Association between ideal cardiovascular health and multiple disabilities among US adults, BRFSS 2017-2019

Abstract

Objectives: Cardiovascular health is the leading cause of death and disability in the United States. Our objective was to estimate the association between ideal cardiovascular health (ICVH) and multiple disabilities among US adults stratified into the three age groups of young (18-44 years), midlife (45-64 years), and older adults (≥65 years).

Study design: We conducted a cross-sectional analysis using data pooled from the 2017 and 2019 Behavioral Risk Factor Surveillance System (BRFSS).

Methods: Using American Heart Association's seven-component (four ideal behaviors and three ideal health factors) scoring tool, we identified ICVH as a composite score ≥5 and also computed the ideal behavioral (score ≥3) and ideal health factors (score = 3) submetrics. The outcome, single vs multiple disabilities indicator, was defined using US Census's disability domains and analyzed using multinomial regression.

Results: For all three groups, the prevalence of multiple disabilities was significantly lower among those meeting ICVH, ideal behavioral, and ideal health factors compared with those that did not. After controlling for covariates, ICVH score ≥5 was associated with lower relative risk of multiple disabilities in all groups. Although both ideal health and ideal behavioral factors were associated with lower relative risk of multiple disabilities among all groups, the reduction in risk was the highest for multiple disabilities and ideal behavioral factors among midlife (relative risk ratio: 0.30, 95% confidence interval: 0.25, 0.36) and older adults (relative risk ratio: 0.40, 95% confidence interval: 0.33, 0.48).

Conclusion: Adults with less-than-ideal cardiovascular health had a higher relative risk of multiple disabilities. Addressing the risk of multiple disabilities of US adults will require effective promotion of ICVH.

Keywords: Behavioral factors; Health promotion; Ideal cardiovascular health; Midlife and older adults; Multiple disabilities.