Associations Between Dietary Intake And Frailty In Older Ethnically Diverse Migrant Women

Abstract

PURPOSE: Frailty syndrome is a wasting disorder with weight loss commonly used as a proxy measure of inadequate dietary intake in older adults. However, many older adults are overweight/obese, and the absence of weight loss may not be adequately sensitive to identify individuals consuming a poor quality diet and are frail. This is particularly problematic in older ethnically diverse migrant women due to their relatively high rates of overweight/obesity. Our aim was to investigate the association between dietary intake and frailty syndrome in older (>60y) ethnically diverse migrant women (n=60). METHODS: Frailty was defined as meeting two of the following criteria: feelings of exhaustion, low level of accelerometry-measured physical activity (PA), low walking speed, and weakness. 24hr dietary recall was used to estimate daily intakes of energy, protein, retinol, Vitamins D, C, E, folate, Ca, Fe, and Zn; low intake was defined as the lowest quintile of intake in this sample. RESULTS: Twenty-three percent of participants (mean age 70.8±8.0y) were classified as frail. Mean BMI was 29.4±4.8kg/m2; no participant had a BMI indicative of underweight. However, 57.1% reported low intake values of at least 3 nutrients. Weight loss (p=0.3, Fisher’s exact test) and BMI (r= 0.05, p=0.7) were not associated with frailty. Logistic regression indicated that low energy intake was independently associated with frailty (OR:0.08, 95%CI:0.01-0.59). After controlling for low energy intake, low intakes of retinol (OR:0.06, 95%CI:0.006-0.64) and of >3 nutrients were associated with frailty (OR:0.008, 95%CI:0.001-0.41). Percentages of women with low levels of PA and slow walking speed increased with the number of nutrient intakes in the lowest quintile, with only slowness being independently related to frailty (OR:0.005, 95%CI:0.001-0.16). CONCLUSIONS: Low intakes of energy and selected nutrients were common in this sample and were associated with frailty. Due to the higher prevalence of overweight/obesity and related complications in older ethnic minority migrant women, dietary intake may be a better indicator of frailty rather than weight loss and BMI. Funding: The National Council on Science and Technology, Mexico; University of Birmingham Institute for Research Into Superdiversity.