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Protein intake and transitions between frailty states and to death in very old adults: the Newcastle 85+ study.

ABSTRACT: OBJECTIVES:To examine the association of protein intake with frailty progression in very old adults. DESIGN:The Newcastle 85+ study, a prospective longitudinal study of people aged 85 years old in Northeast England and followed over 5 years. SETTING AND PARTICIPANTS:668 community-dwelling older adults (59% women) at baseline, with complete dietary assessment and Fried frailty status (FFS). MEASURES:Dietary intake was estimated with 2?×?24-h multiple pass recalls at baseline. FFS was based on five criteria: shrinking, physical endurance/energy, low physical activity, weakness and slow walking speed and was available at baseline and 1.5, 3 and 5 years. The contribution of protein intake (g/kg adjusted body weight/day [g/kg aBW/d]) to transitions to and from FFS (robust, pre-frail and frail) and to death over 5 years was examined by multi-state models. RESULTS:Increase in one unit of protein intake (g/kg aBW/d) decreased the likelihood of transitioning from pre-frail to frail after adjusting for age, sex, education and multimorbidity (hazard ratios [HR]: 0.44, 95% confidence interval [CI]: 0.25-0.77) but not for the other transitions. Reductions in incident frailty were equally present in individuals with protein intake ?0.8 (HR: 0.60, 95% CI: 0.43-0.84) and ?1 g/kg aBW/d (HR: 0.63, 95% CI: 0.44-0.90) from 85 to 90 years. This relationship was attenuated after adjustment for energy intake, but the direction of the association remained the same (e.g. g/kg aBW/d model: HR: 0.71, 95% CI: 0.36-1.41). CONCLUSION:High protein intake, partly mediated by energy intake, may delay incident frailty in very old adults. Frailty prevention strategies in this age group should consider adequate provision of protein and energy.

SUBMITTER: Mendonca N

PROVIDER: S-EPMC6939283 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Protein intake and transitions between frailty states and to death in very old adults: the Newcastle 85+ study.

Mendonça Nuno N Kingston Andrew A Granic Antoneta A Jagger Carol C

Age and ageing 20191201 1

<h4>Objectives</h4>To examine the association of protein intake with frailty progression in very old adults.<h4>Design</h4>The Newcastle 85+ study, a prospective longitudinal study of people aged 85 years old in Northeast England and followed over 5 years.<h4>Setting and participants</h4>668 community-dwelling older adults (59% women) at baseline, with complete dietary assessment and Fried frailty status (FFS).<h4>Measures</h4>Dietary intake was estimated with 2 × 24-h multiple pass recalls at b ...[more]

PMID: 31711099

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Project description:BackgroundLow protein intake has been linked to reduced muscle strength and physical performance in older adults but little is known about how it may affect muscle health and subsequent functional decline in the very old (aged 85+), who are at enhanced risk of malnutrition and loss of muscle mass and strength.AimsTo investigate the associations between low protein intake, defined as the intake of <1 g protein/kg adjusted body weight/day (<1 g/kg aBW/d) and decline in muscle strength and physical performance in the very old.MethodsThe analytic sample consisted of 722 community-dwelling participants (60% women) from the Newcastle 85+ Study who had protein intake at baseline. Participants were followed-up for change in grip strength (GS) and Timed Up-and-Go (TUG) test over 5 years (baseline, 18, 36, and 60 months). We used mixed models to determine the effects of low protein intake on muscle strength and physical performance in all participants, and also stratified by sex.ResultsAt baseline, 390 (54%) participants (261 women, p < 0.001) reported low protein intake, and these differed from participants with good intake (≥1 g/kg aBW/d) on several measures of health and function. In the model adjusted for protein intake, consuming <1 g/kg aBW/d of protein was associated with a 1.62 kg lower GS (p = 0.008) in all participants, and especially in women (β (SE) = -0.83 (0.41), p = 0.05) after adjusting for key baseline covariates (anthropometry, multimorbidity, arthritis in hands, cognitive status and physical activity). The rate of decline in GS over 5 years was not associated with protein intake. Women, but not men, with low protein intake had worse baseline TUG (β (SE) = 0.04 (0.02), p = 0.03) compared with those with good protein intake in the fully adjusted model, but the rate of decline in TUG was not affected by daily protein status.ConclusionsIntake of <1 g protein/kg aBW/d may negatively affect muscle strength and physical performance in late life, especially in older women, independently of important covariates. More research is needed in the very old to define the optimal protein intake for maintenance of muscle health and function.

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Protein intake and transitions between frailty states and to death in very old adults: the Newcastle 85+ study.

Publications

Protein intake and transitions between frailty states and to death in very old adults: the Newcastle 85+ study.

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