Prospective Associations of Diet Quality With Incident Frailty in Older Adults: The Health, Aging, and Body Composition Study

Linda M Hengeveld, Hanneke A H Wijnhoven, Margreet R Olthof, Ingeborg A Brouwer, Eleanor M Simonsick, Stephen B Kritchevsky, Denise K Houston, Anne B Newman, Marjolein Visser

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

OBJECTIVE: To examine associations of diet quality indicators with 4-year incidence of frailty in community-dwelling older adults.

DESIGN: Prospective cohort study.

SETTING: Health, Aging, and Body Composition Study, United States.

PARTICIPANTS: Community-dwelling men and women, aged 70 to 81 years in 1998 to 1999 (first follow-up, present study's baseline; n = 2154).

MEASUREMENTS: At first follow-up, dietary intake over the preceding year was assessed with a food frequency questionnaire. Indicators of diet quality include the Healthy Eating Index (categorized as poor, medium, and good), energy intake, and protein intake (a priori adjusted for energy intake using the nutrient residual model). Frailty status was determined using Fried's five-component frailty phenotype and categorized into "robust" (0 components present), "pre-frailty" (1 - 2 components present), or "frail" (3-5 components present). Cox proportional hazards analysis was used to examine associations of the diet quality indicators with 4-year incidence of (1) frailty and (2) pre-frailty or frailty. Competing risk analysis was used to examine associations with frailty by accounting for competing risks of death.

RESULTS: During the 4-year follow-up, 277 of the 2154 participants, robust or pre-frail at baseline, developed frailty, and 629 of the 1020 participants, robust at baseline, developed pre-frailty or frailty. Among the robust and pre-frail, after adjustment for confounders including energy intake, those consuming poor- and medium-quality diets had a higher frailty incidence than those consuming good-quality diets (hazard ratio [HR] = 1.92 [95% confidence interval {CI} = 1.17-3.17] and HR = 1.40 [95% CI = 0.99-1.98], respectively). No associations for energy or protein intake were observed. Competing risk analyses yielded similar results. Among the robust, those with lower vegetable protein intake had a higher "pre-frailty or frailty" incidence (per -10 g/d: HR = 1.20; 95% CI = 1.04-1.39). No other associations were observed.

CONCLUSION: Poorer overall diet quality and lower vegetable protein intake may increase the risk of becoming frail in old age. We found no association for intakes of energy, total protein, or animal protein.

Original languageEnglish
Pages (from-to)1835-1842
Number of pages8
JournalJournal of the American Geriatrics Society
Volume67
Issue number9
Early online date2 Jul 2019
DOIs
Publication statusPublished - Sept 2019

Bibliographical note

© 2019 The Authors Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Funding

FundersFunder number
European Horizon 2020
L.M.H.
National Institutes of Health
National Institute on AgingN01AG062103, N01-AG-6-2106, N01-AG-6-2101, R01-AG028050
National Institute of Nursing ResearchR01-NR012459
European Commission678732

    Fingerprint

    Dive into the research topics of 'Prospective Associations of Diet Quality With Incident Frailty in Older Adults: The Health, Aging, and Body Composition Study'. Together they form a unique fingerprint.

    Cite this