Frailty is a risk factor that particularly affects the elderly population, which is predominantly female. Nutrition has been identified as a key contributor to frailty, and with diet modification, a potential therapeutic target.
With advances in science and medicine, our population is living to ages that we have not seen before. This comes with a new set of problems and medical conditions that we need to focus on to ensure continued quality of life for our elderly citizens. Frailty is one of these age-associated conditions that can lead to health deficits and eventual mortality.
Frailty is a geriatric syndrome characterized by elevated risk of declines of health and function. Elderly humans are more vulnerable to stressors and changes in conditions, and see adverse health effects more frequently than those who are younger. The prevalence of frailty increases with age, but there are changes people can make to delay or limit its effects. Early studies suggest that dietary interventions have a positive impact on people with frailty and that balanced nutrition can limit its effects on function. However, these studies had short term follow up and failed to account for a number of potentially confounding factors. In a recent study, researchers sought to determine a relationship between nutrition and mortality in elderly women with frailty. Elderly women were specifically chosen as opposed to males because the aging population is predominantly female.
In a new study published in the American Journal of Clinical Nutrition, Zaslavsky et al. examined the impact of energy and protein intakes, as well as dietary indexes such as the alternate Mediterranean diet (aMED), on mortality in frail elderly females. The researchers hypothesized that more balanced diets and higher protein and energy intakes would result in lower mortality. Frailty was defined as the presence of 3 of 5 symptoms: muscle weakness, slow walking, exhaustion, low physical activity and unintentional weight loss. Women 50-79 years old were included in the study, consisting of a clinic visit and a follow up 3 years later. Diet was self-reported and converted to protein and energy intakes by researchers, and frailty criteria were compared from baseline visit to follow up to determine qualification for the study. Following the 3 year follow up, mortality was monitored by study physicians using hospital records, coronary reports and the National Death Index. Individuals’ dietary habits and their mortality were compared.
The researchers found that over 12.4 years of study follow up, individuals who kept quantitatively and qualitatively better diets had decreased mortality rates than their peers. In addition to aMED, the dietary approaches to stop hypertension (DASH) and dietary inflammatory index (DII) were used as dietary indices. Elderly females who had greater protein and energy intake, and whom adhered better to aMED and DASH diets had lower rates of mortality. This association was even stronger for women who had pre-existing risk factors, such as chronic comorbidity and women who were smokers. Of particular importance is the relationship between protein intake and all-cause mortality, which suggests that elderly women may have increased protein demands than previously thought. Overall, this study highlights the importance of good nutrition, particularly in our aging population, and brings to attention certain aspects of our diets that could be modified to improve health and function.
Written By: Wesley Tin, BMSc
- Zaslavsky O, Zelber-Sagi S, Hebert JR, et al. Biomarker-calibrated nutrient intake and healthy diet index associations with mortality risks among older and frail women from the Women’s Health Initiative. Am J Clin Nutr. 2017;105(6):1399-1407. doi:10.3945/ajcn.116.151530