Abstract
Both inflammation and poor nutritional status are major risk factors of frailty, and the dietary inflammatory index (DII) has been suggested as being associated with the risk of frailty. The present study aimed to investigate whether DII scores were positively associated with the risk of frailty in older individuals, particularly those with poor nutritional status. In total, 321 community-dwelling older individuals aged 70–85 years were recruited and categorized as non-frail, pre-frail, and frail according to the Cardiovascular Health Study index. DII scores were calculated based on 24-h dietary recall, and nutritional status was assessed using the Mini Nutritional Assessment. Multinomial logistic regression analysis showed that DII scores were positively associated with the risk of frailty in older individuals (odds ratio, OR 1.64, 95% confidence interval, 95% CI 1.25–2.17), particularly those with poor nutritional status (OR 1.68, 95% CI 1.21–2.34). Among the frailty criteria, weight loss (OR 1.29, 95% CI 1.03–1.60), low walking speed (OR 1.33, 95% CI 1.10–1.61), and low grip strength (OR 1.34, 95% CI 1.13–1.60) were associated with DII scores. In addition, the optimal DII cut-off score for frailty was ≥0.93 (sensitivity 71%; specificity: 72%; area under the receiver operating characteristic curve, AUC = 0.792). The present study showed that a pro-inflammatory diet was associated with increased risk of frailty, particularly in older individuals with poor nutritional status. Future randomized controlled trials with a low DII diet for the prevention of frailty are needed to confirm our finding.
Highlights
Frailty is characterized by slowness, weakness, exhaustion, low physical activity, and unintentional weight loss, and this condition is associated with a high risk for subsequent falls, hospitalization, disability, and mortality [1]
The present study showed that the dietary inflammatory index (DII) scores, indicating inflammatory diet, were positively associated with the risk of frailty in older individuals, in those with poor nutritional status
In the present frailty was assessed using the Cardiovascular Health Study (CHS) index since Jung et al [3] reported that the CHS index but not the study, frailty was assessed using the CHS index since Jung et al [3] reported that the CHS index but Study of Osteoporotic Fractures (SOF) index was positively associated with mortality, functional decline, and hospitalization in older not the SOF index was positively associated with mortality, functional decline, and hospitalization in individuals
Summary
Frailty is characterized by slowness, weakness, exhaustion, low physical activity, and unintentional weight loss, and this condition is associated with a high risk for subsequent falls, hospitalization, disability, and mortality [1]. One of the major risk factors of frailty is malnutrition, which can accelerate the age-associated decline in muscle mass and strength [4]. Malnutrition is commonly assessed using the Mini. Nutritional Assessment (MNA) in older individuals, and MNA questions and frailty criteria overlap, those related to physical weakness and weight loss [5]. A previous study has reported that approximately 90% of older individuals at risk of malnutrition based on the MNA were frail or pre-frail [6]. Malnutrition interacts with inflammation in a vicious cycle whereby it increases the risk and severity of inflammation, but is a result of inflammation [7]
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