Abstract

The impact of dietary patterns rather than single foods or nutrients on health outcomes is increasingly recognized. This cross-sectional study examines the dietary patterns of 527 non-institutionalized functionally independent older people aged ≥70 years from Gipuzkoa (Spain). Sociodemographic characteristics, health status, anthropometric measures and dietary data are collected. Multiple correspondence analysis (MCA) and cluster analysis are performed to identify dietary patterns and groups of individuals. Frequency of selected food items and compliance with food recommendations are included in the MCA. A high proportion of the sample population are overweight or obese, whereas only 3.3% are at risk of malnutrition (determined with the Mini Nutritional Assessment). Frail individuals (n = 130), measured with the Timed-Up and Go test are older, have a lower educational level, are more obese, present a poorer health status (more depressive symptoms, polypharmacy and falls, among others) and worse compliance with food recommendations than robust individuals (n = 392). Three groups of individuals are identified: cluster one (n = 285), cluster two (n = 194) and cluster three (n = 48). A gradient of increasing frailty and poorer health status is observed from cluster one to cluster three. The latter also shows the poorest dietary pattern, regarding dietary recommendations. The use of an easy-to-use tool to assess diet allows detection of differences among the three clusters. There is a need to increase awareness on the implementation of nutritional screening and a subsequent dietary assessment in primary care settings to provide nutritional care to elder, and moreover, frail individuals.

Highlights

  • The aging of the population constitutes an important health challenge due to the increase in the life expectancy

  • Frailty may be reversible, and the effectiveness of interventions based on exercise, dietary improvement or control of polypharmacy is well known [4,5]

  • The objective of this study is to examine the dietary patterns in a sample of non-institutionalized functionally independent older people living in the province of Gipuzkoa (Basque Country, Spain) and to explore potential associations between these patterns and frailty

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Summary

Introduction

The aging of the population constitutes an important health challenge due to the increase in the life expectancy. Aging is a complex and multifactorial process accompanied by a series of physiological changes that lead to a progressive loss of adaptation to environmental demands and increasing vulnerability. One of the most severe expressions of aging is frailty [1]. Frailty is characterized by a progressive loss of functional capacity that can lead to dependence, institutionalization and death [2,3]. Frailty may be reversible, and the effectiveness of interventions based on exercise, dietary improvement or control of polypharmacy is well known [4,5].

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