Introduction:
There was a 19% increase in the older adult population ages 65 and older in New York City (NYC) between 2005 and 2015, which now comprises about 1.13 million people. Cardiovascular disease (CVD) is the leading cause of death among this older adult population. Dietary modification has been linked to improved CVD outcomes in older adults, demonstrating that prevention efforts are still effective in older age. Over the past decade, NYC has led numerous initiatives to improve dietary and physical activity behaviors. Little is known about the impact of these policies on CVD health and behavioral risk factors among older adults.
Hypothesis:
We anticipate that cardiovascular disease risk factors (fruit and vegetable intake; sugar-sweetened beverage (SSB) intake; exercise; diabetes; cholesterol; and hypertension) will have remained stagnant over an eight year period, from 2009 to 2017, as older adults remain a largely under-reached population.
Methods:
The New York City Community Health Survey (CHS) is an annual cross-sectional survey among NYC residents. A trend analysis was conducted using data from 2009 to 2017. Adults aged 65 years and older were included in the analysis (n= 20,771). Annual estimates of the percentage of persons with select CVD risk factors were calculated. Linear regression was used to measure changes over time; binary variables were scaled as 0 to 100 to represent percentages. Nonlinearity assessments were conducted and segmented regression models were used when appropriate. All analyses were conducted in SUDAAN v.11.0.3, using appropriate sample weights incorporating the complex survey design.
Results:
In 2017, over one-quarter (27.3%; 703/2,576) of older adults were diagnosed with diabetes, and almost two-thirds (64.8%; 1,664 /2,568) were diagnosed with hypertension. Only 10.4% (257/2,475) of older adults consumed 5 or more servings of fruits and vegetables and 17.3% (440/2,548) consumed at least one serving of SSB per day. From 2009-2017, there was an increase in the prevalence of diabetes among older adults (Average Percent Change [APC] 0.68; p<0.0001). There were decreases in the percentages of older adults consuming five or more servings of fruits and vegetables (APC -0.30; p=0.007) and one or more SSB across the years (APC -0.38; p=0.010). From 2010-2014, there was a decrease in the prevalence of older adults with high cholesterol (APC -1.06; p=0.047). There were no significant changes in hypertension or exercise rates over time.
Conclusion:
Decreases in SSB consumption and cholesterol indicate that some prevention efforts may have reached the older adult population. Despite these successes, more older adults suffer from diabetes and hypertension and fewer consume the recommended five servings of fruits and vegetables. In conclusion, more targeted policies and programs are needed to address CVD risks among older adults, as this population continues to grow.
Cardiovascular disease risk factors among older Chinese Americans living in New York City
