Secondhand smoke is positively associated with pre-frailty and frailty in non-smoking older adults

Abstract

IntroductionEither exposure to secondhand smoke (SHS) or frailty has been linked to adverse health outcomes in nonsmoking adults. However, their relationship is rarely studied. The purpose of this study is to examine the association between serum cotinine level and frailty status among non-smoking older adults.MethodThe study population consisted of 2,703 older adults aged ≥60 from the National Health and Nutrition Examination Survey 2011–2014. Non-smokers were included based on (1) a serum cotinine level ≤ 10 ng/mL and 2) a response of “no” to the question, “Do you currently smoke?” Frailty status was measured based on the Fried Phenotype and had three groups- robust, pre-frailty, and frailty. Multinomial logistic regression models were constructed to examine the association between serum cotinine level quartile and frailty status, controlling for age, sex, race/ethnicity, education, depressive symptoms, alcohol use, and systolic blood pressure.ResultsAbout half of the participants (median age 70.0 years, range 64–78) were female (53.6%), non-Hispanic White (48.3%), and completed some college and above (50.1%). Multinomial logistic regression with a reference group being those in the 1st quantile (the lowest) of serum cotinine level showed that participants in the 4th quartile (the highest) of serum cotinine level had increased odds of pre-frailty vs. robust (OR 1.522, 95% confidence interval [CI] 1.060, 2.185, P = 0.023) as well as increased odds of frailty vs. robust (OR 2.349, 95% CI 1.081, 5.107, P = 0.031).ConclusionsHigher serum cotinine level is associated with increased risk of pre-frailty and frailty versus robust in non-smoking older adults. Prevention and reduction of SHS in older adults may help protect them from developing pre-frailty or frailty.

Concurrent serum lead levels and cognitive function in older adults

“…In the present study, we categorized participants' plasma levels of lead into four groups based on quartile and used the 1st quartile (the lowest quartile) as a reference. This is consistent with prior NHANES-based epidemiological studies (Fu et al, 2022a , b ; Li et al, 2023 ).…”

Frailty is associated with worse cognitive functioning in older adults

“…In this group of 2,296 older adults, we found that 3 4 of them had either pre-frailty or frailty. Compared to robust, frailty was independently associated with worse DSST and global cognition z-scores.…”

“…Frailty is characterized by a compromised ability to respond to external stimuli. It is associated with a long-term cumulative decline in reserves and functions in multiple systems in the human body ( 2 , 3 ). Pre-frailty is a latent condition that increases a person’s risk of frailty and typically occurs before clinically identifiable frailty ( 4 ).…”

Effects of cigarette smoking and secondhand smoke exposure on physical frailty development among community‐dwelling older adults in Japan: Evidence from a 10‐year population‐based cohort study

“…Secondhand smoke is also associated with a higher incidence of both pre‐frailty and frailty. Fu et al 22 . investigated the data of non‐smokers obtained from the US National Health and Nutrition Examination Survey, and found that higher serum cotinine levels are associated with an increased risk of pre‐frailty and frailty in non‐smoking older adults.…”

“…Kaskirbayeva et al 21 identified smoking as one of the risk factors for the progression of frailty in older adults. Fu et al 22 used a registered database and found that not only does tobacco smoking negatively affect frailty prevention, but secondhand smoking also plays a role in determining frailty and pre-frailty. Also, previous studies and meta-analyses showed that there was a significantly increased likelihood of frailty in patients with chronic bronchitis or chronic obstructive pulmonary disease, and chronic obstructive pulmonary disease is a common chronic disease among people with a smoking habit.…”