Table 2. Association between health behaviors at age 50 and onset of frailty over a mean follow-up of 20 years.

Health behaviors	N frail/N total	Frail %	Model 1*†		Model 2*‡		Model 3*§		Model 4‖
			HR (95% CI)	p	HR (95% CI)	p	HR (95% CI)	p	HR (95% CI)	p
Smoking status
Never smoked	235/3,202	7.34	0.59 (0.46–0.77)	<0.001	0.62 (0.48–0.81)	<0.001	0.62 (0.47–0.80)	<0.001	0.68 (0.52–0.89)	0.01
Ex-smoking	127/2,378	5.34	0.50 (0.38–0.67)	<0.001	0.52 (0.39–0.69)	<0.001	0.50 (0.37–0.66)	<0.001	0.53 (0.40–0.71)	<0.001
Current smoking	83/777	10.68	1 (ref)		1 (ref)		1 (ref)		1 (ref)
Alcohol consumption
None	116/989	11.73	1.22 (0.91–1.65)	0.18	1.08 (0.79–1.46)	0.64	1.11 (0.81–1.51)	0.51	1.15 (0.85–1.57)	0.37
Moderate	225/3,543	6.35	0.76 (0.59–0.97)	0.03	0.72 (0.56–0.92)	0.01	0.75 (0.58–0.97)	0.03	0.76 (0.59–0.98)	0.03
High	104/1,825	5.70	1 (ref)		1 (ref)		1 (ref)		1 (ref)
Physical activity
Inactive	104/703	14.79	1 (ref)		1 (ref)		1 (ref)		1 (ref)
Moderately active	142/1,500	9.47	0.81 (0.62–1.05)	0.11	0.87 (0.65–1.17)	0.37	0.90 (0.68–1.19)	0.47	0.94 (0.71–1.25)	0.67
Active	199/4,154	4.79	0.55 (0.42–0.72)	<0.001	0.59 (0.45–0.78)	<0.001	0.61 (0.47–0.81)	<0.001	0.66 (0.48–0.88)	0.001
Fruits and vegetables consumption
Less than once a day	179/2,186	8.19	1 (ref)		1 (ref)		1 (ref)		1 (ref)
Once a day	183/2,445	7.48	0.83 (0.67–1.02)	0.08	0.87 (0.70–1.08)	0.19	0.85 (0.68–1.06)	0.14	0.91 (0.73–1.13)	0.40
At least twice a day	83/1,726	4.81	0.64 (0.49–0.85)	<0.001	0.68 (0.52–0.90)	0.01	0.65 (0.50–0.87)	<0.001	0.70 (0.53–0.92)	0.01

*Models 1, 2, and 3 were estimated for each health behavior separately.

^†Model 1: age as a timescale, adjusted for sex, ethnicity, marital status, and wave of inclusion.

^‡Model 2: model 1 additionally adjusted for education and occupational position.

^§Model 3: model 2 additionally adjusted for the number of morbidities at age 50.

^‖Model 4: model 3 additionally adjusted for all other health behaviors.

Abbreviations: CI, confidence interval; HR: hazard ratio; ref, reference group