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<p>The effect of dietary quality trajectories on cognitive frailty in older adults has not been explored previously. This population-based study examines this association. Participants were recruited between 2011 and 2013 and followed through 2022 (median follow-up: 7.6&#xa0;years). The study included 519 older adults, with dietary quality assessed at four time points and cognitive frailty evaluated at five time points. Dietary intake was assessed by food frequency questionnaires, and dietary quality trajectories were identified using growth mixture modeling based on the modified Alternative Healthy Eating Index. A battery of psychoneurological tests was used to evaluate global and domain-specific cognition. Physical frailty was measured using modified Fried’s frailty phenotype. Cognitive frailty was defined as the coexistence of cognitive impairment and physical frailty and categorized into six ordinal levels according to combinations of cognitive and frailty status. Generalized linear mixed models were utilized to examine the relationship between trajectories of dietary quality and cognitive frailty adjusting for important covariates. Participants’ baseline mean age was 72.7&#xa0;years. Compared with Relatively Lower trajectory, Relatively Higher dietary quality trajectory was associated with traditional cognitive frailty (adjusted odds ratio (aOR) = 0.62) and impaired memory-frailty (aOR = 0.48–0.50), whereas Hill-Shaped trajectory was associated only with impaired memory-frailty (aOR = 0.60). Valley-Shaped trajectory was consistently associated with impaired memory-frailty (aOR = 0.48–0.56). Based on stratified analyses, these associations mainly became more evident in participants aged ≥ 75&#xa0;years, men, those with normal body mass index (18.5–24&#xa0;kg/m<sup>2</sup>), apolipoprotein E ε4 non-carriers, those without diabetes, hyperlipidemia, and those with hypertension. This study identified four dietary quality trajectories, and elevated dietary quality was associated with lower odds of traditional cognitive frailty and impaired memory-frailty in older adults. Our findings provide valuable insights for identifying vulnerable subpopulations and contribute to the early prevention of cognitive frailty.</p>

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Longitudinal association between dietary quality trajectories and cognitive frailty in older adults: a 12-year study of the TIGER cohort

  • 期刊论文

  • 发表日期：

    2026年7月29日

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  • Ting-I. Lee,
  • Bo-Yu Hsiao,
  • Te-Hsuan Huang,
  • Ling-Wei Chen,
  • Yi-Chun Chou,
  • Meei-Shyuan Lee,
  • Jeng-Min Chiou,
  • Yen-Ching Chen,
  • Jen-Hau Chen

摘要

The effect of dietary quality trajectories on cognitive frailty in older adults has not been explored previously. This population-based study examines this association. Participants were recruited between 2011 and 2013 and followed through 2022 (median follow-up: 7.6 years). The study included 519 older adults, with dietary quality assessed at four time points and cognitive frailty evaluated at five time points. Dietary intake was assessed by food frequency questionnaires, and dietary quality trajectories were identified using growth mixture modeling based on the modified Alternative Healthy Eating Index. A battery of psychoneurological tests was used to evaluate global and domain-specific cognition. Physical frailty was measured using modified Fried’s frailty phenotype. Cognitive frailty was defined as the coexistence of cognitive impairment and physical frailty and categorized into six ordinal levels according to combinations of cognitive and frailty status. Generalized linear mixed models were utilized to examine the relationship between trajectories of dietary quality and cognitive frailty adjusting for important covariates. Participants’ baseline mean age was 72.7 years. Compared with Relatively Lower trajectory, Relatively Higher dietary quality trajectory was associated with traditional cognitive frailty (adjusted odds ratio (aOR) = 0.62) and impaired memory-frailty (aOR = 0.48–0.50), whereas Hill-Shaped trajectory was associated only with impaired memory-frailty (aOR = 0.60). Valley-Shaped trajectory was consistently associated with impaired memory-frailty (aOR = 0.48–0.56). Based on stratified analyses, these associations mainly became more evident in participants aged ≥ 75 years, men, those with normal body mass index (18.5–24 kg/m2), apolipoprotein E ε4 non-carriers, those without diabetes, hyperlipidemia, and those with hypertension. This study identified four dietary quality trajectories, and elevated dietary quality was associated with lower odds of traditional cognitive frailty and impaired memory-frailty in older adults. Our findings provide valuable insights for identifying vulnerable subpopulations and contribute to the early prevention of cognitive frailty.