Socioeconomic status, healthy lifestyle, and the risk of frailty: Evidence from two prospective cohort studies.

IF 6 2区医学 Q1 GERIATRICS & GERONTOLOGY

International psychogeriatrics Pub Date : 2026-08-01 Epub Date: 2026-03-09 DOI:10.1016/j.inpsyc.2025.100177

Ran Yan, Yawen Yin, Yizhen Hu, Juxiang Yang, Hongchu Wang, Yi Wang, Gang Song

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引用次数: 0

Abstract

Background: The intricate interplay between socioeconomic status (SES) and healthy lifestyle behaviors in the development of frailty remains incompletely understood.

Methods: Using data from two nationally representative cohort studies: the Health and Retirement Study (HRS, 2008-2020; n = 23,183) and the English Longitudinal Study of Ageing (ELSA, 2004-2018; n = 11,182). SES was derived using latent class analysis (LCA) incorporating education level, total household income and wealth. A composite healthy lifestyle score included four factors: never smoking, low to moderate alcohol consumption, top tertile of physical activity, and active social contact.

Results: Participants with low SES had significantly increased risks of developing frailty compared to those with high SES (HRS: HR: 2.03; 95 % CI, 1.86-2.21; ELSA: HR: 4.58; 95 % CI, 3.84-5.45). The mediating effect of a lifestyle on the SES-frailty association accounted for 5.3 % (95 % CI, 1.9-8.8) in HRS and -2.3 % (95 % CI, -3.3 to -1.3) in ELSA. Compared to individuals with both high SES and a favorable lifestyle, those with low SES and an unfavorable lifestyle exhibited a markedly elevated risk of frailty (HRS: HR: 3.70; 95 % CI, 3.20-4.27; ELSA: HR: 6.18; 95 % CI, 3.61-10.56), and persistently higher frailty index scores.

Conclusions: Among older adults in the U.S. and U.K., favorable lifestyle behaviors modestly attenuated-but did not eliminate-the impact of socioeconomic disadvantage on frailty risk. Structural interventions targeting social determinants are warranted to reduce disparities in late-life health.

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社会经济地位、健康生活方式和衰弱风险：来自两项前瞻性队列研究的证据

背景：社会经济地位（SES）和健康生活方式行为之间复杂的相互作用在虚弱的发展中仍未完全了解。方法：使用两项具有全国代表性的队列研究的数据：健康与退休研究（HRS, 2008-2020; n = 23,183）和英国老龄化纵向研究（ELSA, 2004-2018; n = 11,182）。社会经济地位采用潜类分析（LCA），结合教育水平、家庭总收入和财富。综合健康生活方式评分包括四个因素：从不吸烟、低至中度饮酒、体育锻炼的最高水平和积极的社会交往。结果：与高SES的参与者相比，低SES的参与者发生虚弱的风险显著增加（HRS: HR: 2.03; 95 % CI, 1.86-2.21; ELSA: HR: 4.58; 95 % CI, 3.84-5.45）。生活方式对ses -衰弱关联的中介作用在HRS中占5.3 %(95 % CI, 1.9-8.8)，在ELSA中占-2.3 %（95 % CI, -3.3至-1.3）。与高经济地位和良好生活方式的个体相比，低经济地位和不良生活方式的个体表现出明显升高的衰弱风险（HRS: HR: 3.70; 95 % CI, 3.20-4.27; ELSA: HR: 6.18; 95 % CI, 3.61-10.56），并且持续较高的衰弱指数得分。结论：在美国和英国的老年人中，良好的生活方式行为适度地减弱了——但并没有消除——社会经济劣势对虚弱风险的影响。有必要针对社会决定因素采取结构性干预措施，以缩小晚年健康方面的差距。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International psychogeriatrics 医学-精神病学

CiteScore

9.10

自引率

8.60%

发文量

217

审稿时长

3-6 weeks

期刊介绍： A highly respected, multidisciplinary journal, International Psychogeriatrics publishes high quality original research papers in the field of psychogeriatrics. The journal aims to be the leading peer reviewed journal dealing with all aspects of the mental health of older people throughout the world. Circulated to over 1,000 members of the International Psychogeriatric Association, International Psychogeriatrics also features important editorials, provocative debates, literature reviews, book reviews and letters to the editor.