Malnutrition Risk, Physical Function Decline and Disability in Middle-Aged and Older Adults Followed Up in the Singapore Longitudinal Ageing Study

• Published in: Clinical interventions in aging Vol. 16; pp. 1527 - 1539
• Main Authors: Hai, Shan, Gao, Qi, Gwee, Xinyi, Chua, Denise Qian Ling, Yap, Keng Bee, Ng, Tze Pin
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2021; Taylor & Francis Ltd; Dove; Dove Medical Press
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; ageing; Aging; Blood pressure; Cholesterol; Chronic illnesses; Cohort analysis; Complications and side effects; Diabetes; Disability; Disabled Persons; Food and nutrition; functionality; Gait; Geriatrics; Health aspects; Hemoglobin; Humans; Hypertension; Long term health care; Longitudinal Studies; Lymphocytes; Malnutrition; Middle age; Middle Aged; Middle aged persons; Mortality; Older people; Original Research; Physiology; Population; prospective cohort study; Prospective Studies; Psychological aspects; Public housing; Questionnaires; Risk factors; Singapore - epidemiology; Singapore; malnutrition; ageing; functionality; prospective cohort study
• ISSN: 1178-1998; 1176-9092; 1178-1998
• DOI: 10.2147/CIA.S322696

Malnutrition and population ageing are doubly global healthcare challenges. It is widely recognized that disability is a major contributor to malnutrition among older people, but the importance of reducing malnutrition risk (MR) for disability prevention is given little attention. We investigated the association between MR and risk of incident disability and functional decline among community-dwelling older persons. Prospective cohort study of community-dwelling older adults aged 55 and above (Singapore Longitudinal Ageing Study) with 3-5 years follow-up. MR was measured at baseline using an appropriate and validated index (ENIGMA); physical and functional measures at baseline and follow-up included instrumental and basic activity of daily living (ADL), knee extension (KES), gait velocity (GV), timed up-and-go (TUG). Compared to low MR, mild-moderate MR (OR = 1.43, 95% CI = 1.02-2.01) and severe MR (OR=1.74, 95% CI=1.10-2.74) were associated with higher risks of incident disability. Severe MR was associated with functional decline (OR = 1.69, 95% CI = 1.11-2.57). Estimates were adjusted for demographic, social, lifestyle behaviour and health variables. In particular, eating difficulty was associated with incident disability and functional decline, and low lymphocyte with functional decline. Severe MR and low albumin were associated with 37% worse GV and 126% worse TUG declines; consuming few vegetables or fruits with 34% worse KES decline; polypharmacy with 56% worse TUG decline. Malnutrition risk increased the risk of incident disability and functional decline in non-disabled persons, it worsened physical performance declines. Further studies should investigate the effectiveness of nutritional interventions in reducing the risk of disability among older people.