Kodama Sayuri, Hoshi Tanji, Kurimori Sugako
Department of Food and Nutrition Science, Sagami Women's Junior College, 2-1-1 Bunkyo, Minami-ku, Sagamihara-shi, Kanagawa-ken, 252-0383, Japan.
Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo, 192-0397, Japan.
BMC Geriatr. 2021 Jun 26;21(1):385. doi: 10.1186/s12877-021-02332-5.
Few studies have shown age stage and sex differences in the association among dietary patterns and various health factors related to disability in older people. This study aimed to reveal the differences of characteristics, including several dietary patterns, associated with a decline in independence over 3 years in community-dwelling independent older people. Specifically, we examined data by age stage, for people between 65 and 75 years (earlier-stage) and people aged 75 years or above (later-stage), and sex.
We conducted a nationwide longitudinal study of 25 Japanese prefectures from 2013 to 2016; 2250 participants' complete data (1294 men and 956 women) were analyzed. Independence was evaluated based on instrumental activities of daily living (IADL) scores (maximum = 12). Dietary patterns were derived from a principal component analysis of the seven food groups. Baseline IADL-related factors linked to independence 3 years later were selected. Multiple logistic regression analysis for having low independence-without a full score of IADL 3 years after baseline-was conducted, adjusted for baseline IADL scores. Finally, to compare differences among age stage and sex groups, we used Multiple-Group Path Analysis.
Participants with a full IADL score 3 years later were classified as high independence (69.6%), and those without the full score were classified as low independence (30.4%). Only the later-stage older peoples' proportion of low independence 3 years later was significantly higher than those at baseline. A high meat frequency pattern was associated with a significantly higher risk of decline in independence 3 years later in later-stage older women. The earlier-stage older people showed that 18.5 ≤ BMI < 25 was associated with a lower risk, referring to BMI < 18.5. In the later-stage, exercising three or more times a week with enjoyment and fulfillment was associated with a significantly lower risk.
The IADL disability in older people aged 75 and over showed a rapid change. The different characteristics associated with the risk of decline in independence among age stage and sex were revealed. Targeting age stage and sex separately for community-based comprehensive supportive strategies would be necessary for a long life globally.
很少有研究表明饮食模式与老年人各种与残疾相关的健康因素之间的关联存在年龄阶段和性别差异。本研究旨在揭示社区居住的独立老年人在3年期间与独立性下降相关的特征差异，包括几种饮食模式。具体而言，我们按年龄阶段（65至75岁（早期）和75岁及以上（晚期）的人群）和性别对数据进行了分析。
我们在2013年至2016年期间对日本25个县进行了一项全国性纵向研究；分析了2250名参与者的完整数据（1294名男性和956名女性）。基于日常生活活动能力（IADL）评分（最高=12分）评估独立性。饮食模式源自对七个食物组的主成分分析。选择与3年后独立性相关的基线IADL相关因素。对基线3年后IADL未得满分的低独立性情况进行多因素逻辑回归分析，并根据基线IADL评分进行调整。最后，为比较年龄阶段和性别组之间的差异，我们使用了多组路径分析。
3年后IADL得满分的参与者被归类为高独立性（69.6%），未得满分的参与者被归类为低独立性（30.4%）。只有晚期老年人3年后低独立性的比例显著高于基线水平。高肉类摄入频率模式与晚期老年女性3年后独立性下降的风险显著较高相关。早期老年人显示，参照BMI<18.5，18.5≤BMI<25与较低风险相关。在晚期，每周享受并充实锻炼三次或更多次与显著较低风险相关。
75岁及以上老年人的IADL残疾显示出快速变化。揭示了年龄阶段和性别中与独立性下降风险相关的不同特征。全球范围内，针对基于社区的综合支持策略分别针对年龄阶段和性别将是长寿所必需的。
