Advertisement

Exercise and/or Dietary Varieties and Incidence of Frailty in Community-Dwelling Older Women: A 2-Year Cohort Study

  • Yosuke OsukaEmail author
  • N. Kojima
  • Y. Yoshida
  • M. Kim
  • Cw. Won
  • T. Suzuki
  • H. Kim
Article
  • 11 Downloads

Abstract

Objective

Exercise and dietary habits rich in variety may reduce the risk of frailty incident, but such association remains unexamined. This study aimed to examine the longitudinal associations between exercise and/or dietary varieties and incidence of frailty in older women.

Design

A 2-year population-based prospective cohort study.

Setting and participants

Six hundred and four community-dwelling older Japanese women aged ≥75 years with non-frailty at baseline survey.

Measurements

Frailty was assessed using Fried’s frailty criteria composed of shrinking, weakness, slowness, low activity, and exhaustion at both baseline and follow-up surveys. Frailty incident was defined as the presence of =3 components at the follow-up survey. At baseline, information about exercise and dietary habits were obtained from all participants through a face-to-face interview. Participants were grouped into two categories, high (=2) and low (<2) exercise varieties, assessed by the number of participations in 17 exercise types. By dietary variety, assessed using Dietary Variety Score (range, 0 to 10), participants were grouped into two, high (=4 points) and low (<4 points) dietary varieties. Binary logistic regression analyses were applied to obtain adjusted odds ratios (ORs) and 95% confident intervals (CIs) of the incidence of frailty in the 4 groups (low-exercise and low-dietary varieties [low EV + low DV] as reference; low-exercise and high-dietary varieties [low EV + high DV]; high-exercise and low-dietary varieties [high EV + low DV]; and high-exercise and high-dietary varieties [high EV + high DV]).

Results

Frailty incidence rate was 9.3% over the 2-year follow-up period. Incidence rates of frailty in the 4 groups were as follows: 23.7%, 10.1%, 6.5%, and 7.7% in the low EV + low DV, low EV + high DV, high EV + low DV, and high EV + high DV groups, respectively. After adjustment for covariates, only the high EV + high DV group was associated with a significantly lower OR (0.38; 95% CI 0.15–0.92) of frailty incidence compared with the low EV + low DV group.

Conclusion

Higher variety of exercise and diet was significantly associated with lower incidence of frailty. Thus, the combination of variety-rich exercise and dietary program may be useful in preventing the incidence of frailty in older women.

