Association between Food Store Availability and the Incidence of Functional Disability among Community-Dwelling Older Adults: Results from the Japanese Gerontological Evaluation Cohort Study.

Momosaki Momosaki,Wakabayashi Wakabayashi,Kondo Kondo,Maeda Maeda,Tani Tani,Shamoto Shamoto,Nishioka Nishioka,Hanazato Hanazato,Kojima Kojima,Suzuki Suzuki

doi:10.3390/nu11102369

Abstract

This study sought to clarify the association between food store availability and the incidence of disability in older adults. This study utilized a population-based cohort study of independent Japanese adults aged ≥65 years, which was a 6 year follow-up of participants in the Japan Gerontological Evaluation Study. A total of 31,273 respondents were extracted. Food store availability was evaluated based on the existence of food stores within 500/1000 m of the home. We utilized participant-reported subjective measurement as well as geographic information system-based objective measurement for the evaluation. The incidence of disability was determined using municipal data on eligibility for long-term care insurance benefits. There were 7643 (24.4%) community-dwelling participants with low subjective food store availability and 5673 (18.1%) with low objective food store availability. During the follow-up period of 6 years, the cumulative incidence of disability was 20.9%, with a significant association between low subjective food store availability and increased disability. Participants who reported low subjective food store availability had a significantly higher likelihood of developing disability (hazard ratio = 1.18, 95% confidence interval: 1.11–1.25) than those who reported high subjective food store availability after adjusting for age, sex, sociodemographic status, environmental status, walking and going out, dietary food intake, body mass index, and comorbidities. Low subjective food store availability was associated with early onset of disability. Accessibility of food stores might contribute to maintaining a disability-free life.

Highlights

Life expectancy is increasing worldwide, with a resultant increase in the elderly population who are at high risk of physical frailty, sarcopenia, progressive functional disability, dependency, and institutionalization, and will have serious social, medical, and economic impacts [1]
Among all participants (n = 31,273, mean age: 74.1 years), 20.5% worked, 84.2% lived with others, 70.1% were married, 7.6% were underweight, 32.5% had cognitive decline, 24.4% had low subjective food store availability, 18.1% had low objective food store availability, and cumulative incidence of functional disability after 6 years was 20.9%
Low subjective food store availability was associated with early onset of disability among community-dwelling older adults, but this was not the case for objective food store availability

Summary

Introduction

Life expectancy is increasing worldwide, with a resultant increase in the elderly population who are at high risk of physical frailty, sarcopenia, progressive functional disability, dependency, and institutionalization, and will have serious social, medical, and economic impacts [1]. Clinical Practice Guidelines for the Management of Frailty provisionally recommend that screening should be performed for frail older adults who have unintended weight loss to identify possible reversible causes and that protein and caloric supplementation/food fortification should be considered in such individuals [3]. As well as accessibility to food in terms of whether a variety of foods can be obtained, are considered to affect nutritional status. People who reside far from a grocery store are reported to have a 25%–46% lower likelihood of healthy dietary habits than those with the most stores nearby among community-dwelling residents in the United States [5]; low subjective accessibility of food increases the risk of low dietary variability among community-dwelling older adults in Japan [6]

Methods

Results

Conclusion