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

Zhenmei Fu; Tian Zhou; Fanghong Dong; Mengchi Li; Xuechun Lin; Weixia Ma; Yuting Song; Song Ge

doi:10.3389/fpsyt.2022.1095254

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

Front Psychiatry. 2022 Dec 15:13:1095254. doi: 10.3389/fpsyt.2022.1095254. eCollection 2022.

Authors

Zhenmei Fu¹, Tian Zhou², Fanghong Dong³, Mengchi Li⁴, Xuechun Lin⁵, Weixia Ma⁶, Yuting Song⁷, Song Ge⁸

Affiliations

¹ Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
² School of Nursing, Xuzhou Medical University, Xuzhou, Jiangsu, China.
³ School of Nursing, Hebei University, Baoding, China.
⁴ Johns Hopkins University School of Nursing, Baltimore, MD, United States.
⁵ Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁶ Department of Pulmonary and Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
⁷ Qingdao University School of Nursing, Qingdao, Shandong, China.
⁸ Department of Natural Sciences, University of Houston-Downtown, Houston, TX, United States.

Abstract

Introduction: Either 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.

Method: The 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.

Results: About 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 1^st quantile (the lowest) of serum cotinine level showed that participants in the 4^th 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).

Conclusions: Higher 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.

Keywords: NHANES; cognitive function; cotinine; older adults; secondhand smoke; tobacco.