Key words

Variety exercise dietary frailty 

References

  1. 1.
    Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146–156.CrossRefGoogle Scholar
  2. 2.
    Clegg A, Young J, Iliffe S, Rikkert MO, Rockwood K. Frailty in elderly people. Lancet 2013;381:752–762. doi:10.1016/s0140–6736(12)62167–9.CrossRefGoogle Scholar
  3. 3.
    Feng Z, Lugtenberg M, Franse C et al. Risk factors and protective factors associated with incident or increase of frailty among community–dwelling older adults: A systematic review of longitudinal studies. PLoS One 2017;12:e0178383. doi:10.1371/journal.pone.0178383.Google Scholar
  4. 4.
    Ottenbacher KJ, Graham JE, Al Snih S et al. Mexican Americans and frailty: findings from the Hispanic established populations epidemiologic studies of the elderly. Am J Public Health 2009;99:673–679. doi:10.2105/ajph.2008.143958.CrossRefGoogle Scholar
  5. 5.
    Woods NF, LaCroix AZ, Gray SL et al. Frailty: emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. J Am Geriatr Soc 2005;53:1321–1330. doi:10.1111/j.1532–5415.2005.53405.x.CrossRefGoogle Scholar
  6. 6.
    Liljas AEM, Carvalho LA, Papachristou E et al. Self–reported hearing impairment and incident frailty in English community–dwelling older adults: A 4–year follow–up study. J Am Geriatr Soc 2017;65:958–965. doi:10.1111/jgs.14687.CrossRefGoogle Scholar
  7. 7.
    Liljas AEM, Carvalho LA, Papachristou E et al. Self–reported vision impairment and incident prefrailty and frailty in English community–dwelling older adults: findings from a 4–year follow–up study. J Epidemiol Community Health 2017;71:1053–1058. doi:10.1136/jech–2017–209207.Google Scholar
  8. 8.
    Wade KF, Lee DM, McBeth J et al. Chronic widespread pain is associated with worsening frailty in European men. Age Ageing 2016;45:268–274. doi:10.1093/ageing/afv170.CrossRefGoogle Scholar
  9. 9.
    Afilalo J, Karunananthan S, Eisenberg MJ, Alexander KP, Bergman H. Role of frailty in patients with cardiovascular disease. Am J Cardiol 2009;103:1616–1621. doi:10.1016/j.amjcard.2009.01.375.CrossRefGoogle Scholar
  10. 10.
    Garcia–Esquinas E, Graciani A, Guallar–Castillon P, Lopez–Garcia E, Rodriguez–Manas L, Rodriguez–Artalejo F. Diabetes and risk of frailty and its potential mechanisms: a prospective cohort study of older adults. J Am Med Dir Assoc 2015;16:748–754. doi:10.1016/j.jamda.2015.04.008.CrossRefGoogle Scholar
  11. 11.
    Lakey SL, LaCroix AZ, Gray SL et al. Antidepressant use, depressive symptoms, and incident frailty in women aged 65 and older from the Women’s Health Initiative Observational Study. J Am Geriatr Soc 2012;60:854–861. doi:10.1111/j.1532–5415.2012.03940.x.CrossRefGoogle Scholar
  12. 12.
    Raji MA, Al Snih S, Ostir GV, Markides KS, Ottenbacher KJ. Cognitive status and future risk of frailty in older Mexican Americans. J Gerontol A Biol Sci Med Sci 2010;65:1228–1234. doi:10.1093/gerona/glq121.CrossRefGoogle Scholar
  13. 13.
    Kojima G, Iliffe S, Jivraj S, Liljas A, Walters K. Does current smoking predict future frailty? The English longitudinal study of ageing. Age Ageing 2018;47:126–131. doi:10.1093/ageing/afx136.Google Scholar
  14. 14.
    Ortola R, Garcia–Esquinas E, Leon–Munoz LM et al. Patterns of alcohol consumption and risk of frailty in community–dwelling older adults. J Gerontol A Biol Sci Med Sci 2016;71:251–258. doi:10.1093/gerona/glv125.CrossRefGoogle Scholar
  15. 15.
    Peterson MJ, Giuliani C, Morey MC et al. Physical activity as a preventative factor for frailty: the health, aging, and body composition study. J Gerontol A Biol Sci Med Sci 2009;64:61–68. doi:10.1093/gerona/gln001.CrossRefGoogle Scholar
  16. 16.
    Song J, Lindquist LA, Chang RW et al. Sedentary Behavior as a Risk Factor for Physical Frailty Independent of Moderate Activity: Results From the Osteoarthritis Initiative. Am J Public Health 2015;105:1439–1445. doi:10.2105/ajph.2014.302540.CrossRefGoogle Scholar
  17. 17.
