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Nakagawa S, Miura K, Arai E, Taira K, Watanabe Y, Shirobe M, Motokawa K, Ohara Y, Iwasaki M, Hirano H, Ono T, Adachi A, Watanabe T, Yamazaki Y. Oral frailty, appetite and dietary variety in late-stage older adults: A cross-sectional study (the STudy of lAte-stage oldeR adulTs in Tottori; START Tottori). Geriatr Gerontol Int 2024. [PMID: 38714504 DOI: 10.1111/ggi.14892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 02/19/2024] [Accepted: 04/23/2024] [Indexed: 05/10/2024]
Abstract
AIM Efforts to combat frailty and preserve good health in older adults have highlighted oral frailty as an early indicator of overall frailty. Individuals showing oral frailty are at an elevated risk of insufficient nutritional intake compared with those without oral frailty; however, underlying mechanisms remain poorly explored. In this cross-sectional study, we aimed to examine the link between oral frailty and undernutrition, especially regarding poor appetite and low dietary diversity. METHODS The analysis included 2727 late-stage older adults (mean age 79.9 ± 4.3 years) who underwent dental checkups in a prefecture in Japan from 2016 to 2020. The examination involved a questionnaire survey (covering basic information, frailty screening index, appetite index: Simplified Nutritional Appetite Questionnaire; and dietary variety: Dietary Variety Score) and a measurement survey (including intraoral confirmation, oral diadochokinesis and masticatory efficiency test). Individuals with three or more indications of poor oral function, identified through oral function assessment, were defined as showing oral frailty. Binomial logistic regression and path analyses examined associations among oral frailty, Simplified Nutritional Appetite Questionnaire and Dietary Variety Score. RESULTS Among those analyzed, 1208 (44.3%) participants were categorized into the oral frailty group. Binomial logistic regression analysis showed that Simplified Nutritional Appetite Questionnaire (odds ratio for oral frailty per 1-point increase 0.88, 95% confidence interval 0.84-0.93) and Dietary Variety Score (odds ratio 0.95, 95% confidence interval 0.92-0.98) were significantly associated with oral frailty. The path analysis showed individual associations between each examined factor. CONCLUSIONS Oral frailty was associated with decreased appetite and dietary variety in late-stage older adults. Geriatr Gerontol Int 2024; ••: ••-••.
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Affiliation(s)
- Sayuri Nakagawa
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kazuhito Miura
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Eri Arai
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Kenshu Taira
- Department of Public Health and Hygiene, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Maki Shirobe
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Yuki Ohara
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Masanori Iwasaki
- Department of Preventive Dentistry, Faculty of Dental Medicine and Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hirohiko Hirano
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| | - Takahiro Ono
- Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, Osaka, Japan
| | | | | | - Yutaka Yamazaki
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
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Harada K, Masumoto K, Okada S. Between- and Within-Couple Concordance for Health Behaviors Among Japanese Older Married Couples: Examining the Moderating Role of Working Time. Int J Behav Med 2024; 31:215-228. [PMID: 36991277 DOI: 10.1007/s12529-023-10174-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 03/31/2023]
Abstract
BACKGROUND Although previous studies report spousal concordance for health behaviors at between-couple levels, concordance at within-couple levels remains unconfirmed. To clarify the behavioral mechanisms of spousal concordance for health behaviors among older couples at both levels, it is necessary to examine the moderators (effect modifiers) of spousal concordance. This study examined (1) whether spousal concordance for dietary variety, exercise behavior, and TV viewing behavior was observed at both the between-couple and the within-couple levels and (2) whether this spousal concordance was moderated by working time among older Japanese couples. METHOD This study analyzed data obtained from a questionnaire-based, three-wave longitudinal survey (baseline, 1-year follow-up, 3-year follow-up) among 210 Japanese older couples. Each spouse's dietary variety, exercise time, TV viewing time, the couple's working time, and demographic factors were investigated by multi-level analyses. RESULTS One spouse's dietary variety and TV viewing time, but not exercise time, were significantly associated with the other spouse's corresponding behaviors at both levels. The regressions of the wife's TV viewing time on the husband's TV viewing time were moderated by working time at the within-couple level; the regressive effects of wife's TV viewing time on husband's TV viewing time were more relevant as working time was lower. CONCLUSION This study found that spousal concordance for dietary variety and TV viewing was observed at within-couple and between-couple levels among older Japanese couples. In addition, shorter working time partly moderates the wife's influence on the husband's TV viewing among older couples at the within-couple level.
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Affiliation(s)
- Kazuhiro Harada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan.
| | - Kouhei Masumoto
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan
| | - Shuichi Okada
- Active Aging Research Hub, Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, 657-8501, Japan
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Yokoro M, Otaki N, Imamura T, Tanino N, Fukuo K. Association between social network and dietary variety among community-dwelling older adults. Public Health Nutr 2023; 26:2441-2449. [PMID: 37395300 DOI: 10.1017/s1368980023001325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVE Social networks are critical social health factors for older adults. This study examined the association between social networks and dietary variety among community-dwelling older adults. DESIGN A cross-sectional study, using the dietary variety score (DVS) developed for older Japanese people to assess dietary variety and the Lubben Social Network Scale (LSNS-6) to assess social networks. SETTING N City, H Prefecture, Japan. PARTICIPANTS Community-dwelling older adults aged ≥ 65 years (n 1229). RESULTS The LSNS-6 score in the low DVS group was lower than that in the middle and high DVS groups (12·2 ± 5·6 v. 13·4 ± 5·4 and 14·4 ± 5·7, P < 0·001). The population of social isolation (LSNS-6, < 12) in the low DVS group was higher than that in the middle and high DVS groups (43·5 % v. 35·8 % and 31·0 %, P = 0·005). Multivariate linear regression analysis showed that the LSNS-6 score was positively correlated with DVS (standardised coefficient, 0·092; P = 0·002). Social isolation was also significantly associated with a low DVS in the multivariate-adjusted logistic analysis model (OR, 1·30; 95 % CI 1·00, 1·68; P = 0·048). Stratified analysis results revealed the LSNS-6 and DVS were significantly associated in participants with the following characteristics: younger age (< 75 years), women and those living with someone. CONCLUSIONS Social networks were associated with dietary variety; social isolation was related to poor dietary variety among community-dwelling older adults. An association between social networks and dietary variety was observed among young-old older adults, women and those living with someone.
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Affiliation(s)
- Miyuki Yokoro
- Department of Dietary Life and Food Sciences, Junior College Division, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
- Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
| | - Naoto Otaki
- Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
- Department of Food Sciences and Nutrition, School of Food Sciences and Nutrition, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
| | - Tomomi Imamura
- Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
- Department of Innovative Food Sciences, School of Food Sciences and Nutrition, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
| | - Norikazu Tanino
- Department of Food Sciences and Nutrition, School of Food Sciences and Nutrition, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
| | - Keisuke Fukuo
- Research Institute for Nutrition Sciences, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
- Department of Food Sciences and Nutrition, School of Food Sciences and Nutrition, Mukogawa Women's University, 6-46 Ikebiraki-cho, Nishinomiya, Hyogo663-8558, Japan
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Duan Y, Qi Q, Cui Y, Yang L, Zhang M, Liu H. Effects of dietary diversity on frailty in Chinese older adults: a 3-year cohort study. BMC Geriatr 2023; 23:141. [PMID: 36918767 PMCID: PMC10012609 DOI: 10.1186/s12877-023-03875-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/06/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Frailty has emerged as a global health burden with increased population aging. A diverse diet is essential for an adequate and balanced supply of nutrients. However, limited evidence supports the relationship between dietary diversity and frailty. We therefore assessed the associations of dietary diversity with the risk of frailty. METHODS We used the Chinese Longitudinal Healthy Longevity Survey to analyze a prospective cohort of Chinese older adults. A total of 1948 non-frail older adults were included in the final sample. Participants were categorized into groups with high or low dietary diversity scores (DDSs) using a food frequency questionnaire. A Generalized Estimating Equation were used to estimate risk ratios (RRs) and 95% confidence intervals (CIs) for determining frailty incidence. RESULTS Among 1,948 participants, 381 had frailty with the prevalence of 19.56% during the 3-year follow-up period. Compared with the low DDS group, the high DDS group exhibited a lower risk of frailty (RR, 0.72; 95% CI: 0.57-0.91). Compared with those with a consistently low DDS, the RR of participants with a consistently high DDS for frailty was 0.56 (95% CI: 0.42-0.74). Moreover, meat, beans, fish, nuts, fresh fruits, and fresh vegetables were inversely associated with frailty. In stratified analysis, a consistently high DDS, compared with a consistently low DDS, reduced the risk of frailty for people aged 65-79 years and those living in town and rural areas. CONCLUSION This study found a prospective association between dietary diversity and frailty among Chinese older adults. These findings stressed that it is important to improve dietary diversity for older adults to promote healthy ageing, particularly for young older adults and in town and rural areas.
