Adherence to life's essential 8 and functional disability in older adults: Findings from the ELSI-Brazil study

OBJECTIVE: To investigate the association between adherence to life's essential 8 (LE8) and functional disability in older Brazilian adults, stratified by gender and different types of disability. METHODS: Data from the baseline of the Brazilian Longitudinal Study of Aging (ELSI-Brazil, 2015-2016) were used. The exposure variable was adherence to LE8 (diet, physical activity, nicotine exposure, sleep quality, body mass index, non-HDL cholesterol, glycated hemoglobin, and blood pressure), classified as high, moderate, or low adherence. Study outcomes were assessed through questions related to difficulty performing basic (b-ADL) and instrumental (i-ADL) activities of daily living. Data analysis was conducted using logistic regression. RESULTS: Among 1951 participants (52.5% female), 15.8% reported disability in b-ADL, 48.5% in i-ADL, and 76.7% had moderate adherence to LE8. In the adjusted model, women with high adherence to LE8 showed lower odds of disability in b-ADL (OR 0.31; 95%CI 0.10; 0.94) and i-ADL (OR 0.27; 95%CI 0.13; 0.55), while those with moderate adherence had lower odds of disability in i-ADL (OR 0.45; 95%CI 0.26; 0.79) compared to women with low adherence. For men, high adherence to LE8 reduced the odds of disability in b-ADL (OR 0.07; 95%CI 0.01; 0.34), but there was no association with disability in i-ADL. CONCLUSION: High adherence to LE8 was associated with lower odds of disability in b-ADL for both women and men, while moderate and high adherences were associated with lower odds of disability in i-ADL for women. The results underscore the importance of the association between adherence to LE8 and lower odds of functional disability, particularly among women.