Department of Nutrition, China Medical University, 91 Hsueh-shih Road, Taichung, 40402, Taiwan, ROC.
Graduate Institute of Life Sciences, National Defense Medical Center, 161 Minchuan East Road, Sec. 6, Taipei, 11490, Taiwan, ROC.
Sci Rep. 2018 May 8;8(1):7113. doi: 10.1038/s41598-018-24625-3.
Nutritional factors contributing to disability and mortality are modifiable in later life. Indices would add utility. We developed a gender-specific Healthy Ageing Nutrition Index (HANI) for all-cause mortality in free-living elderly. We stratified 1898 participants aged ≥65 y from the 1999-2000 Nutrition and Health Survey in Taiwan by region and randomly allocated them into development and validation sets. Linkage to the National Death Registry database until December 31, 2008 enabled mortality prediction using Cox proportional-hazards models. Four factors (appetite, eating with others, dietary diversity score, and BMI) with best total of 25 HANI points for men; and 3 factors (cooking frequency, dietary diversity score, and BMI) with best total of 27 HANI points for women, were developed. In the validation set, the highest HANI group exhibited a greater intake of plant-derived food and associated nutrients, a favourable quality of life, and more muscle mass, compared with the lowest group. The highest HANI group predicts mortality risk lower by 44 percent in men and 61 percent in women. Adjusted mortality HRs were comparable between sets. HANI is a simple, non-invasive, inexpensive, and potentially modifiable tool for nutrition monitoring and survival prediction for older adults, superior to its individual components.
导致残疾和死亡的营养因素在晚年是可以改变的。指数可以增加其效用。我们为所有原因的死亡率开发了一个特定于性别的健康老龄化营养指数 (HANI),适用于生活在自由环境中的老年人。我们按地区对来自台湾 1999-2000 年营养与健康调查的 1898 名年龄≥65 岁的参与者进行分层,并将他们随机分配到开发和验证组中。与国家死亡登记数据库的链接,直至 2008 年 12 月 31 日,使得能够使用 Cox 比例风险模型进行死亡率预测。对于男性,有 4 个因素(食欲、与他人一起进食、饮食多样性评分和 BMI)和总共 25 个 HANI 点的最佳组合;对于女性,有 3 个因素(烹饪频率、饮食多样性评分和 BMI)和总共 27 个 HANI 点的最佳组合。在验证组中,与最低组相比,HANI 得分最高的组表现出更多的植物性食物和相关营养素的摄入、更优的生活质量和更多的肌肉量。HANI 得分最高的男性组的死亡风险预测降低了 44%,女性组的死亡风险预测降低了 61%。调整后的死亡率 HR 在两组之间相当。HANI 是一种简单、非侵入性、廉价且潜在可改变的工具,可用于监测老年人的营养状况和预测生存,优于其各个组成部分。