Cardiovascular diseases (CVD) are a leading cause of morbidity and mortality worldwide. While CVDs are predominantly diseases of aging, age itself does not predict CVD risk; people age at different rates. Frailty is a state of accelerated aging that increases the risk of adverse health outcomes. Frail people are at higher risk of developing CVDs, experiencing complications, and dying from these diseases than fit people of the same age. Indeed, frailty predicts the likelihood of developing CVD independently of traditional risk factors for CVD. It is known that older women are frailer than men and tend to express CVDs differently than men, but whether relationships between frailty and CVD are sex specific is unclear. It is possible that shared pathophysiological mechanisms such as chronic inflammation may help explain links between CVD and frailty. Importantly, the degree of frailty can be modified by lifestyle interventions. For example, sedentary lifestyles, food insecurity, and suboptimal dietary habits can exacerbate frailty whereas diet and exercise interventions can attenuate frailty. The investigators propose that a comprehensive health strategy targeting diet and physical activity to reduce frailty will reduce the risk of cardiovascular disease (CVD), thereby promoting healthy aging. Engaging in physical activity (e.g. exercise) helps improve aerobic fitness, increase muscle mass, promote cardiac regeneration, enhance metabolic function, regulate blood pressure, improve insulin sensitivity, reduce inflammation (a key frailty mechanism), and lessen frailty. High-quality dietary protein is essential to maintain muscle mass/function, preserve mobility, attenuate inflammation, and reduce frailty. Packed with antioxidants such as anthocyanins and flavonoids, with high levels of fiber, vitamins, and minerals, blueberries, a local Nova Scotian food, can help lower blood pressure, improve blood vessel function, reduce inflammation, and help the body utilize dietary protein. These are critical aspects of a strong heart and healthy aging. To date, many frailty intervention studies have been limited by small sample sizes, underrepresentation of women, and/or by testing individual lifestyle modifications rather than synergistic effects; additionally, none have investigated how reducing frailty impacts cardiovascular outcomes. Our goal is to determine if a year-long multidomain intervention of protein, blueberries, and exercise reduces frailty and cardiovascular disease risk in older at-risk Nova Scotians of both sexes.
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Functional Fitness
Timeframe: Baseline, 3,6,9, and 12 months
Echocardiography
Timeframe: Baseline, 12 Months
Inflammatory Markers
Timeframe: Baseline, 12 Months
Frailty
Timeframe: Baseline, 3,6,9, and 12 months
Cardiovascualr Risk: Blood pressure
Timeframe: Baseline, 3, 6, 9, 12 months
Cardiovascualr Risk: Lipid Profile
Timeframe: Baseline, 12 months
Cardiovascualr Risk: Blood glucose
Timeframe: Baseline, 12 months
Frailty: Clinical Frailty Scale (CFS)
Timeframe: Baseline, 3, 6, 9, 12 months
Frailty: Pictorial Fit to frail Scale (PFFS)
Timeframe: Baseline, 3, 6, 9, 12 months
Household Foodwork Interactional Assessment 10 Questions (FIA-Q10)
Timeframe: Baseline, 6-month, 12-month, 1 year
ASA24 Dietary Assessment Tool
Timeframe: Baseline, 6-month, 12-month, 1-year.