Supplementary Material for: Impact of Lifestyle Activity Engagement on Incident Disability: A Stratified Analysis by Cardiovascular Disease Risk

Introduction: Cardiovascular disease (CVD) is associated with disability, highlighting the need for prevention strategies that assess and mitigate CVD risk. This study aimed to examine the relationship between participation in lifestyle activities and incident disability among older individuals at high risk of CVD. Methods: This prospective cohort study included 3,217 older adults (mean age 70.7 years, standard deviation ± 6.8; 1,843 women [57.3%]). Absolute CVD risk was estimated using the revised World Health Organization charts, categorizing individuals’ risk levels as either low (< 10%) or high (≥ 10%). The incidence of disability was monitored for 60 months. Baseline assessments included the frequency of participation in 36 lifestyle activities spanning physical, cognitive, and social domains, measured by annual participation frequency. A total score was calculated and categorized into three tertiles based on the frequency of participation (low, moderate, and high groups). An adjusted Cox proportional hazard analysis assessed disability risk based on baseline participation in lifestyle activities stratified by CVD risk level. Results: Over 60 months, 326 participants (10.2%) experienced disability. Older adults who were highly active in cognitive and social activities had a lower risk of disability than those who were less active. Stratified analysis based on CVD risk level showed that engagement in lifestyle activities was linked to disability risk among older adults at high risk of CVD, whereas no such association was observed in those at low risk. Conclusion: Among older adults at high CVD risk, greater engagement in lifestyle activities was associated with a reduced risk of disability after 60 months.