更高的饮食多样性与更健康的衰老：来自台湾老化纵向研究的社区居住中年和老年人的 4 年研究。

Higher dietary diversity and better healthy aging: A 4-year study of community-dwelling middle-aged and older adults from the Taiwan Longitudinal Study of Aging.

机构信息

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.

Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Taipei, Taiwan.

出版信息

Exp Gerontol. 2022 Oct 15;168:111929. doi: 10.1016/j.exger.2022.111929. Epub 2022 Aug 14.

DOI:10.1016/j.exger.2022.111929

PMID:35977645

Abstract

OBJECTIVES

To investigate the relationship between dietary diversity and healthy aging (in terms of mobility performance, physical functions, cognitive functions, and depressive symptoms) among community-dwelling middle-aged and older adults by using a nationally representative population-based cohort study.

METHODS

Data from 3213 study participants in the Taiwan Longitudinal Study on Aging (TLSA) were retrieved for analysis, and all participants were divided into five groups according to the quintile of dietary variety scores (DVSs). In the 4-year follow-up study, multivariate logistic regression models were applied to investigate the associations between DVS subgroups and declines in mobility performance, physical function (activities of daily living (ADLs) and instrumental activities of daily living (IADLs)), cognitive function and depressive symptoms.

RESULTS

In this study, the DVS quintile identified people who were significantly vulnerable in diet quality. Among those in the lowest DVS quintile, the proportions consuming seafood, eggs, and beans/legumes per week were 0.3 %, 7.8 % and 12.6 %, respectively, while among those in the highest DVS quintile, the proportions were 40.2 %, 83.1 %, and 82.7 %, respectively. "Inverse" dose-response associations were observed between the DVS and the risks of decline in mobility performance, physical function (ADLs and IADLs), cognitive function, and depressive symptoms. These risks decreased with the higher DVS quintile group as compared to the lowest DVS quintile group. Even after adjustments for demographics, health behaviors (e.g., physical activity) and comorbidities, participants in the highest DVS quintile group were still associated with the lowest risk of decline in ADLs (adjusted odds ratio (aOR) 0.59 [95 % confidence interval (CI) 0.37-0.94], p < 0.05) and IADLs (aOR 0.53 [0.39-0.73], p < 0.01). However, no such association was observed in the risk of worsened mobility performance, cognitive function and depressive symptoms.

CONCLUSIONS

In conclusion, higher dietary diversity has protective effects in declines in multidimensional outcomes associated with healthy aging, particularly physical functions (ADL and IADL), among community-dwelling middle-aged and older adults. Intervention studies are needed to confirm the causal relationships between dietary diversity and healthy aging.

摘要

目的

通过一项全国代表性的基于人群的队列研究，调查社区居住的中年和老年人中饮食多样性与健康老龄化（表现在行动能力、身体功能、认知功能和抑郁症状方面）之间的关系。

方法

从台湾老龄化纵向研究（TLSA）中检索了 3213 名研究参与者的数据进行分析，并根据饮食多样性评分（DVS）的五分位数将所有参与者分为五组。在 4 年的随访研究中，应用多变量逻辑回归模型来研究 DVS 亚组与行动能力、身体功能（日常生活活动（ADL）和工具性日常生活活动（IADL））、认知功能和抑郁症状下降之间的关系。

结果

在这项研究中，DVS 五分位数确定了在饮食质量方面明显脆弱的人群。在最低 DVS 五分位数组中，每周食用海鲜、鸡蛋和豆类/豆制品的比例分别为 0.3%、7.8%和 12.6%，而在最高 DVS 五分位数组中，这一比例分别为 40.2%、83.1%和 82.7%。观察到 DVS 与行动能力、身体功能（ADL 和 IADL）、认知功能和抑郁症状下降风险之间呈“反向”剂量反应关系。与最低 DVS 五分位数组相比，这些风险随着 DVS 五分位数组的升高而降低。即使在调整了人口统计学、健康行为（如身体活动）和合并症后，最高 DVS 五分位数组的参与者在 ADL（调整后的比值比（aOR）0.59 [95%置信区间（CI）0.37-0.94]，p<0.05）和 IADL（aOR 0.53 [0.39-0.73]，p<0.01）下降方面的风险仍最低。然而，在行动能力、认知功能和抑郁症状恶化的风险方面，并没有观察到这种关联。