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Affiliation(s)
- Ying Duan
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China
| | - Qi Qi
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China
| | - Yan Cui
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China
| | - Ling Yang
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China
| | - Min Zhang
- School of Health Management, Bengbu Medical College, Bengbu, Anhui, China
| | - Huaqing Liu
- School of Public Health, Bengbu Medical College, No.2600 Donghai Ave, Bengbu, 233030, China.
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Wang XM, Zhong WF, Li ZH, Chen PL, Zhang YJ, Ren JJ, Liu D, Shen QQ, Yang P, Song WQ, Liang F, Nan Y, Xiang JX, Wu YR, Lv YB, Gao X, Kraus VB, Shi XM, Mao C. Dietary diversity and frailty among older Chinese people: evidence from the Chinese Longitudinal Healthy Longevity Study. Am J Clin Nutr 2023; 117:383-391. [PMID: 36811562 DOI: 10.1016/j.ajcnut.2022.11.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 10/26/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dietary diversity is widely advocated as a means to promote health, but little is known regarding whether the beneficial effects still apply in older adults. OBJECTIVE To examine the association between the dietary diversity score (DDS) and frailty among older Chinese adults. METHODS A total of 13,721 adults aged ≥65 y without frailty at baseline were enrolled. The DDS at baseline was constructed based on 9 items of a food frequency questionnaire. We used 39 self-reported health items to construct a frailty index (FI), with FI ≥ 0.25 indicating frailty. Cox models with restricted cubic splines were used to evaluate the dose-response relationships of DDS (continuous) with frailty. In addition, Cox proportional hazard models were used to examine the association between DDS (categorized as scores ≤4, 5-6, 7, and ≥8) and frailty. RESULTS During the mean follow-up of 5.94 y, 5250 participants met the criteria for frailty. Each 1-unit increase in DDS corresponded to a 5% lower risk of frailty (hazard ratio [HR]; 0.95; 95% CI: 0.94, 0.97]. Compared with participants with DDS ≤4 points, those with a DDS of 5-6, 7, and ≥8 points exhibited a lower frailty risk, with HRs of 0.79 (95% CI: 0.71, 0.87), 0.75 (95% CI: 0.68, 0.83), and 0.74 (95% CI: 0.67, 0.81), respectively (P-trend < 0.001). Protein-rich food items, such as meat; eggs; and beans, were associated with protective effects against frailty. In addition, a significant association was observed between higher consumption of 2 high-frequency foods, tea and fruits, and lower risk of frailty. CONCLUSIONS A higher DDS was associated with a lower risk of frailty among older Chinese adults. This study highlights the importance of a diverse diet as a potential modifiable behavioral factor for preventing frailty in older Chinese adults.
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Affiliation(s)
- Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yu-Jie Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiao-Jiao Ren
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Dan Liu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiao-Qiao Shen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei Yang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei-Qi Song
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Fen Liang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying Nan
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Jia-Xuan Xiang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yin-Ru Wu
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Yue-Bin Lv
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiang Gao
- Nutritional Epidemiology Lab, Pennsylvania State University, Philadelphia, PA, USA; and
| | - Virginia Byers Kraus
- Duke Molecular Physiology Institute and Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Xiao-Ming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
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Kawai H, Obuchi S, Ejiri M, Ito K. Association between daily life walking speed and frailty measured by a smartphone application: a cross-sectional study. BMJ Open 2023; 13:e065098. [PMID: 36609327 PMCID: PMC9827245 DOI: 10.1136/bmjopen-2022-065098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To assess whether frailty can be assessed using a smartphone and whether daily walking speed (DWS) is associated with frailty. DESIGN Cross-sectional study. SETTING Three prefectures (Kanagawa, Saitama and Tokyo) in Japan. PARTICIPANTS The study enrolled 163 participants (65 in the robust group, 69 in the prefrailty group and 29 in the frailty group) by sending letters to house owners aged≥55 years. PRIMARY AND SECONDARY OUTCOME MEASURES The participants downloaded the DWS measurement application on their smartphones, which measured the daily walking (DW) parameters (DWS, step length and cadence) and the Kihon checklist for frailty assessment. The differences in the DW parameters between the robust, prefrailty and frailty groups were examined using one-way analysis of variance. We conducted logistic regression analysis for the Crude model (each DW parameter), model 1 (adjusted for the number of steps) and model 2 (model 1+age, sex and the number of chronic diseases). RESULTS DWS was marginally significantly slower in the frailty group than in the prefrailty and robust group (robust 1.26 m/s vs prefrailty 1.25 m/s vs frailty 1.19 m/s, p=0.060). Step length was significantly smaller in the frailty group than in the robust group (robust 66.1 cm vs prefrailty 65.9 vs frailty 62.3 cm, p<0.01). Logistic regression analysis for the three models revealed that DWS was significantly associated with frailty. CONCLUSIONS DWS measured using the smartphone application was associated with frailty. This was probably due to the shorter step length and body height seen in frail individuals.
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Affiliation(s)
- Hisashi Kawai
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Shuichi Obuchi
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Manami Ejiri
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kumiko Ito
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Hanlon P, Guo X, McGhee E, Lewsey J, McAllister D, Mair FS. Systematic review and meta-analysis of prevalence, trajectories, and clinical outcomes for frailty in COPD. NPJ Prim Care Respir Med 2023; 33:1. [PMID: 36604427 PMCID: PMC9816100 DOI: 10.1038/s41533-022-00324-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
This systematic review synthesised measurement and prevalence of frailty in COPD and associations between frailty and adverse health outcomes. We searched Medline, Embase and Web of Science (1 January 2001-8 September 2021) for observational studies in adults with COPD assessing frailty prevalence, trajectories, or association with health-related outcomes. We performed narrative synthesis and random-effects meta-analyses. We found 53 eligible studies using 11 different frailty measures. Most common were frailty phenotype (n = 32), frailty index (n = 5) and Kihon checklist (n = 4). Prevalence estimates varied by frailty definitions, setting, and age (2.6-80.9%). Frailty was associated with mortality (5/7 studies), COPD exacerbation (7/11), hospitalisation (3/4), airflow obstruction (11/14), dyspnoea (15/16), COPD severity (10/12), poorer quality of life (3/4) and disability (1/1). In conclusion, frailty is a common among people with COPD and associated with increased risk of adverse outcomes. Proactive identification of frailty may aid risk stratification and identify candidates for targeted intervention.
