Malnutrition significantly affected centenarian prognoses: A prospective study with 5-year follow-up

Abstract

The world is currently facing a much-needed conundrum, and population aging has become an important worldwide problem. Appropriate nutritional intervention could prolong survival time and reduce mortality rate. However, scarce study has involved the effects of nutrition on survival time in centenarians and evaluated the malnutrition with prognostic nutritional index (PNI) in relation to healthy aging. This prospective study was designed to investigate the effects of malnutrition through PNI assessment on mortality rate and survival time with 5-year follow-up in Chinese centenarians. A household survey was conducted on the centenarians in 18 cities and counties of Hainan province, and malnutrition was evaluated by PNI as an effective tool in 423 centenarians followed up for 5-year. Prevalence of malnutrition was 19.4%. Body mass index (BMI) was significantly lower and malnutrition was significantly more in the dead group than those in the survival group (all P<0.05). Multivariate Cox regression analysis indicated that BMI [Hazard ratio (HR): 0.913; 95%CI: 0.854-0.977] negatively affected mortality rate, whereas malnutrition (HR: 2.630; 95%CI:1.474-4.695) positively affected mortality rate in centenarians (all P<0.05). When BMI was <18.5kg/m2, malnutrition (HR: 4.401; 95%CI: 1.948-9.943) also positively affected mortality rate (P<0.05). This prospective study with 5-year follow-up demonstrated that malnutrition had positive effect on mortality rate, especially when BMI was lower than 18.5kg/m2, in Chinese centenarians. In order to reduce mortality rate and prolong survival time, it is essential to pay attention to malnutrition in elderly population.