In addition, selleck screening library we cannot rule out other mechanisms besides the antioxidant effect that explain such associations. Several researchers support the notion that fruit and vegetable intake is a marker
of healthy lifestyle behavior rather than an etiological factor of noncommunicable diseases, as it is highly correlated with other disease risk factors.37 Although a few studies found that smokers are at high risk of frailty/prefrailty,38 and 39 to our knowledge, no other studies have reported a beneficial effect of stopping smoking on frailty/prefrailty. This positive healthy behavior was also observed in this study when looking at cognitive function: ex-smokers had lower risk of poor cognition.40 Greater beneficial health effects among those who give up smoking compared with nonsmokers may be due to a greater improvement in other health behaviors. The higher magnitude of association and prediction between UK-371804 purchase the Finnish score and frailty may be due to its composition: this model included
the risk factors that were more strongly associated with frailty as seen previously in this article. This association was not driven by any one specific risk factor included in this score. In particular, physical inactivity, which is also included in the operationalization of the Fried frailty measure, was not solely responsible for the stronger association. Smaller associations of the Cambridge and Framingham risk scores with frailty may be explained by the effect of sex, as the direction of the
association was unexpected in the prediction of frailty. In addition, 3 strong predictors of frailty were not included. Indeed, old women are more likely to become frail than old men,30 whereas in the prediction of diabetes, sex has a nonsignificant effect in the Framingham score (β for men = −0.01) and women are less at risk in the Cambridge score (β for women = −0.88). Our study has some limitations. First, we identified PtdIns(3,4)P2 frailty cases using a measure operationalized by Fried and colleagues,20 but a recent review identified more than 20 alternative measures of frailty.41 Although there are no gold standard measures, the measure by Fried and colleagues20 is the most widely used. Second, contrary to cardiovascular diseases whose gold standard risk score is the Framingham risk score and that is routinely used in clinical and public health practice, there is no such gold standard for diabetes. Although there are numerous diabetes risk scores, they are less known and used.42 However, in the literature, the 3 risk scores that we used were widely validated and well known compared with other diabetes risk scores.