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Affiliation(s)
- Peter Hanlon
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK.
| | - Xuetong Guo
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Eveline McGhee
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jim Lewsey
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - David McAllister
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Frances S Mair
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Xue Q, Shen M, Lin Q, Wu X, Yang M. The Association between Dietary Protein Diversity and Protein Patterns with Frailty in Older Chinese Adults: A Population-Based Cohort Study. J Nutr Health Aging 2023; 27:1219-1227. [PMID: 38151873 DOI: 10.1007/s12603-023-2043-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/24/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES Frailty is a pervasive condition among older people worldwide. Despite the association between higher protein intake and lower frailty risk has been well documented, older individuals encounter barriers to enhancing their protein consumption due to reduced appetite and impaired digestive capacity. This study aims to delve into the potential correlation between dietary protein diversity, protein patterns, and the risk of frailty among older Chinese individuals. DESIGN Prospective cohort study. SETTING Community-based. PARTICIPANTS 2,216 participants aged 65 and above and not frail at the baseline were recruited from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) dataset spanning from 2014 to 2018. MEASUREMENTS Dietary protein diversity was evaluated utilizing a protein diversity score (PDS), calculated based on the results of a food frequency questionnaire. Dietary protein patterns were identified by employing principal component analysis (PCA). Frailty was ascertained using a 40-item frailty index (FI) where FI > 0.21 indicated frailty. Logistic analysis was employed to investigate the association between dietary variables and frailty. RESULTS 541 participants were identified as frail after a 4-year follow-up. After adjusting for confounders, each 1-unit increase in PDS was linked to a 10% decrease in frailty risk. Compared to individuals with PDS ≤ 1, those with PDS scores of 2-3, 4-5, and 6 had lower risks of frailty, with OR (95% CI) of 0.78 (0.58-1.06), 0.58 (0.38-0.87), 0.42 (0.20-0.81), respectively (P trend = 0.038). Individuals who consistently maintained high PDS demonstrated a lower frailty risk in contrast to those who maintained low PDS (OR = 0.60, 95% CI, 0.41-0.87). Additionally, the "meat-fish" pattern exhibited a protective association with frailty, with OR Q4 versus Q1 (95% CI) of 0.54 (0.40-0.74), P trend < 0.001. CONCLUSION Maintaining a variety of dietary protein sources and following a "meat-fish" protein pattern might decrease the likelihood of frailty among the older Chinese population.
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Affiliation(s)
- Q Xue
- Min Yang, School of Public Health, and Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine 886 Yu-hang-tang RD, Hangzhou, China, Tel: 13516852440, E-mail:
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Kikutani T, Takahashi N, Tohara T, Furuya H, Tanaka K, Hobo K, Isoda T, Fukui T. Relationship between maintenance of occlusal support achieved by home-visit dental treatment and prognosis in home-care patients-a preliminary study. Geriatr Gerontol Int 2022; 22:976-981. [PMID: 36127817 PMCID: PMC9825876 DOI: 10.1111/ggi.14482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/07/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023]
Abstract
AIM To determine whether occlusal maintenance and reconstruction by dental intervention is associated with the prognosis of older home-care patients. METHODS The study participants were 289 older home-care patients (101 males, mean age 82.2 ± 7.7 years) who received visiting dental treatment from dental clinics in the region between 2012 and 2018. The participants were followed up for 1000 days after receiving the necessary dental treatment in a home-visit setting. The participants were divided into three groups: those with natural tooth occlusion, those whose molar occlusion was maintained or reconstructed by dentures, and those whose occlusion was not reconstructed. Factors associated with prognosis were determined using the Cox proportional hazard model, with occlusal status, comorbidities, the activity of daily living, and residence status as explanatory variables. RESULTS In the overall population, occlusal status (hazard ratio [HR] of those with occlusal disintegration versus those with natural tooth occlusion: 2.1, confidence interval [95% CI]: 1.18-3.82) and age (HR: 2.28, 95% CI: 1.44-3.61) were identified as significant factors. In the group of participants aged <85 years, only occlusal status (HR of those with occlusal disintegration versus those with natural tooth occlusion: 3.4, 95% CI: 1.34-8.68) was a significant factor. In the group of participants aged ≥85 years, occlusal status was not significantly associated with prognosis. CONCLUSIONS The maintenance and acquisition of occlusal support achieved by dental treatment contribute to improved prognosis in older patients younger than 85 years requiring home nursing care. Geriatr Gerontol Int 2022; 22: 976-981.
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Affiliation(s)
- Takeshi Kikutani
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Noriaki Takahashi
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Takashi Tohara
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Hiroyasu Furuya
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Kumi Tanaka
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Kimiko Hobo
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
| | - Tomoko Isoda
- The Nippon Dental University, Tama Oral Rehabilitation ClinicTokyoJapan,Division of Rehabilitation for Speech and Swallowing DisordersThe Nippon Dental UniversityTokyoJapan
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Osuka Y, Kojima N, Sugie M, Omura T, Motokawa K, Ueda T, Maruo K, Ono R, Aoyama T, Inoue S, Kim H, Sasai H. Effects of a home-based Radio-Taiso exercise programme on health-related quality of life in older adults with frailty: protocol for an assessor-blind randomised controlled trial. BMJ Open 2022; 12:e063201. [PMID: 36137626 PMCID: PMC9511584 DOI: 10.1136/bmjopen-2022-063201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Few clinical trials have examined the effects of home-based exercise programmes on health-related quality of life (HR-QoL) in older adults with frailty. Radio-Taiso is the most famous exercise programme in Japan. A home-based Radio-Taiso exercise programme may serve as an accessible, scalable and sustainable care intervention for older adults with frailty. The primary aim of this trial is to test whether older adults with frailty who are prescribed our home-based Radio-Taiso exercise programme will receive greater benefits for HR-QoL compared with those who are not prescribed the exercise programme. Potential mechanisms underlying the effectiveness of the programme and the effects of the programme on daily lifestyle will also be investigated. METHODS AND ANALYSIS This assessor-blind randomised controlled trial will be conducted at the Tokyo Metropolitan Institute of Gerontology (TMIG) in Itabashi-ku, Tokyo, Japan. From April to May 2022, 226 older adults with prefrailty or frailty according to the revised Japanese version of the Cardiovascular Health Study criteria will be included from a large database. After a baseline assessment in June 2022, participants will be randomly assigned to the intervention (home-based Radio-Taiso exercise and nutrition programme) or control (nutrition programme) groups at a 1:1 ratio. After intervention completion, a follow-up assessment will be conducted in September 2022. The primary outcome is the change in the mental domain of HR-QoL assessed using SF-36. Secondary outcomes include physical and role/social domains and subscales of HR-QoL, frailty phenotype, physical fitness, posture, cognition, exercise self-efficacy, depressive symptoms, brain-derived neurotrophic factor, social network, habitual energy intake, physical activity and sleep conditions. ETHICS AND DISSEMINATION The Research Ethics Committee of TMIG has approved the research protocol. This trial will be conducted in accordance with the principles of the Declaration of Helsinki. The findings will be presented at international academic conferences and published in peer-reviewed international journals. TRIAL REGISTRATION NUMBER UMIN000047229.
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Affiliation(s)
- Yosuke Osuka
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Narumi Kojima
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Masamitsu Sugie
- Department of Cardiology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi-ku, Japan
| | - Takuya Omura
- Department of Geriatric Medicine, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Keiko Motokawa
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Takuya Ueda
- The Tokyo Metropolitan Support Center for Preventative Long-term and Frail Elderly Care, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Kazushi Maruo
- Department of Biostatistics, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Risa Ono
- Japan Radio-Taiso Federation, Chiyoda-ku, Japan
| | | | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, Shinjyuku-ku, Japan
| | - Hunkyung Kim
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
| | - Hiroyuki Sasai
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, Itabashi-ku, Japan
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11
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Huang WC, Huang YC, Lee MS, Doong JY, Pan WH, Chang HY. The Combined Effects of Dietary Diversity and Frailty on Mortality in Older Taiwanese People. Nutrients 2022; 14:nu14183825. [PMID: 36145199 PMCID: PMC9502423 DOI: 10.3390/nu14183825] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To assess the prospective association between frailty and dietary diversity on mortality. METHOD This prospective cohort study used the 2005-2008 Nutrition and Health Survey in Taiwan (N = 330; age ≥ 65 years) and this was linked to the Death Registry where we used the data that was recorded up to 31 January 2020. Dietary intake information was assessed using a 24-h dietary recall and food-frequency questionnaire, which were calculated a dietary diversity score (DDS; range, 0-6) and food consumption frequency. Assessment of frailty phenotypes was based on FRAIL scale which was proposed by the International Academy on Nutrition and Aging. RESULTS Frail older adults had a higher risk of all-cause mortality when they were compared to those with robust physiologies (hazard ratio [HR]: 3.73, 95% confidence interval [CI]: 2.13-6.52). Frailty and a lower DDS were associated with a higher risk of mortality (joint adjusted HR: 2.30, 95% CI: 1.11-4.75) which, compared with a robust physiology and higher DDS, were associated with a lower risk of mortality. CONCLUSIONS Frailty and a lower DDS were associated with a higher mortality. Prefrailty and frailty with a higher DDS were associated with a lower risk of mortality when compared with those with prefrailty and frailty and a lower DDS. These results suggest that eating a wide variety of foods might reduce the risk of mortality in older adults with prefrailty and frailty.
