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Exposure to secondhand tobacco smoke and the frailty syndrome in US older adults

AGE volume 37, Article number: 26 (2015) Cite this article

Abstract

Exposure to secondhand tobacco smoke (SHS) is a well-established risk factor for cardiovascular disease and lung cancer in nonsmoking adults. However, few studies have focused on the health consequences of exposure to SHS in older adults. This is the first study to assess the association between SHS and the frailty syndrome in the nonsmoking older adult population. Cross-sectional study was conducted among 2059 nonsmoking adults aged ≥60 years who participated in the third US National Health and Nutrition Examination Survey and had completed a physical examination. Exposure to SHS was assessed by serum cotinine concentrations and by self-reported data from the home questionnaire. Frailty was ascertained with a slight modification of the Fried criteria. Analyses were performed with logistic regression and adjusted for the main confounders. The median (interquartile range) concentration of serum cotinine was 0.095 (IQR 0.035–0.211) ng/mL. The prevalence of frailty was 6.0 %. The odds ratios (95 % confidence interval [CI]) of frailty comparing the second, third, and fourth to the lowest quartile of serum cotinine were, respectively, 1.44 (0.67–3.06), 1.46 (0.75–2.85), and 2.51 (1.06–5.95), p value for trend 0.04. An increased frequency of frailty was also observed in participants reporting to live with ≥2 smokers at home (odds ratio 5.37; 95 % CI 1.13–25.5). In the US nonsmoking older adult population, exposure to SHS was associated with an increased frequency of frailty. More efforts are needed to protect older adults from SHS, especially at home and in other areas not covered by smoke-free regulations.

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Acknowledgments

Author Contributions

EGE conceived the study, performed the statistical analyses, and drafted the manuscript. FRA and ANA drafted and reviewed the manuscript for important intellectual content. EGE and FRA had primary responsibility for the final content.

Funding

This work was supported by grants from the Instituto de Salud Carlos III, Ministry of Health of Spain (PI12/1166), and from the European Commission (FRAILOMIC Initiative FP7-HEALTH-2012-Proposal No: 305483–2). Dr. Navas-Acien was supported by the Flight Attendant Medical Research Institute.

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Authors and Affiliations

  1. Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/IdiPAZ, and CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain

    Esther García-Esquinas & Fernando Rodríguez-Artalejo

  2. Department of Environmental Health Sciences, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

    Esther García-Esquinas & Ana Navas-Acien

  3. Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

    Ana Navas-Acien

  4. Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA

    Ana Navas-Acien

Authors
  1. Esther García-Esquinas
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  2. Ana Navas-Acien
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  3. Fernando Rodríguez-Artalejo
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Correspondence to Esther García-Esquinas.

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García-Esquinas, E., Navas-Acien, A. & Rodríguez-Artalejo, F. Exposure to secondhand tobacco smoke and the frailty syndrome in US older adults. AGE 37, 26 (2015). https://doi.org/10.1007/s11357-015-9762-4

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  • DOI: https://doi.org/10.1007/s11357-015-9762-4

Keywords

  • Tobacco smoke pollution
  • Air pollution
  • Indoor
  • Older adults
  • Second hand smoke
  • Cotinine
  • Frailty