    Leon–Munoz LM, Guallar–Castillon P, Lopez–Garcia E, Rodriguez–Artalejo F. Mediterranean diet and risk of frailty in community–dwelling older adults. J Am Med Dir Assoc 2014;15:899–903. doi:10.1016/j.jamda.2014.06.013.CrossRefGoogle Scholar
  18. 18.
    Shikany JM, Barrett–Connor E, Ensrud KE et al. Macronutrients, diet quality, and frailty in older men. J Gerontol A Biol Sci Med Sci 2014;69:695–701. doi:10.1093/gerona/glt196.CrossRefGoogle Scholar
  19. 19.
    Kojima G, Avgerinou C, Iliffe S, Walters K. Adherence to mediterranean diet reduces incident frailty risk: systematic review and meta–analysis. J Am Geriatr Soc 2018;66:783–788. doi:10.1111/jgs.15251.CrossRefGoogle Scholar
  20. 20.
    Wang Y, Hao Q, Su L, Liu Y, Liu S, Dong B. Adherence to the mediterranean diet and the risk of frailty in old people: A aystematic review and meta–analysis. J Nutr Health Aging 2018;22:613–618. doi:10.1007/s12603–018–1020–x.CrossRefGoogle Scholar
  21. 21.
    de Labra C, Guimaraes–Pinheiro C, Maseda A, Lorenzo T, Millan–Calenti JC. Effects of physical exercise interventions in frail older adults: a systematic review of randomized controlled trials. BMC Geriatr 2015;15:154. doi:10.1186/s12877–015–0155–4.CrossRefGoogle Scholar
  22. 22.
    Cadore EL, Rodriguez–Manas L, Sinclair A, Izquierdo M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res 2013;16:105–114. doi:10.1089/rej.2012.1397.CrossRefGoogle Scholar
  23. 23.
    Kim H, Suzuki T, Kim M et al. Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community–dwelling frail Japanese women: a randomized double blind, placebo–controlled, follow–up trial. PLoS One 2015;10:e0116256. doi:10.1371/journal. pone.0116256.Google Scholar
  24. 24.
    Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community–dwelling older persons: a systematic review. J Am Geriatr Soc 2012;60:1487–1492. doi:10.1111/j.1532–5415.2012.04054.x.CrossRefGoogle Scholar
  25. 25.
    Kim H, Suzuki T, Kim M et al. Incidence and predictors of sarcopenia onset in community–dwelling elderly Japanese women: 4–year follow–up study. J Am Med Dir Assoc 2015;16:85.e81–88. doi:10.1016/j.jamda.2014.10.006.CrossRefGoogle Scholar
  26. 26.
    Satake S, Shimada H, Yamada M et al. Prevalence of frailty among communitydwellers and outpatients in Japan as defined by the Japanese version of the Cardiovascular Health Study criteria. Geriatrics & Gerontology International 2017;17:2629–2634. doi:doi:10.1111/ggi.13129.CrossRefGoogle Scholar
  27. 27.
    Shinkai S, Watanabe S, Kumagai S et al. Walking speed as a good predictor for the onset of functional dependence in a Japanese rural community population. Age Ageing 2000;29:441–446.CrossRefGoogle Scholar
  28. 28.
    Osuka Y, Suzuki T, Kim M et al. Association between exercise type and the decline in instrumental activities of daily living in community–dwelling older women: A 4–year prospective study. Prev Med 2018;112:23–30. doi:10.1016/j.ypmed.2018.03.019.CrossRefGoogle Scholar
  29. 29.
    Kumagai S, Watanabe S, Shibata H et al. Effects of dietary variety on declines in highlevel functional capacity in elderly people living in a community. Nihon Koshu Eisei Zasshi 2003;50:1117–1124.Google Scholar
  30. 30.
    Sheehan DV, Lecrubier Y, Sheehan KH et al. The Mini–International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM–IV and ICD–10. J Clin Psychiatry 59 Suppl 1998;20:22–33;quiz 34–57.Google Scholar
  31. 31.
    Kahn RL, Goldfarb AI, Pollack M, Peck A. Brief objective measures for the determination of mental status in the aged. Am J Psychiatry 1960;117:326–328. doi:10.1176/ajp.117.4.326.Google Scholar
  32. 32.
    Kahn RL, Miller NE. Assessment of Altered Brain Function in the Aged. In: Storandt M, Siegler IC, Elias MF, editors. The Clinical Psychology of Aging. Boston, MA: Springer US; 1978. p. 43–69.Google Scholar
  33. 33.
    Soysal P, Isik AT, Carvalho AF et al. Oxidative stress and frailty: A systematic review and synthesis of the best evidence. Maturitas 2017;99:66–72. doi:10.1016/j. maturitas.2017.01.006.CrossRefGoogle Scholar
  34. 34.