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Affiliation(s)
- Wei-Ching Huang
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114201, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan
| | - Yi-Chen Huang
- Department of Nutrition, China Medical University, Taichung 406040, Taiwan
| | - Meei-Shyuan Lee
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114201, Taiwan
- School of Public Health, National Defense Medical Center, Taipei 114201, Taiwan
| | - Jia-Yau Doong
- Department of Nutritional Science, Fu Jen Catholic University, New Taipei City 242062, Taiwan
| | - Wen-Harn Pan
- Institute of Biomedical Sciences, Academia Sinica, Taipei 11529, Taiwan
| | - Hsing-Yi Chang
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 114201, Taiwan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli 35053, Taiwan
- Correspondence: ; Tel.: +886-037-206-166 (ext. 36333)
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Bocquier A, Jacquemot AF, Dubois C, Tréhard H, Cogordan C, Maradan G, Cortaredona S, Fressard L, Davin-Casalena B, Vinet A, Verger P, Darmon N, Arquier V, Briclot G, Chamla R, Cousson-Gélie F, Danthony S, Delrieu K, Dessirier J, Féart C, Fusinati C, Gazan R, Gibert M, Lamiraud V, Maillot M, Nadal D, Trotta C, Verger EO, Viriot V. Study protocol for a pragmatic cluster randomized controlled trial to improve dietary diversity and physical fitness among older people who live at home (the "ALAPAGE study"). BMC Geriatr 2022; 22:643. [PMID: 35927684 PMCID: PMC9351201 DOI: 10.1186/s12877-022-03260-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 07/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diet and physical activity are key components of healthy aging. Current interventions that promote healthy eating and physical activity among the elderly have limitations and evidence of French interventions' effectiveness is lacking. We aim to assess (i) the effectiveness of a combined diet/physical activity intervention (the "ALAPAGE" program) on older peoples' eating behaviors, physical activity and fitness levels, quality of life, and feelings of loneliness; (ii) the intervention's process and (iii) its cost effectiveness. METHODS We performed a pragmatic cluster randomized controlled trial with two parallel arms (2:1 ratio) among people ≥60 years old who live at home in southeastern France. A cluster consists of 10 people participating in a "workshop" (i.e., a collective intervention conducted at a local organization). We aim to include 45 workshops randomized into two groups: the intervention group (including 30 workshops) in the ALAPAGE program; and the waiting-list control group (including 15 workshops). Participants (expected total sample size: 450) will be recruited through both local organizations' usual practices and an innovative active recruitment strategy that targets hard-to-reach people. We developed the ALAPAGE program based on existing workshops, combining a participatory and a theory-based approach. It includes a 7-week period with weekly collective sessions supported by a dietician and/or an adapted physical activity professional, followed by a 12-week period of post-session activities without professional supervision. Primary outcomes are dietary diversity (calculated using two 24-hour diet recalls and one Food Frequency Questionnaire) and lower-limb muscle strength (assessed by the 30-second chair stand test from the Senior Fitness Test battery). Secondary outcomes include consumption frequencies of main food groups and water/hot drinks, other physical fitness measures, overall level of physical activity, quality of life, and feelings of loneliness. Outcomes are assessed before the intervention, at 6 weeks and 3 months later. The process evaluation assesses the fidelity, dose, and reach of the intervention as its causal mechanisms (quantitative and qualitative data). DISCUSSION This study aims to improve healthy aging while limiting social inequalities. We developed and evaluated the ALAPAGE program in partnership with major healthy aging organizations, providing a unique opportunity to expand its reach. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05140330 , December 1, 2021. PROTOCOL VERSION Version 3.0 (November 5, 2021).
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Affiliation(s)
- Aurélie Bocquier
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France. .,Université de Lorraine, APEMAC, F-54000, Nancy, France.
| | - Anne-Fleur Jacquemot
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Bordeaux Population Health Research Center, University of Bordeaux, Inserm, UMR 1219, F-33000, Bordeaux, France
| | | | - Hélène Tréhard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, INSERM, SESSTIM, Aix Marseille Institute of Public Health, ISSPAM, Marseille, France
| | - Chloé Cogordan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Gwenaëlle Maradan
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France
| | - Sébastien Cortaredona
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Lisa Fressard
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | | | - Agnès Vinet
- Avignon Université, UPR EA4278, F-84000, Avignon, France
| | - Pierre Verger
- ORS PACA, Observatoire Régional de la Santé Provence-Alpes-Côte d'Azur, Marseille, France.,Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France.,IHU-Méditerranée Infection, Marseille, France
| | - Nicole Darmon
- MoISA, Université de Montpellier, CIHEAM-IAMM, CIRAD, INRAE, Institut Agro, IRD, Montpellier, France
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Lyu W, Tanaka T, Son BK, Akishita M, Iijima K. Associations of multi-faceted factors and their combinations with frailty in Japanese community-dwelling older adults: Kashiwa Cohort Study. Arch Gerontol Geriatr 2022; 102:104734. [DOI: 10.1016/j.archger.2022.104734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 04/29/2022] [Accepted: 05/11/2022] [Indexed: 12/31/2022]
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Liu J, Fujii Y, Fujii K, Seol J, Kim M, Tateoka K, Nagata K, Zhang H, Okura T. Pre-frailty associated with traffic crashes in Japanese community-dwelling older drivers. Traffic Inj Prev 2022; 23:73-78. [PMID: 35113747 DOI: 10.1080/15389588.2022.2030473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
Objectives: Frailty might be useful to identify older drivers who are at risk for traffic crashes. We aim to examine the association between pre-frailty/frailty defined by the Kihon Checklist (KCL) and the involvement of traffic crashes and clarify whether some domains of the KCL are associated with traffic crashes.Methods: This cross-sectional study analyzed data from 2,208 Japanese community-dwelling older drivers aged ≥ 65 years in Kasama City, who participated in our postal survey in November 2019. A self-reported history of traffic crashes was used to divide participants into non-crash-involved and crash-involved groups.Results: A total of 192 (8.7%) participants had been involved in traffic crashes in the past year. The crash-involved group was found to have gained more body mass index, driven more frequently, and scored higher on the total KCL score than the non-crash-involved group (all P < .05). Binary logistic regression analyses showed that after adjusting for age, sex, education, driving frequency, and driving distance, pre-frailty (OR = 1.52, 95% CI: 1.10-2.10) was more significantly associated with traffic crashes as compared to robustness. Those who had impairment in the oral domain (OR = 1.57, 95% CI: 1.09-2.27) and memory domain (OR = 1.38, 95% CI: 1.01-1.90) were also more likely to be involved in traffic crashes.Conclusion: The results suggest that identifying pre-frailty may play an important pole in crash prevention. Additionally, more attention should be given to older drivers with oral dysfunction and cognitive impairment.
