Lai Jun S, Cheng Grand H-L, Chong Yap-Seng, Chong Mary F-F, Koh Woon-Puay
Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Innov Aging. 2023 Apr 26;7(4):igad036. doi: 10.1093/geroni/igad036. eCollection 2023.
Studies on longitudinal trajectories of diet and the influence on aging in older adults are limited. We characterized diet quality trajectories over the past 2 decades among adults aged ≥85 years and examined their associations with cognitive and psychosocial outcomes.
We used data from 861 participants in the population-based Singapore Chinese Health Study. Dietary intakes were assessed at baseline (mean age [range]: 65 [60-74] years) and at follow-ups 3 (85 [81-95]) and 4 (88 [85-97]) years. Diet quality was measured by adherence to the Dietary Approaches to Stop Hypertension pattern, and group-based trajectory modeling was used to derive diet quality trajectories. At Follow-up 4, we assessed cognition using the Singapore-modified Mini-Mental State Examination, depressive symptoms using the 15-item Geriatric Depression Scale, social engagement, and self-rated health. Multivariable logistic regression models examined associations of diet quality trajectories with these outcomes.
About 49.7% had a trajectory with consistently low diet quality scores, whereas 50.3% had a trajectory with consistently high diet quality scores. Compared to the "consistently low" trajectory, the "consistently high" trajectory had 29% and 26% lower likelihoods of cognitive impairment and depressive symptoms, respectively (odds ratio, 95% confidence interval: 0.71 [0.51, 0.99] and 0.74 [0.55, 0.99], respectively); as well as 47% higher likelihood of social engagement (1.47 [1.09, 1.98]). No statistically significant association was observed between the trajectories and self-rated health.
Maintaining high diet quality throughout the older adult life course was associated with better cognitive and psychosocial well-being in adults aged ≥85 years.
关于老年人饮食的纵向轨迹及其对衰老影响的研究有限。我们对85岁及以上成年人过去20年的饮食质量轨迹进行了特征描述，并研究了它们与认知和心理社会结局的关联。
我们使用了基于人群的新加坡华人健康研究中861名参与者的数据。在基线（平均年龄[范围]：65[60 - 74]岁）以及随访3年（85[81 - 95]岁）和4年（88[85 - 97]岁）时评估饮食摄入量。通过遵循终止高血压饮食模式来衡量饮食质量，并使用基于组的轨迹模型得出饮食质量轨迹。在随访4时，我们使用新加坡改良的简易精神状态检查表评估认知，使用15项老年抑郁量表评估抑郁症状、社会参与度和自评健康状况。多变量逻辑回归模型研究了饮食质量轨迹与这些结局的关联。
约49.7%的人饮食质量得分轨迹持续较低，而50.3%的人饮食质量得分轨迹持续较高。与“持续低”轨迹相比，“持续高”轨迹发生认知障碍和抑郁症状的可能性分别低29%和26%（优势比，95%置信区间：分别为0.71[0.51, 0.99]和0.74[0.55, 0.99]）；社会参与度高47%（1.47[1.09, 1.98]）。未观察到轨迹与自评健康之间存在统计学上的显著关联。
在老年人的整个生命过程中保持高饮食质量与85岁及以上成年人更好的认知和心理社会幸福感相关。
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