Association Between Time Since Smoking Cessation and Frailty Trajectory Among Community-Dwelling Older People: English Longitudinal Study of Ageing.

Objectives: To examine the associations of smoking cessation with the subsequent frailty status trajectory using data from a nationally representative sample of community-dwelling older adults living in England.

Design: A prospective panel study.

Setting and participants: A total of 2600 community-dwelling older adults aged 60 or older in England who used to smoke.

Methods: The past smokers were divided into 5 groups based on years since smoking cessation: 0-10, 11-20, 21-30, 31-40, and 41+ years. The Frailty Index (FI) was constructed using 60 deficits and repeatedly calculated every 2 years over 16 years. Trajectories of FI according to years since smoking cessation were estimated by a mixed-effects model.

Results: A mixed-effects model adjusted for age, sex, education, wealth, and alcohol use showed that FI increased over time in all groups and that longer duration since smoking cessation was significantly associated with lower FI. Those who quit 41 years earlier or more had the lowest frailty trajectory, however, there was still a gap between them and never smokers.

Conclusions and implications: The current study showed that past smokers with a longer duration of quitting smoking had a significantly lower degree of frailty at baseline and over time. These findings highlight beneficial effects of smoking cessation on frailty even in middle or old age and could be used in public health education to promote the importance of quitting smoking.