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Affiliation(s)
- Jue Liu
- Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuya Fujii
- Physical Fitness Research Institute, Meiji Yasuda Life Foundation of Health and Welfare, Tokyo, Japan
| | - Keisuke Fujii
- Department of Occupational Therapy, Faculty of Health Sciences, Kansai University of Health Sciences, Osaka, Japan
| | - Jaehoon Seol
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
- Japan Society for the Promotion of Sciences, Tokyo, Japan
| | - Mijin Kim
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba, Japan
| | - Korin Tateoka
- Doctoral Program in Physical Education, Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Koki Nagata
- Doctoral Program in Public Health, University of Tsukuba, Tsukuba, Japan
| | - Hanlin Zhang
- Master's Program in Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
| | - Tomohiro Okura
- Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba, Japan
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15
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本川 佳. [Food and nutrition for older adults to prevent frailty sarcopenia]. Nihon Ronen Igakkai Zasshi 2021; 58:550-555. [PMID: 34880173 DOI: 10.3143/geriatrics.58.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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16
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Ohara Y, Kawai H, Shirobe M, Iwasaki M, Motokawa K, Edahiro A, Kim H, Fujiwara Y, Ihara K, Watanabe Y, Obuchi S, Hirano H. Association between dry mouth and physical frailty among community-dwelling older adults in Japan: The Otassha Study. Gerodontology 2021; 39:41-48. [PMID: 34762315 DOI: 10.1111/ger.12605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/22/2021] [Accepted: 10/28/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To elucidate the relationship between physical frailty and dry mouth among community-dwelling older adults in Japan. BACKGROUND Oral hypofunction is associated with physical frailty in older adults. Dry mouth, subjectively evaluated as xerostomia and objectively measured as hyposalivation, is highly prevalent in older adults. However, few reports have used both measures of dry mouth and investigated their association with physical frailty. MATERIALS AND METHODS This cross-sectional study included 643 individuals (mean age, 73.9 years) from the Otassha Study in 2019. Xerostomia was assessed using the 5-item Summated Xerostomia Inventory (SXI). Hyposalivation was assessed by measuring the amount of resting saliva using the modified cotton roll method. Frailty phenotypes were defined by weakness, slowness, weight loss, low physical activity level and exhaustion components, and served as the outcome variable. Participants with three or more components were considered physically frail, and those with one or two components were considered pre-frail. Ordinal logistic regression analyses were performed to evaluate the associations between physical frailty and xerostomia and hyposalivation. RESULTS Among the participants, 4.5% and 49.8% had physical frailty and pre-frailty, respectively. In ordinal logistic regression analysis adjusted for demographic and health characteristics, the SXI score was associated with physical frailty status (adjusted odds ratio for a one-point increase in SXI, 1.12; 95% confidence interval, 1.06-1.19). However, no difference was observed between the amount of resting saliva and severity of physical frailty. CONCLUSION Xerostomia is associated with physical frailty among community-dwelling older adults in Japan. CLINICAL TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Maki Shirobe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hunkyung Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | | | - Kazuhige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Yutaka Watanabe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Department of Dental and Oral Surgery, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
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Jang W, Shin Y, Kim Y. Dietary Pattern Accompanied with a High Food Variety Score Is Negatively Associated with Frailty in Older Adults. Nutrients 2021; 13:nu13093164. [PMID: 34579040 PMCID: PMC8472458 DOI: 10.3390/nu13093164] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 12/26/2022] Open
Abstract
Proper nutrition is a modifiable factor in preventing frailty. This study was conducted to identify the association between dietary patterns and frailty in the older adult population. The cross-sectional analysis was performed on 4632 subjects aged ≥65 years enrolled in the Korea National Health and Nutrition Examination Survey from 2014–2018. Food variety score (FVS) was defined as the number of foods items consumed over a day. Three dietary patterns were identified using factor analysis: “white rice and salted vegetables,” “vegetables, oils, and fish,” and “noodles and meat.” The higher “white rice and salted vegetables” pattern score was related to significantly lower FVS, whereas higher “vegetables, oils, and fish” and “noodles and meat” pattern scores were associated with a higher FVS. Participants with higher FVS showed a low risk of frailty (odds ratio (OR) (95% confidence interval, CI) = 0.44 (0.31–0.61), p-trend = 0.0001) than those with lower FVS. Moreover, the “vegetables, oils, and fish” pattern score was significantly associated with a low risk of frailty (OR (95% CI) = 0.55 (0.40–0.75), p-trend = 0.0002). These results suggested that consuming a dietary pattern based on vegetables, oils, and fish with high FVS might ameliorate frailty in older adults.
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Affiliation(s)
- Won Jang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea; (W.J.); (Y.S.)
| | - Yoonjin Shin
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea; (W.J.); (Y.S.)
| | - Yangha Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 03760, Korea; (W.J.); (Y.S.)
- Graduate Program in System Health Science and Engineering, Ewha Womans Universty, Seoul 03760, Korea
- Correspondence: ; Tel.: +82-2-3277-3101
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Na W, Kim H, Sohn C. Association between frailty and dietary quality in community-dwelling elderly: data from the 6th Korea National Health and Nutrition Examination Survey (2014-2015). J Clin Biochem Nutr 2021; 68:268-274. [PMID: 34025032 PMCID: PMC8129983 DOI: 10.3164/jcbn.20-133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 09/16/2020] [Indexed: 11/22/2022] Open
Abstract
Frailty is a progressive age-related disorder associated with odds ratio for subsequent falls, disability, and mortality. This study analyzed the association between frailty odds ratios and diet quality using the Korean Healthy Eating Index in older individuals. Data were obtained for 2,660 community-dwelling individuals aged ≥60 years who participated in the 6th Korea National Health and Nutrition Survey (2014-2015). Frailty was diagnosed following the Fried phenotype index based on five criteria: unintentional weight loss, emotional exhaustion, low physical activity, slow walking speed, and weak grip strength. The participants were categorized as normal, pre-frail, and frail. Diet quality was assessed using Korean Healthy Eating Index scores calculated based on 24-h dietary recall. Compared to the group with the highest Korean Healthy Eating Index score, the group with low Korean Healthy Eating Index showed a 1.71-fold higher pre-frail odds ratio (95% CI 1.31-2.22, p<0.001) and 1.87-fold higher frail odds ratio (95% CI 1.21-2.91, p = 0.009). Also, compared to the group with the highest adequacy score, the group with the lowest score showed a 1.51-fold higher pre-frail odds ratio (95% CI 1.16-1.96, p = 0.010) and a 2.39-fold higher frail odds ratio (95% CI 1.48-3.86, p = 0.002). The findings of this study suggested that a high-quality diet, as assessed by Korean Healthy Eating Index, was negatively associated with the odds ratio of frailty.
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Affiliation(s)
- Woori Na
- Department of Food and Nutrition, Wonkwang University 460, Iksan-daero, Iksan-si, Jeollabuk-do, 54538, Korea
| | - Hyeji Kim
- Department of Food and Nutrition, Wonkwang University 460, Iksan-daero, Iksan-si, Jeollabuk-do, 54538, Korea
| | - Cheongmin Sohn
- Department of Food and Nutrition, Wonkwang University 460, Iksan-daero, Iksan-si, Jeollabuk-do, 54538, Korea
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Kong LN, Lyu Q, Yao HY, Yang L, Chen SZ. The prevalence of frailty among community-dwelling older adults with diabetes: A meta-analysis. Int J Nurs Stud 2021; 119:103952. [PMID: 34022743 DOI: 10.1016/j.ijnurstu.2021.103952] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 03/17/2021] [Accepted: 04/13/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Coexistence of frailty and chronic diseases including diabetes is related to a higher risk of adverse health outcomes. There is an increasing interest in the intersection of diabetes and frailty. Understanding the prevalence of frailty in older adults with diabetes is of great importance. However, estimates of the prevalence of frailty among this population varied widely in the relevant literature. OBJECTIVES To conduct a systematic review and meta-analysis to estimate the overall prevalence of frailty and prefrailty among community-dwelling older adults with diabetes, and examine the risk factors associated with frailty in this population. METHODS PubMed, Web of Science, Embase, Wiley Cochrane Library, and Cumulative Index of Nursing and Allied Health were searched from inception to May 30th, 2020. Investigators assessed eligibility, extracted data and evaluated methodological quality. The pooled prevalence of frailty and prefrailty was calculated using the random-effects model. Meta-regression analysis and subgroup analysis were conducted to explore sources of heterogeneity. RESULTS A total of 32 studies met the inclusion criteria, involving 14,450 individuals. The pooled prevalence of frailty and prefrailty in older adults with diabetes was 20.1% (95% CI = 16.0-24.2%) and 49.1% (95%CI = 45.1-53.1%), respectively, with significant heterogeneity across the studies. Frailty was more prevalent in older adults with diabetes than those without diabetes (OR = 1.61, 95%CI = 1.47-1.77, p < 0.001). The pooled prevalence of frailty was lower in studies using Frailty Phenotype to define frailty (16.3%) and conducted in Asia (14.3%). Female gender and unmarried status were risk factors of frailty among this population. CONCLUSION Frailty and prefrailty are common in community-dwelling older adults with diabetes. Early screening of frailty and interventions should be integrated into diabetes care for older adults to prevent and reduce the negative effects of frailty at the community level. Better quality longitudinal research is required to examine the temporal relationship between diabetes and frailty.
