Associations of psychosocial factors with cardiovascular health in aging: insights from the Inlife-Aging Project

Life's Essential 8 (LE8) provides a multidimensional framework to assess cardiovascular health (CVH) in aging populations. The objective of this study was to describe LE8 component scores and their variation by age, sex, and psychosocial factors in middle-aged and older adults from Cádiz, Spain. Cross-sectional data were analyzed from 495 adults aged 50-79 years (59.4% women; 34.7% ≥ 65 years). LE8 scores were calculated following American Heart Association guidelines. Group comparisons used t-tests, ANOVA, and chi-square tests to explore differences across demographic and psychosocial variables. Age- and sex-adjusted linear regressions were fitted for CVH, health behaviors (HB), and health factors (HF). Most participants showed moderate CVH, HB, and HF scores (76.6%; 53.1%; 62.2%). Diet quality had the lowest mean (40.8 ± 31.7), while physical activity and sleep health were the highest (88.3 ± 30.6 and 85.0 ± 22.2). Middle-aged adults presented higher CVH and HF scores (mean differences [MD]: 2.5 ± 0.3; 7.8 ± 1.5), whereas older adults scored better in HB (MD: 2.8 ± 1.4). Women exhibited higher CVH, HB, and HF scores than men (MD: 3.6 ± 0.3; 2.8 ± 0.4; 4.4 ± 0.4), with middle-aged women showing the most favorable CVH profile (73.0 ± 10.5) and older men the least favorable (66.4 ± 11.0). Higher self-rated health (β = 0.240; R2 = 0.096) and educational attainment (β = 0.235; R2 = 0.090) were the strongest correlates of CVH (both P < 0.001). LE8 scoring revealed an intermediate CVH profile, with disparities by age, sex, and psychosocial context. Middle-aged women showed the most favorable profiles, while self-rated health and educational attainment emerged as key psychosocial markers for CVH assessment.