Abstract
The effects of social frailty on diet and nutrition are under-investigated. Our study aimed to assess the association between social frailty and diet quality, diet quantity, and nutrition over a 3-year period in community-dwelling older Japanese adults. This prospective cohort study recruited individuals aged ≥60 years from a community college and followed up 666 participants annually. Social frailty was determined using a 4-item questionnaire. Diet quantity (energy and macronutrient intake) and diet quality (dietary diversity score and Diet Quality Index-International) were assessed using a food frequency questionnaire. Nutrition was evaluated using the Mini-Nutritional Assessment (MNA). Out of the 666 participants (56.5% women), 250 (37.5%) were categorized as having social prefrailty or frailty. Regarding diet quantity, energy intake (β = −1.59kcal/kg/day, p < 0.01) and nutrient intake (protein intake, β = −0.08g/kg/day; fat intake, β = −0.06g/kg/day; carbohydrate intake, β = −0.18g/kg/day; fiber intake, β = −0.01g/kg/day; all p < 0.05) were lower in men with social prefrailty or frailty than in men with social robustness. Dietary diversity score (β = −0.25, p = 0.01) and MNA score (β = −0.32, p = 0.04) decreased in men with social prefrailty or frailty. However, these associations were not observed in women. Social frailty is associated with lower dietary intake, poor diet quality, and poor nutrition among community-dwelling older men. Future studies are required to determine the benefits of sex-specific interventions targeting social frailty on nutritional outcomes.
Highlights
Frailty has several multifactorial etiologies involving an individual’s physical, psychological, and social domains [1]
Our findings suggest that social frailty is associated with diet quantity, diet quality, and nutritional status in community-dwelling older men, but not in older women
The present study reveals that social frailty is associated with lower dietary intake, poor diet quality, and poor nutritional status among older Japanese men, but not among women
Summary
Frailty has several multifactorial etiologies involving an individual’s physical, psychological, and social domains [1]. Physical frailty has been widely investigated, the definition of social frailty and its impacts on health outcome have been relatively insufficiently investigated [2]. Social frailty in older adults has been reported to be associated with poor physical function, disability, cognitive impairment, depression, and higher mortality [4,5,6,7,8]. The social vulnerability index established according to the deficit accumulation model was associated with physical frailty, disability, and survival [9,10,11]. A theory-guided approach demonstrated the independent association of social frailty with unfavorable health outcomes, including malnutrition [12]. Other associated health adverse effects of social frailty are not well understood yet, such as its effects on dietary intake, including dietary quantity and quality
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