[Relationship between eating alone and dietary variety among urban older Japanese adults]

Relationship between Eating Alone and Poor Appetite Using the Simplified Nutritional Appetite Questionnaire

One prominent factor associated with malnutrition is poor appetite. In Japan, the number of older adults living alone has increased annually. Those living alone tended to eat alone, which may lead to poor appetite. This study aimed to investigate the association between eating alone and poor appetite using an index called the Simplified Nutritional Appetite Questionnaire (SNAQ). We surveyed 818 people aged 70 and over in Takashimadaira, Itabashi-ku, Tokyo, Japan, in 2016. Comparisons were made between two groups, a poor appetite group (n = 295) and a good appetite group (n = 523), and results indicate that the poor appetite group had a higher rate of eating alone than the good appetite group (38.0% vs. 20. 1%: p < 0.001). Multivariable logistic regression (OR; 95%CI) was performed and poor appetite was significantly associated with the Geriatric Depression Scale (GDS) score (1.707; 1.200–2.427), the number of medications (1.061; 1.007–1.118), JST score (0.894; 0.841–0.950), the indication of “very healthy” on a self-rated health scale (0.343; 0.152–0.774), and reports of eating alone (1.751; 1.130–2.712). Our results suggest that eating alone is associated with a poor appetite.

Interaction of Eating Status and Dietary Variety on Incident Functional Disability among Older Japanese Adults

OBJECTIVES

To examine whether eating status and dietary variety were associated with functional disability during a 5-year follow-up analysis of older adults living in a Japanese metropolitan area.

DESIGN

A 5-year follow-up study.

SETTING

Ota City, Tokyo, Japan.

PARTICIPANTS

A total of 10,308 community-dwelling non-disabled adults aged 65-84 years.

MEASUREMENTS

Eating status was assessed using a self-reported questionnaire. Dietary variety was assessed using the dietary variety score (DVS). Based on the responses, participants were classified according to eating alone or together and DVS categories (low: 0-3; high: 4-10). Functional disability incidence was prospectively identified using the long-term care insurance system's nationally unified database. Multilevel survival analyses calculated the adjusted hazard ratio (HR) and 95% confidence interval (CI) for incident functional disability.

RESULTS

During a 5-year follow-up, 1,991 (19.3%) individuals had functional disabilities. Eating status or DVS were not independently associated with incident functional disability. However, interaction terms between eating status and DVS were associated with functional disability; HR (95% CI) for eating together and low DVS was 1.00 (0.90-1.11), eating alone and high DVS was 0.95 (0.77-1.17), and eating alone and low DVS was 1.20 (1.02-1.42), compared to those with eating together and high DVS.

CONCLUSION

Older adults should avoid eating alone or increase dietary variety to prevent functional disability. This can be ensured by providing an environment of eating together or food provision services for eating a variety of foods in the community.

Sex-Specific Association between Social Frailty and Diet Quality, Diet Quantity, and Nutrition in Community-Dwelling Elderly

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.

Sarcopenia Prevalence and Risk Factors among Japanese Community Dwelling Older Adults Living in a Snow-Covered City According to EWGSOP2

Sarcopenia is a common problem among the elderly worldwide. Muscle mass can decrease with aging and decreased physical activity may occur. However, the sarcopenia prevalence among community dwelling older adults living in snow-covered cities remains largely unknown. Therefore, we evaluated the prevalence of and risk factors for sarcopenia in this population aged 65 years or older according to the definitions and diagnoses of the European Working Group on Sarcopenia in Older People-2 from two welfare centers in Sapporo, Hokkaido, Japan. The demographic characteristics, nutrition, and depression status of 310 participants were assessed using a standardized questionnaire. All participants were assessed for grip strength. Skeletal muscle index, body mass index (BMI), and total body water (TBW) were measured using bioelectrical impedance analysis. The overall sarcopenia prevalence in the study population was 8.1%. Multivariate analysis revealed that diabetes and taking more than four drugs per day were independently associated with sarcopenia (adjusted odds ratio (OR) = 3.66, 95% confidence interval (CI) = 1.06⁻12.61; OR = 2.66, CI = 1.05⁻6.77, respectively). BMI and TBW were negatively associated with sarcopenia. Sarcopenia prevalence was low in community dwelling older adults living in the snow-covered city. It is indicated that welfare center exercise may be a good intervention for the prevention of sarcopenia. Moreover, the management of diabetes, medication, and nutrition is necessary for sarcopenia prevention in community dwelling older adults.