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

doi:10.1111/jgs.16011

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 Journal › Article › Academic › peer-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 language	English
Pages (from-to)	1835-1842
Number of pages	8
Journal	Journal of the American Geriatrics Society
Volume	67
Issue number	9
Early online date	2 Jul 2019
DOIs	https://doi.org/10.1111/jgs.16011
Publication status	Published - Sept 2019

Bibliographical note

Funding

Financial Disclosure: This research was supported, in part, by the Intramural Research Program of the National Institutes of Health, National Institute on Aging (NIA); NIA contracts N01-AG-6-2101, N01-AG-6-2103, and N01-AG-6-2106; NIA grant R01-AG028050; and National Institute of Nursing Research grant R01-NR012459. Funding was provided by the European Horizon 2020 PROMISS Project \u201CPRevention Of Malnutrition In Senior Subjects in the EU,\u201D grant agreement 678732. The content only reflects the author's view, and the Commission is not responsible for any use that may be made of the information it contains. Conflict of Interest: The authors declare no conflicts of interest related to this research. Author Contributions: L.M.H., H.A.H.W., M.R.O., I.A.B., and M.V.: involved in the design of the study; L.M.H.: performed the statistical analyses and wrote the initial manuscript; all authors: contributed to the interpretation of the data, critically revised the manuscript, and gave final approval. Sponsor's Role: None.

Funders	Funder number
L.M.H.
National Institutes of Health
European Commission
European Horizon 2020
National Institute on Aging	N01AG062103, N01AG062101, R01AG028050, N01AG062106
National Institute of Nursing Research	R01NR012459
Horizon 2020 Framework Programme	678732

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 1 No Poverty

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Hengeveld, L. M., Wijnhoven, H. A. H., Olthof, M. R., Brouwer, I. A., Simonsick, E. M., Kritchevsky, S. B., Houston, D. K., Newman, A. B., & Visser, M. (2019). Prospective Associations of Diet Quality With Incident Frailty in Older Adults: The Health, Aging, and Body Composition Study. Journal of the American Geriatrics Society, 67(9), 1835-1842. https://doi.org/10.1111/jgs.16011

@article{e2b1570e7d4447478c9cde5a2f24e14f,

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

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.",

author = "Hengeveld, \{Linda M\} and Wijnhoven, \{Hanneke A H\} and Olthof, \{Margreet R\} and Brouwer, \{Ingeborg A\} and Simonsick, \{Eleanor M\} and Kritchevsky, \{Stephen B\} and Houston, \{Denise K\} and Newman, \{Anne B\} and Marjolein Visser",

note = "{\textcopyright} 2019 The Authors Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.",

year = "2019",

month = sep,

doi = "10.1111/jgs.16011",

language = "English",

volume = "67",

pages = "1835--1842",

journal = "Journal of the American Geriatrics Society",

issn = "0002-8614",

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TY - JOUR

T1 - Prospective Associations of Diet Quality With Incident Frailty in Older Adults

T2 - The Health, Aging, and Body Composition Study

AU - Hengeveld, Linda M

AU - Wijnhoven, Hanneke A H

AU - Olthof, Margreet R

AU - Brouwer, Ingeborg A

AU - Simonsick, Eleanor M

AU - Kritchevsky, Stephen B

AU - Houston, Denise K

AU - Newman, Anne B

AU - Visser, Marjolein

PY - 2019/9

Y1 - 2019/9

N2 - 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.

AB - 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.

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U2 - 10.1111/jgs.16011

DO - 10.1111/jgs.16011

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C2 - 31267522

SN - 0002-8614

VL - 67

SP - 1835

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JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

IS - 9

ER -

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

Abstract

Bibliographical note

Funding

UN SDGs

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