Lower-caloric intake but different nutrient profiles in cognition impaired and in frail elderlies

Abstract

Abstract Background Frailty and dementia are two common geriatric syndromes associated with poor nutritional status. The nutritional role in the pathogenesis of frailty and dementia remains unclear. We examined the associations between energy intake and frailty/cognition impairment and also compared the nutrient intake between frail and cognition impaired elderlies by sex. Methods Data of 1,920 elderly adults (≧65y) from the 2014-2017 Nutrition and Health Survey in Taiwan was used. Frailty was defined using modified L. Fried criteria. The Chinese Mini-Mental State Examination score was grouped into tertiles: cognitive impairment (score ≦ 23), mild cognitive impairment (score = 24-27), and the normal (score ≧28). Total energy intake was grouped into tertiles. Logistic regression adjusted for age, sex, and sampling strata was used for association test. The trend test was performed using generalized linear model with age adjustment to examine whether various nutrient intake indicators had an ordered relationship with the severity of frailty and cognitive impairment. Results Lower energy intake (men <1540 Kcal or women<1182 Kcal) was significantly associated with frailty (odds ratio [OR]: 1.97; 95% confidence interval [CI]: 1.45-2.66) and cognition impairment (OR: 1.88; 95%CI: 1.43-2.47), respectively. Larger number of micronutrients and food substances per Kg body weight exhibited decreasing trends with MCI (protein, fat, carbohydrate, vitamins B1, B2, B3, B6, B12, C, E, Ca, P, Fe, Mg, K, Zn, dietary fiber, and cholesterol) than with frailty (protein, vitamin B1, B3, B6, C, P, Mg, K, Zn, polyunsaturated fatty acids, and dietary fiber). Conclusions The lower the energy intake, the higher the odds ratio for frailty and for dementia. Dietary quality expressed by nutrient intake per Kg body weight was poorer in elderlies with cognition impairment than those with frailty. Key messages Lower energy intake is associated with MCI and with frailty, respectively. The MCI elderlies involve more micronutrient deficiencies than the frail counterpart.