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Affiliation(s)
- Ling-Na Kong
- School of Nursing, Chongqing Medical University, No. 1 Yixueyuan Road, Yu Zhong District, Chongqing 400016, PR China; School of Nursing, The first Affiliated Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Qiong Lyu
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Hai-Yan Yao
- Library, The first Affiliated Hospital of Chongqing Medical University, Chongqing, PR China
| | - Li Yang
- School of Nursing, Qingdao University, Qingdao, PR China
| | - Shuo-Zhen Chen
- Clinical Nursing Teaching and Research Section, Affiliated Hospital of Zunyi Medical University, Zunyi, PR China
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Narita M, Kitamura A, Taniguchi Y, Seino S, Yokoyama Y, Nofuji Y, Amano H, Nishi M, Takemi Y, Shinkai S. [Trajectories of Dietary Variety Score among community-dwelling older Japanese and their related factors]. Nihon Ronen Igakkai Zasshi 2021; 58:81-90. [PMID: 33627566 DOI: 10.3143/geriatrics.58.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM To categorize the age-related trajectories of dietary variety score (DVS) in the community-dwelling elderly and to examine the associated factors. METHODS The study population included 1,195 people who underwent a medical checkup for the elderly in Kusatsu-town, Gunma Prefecture in 2012 to 2017. A multinomial logistic regression analysis was performed to examine the factors associated with the age-related trajectories of DVS. The dependent variables were sex, age, family structure, years of education, BMI, subjective chewing ability, TMIG-IC, GDS-15, MMSE, smoking, alcohol consumption, and history of hypertension, dyslipidemia, diabetes mellitus, and stroke. RESULTS The adjusted odds ratio (95% confidence intervals) of the low trajectory group in comparison to the medium trajectory group were 2.69 (1.02-7.08) for subjective chewing ability (no chewing), 1.11 (1.06-1.17) for GDS-15, 1.76 (1.14-2.73) for current smoking, and 1.70 (1.19-2.43) for past smoking. In contrast, the adjusted odds ratio of the high trajectory group in comparison to the medium trajectory group were 0.61 (0.37-1.00) for men, 1.04 (1.01-1.07) for age, 0.58 (0.38-0.89) for subjective masticatory ability (difficult to chew), 0.88 (0.82-0.96) for GDS-15, and 0.55 (0.37-0.83) for a history of hypertension. CONCLUSIONS The age-related trajectory patterns of DVS in the community-dwelling elderly can be categorized into three types. In order to maintain a high quality of food intake, it was shown that, in addition to subjective masticatory ability and mental health factors, such as depression, we should pay attention to the control of hypertension, which is a risk factor for lifestyle diseases, and lifestyle habits such as smoking.
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Affiliation(s)
| | | | | | | | | | - Yu Nofuji
- Tokyo Metropolitan Institute of Gerontology
| | | | | | | | - Shoji Shinkai
- Tokyo Metropolitan Institute of Gerontology.,Kagawa Nutrition University
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21
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Hayakawa M, Motokawa K, Mikami Y, Yamamoto K, Shirobe M, Edahiro A, Iwasaki M, Ohara Y, Watanabe Y, Kawai H, Kojima M, Obuchi S, Fujiwara Y, Kim H, Ihara K, Inagaki H, Shinkai S, Awata S, Araki A, Hirano H. Low Dietary Variety and Diabetes Mellitus Are Associated with Frailty among Community-Dwelling Older Japanese Adults: A Cross-Sectional Study. Nutrients 2021; 13:641. [PMID: 33669388 DOI: 10.3390/nu13020641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 02/06/2021] [Accepted: 02/09/2021] [Indexed: 12/25/2022] Open
Abstract
The association between dietary diversity and frailty remains unknown in older people. We evaluated whether a limited dietary variety is associated with frailty in older adults with diabetes mellitus (DM). This cross-sectional investigation included 1357 adults (median age: 77 years, women: 61.3%). DM was determined by self-reporting, the Dietary Variety Score (DVS) was used to evaluate dietary variety, and the revised Japanese version of the Cardiovascular Health Study criteria evaluated frailty. Participants were divided into 4 groups: no DM/high DVS (non-DMHV), no DM/low DVS (non-DMLV), DM/high DVS (DMHV), and DM/low DVS (DMLV). The prevalence of frailty in each group was 3.6%, 6.7%, 6.7%, and 12.2%. After adjusting for covariates, logistic regression analysis revealed the highest odds ratio (OR) of frailty in the DMLV (non-DMLV, OR = 2.18 (95% confidence interval (CI): 1.25–3.83); DMHV, OR = 1.87 (95% CI: 0.63–5.52); DML, OR = 5.03 (95% CI: 2.05–12.35)). Another logistic regression analysis revealed that a low DVS and DM were independently associated with frailty. Both a low dietary variety and DM were independently related to frailty in older people and the combination increased the prevalence of frailty. These findings suggest that high dietary variety could be important for the prevention of frailty in people with DM.
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Motokawa K, Mikami Y, Shirobe M, Edahiro A, Ohara Y, Iwasaki M, Watanabe Y, Kawai H, Kera T, Obuchi S, Fujiwara Y, Ihara K, Hirano H. Relationship between Chewing Ability and Nutritional Status in Japanese Older Adults: A Cross-Sectional Study. Int J Environ Res Public Health 2021; 18:ijerph18031216. [PMID: 33572969 PMCID: PMC7908427 DOI: 10.3390/ijerph18031216] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/21/2021] [Accepted: 01/25/2021] [Indexed: 01/07/2023]
Abstract
Objectives: This study aimed to determine the relationship between objective chewing ability and the nutritional status of Japanese community-dwelling elders. Design: A cross-sectional study. Participants: A total of 509 community-dwelling elders living in the Tokyo metropolitan area participated in a comprehensive survey conducted in October 2013. Measurements: The basic characteristics were sex, age, and body mass index. Undernutrition was examined through serum albumin levels. Chewing ability was examined through color-changeable xylitol gum by evaluating the color changes in chewing gum. Nutritional intake was examined using the semi-quantitative food frequency questionnaire. Results: In the poor chewing ability group, all nutrient intake levels were significantly low, except for carbohydrates, and intake levels for all food groups were significantly low, except for cereals, confectionery, sugars, seasonings, and spices. Additionally, after adjusting for covariates for sex, age, Tokyo Metropolitan Institute of Gerontology-Index of Competence (TMIG-IC) score, Mini-Mental State Examination (MMSE) score, body mass index (BMI), stroke, number of functional teeth, energy intake, and protein intake, chewing ability was found to be significantly associated with undernutrition. Conclusion: We concluded that chewing ability was closely associated with nutrient and different food groups’ intake, as well as undernutrition, among Japanese community-dwelling elders. Thus, to ensure comprehensive nutritional management, nutritionists and dentists should collaborate when treating the same patients.
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Affiliation(s)
- Keiko Motokawa
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
- Correspondence: ; Tel.: +81-33-964-3241 (ext. 4215); Fax: +81-33-964-2316
| | - Yurie Mikami
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
| | - Maki Shirobe
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
| | - Ayako Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
| | - Yuki Ohara
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
| | - Masanori Iwasaki
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
| | - Yutaka Watanabe
- Gerodontology, Department of Oral Health Science, Faculty of Dental Medicine, Hokkaido University, Hokkaido 060-8586, Japan;
| | - Hisashi Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
| | - Takeshi Kera
- Department of Physiotherapy, Takasaki University of Health and Welfare, Gunma 373-0033, Japan;
| | - Shuichi Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
| | - Yoshinori Fujiwara
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
| | - Kazushige Ihara
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki University, Aomori 030-8560, Japan;
| | - Hirohiko Hirano
- Tokyo Metropolitan Institute of Gerontology, Tokyo 173-0015, Japan; (Y.M.); (M.S.); (A.E.); (Y.O.); (M.I.); (H.K.); (S.O.); (Y.F.); (H.H.)
