Meal-related difficulties and weight loss in older people: Longitudinal data from MAPT study.

Abstract

Difficulties with meal-related activities (preparing meals and food shopping) may influence food intake, and contribute to nutritional risk among elderly people. All known studies on this topic had a cross-sectional design, thereby no causal relationships could be derived. We aim to investigate if difficulties with meal-related activities can contribute to subsequent weight loss in community-dwelling older people. We used data of older subjects from the MAPT Study (n=1531, median age=74 years, 64% women), who provided prospective data on weight every 6 months and cognitive, physical condition, and functional capacities every year during a 3-year period. Difficulties preparing meals and shopping were evaluated each year with the Alzheimer's Disease Cooperative Study-Activities of Daily Living Prevention Instrument (ADCS ADL-PI) Scale. The risk of losing weight (≥5% or≥3kg in the following year) was estimated using a time-dependent Cox regression model. During the 3-year follow-up, a total of 851 subjects experienced at least a 5% or 3kg weight loss. Two hundred thirty-seven subjects declared having difficulties with meal preparation at least once, and 133 declared having difficulties shopping. Subjects reporting any meal-related difficulties were older (p<0.001), had more depressive symptoms (p<0.001), and a lower physical function (p<0.001) compared to those without difficulties. They also had a lower cognitive score (preparing meals: p<0.001; shopping: p=0.005) and a lower body mass index (preparing meals: p=0.005; shopping: p=0.023) at the end of the study. Meal-related activities were not associated with weight loss in unadjusted analysis and after adjustment for sex, age, depression, physical and cognitive status. Difficulties preparing meals and shopping had no effect on weight loss in community-dwelling older people, despite their association with advanced age, functional decline, and depressive symptoms.