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Research article
Decline in independence after three years and its association with dietary patterns and frailty factors in community-dwelling older people: an analysis by sex and age stage
Sayuri Kodama
Sagami Women's Junior College
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4882-0943
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Support based on sex and age is required to implement longevity strategies. This study clarified the association between declining independence after three years and the dietary patterns and frailty factors of community-dwelling independent older people. We analyzed sex and age stages for people between 65 and 75 years (earlier-stage) and people aged 75 years or above (latter-stage), respectively.
Methods
In a longitudinal study of 25 Japanese prefectures from 2013 to 2016, 3,693 respondents completed baseline and follow-up questionnaires. We analyzed 2,250 participants (1,294 men), after excluding individuals younger than 65 years (n = 510), deceased (n = 35), with missing data (n = 866), or disabled (n = 32). Independence was evaluated based on Instrumental Activities of Daily Living (IADL) scores (maximum = 12). Disability was defined as scoring lower than 9. Dietary patterns were derived from a principal component analysis of 7 food groups. Frailty factors showing a significant relationship with baseline IADL scores were selected. Multivariate logistic regression analysis revealed an association between baseline factors and declining independence after three years.
Results
The average IADL score three years from baseline was 11.5 ± 1.1. There were two IADL score groups: “high independence” (69.6%) and “low independence” (30.4%). Three baseline dietary patterns were identified: “dietary diversity,” “high meat frequency,” “low fruit, vegetable, and dairy product frequency.” The multivariate-adjusted model in the earlier-stage revealed that BMI ≥ 30 (odds ratio (OR) = 0.97, 95% confidence interval (CI): 0.12-7.61) showed no significant difference from 18.5 < BMI (OR = 1). In the latter stage, subjective health and exercising three or more times a week with enjoyment were associated with a lower odds ratio. High meat frequency was related to high OR in all groups, especially latter-stage older women (OR = 1.59, 95% CI: 1.17‐2.15).
Conclusions
Effective integrated support for maintaining independence may be associated with weight management for earlier-stage men, the mental/psychological factors in subjective health and exercise enjoyment for latter-stage older people, and limited meat consumption, especially for latter-stage older women.
Keywords
independence, dietary pattern, frailty, cohort study
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CURRENT STATUS: Under Revision
Version 1
Posted 20 May, 2020
No community comments so far
Editorial decision: Major revision
On 03 Jan, 2021
Review #2 received
Received 22 Dec, 2020
Reviewer #2 agreed
On 13 Dec, 2020
Review #1 received
Received 24 Jul, 2020
Reviewer #1 agreed
On 02 Jul, 2020
Reviewers invited
Invitations sent on 09 Jun, 2020
Editor assigned
On 20 May, 2020
Submission checks complete
On 17 May, 2020
Editor invited
On 17 May, 2020
First submitted
On 12 May, 2020
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Subject Areas
Geriatrics & Gerontology
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This preprint is under consideration at BMC Geriatrics. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Decline in independence after three years and its association with dietary patterns and frailty factors in community-dwelling older people: an analysis by sex and age stage
Sayuri Kodama
Sagami Women's Junior College
Corresponding Author
ORCiD: https://orcid.org/0000-0002-4882-0943
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Revision
Version 1
Posted 20 May, 2020
No community comments so far
Editorial decision: Major revision
On 03 Jan, 2021
Review #2 received
Received 22 Dec, 2020
Reviewer #2 agreed
On 13 Dec, 2020
Review #1 received
Received 24 Jul, 2020
Reviewer #1 agreed
On 02 Jul, 2020
Reviewers invited
Invitations sent on 09 Jun, 2020
Editor assigned
On 20 May, 2020
Submission checks complete
On 17 May, 2020
Editor invited
On 17 May, 2020
First submitted
On 12 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Geriatrics & Gerontology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
Support based on sex and age is required to implement longevity strategies. This study clarified the association between declining independence after three years and the dietary patterns and frailty factors of community-dwelling independent older people. We analyzed sex and age stages for people between 65 and 75 years (earlier-stage) and people aged 75 years or above (latter-stage), respectively.
Methods
In a longitudinal study of 25 Japanese prefectures from 2013 to 2016, 3,693 respondents completed baseline and follow-up questionnaires. We analyzed 2,250 participants (1,294 men), after excluding individuals younger than 65 years (n = 510), deceased (n = 35), with missing data (n = 866), or disabled (n = 32). Independence was evaluated based on Instrumental Activities of Daily Living (IADL) scores (maximum = 12). Disability was defined as scoring lower than 9. Dietary patterns were derived from a principal component analysis of 7 food groups. Frailty factors showing a significant relationship with baseline IADL scores were selected. Multivariate logistic regression analysis revealed an association between baseline factors and declining independence after three years.
Results
The average IADL score three years from baseline was 11.5 ± 1.1. There were two IADL score groups: “high independence” (69.6%) and “low independence” (30.4%). Three baseline dietary patterns were identified: “dietary diversity,” “high meat frequency,” “low fruit, vegetable, and dairy product frequency.” The multivariate-adjusted model in the earlier-stage revealed that BMI ≥ 30 (odds ratio (OR) = 0.97, 95% confidence interval (CI): 0.12-7.61) showed no significant difference from 18.5 < BMI (OR = 1). In the latter stage, subjective health and exercising three or more times a week with enjoyment were associated with a lower odds ratio. High meat frequency was related to high OR in all groups, especially latter-stage older women (OR = 1.59, 95% CI: 1.17‐2.15).
Conclusions
Effective integrated support for maintaining independence may be associated with weight management for earlier-stage men, the mental/psychological factors in subjective health and exercise enjoyment for latter-stage older people, and limited meat consumption, especially for latter-stage older women.