Physical Activity, Diet Quality, and Mortality among Community-Dwelling Prefrail and Frail Older Adults

Abstract

It is unknown if physical activity and diet quality are associated with the risk of poor outcomes, such as mortality, among prefrail and frail older adults. This was a population-based cohort study among 1,487 prefrail and frail older-adults from the Third National Health and Nutrition Survey. Compared to participants who were sedentary (0 bouts of physical activity per week), those who were physically inactive (1–4 bouts of physical activity per week) were 24% less likely to die [HR: 0.76 (95% CI: 0.58–0.98)], and those who were physically active (≥5 bouts of physical activity per week) were 34% less likely to die [HR: 0.66 (95% CI: 0.51–0.86); Ptrend=0.002]. Compared to participants with poor diet quality, those with fair diet quality were 26% less likely to die [HR: 0.74 (95% CI: 0.52–0.98)], and those with good diet quality were 33% less likely to die [HR: 0.67 (95% CI: 0.55–1.00); Ptrend=0.050]. There was a synergistic interaction between physical activity and diet quality on the risk of mortality (Pinteraction=0.058). Participation in physical activity and consumption of a healthy diet is associated with a lower risk of mortality among prefrail and frail older adults.

Diet Quality Is Associated With Mortality in Adults Aged 80 Years and Older: A Prospective Study

“…Results of our current study are also consistent with our earlier study including older persons aged 65 years and older that was of shorter duration (mean follow‐up of 3.1 years) with fewer incident mortalities and found that low diet quality was associated with higher mortality risk . Other observational studies have also found that adherence to a healthy diet, assessed by the Healthy Eating Index (HEI), the Mediterranean diet score, and other indexes, was associated with lower risk of mortality in prefrail and frail older persons as well as older adults with sarcopenia . However, some studies examining the relationships between dietary pattern, diet quality, and mortality among older persons in observational studies revealed inconclusive results .…”

Evaluation of Dietary Patterns and All-Cause Mortality

“…After dual screening, 11 547 relevant studies were identified. The body of evidence included 153 articles (involving 6 550 664 individuals), of which 1 was from a randomized clinical trial (RCT) 18 and 152 were from observational studies 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 ,…”

“…Studies enrolled adults and older adults (aged 17-84 years at baseline) from 28 countries with a high or very high Human Development Index 16 classification (Australia, Belgium, Canada, Czech Republic, Croatia, Denmark, Finland, France, Germany, Greece, Hong Kong, Hungary, Iran, Italy, Japan, Korea, Norway, Netherlands, Poland, Portugal, Russia, Serbia, Singapore, Spain, Sweden, Switzerland, United Kingdom, and United States). Fifty-three studies 21 , 23 , 24 , 27 , 29 , 32 , 33 , 37 , 39 , 40 , 42 , 43 , 44 , 46 , 47 , 52 , 56 , 57 , 58 , 59 , 60 , 61 , 72 , 73 , 74 , 78 , 83 , 86 , 94 , 95 , 96 , 98 , 100 , 101 , 102 , 104 , 107 , 110 , 118 , 125 , 126 , 127 , 129 , 135 , 137 , 150 , 158 , 160 , 161 , 163 , 166 originated from the US. Some studies exclusively enrolled female 29 , …”

“…The approaches for assessing dietary patterns included an RCT 18 ; a priori methods, such as index or score analysis 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 ,…”

“…24,25,30,32,34,35,[46][47][48][49][50][51][52][53]63,64,68,69,71,76,79,81,83,88,97,98,104,[106][107][108][111][112][113][114][115][116][117][122][123][124][125]127,128,141 A few articles reported nonsignificant results with similar patterns. 21,31,33,36,39,42,62,93,102,…”