    Soysal P, Stubbs B, Lucato P et al. Inflammation and frailty in the elderly: A systematic review and meta–analysis. Ageing Res Rev 2016;31:1–8. doi:10.1016/j. arr.2016.08.006.CrossRefGoogle Scholar
  35. 35.
    Wilkinson DJ, Piasecki M, Atherton PJ. The age–related loss of skeletal muscle mass and function: Measurement and physiology of muscle fibre atrophy and muscle fibre loss in humans. Ageing Res Rev 2018;47:123–132. doi:10.1016/j.arr.2018.07.005.CrossRefGoogle Scholar
  36. 36.
    Sandoval–Insausti H, Perez–Tasigchana RF, Lopez–Garcia E, Garcia–Esquinas E, Rodriguez–Artalejo F, Guallar–Castillon P. Macronutrients intake and incident frailty in older adults: A prospective cohort study. J Gerontol A Biol Sci Med Sci 2016;71:1329–1334. doi:10.1093/gerona/glw033.CrossRefGoogle Scholar
  37. 37.
    Lana A, Rodriguez–Artalejo F, Lopez–Garcia E. Dairy consumption and risk of frailty in older adults: A prospective cohort study. J Am Geriatr Soc 2015;63:1852–1860. doi:10.1111/jgs.13626.CrossRefGoogle Scholar
  38. 38.
    Garcia–Esquinas E, Rahi B, Peres K et al. Consumption of fruit and vegetables and risk of frailty: a dose–response analysis of 3 prospective cohorts of community–dwelling older adults. Am J Clin Nutr 2016;104:132–142. doi:10.3945/ajcn.115.125781.CrossRefGoogle Scholar
  39. 39.
    Macdonell S, Miller J, Waters D, Houghton L. Dietary patterns in the frail elderly. Curr Nutr Rep 2016;5:65–75. doi:10.1007/s13668–016–0156–8.Google Scholar
  40. 40.
    Rahi B, Ajana S, Tabue–Teguo M, Dartigues JF, Peres K, Feart C. High adherence to a Mediterranean diet and lower risk of frailty among French older adults communitydwellers: Results from the Three–City–Bordeaux Study. Clin Nutr 2018;37:1293–1298. doi:10.1016/j.clnu.2017.05.020.CrossRefGoogle Scholar
  41. 41.
    Leon–Munoz LM, Garcia–Esquinas E, Lopez–Garcia E, Banegas JR, Rodriguez–Artalejo F. Major dietary patterns and risk of frailty in older adults: a prospective cohort study. BMC Med 2015;13:11. doi:10.1186/s12916–014–0255–6.CrossRefGoogle Scholar
  42. 42.
    Pilleron S, Ajana S, Jutand MA et al. Dietary Patterns and 12–Year Risk of Frailty: Results From the Three–City Bordeaux Study. J Am Med Dir Assoc 2017;18:169–175. doi:10.1016/j.jamda.2016.09.014.CrossRefGoogle Scholar
  43. 43.
    de Haas SCM, de Jonge EAL, Voortman T et al. Dietary patterns and changes in frailty status: the Rotterdam study. Eur J Nutr 2018;57:2365–2375. doi:10.1007/s00394–017–1509–9.CrossRefGoogle Scholar
  44. 44.
    Chan R, Leung J, Woo J. Dietary Patterns and Risk of Frailty in Chinese Community–Dwelling Older People in Hong Kong: A Prospective Cohort Study. Nutrients 2015;7:7070–7084. doi:10.3390/nu7085326.CrossRefGoogle Scholar
  45. 45.
    Chodzko–Zajko WJ, Proctor DN, Fiatarone Singh MA et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009;41:1510–1530. doi:10.1249/MSS.0b013e3181a0c95c.CrossRefGoogle Scholar
  46. 46.
    Cruz–Jentoft AJ, Landi F, Schneider SM et al. Prevalence of and interventions for sarcopenia in ageing adults: a systematic review. Report of the International Sarcopenia Initiative (EWGSOP and IWGS). Age Ageing 2014;43:748–759. doi:10.1093/ageing/afu115.Google Scholar

Copyright information

© Serdi and Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  • Yosuke Osuka
    • 1
    • 6
    Email author
  • N. Kojima
    • 1
  • Y. Yoshida
    • 2
  • M. Kim
    • 3
  • Cw. Won
    • 4
  • T. Suzuki
    • 5
  • H. Kim
    • 1
    • 4
  1. 1.Research Team for Promoting Independence of the ElderlyTokyo Metropolitan Institute of GerontologyTokyoJapan
  2. 2.Research Team for Human CareTokyo Metropolitan Institute of GerontologyTokyoJapan
  3. 3.Department of Biomedical Science and Technology, College of Medicine, East-West Medical Research InstituteKyung Hee UniversitySeoulRepublic of Korea
  4. 4.Department of Family Medicine, College of MedicineKyung Hee UniversitySeoulRepublic of Korea
  5. 5.Institute of GerontologyJ.F. Oberlin UniversityTokyoJapan
  6. 6.Tokyo Metropolitan Institute of GerontologyTokyoJapan

Personalised recommendations