $200 billion annual US health care expenditures for CVD. Better understanding of factors influencing CVD risks and outcomes in this population is clearly of merit. Because atherosclerotic disease is often more advanced late in life, risk factors for CVD may be different among older individuals compared with young or middle-aged adults. Furthermore, risk factors may receive less attention when years of remaining life are diminished. This may be particularly true for lifestyle factors such as diet, physical activity, and smoking. We present evidence from the Cardiovascular Health Study (CHS), a population-based, longitudinal cohort study of determinants of cardiovascular events among adults aged ≥65 years, and review other studies for the associations of lifestyle habits, assessed late in life, with CVD risk among older adults. We also summarize gaps in knowledge, directions for future research, and implications for clinical practice and public health.
