Abstract
Background: Whether multiple nutritional deficiencies have a synergic effect on mobility loss remains unknown. This study aims to evaluate associations between multi-nutritional deficits and physical performance evolution among community-dwelling older adults.Methods: We included 386 participants from the Multidomain Alzheimer Preventive Trial (MAPT) (75.6 ± 4.5 years) not receiving omega-3 polyunsaturated fatty acid (PUFA) supplementation and who had available data on nutritional deficits. Baseline nutritional deficits were defined as plasma 25 hydroxyvitamin D <20 ng/ml, plasma homocysteine >14 μmol/L, or erythrocyte omega-3 PUFA index ≤ 4.87% (lower quartile). The Short Physical Performance Battery (SPPB), gait speed, and chair rise time were used to assess physical performance at baseline and after 6, 12, 24, 36, 48, and 60 months. We explored if nutrition-physical performance associations varied according to the presence of low-grade inflammation (LGI) and brain imaging indicators.Results: Within-group comparisons showed that physical function (decreased SPPB and gait speed, increased chair rise time) worsened over time, particularly in participants with ≥2 nutritional deficits; however, no between-group differences were observed when individuals without deficit and those with either 1 or ≥2 deficits were compared. Our exploratory analysis on nutritional deficit-LGI interactions showed that, among people with ≥2 deficits, chair rise time was increased over time in participants with LGI (adjusted mean difference: 3.47; 95% CI: 1.03, 5.91; p = 0.017), compared with individuals with no LGI.Conclusions: Accumulated deficits on vitamin D, homocysteine, and omega-3 PUFA were not associated with physical performance evolution in older adults, but they determined declined chair rise performance in subjects with low-grade inflammation.Clinical Trial Registration: [https://clinicaltrials.gov/ct2/show/NCT00672685], identifier [NCT00672685].
Highlights
Decline in physical performance, as measured by lower extremity function, often marks the early stage of disability in older age [1, 2]
We explored if nutrition-physical performance associations varied according to the presence of low-grade inflammation (LGI) and brain imaging indicators
Within-group comparisons showed that physical function worsened over time, in participants with ≥2 nutritional deficits; no between-group differences were observed when individuals without deficit and those with either 1 or ≥2 deficits were compared
Summary
As measured by lower extremity function, often marks the early stage of disability in older age [1, 2]. It is crucial to identify modifiable factors, such as nutritional risk factors, and their underlying biological mechanisms leading to impaired mobility in older individuals. Hyperhomocysteinemia (HHcy) has been associated with faster physical impairment, such as in walking test and chair rise test, in several longitudinal studies [5,6,7]. Vitamin D deficiency has been cross-sectionally associated with poor physical performance [8,9,10]; similar associations were not discovered in longitudinal studies [11, 12]. The literature on omega PUFAs is mixed, some studies have found increased omega PUFAs was associated with low risk of mobility disability [13], poor Short Physical Performance Battery (SPPB) score, and slower gait speed over time [14]. This study aims to evaluate associations between multi-nutritional deficits and physical performance evolution among community-dwelling older adults
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