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Huang WC, Huang YC, Lee MS, Chang HY, Doong JY. Frailty Severity and Cognitive Impairment Associated with Dietary Diversity in Older Adults in Taiwan. Nutrients 2021; 13:418. [PMID: 33525496 DOI: 10.3390/nu13020418] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 01/05/2023] Open
Abstract
This study aims to investigate whether frailty severity in conjunction with cognitive function, termed as” cognitive frailty”, is associated with dietary diversity in older adults. This cross-sectional study used the data from the 2014–2016 Nutrition and Health Survey in Taiwan (N = 1115; age ≥ 65 years). Dietary intake was assessed using a 24 h dietary recall and food-frequency questionnaire, and dietary diversity score (DDS; range, 0–6) and food intake frequency were calculated. The presence of frailty phenotypes was determined using the FRAIL scale, which was proposed by the International Association of Nutrition and Aging, and cognitive function was assessed using the Mini–Mental State Examination (MMSE) score. The prevalence of cognitive frailty (FRAIL scale score ≥ 3 and MMSE score ≤ 26) was 4.2%. A higher consumption frequency of dairy products, whole grains, vegetables, fruit, fish and seafood, nuts, tea, and coffee, as well as lower pickled vegetable, was inversely associated with cognitive frailty. Those with prefrailty or frailty and lower DDS demonstrated a higher cognitive impairment risk (adjust odds ratio (OR) = 2.15, 95% confidence interval = 1.21–3.83) than those without frailty and higher DDS. Older adults with cognitive prefrailty or cognitive frailty were associated with lower DDS, and frailty with lower DDS was associated with worsening cognitive function.
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Hoshino D, Hirano H, Edahiro A, Motokawa K, Shirobe M, Watanabe Y, Motohashi Y, Ohara Y, Iwasaki M, Maruoka Y, Yokoyama Y, Narita M, Taniguchi Y, Shinkai S, Kitamura A. Association between Oral Frailty and Dietary Variety among Community-Dwelling Older Persons: A Cross-Sectional Study. J Nutr Health Aging 2021; 25:361-368. [PMID: 33575729 DOI: 10.1007/s12603-020-1538-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To examine the association between the severity of oral frailty (OF), which is one of the comprehensive oral functions evaluated, and dietary variety in community-dwelling older persons. DESIGN Cross-sectional study. SETTING Community-based. PARTICIPANTS A total of 769 community-dwelling older persons aged 65 and over. INTERVENTIONS We examined basic demographic information, functional status, cognitive status, depressive symptoms, medical history, and oral functions of the participants. MEASUREMENTS OF was defined by 1-2 and 3 or more of 6 items of oral function evaluation in the pre-oral frailty and oral frailty groups, respectively. Dietary variety was assessed using the dietary variety score (DVS). The participants were categorized into 3 groups for evaluation: those with a low score (0-2), medium score (3-5), and high score (≥6). Ordinal logistic regression analysis was performed to examine the association between OF and DVS. RESULTS The rate of OF in the participants was 21.6%, and its severity was significantly associated with DVS after adjusting for potential confounders (Pre-OF; adjusted odds ratio [OR] = 1.687, 95% confidence interval [CI] = 1.219-2.335, OF; adjusted OR = 2.857, 95% CI = 1.489-5.484). CONCLUSION The severity of OF was significantly associated with DVS in community-dwelling older persons. This suggests that DVS may be useful in understanding the effects of OF on the nutritional status. Further longitudinal studies are needed to elucidate the association between OF and DVS.
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Affiliation(s)
- D Hoshino
- Daichi Hoshino, Department of Special Needs Dentistry, Division of Community Based Comprehensive Dentistry, School of Dentistry, Showa University, Tokyo 145-8515, Japan, Phone: +81 337 87 1151, Fax: +81 337 85 6403,
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Huang CH, Okada K, Matsushita E, Uno C, Satake S, Arakawa Martins B, Kuzuya M. Sex-Specific Association between Social Frailty and Diet Quality, Diet Quantity, and Nutrition in Community-Dwelling Elderly. Nutrients 2020; 12:nu12092845. [PMID: 32957506 PMCID: PMC7551288 DOI: 10.3390/nu12092845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022] Open
Abstract
The effects of social frailty on diet and nutrition are under-investigated. Our study aimed to assess the association between social frailty and diet quality, diet quantity, and nutrition over a 3-year period in community-dwelling older Japanese adults. This prospective cohort study recruited individuals aged ≥60 years from a community college and followed up 666 participants annually. Social frailty was determined using a 4-item questionnaire. Diet quantity (energy and macronutrient intake) and diet quality (dietary diversity score and Diet Quality Index-International) were assessed using a food frequency questionnaire. Nutrition was evaluated using the Mini-Nutritional Assessment (MNA). Out of the 666 participants (56.5% women), 250 (37.5%) were categorized as having social prefrailty or frailty. Regarding diet quantity, energy intake (β = −1.59kcal/kg/day, p < 0.01) and nutrient intake (protein intake, β = −0.08g/kg/day; fat intake, β = −0.06g/kg/day; carbohydrate intake, β = −0.18g/kg/day; fiber intake, β = −0.01g/kg/day; all p < 0.05) were lower in men with social prefrailty or frailty than in men with social robustness. Dietary diversity score (β = −0.25, p = 0.01) and MNA score (β = −0.32, p = 0.04) decreased in men with social prefrailty or frailty. However, these associations were not observed in women. Social frailty is associated with lower dietary intake, poor diet quality, and poor nutrition among community-dwelling older men. Future studies are required to determine the benefits of sex-specific interventions targeting social frailty on nutritional outcomes.
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Affiliation(s)
- Chi Hsien Huang
- Department of Community Health and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 4668550, Japan;
- Department of Family Medicine, E-Da Hospital, No.1, Yida Road, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan
- School of Medicine for International Students, College of Medicine, I-Shou University, No.8, Yida Rd., Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan
- Institutes of Innovation for Future Society, Nagoya University, NIC, Chikusa Ward, Furocho, Nagoya 4648601, Japan;
- Correspondence: (C.H.H.); (M.K.); Tel.: +052-744-2369 (M.K.)
| | - Kiwako Okada
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Takenoyama–57, Iwasakicho, Nisshin 4700196, Japan; (K.O.); (E.M.)
| | - Eiji Matsushita
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Takenoyama–57, Iwasakicho, Nisshin 4700196, Japan; (K.O.); (E.M.)
| | - Chiharu Uno
- Institutes of Innovation for Future Society, Nagoya University, NIC, Chikusa Ward, Furocho, Nagoya 4648601, Japan;
- Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Takenoyama–57, Iwasakicho, Nisshin 4700196, Japan; (K.O.); (E.M.)
| | - Shosuke Satake
- Section of Frailty Prevention, Department of Frailty Research, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu City 4748511, Japan;
- Department of Geriatric Medicine, Hospital, National Center for Geriatrics and Gerontology, 7–430 Morioka-cho, Obu City 4748511, Japan
| | - Beatriz Arakawa Martins
- Department of Community Health and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 4668550, Japan;
- Adelaide Geriatrics Training and Research with Aged Care (G-TRAC Centre), Discipline of Medicine, Adelaide Medical School, University of Adelaide, 61 Silkes Rd, Paradise, Adelaide 5075, Australia
- National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing, University of Adelaide, Adelaide 5005, Australia
| | - Masafumi Kuzuya
- Department of Community Health and Geriatrics, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya 4668550, Japan;
- Institutes of Innovation for Future Society, Nagoya University, NIC, Chikusa Ward, Furocho, Nagoya 4648601, Japan;
- Correspondence: (C.H.H.); (M.K.); Tel.: +052-744-2369 (M.K.)
