Sustaining an ageing population: the role of micronutrients in frailty and cognitive impairment

Abstract

Age-related frailty and cognitive decline are complex multidimensional conditions that significantly impact the ability of older adults to sustain functional capacity and independence. While underlying causes remain poorly understood, nutrition continually emerges as one associated risk element. Many studies have addressed the importance of adequate nutrition in delaying the onset of these conditions, but the specific role of micronutrients is not well established. The consideration of pre-frailty as an outcome variable is also limited in the current literature. In this review, we focus on the potential value of maintaining micronutrient sufficiency to sustaining the health of the ageing population. Using data from the Irish longitudinal study on ageing, we consider several vitamins known to have a high prevalence of low status in older adults and their impact on pre-frailty, frailty and cognitive impairment. They include vitamin B12 and folate, both of which are associated with multiple biological mechanisms involved in long-term health, in particular in cognitive function; vitamin D, which has been associated with increased risk of musculoskeletal disorders, depression and other chronic diseases; and the carotenoids, lutein and zeaxanthin, that may help mitigate the risk of frailty and cognitive decline via their antioxidant and anti-inflammatory properties. We show that low concentrations of folate and carotenoids are implicated in poorer cognitive health and that the co-occurrence of multiple nutrient deficiencies confers greatest risk for frailty and pre-frailty in the Irish longitudinal study on ageing cohort. These health associations contribute to evidence needed to optimise micronutrient status for health in the older adult population.

Understanding exogenous factors and biological mechanisms for cognitive frailty: a multidisciplinary scoping review

“…Vicente et al (2020) suggested that more inflammatory diets could lead to higher chances of being frail/pre-frail. In another review, O’Connor et al, (2023) suggested that micronutrients B12 and folate, vitamin B12 and folate; vitamin D; carotenoids, lutein and zeaxanthin were all important, but most of the consituent studies reviewed examined PF or CI, not CF. Khalid et al, (2022) however, specifically associated Beta-cryptoxanthin and zeaxanthin with CF.…”

“…In another review,O'Connor et al, (2023) suggested that micronutrients B12 and folate, vitamin B12 and folate; vitamin D; carotenoids, lutein and zeaxanthin were all important, but most of the consituent studies reviewed examined PF or…”

Development and Validation of a Nomogram for Predicting Nutritional Risk Based on Frailty Scores in Older Stroke Patients

“…Therefore, the concurrence of frailty with stroke elevates the predisposition to nutritional risks. Elevated nutritional risks might exacerbate age-associated muscle atrophy and diminished strength, potentially leading to functional incapacitation, mood disorders, falls, compromised immune response, and cognitive impairments, thereby intensifying frailty [ 21 ].…”

Malnutrition, Depression, Poor Sleep Quality, and Difficulty Falling Asleep at Night Are Associated with a Higher Risk of Cognitive Frailty in Older Adults during the COVID-19 Restrictions

“…Malnutrition refers to a condition characterized by an inadequate intake of nutrients, an imbalance of vital nutrients, or an impaired ability to utilize nutrients effectively [ 25 ]. Insufficient intake of essential nutrients can give rise to various health problems, such as weakness, fatigue, and an increased risk of cognitive decline and dementia in older individuals [ 7 , 26 ]. Furthermore, malnutrition can lead to chronic inflammation, which in turn can cause damage to brain cells, impair cognitive function, and contribute to cognitive frailty [ 26 , 27 ].…”

“…Insufficient intake of essential nutrients can give rise to various health problems, such as weakness, fatigue, and an increased risk of cognitive decline and dementia in older individuals [ 7 , 26 ]. Furthermore, malnutrition can lead to chronic inflammation, which in turn can cause damage to brain cells, impair cognitive function, and contribute to cognitive frailty [ 26 , 27 ]. However, studies on the association between malnutrition and cognitive frailty in community-dwelling elderly are limited.…”