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Harada K, Masumoto K, Okada S. Distance to supermarkets and dietary variety among Japanese older adults: examining the moderating role of grocery delivery services. Public Health Nutr 2021; 24:2077-84. [PMID: 32723418 DOI: 10.1017/S1368980020002219] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To examine whether using grocery delivery services moderates the relationship between distance to supermarket and dietary variety among Japanese older adults. DESIGN We conducted a 1-year prospective cohort study. Distance to supermarket was measured using geographic information systems. We collected information on dietary variety score (range 0-10), regular use of grocery delivery services and socio-demographic factors using a questionnaire delivered via post. SETTING The current study was performed in Nada Ward, Kobe City, Japan, from 2017 to 2018. PARTICIPANTS Older adults living in Nada Ward (n 778). RESULTS The linear mixed model showed that a longer distance to supermarket (per 100 m: B = -0·07, 95 % CI -0·14, -0·01, P = 0·048) significantly predicted lower dietary variety after adjusting for socio-demographic factors. Using grocery delivery services (B = 0·28, 95 % CI -0·08, 0·64, P = 0·127) did not significantly predict dietary variety, and neither did its interaction with distance to supermarket (B = -0·04, 95 % CI -0·17, 0·10, P = 0·604). CONCLUSIONS The current study found that longer distance to supermarket was associated with lower dietary variety among Japanese older adults and that the use of grocery delivery services did not moderate this association. The findings imply that the use of grocery delivery services is insufficient to reduce the negative influence of inconvenient food access on dietary variety among older adults.
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Amato M, Bonomi A, Laguzzi F, Veglia F, Tremoli E, Werba JP, Giroli MG. Overall dietary variety and adherence to the Mediterranean diet show additive protective effects against coronary heart disease. Nutr Metab Cardiovasc Dis 2020; 30:1315-1321. [PMID: 32513579 DOI: 10.1016/j.numecd.2020.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 03/27/2020] [Accepted: 04/01/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND AND AIM Along with the increasing evidence of the cardioprotective effects of the Mediterranean Diet (MD), the scientific interest and advocacy of dietary variety as a potentially healthy eating habit gradually faded, until its complete oblivion in the latest European cardiovascular prevention guidelines. Our study aims to investigate whether dietary variety adds to the "Mediterranean-ness" of the diet in protecting against coronary heart disease (CHD). METHODS AND RESULTS In this case-control Italian study, data on eating habits were collected from 178 patients with CHD and 155 healthy controls, primarily males, frequency matched for age and gender, using the Food Frequency Questionnaire (FFQ) of the European Prospective Investigation into Cancer and Nutrition. Adherence to MD was estimated from FFQ by the Mediterranean Diet Score (MDS), an index developed by Trichopoulou (2003) ranging from 0 to 9, with higher scores indicating a stricter adherence. Overall dietary variety was computed from FFQ as a count of single food items consumed at least once a month. Associations between MDS or overall dietary variety and coronary status were evaluated by logistic regression models adjusted for BMI, physical activity, smoking, education, and caloric intake; the Odds Ratio (OR) for CHD for each 1.5-point increase in MDS was 0.76 [IC 95% 0.59; 0.98], whereas the OR for CHD for each 15-item increase in dietary variety was 0.62 [IC 95% 0.46; 0.84]. Remarkably, adherence to MD and overall dietary variety were independently associated with a significantly reduced chance of CHD. CONCLUSION Dietary Mediterranean-ness and overall dietary variety exhibit additive cardioprotective effects.
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Affiliation(s)
- Manuela Amato
- Unit of Atherosclerosis Prevention, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy.
| | - Alice Bonomi
- Units of Biostatistics, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy
| | - Federica Laguzzi
- Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, Box 210, 17177, Stockholm, Sweden
| | - Fabrizio Veglia
- Units of Biostatistics, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy
| | - Elena Tremoli
- Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy
| | - José P Werba
- Unit of Atherosclerosis Prevention, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy
| | - Monica G Giroli
- Unit of Atherosclerosis Prevention, Centro Cardiologico Monzino, IRCCS, Via C. Parea 4, 20138, Milan, Italy
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Momosaki R, Wakabayashi H, Maeda K, Shamoto H, Nishioka S, Kojima K, Tani Y, Suzuki N, Hanazato M, Kondo K. Association between Food Store Availability and the Incidence of Functional Disability among Community-Dwelling Older Adults: Results from the Japanese Gerontological Evaluation Cohort Study. Nutrients 2019; 11:E2369. [PMID: 31590318 DOI: 10.3390/nu11102369] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/24/2019] [Accepted: 09/26/2019] [Indexed: 02/05/2023] Open
Abstract
This study sought to clarify the association between food store availability and the incidence of disability in older adults. This study utilized a population-based cohort study of independent Japanese adults aged ≥65 years, which was a 6 year follow-up of participants in the Japan Gerontological Evaluation Study. A total of 31,273 respondents were extracted. Food store availability was evaluated based on the existence of food stores within 500/1000 m of the home. We utilized participant-reported subjective measurement as well as geographic information system-based objective measurement for the evaluation. The incidence of disability was determined using municipal data on eligibility for long-term care insurance benefits. There were 7643 (24.4%) community-dwelling participants with low subjective food store availability and 5673 (18.1%) with low objective food store availability. During the follow-up period of 6 years, the cumulative incidence of disability was 20.9%, with a significant association between low subjective food store availability and increased disability. Participants who reported low subjective food store availability had a significantly higher likelihood of developing disability (hazard ratio = 1.18, 95% confidence interval: 1.11-1.25) than those who reported high subjective food store availability after adjusting for age, sex, sociodemographic status, environmental status, walking and going out, dietary food intake, body mass index, and comorbidities. Low subjective food store availability was associated with early onset of disability. Accessibility of food stores might contribute to maintaining a disability-free life.
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Shibasaki K, Kin SK, Yamada S, Akishita M, Ogawa S. Sex-related differences in the association between frailty and dietary consumption in Japanese older people: a cross-sectional study. BMC Geriatr 2019; 19:211. [PMID: 31382881 PMCID: PMC6683375 DOI: 10.1186/s12877-019-1229-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/26/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Female sex is an important factor predisposing individuals to frailty. Appropriate nutrition is one of the most effective ways to prevent older adults from developing frailty; Sex-related differences have also been detected in the association between nutritional intervention and health-related outcomes. However, few studies have discussed these sex-related differences. The aim of the present study was to investigate the sex-related differences in the association between frailty and dietary consumption. METHODS We conducted a cross-sectional study which investigated community-dwelling older adults aged ≥65 years. We surveyed age, sex, body mass index, family arrangement (living alone, living with a partner or living with parent(s) and/or child (ren)), dietary consumption and frailty status. Dietary consumption was surveyed using a food frequency questionnaire that included 13 major food categories (fish, meat, eggs, dairy products, soybean products, vegetables, seaweeds, potatoes, fruits, fats or oils, snacks, salty foods and alcohol). Frailty was defined by the Kihon Checklist score. The Kihon Checklist is composed of 25 simple yes/no questions, and it has been validated as a metric for frailty. A higher score indicates a greater degree of frailty. Multinomial regression analysis was performed to clarify the association between frailty and dietary consumption for each sex. RESULTS We analyzed 905 older adults (420 (46.4%) were male). After adjusting for cofounders, a low frequency of meat consumption (less than twice/week) was associated with a high prevalence of frailty in men (odds ratio: 2.76 (95%CI: 1.12-6.77), p = 0.027). In contrast, in women, low frequencies of consumption of fish, meat, vegetables, potatoes and snacks were associated with a higher prevalence of frailty compared with those who consumed foods from those categories daily (odds ratios: fish 2.45 (1.02-5.89), p = 0.045; meat 4.05 (1.67-9.86), p = 0.002; vegetables 5.03 (2.13-11.92), p < 0.001; potatoes 3.84 (1.63-9.05), p = 0.002; snacks 2.16 (1.02-4.56), p = 0.043). CONCLUSIONS More food categories were associated with frailty in women than in men. Nutritional intervention to prevent frailty is presumably more effective for women than for men.
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Affiliation(s)
- Koji Shibasaki
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Shin Kei Kin
- Department of Physical Therapy, Health Science University, 7178 Kodachi, Fujikawaguchiko-town, Yamanashi, Japan
| | - Shizuru Yamada
- Komagane-kogen Ladies Clinic, 759-195, Akaho, Komagane-city, Nagano, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
| | - Sumito Ogawa
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
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