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Diet quality in relation to healthy ageing: the Israeli Longitudinal Study on Aging (ILSA)-a study protocol.

ABSTRACT: INTRODUCTION:Population ageing is accelerating rapidly in Israel as well as worldwide, necessitating adaptation of the healthcare system and consideration of new approaches that serve the specific needs of older adults. In addition to cognitive function, frailty is one of the most challenging expressions of physical and mental ageing, a multidimensional syndrome of increased vulnerability. Several studies have shown that low intake of certain micronutrients and protein is associated with higher risk of frailty and cognitive impairment. However, whether global diet quality is involved in the aetiology of the latter outcomes is unclear. METHODS AND ANALYSIS:We are conducting, among older adult subjects who took part in 'Mabat Zahav' (Israeli National Health and Nutrition Survey of Older Adults) in 2005-2006 (T0, n=1852), an extensive follow-up interview (T1) that includes comprehensive geriatric assessment and evaluation of general health and quality of life. Diet quality is evaluated using the Healthy Eating Index (HEI) 2010, based on 24-hour diet recall measured at T0 and T1. Frailty is assessed using two different approaches: the phenotype framework and the accumulation of deficits model. Cognitive function is assessed by Mini-Mental State Examination (MMSE) and cognitive decline is assessed by the difference between repeated MMSE measurements. Different analytic methods will be applied to evaluate the role of diet quality in development of frailty and cognitive decline with inverse probability weighting used to minimise attrition bias. About 600 subjects are expected to be interviewed between May 2017 and December 2019. ETHICS AND DISSEMINATION:Ethical approval was obtained from the Helsinki Committee of Sheba Medical Center, Tel Hashomer, Israel and the Ethical Committee of Tel-Aviv University. All participants sign an informed consent form. The findings of the study will be published in peer-reviewed journals.

SUBMITTER: Goshen A

PROVIDER: S-EPMC6500277 | biostudies-other | 2019 Apr

REPOSITORIES: biostudies-other

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Diet quality in relation to healthy ageing: the Israeli Longitudinal Study on Aging (ILSA)-a study protocol.

Goshen Abigail A Goldbourt Uri U Shohat Tamar T Shimony Tal T Keinan-Boker Lital L Gerber Yariv Y

BMJ open 20190420 4

<h4>Introduction</h4>Population ageing is accelerating rapidly in Israel as well as worldwide, necessitating adaptation of the healthcare system and consideration of new approaches that serve the specific needs of older adults. In addition to cognitive function, frailty is one of the most challenging expressions of physical and mental ageing, a multidimensional syndrome of increased vulnerability. Several studies have shown that low intake of certain micronutrients and protein is associated with ...[more]

PMID: 31005912

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Project description:ImportanceTo our knowledge, the role of overall diet quality in successful aging has not been conclusively demonstrated.ObjectiveTo prospectively examine the association between diet quality and longevity and successful aging in a population-based cohort of older adults.Design, setting, and participantsParticipants in "Mabat Zahav" (the Israeli National Health and Nutrition Survey of Older Adults), an older adult cohort (aged ≥65 years) consisting of a random sample of 1770 individuals, were recruited from July 2005 to December 2006 (time 1 [T1]). Survivors of T1 were again contacted and asked to participate in a second interview. From May 2017 to June 2019 (time 2 [T2]), an extensive face-to-face interview and a functional assessment were conducted in each participant's home in a subsample of 604 participants from T1, representing 72.7% of 820 surviving individuals who were able to complete interviews and assessments.ExposuresA 24-hour dietary recall, assessed at T1, was used to calculate scores from the 2015 version of the Healthy Eating Index (HEI-2015) (scores range from 0 [worst diet] to 100 [best diet]).Main outcomes and measuresTime to death, with follow-up lasting through June 2019, and successful aging. The latter, based on T2 assessment, was defined as (objectively measured) preserved physical and cognitive function and (subjective) mental well-being and favorable self-rated health. Inverse probability weighting was used in the analysis to minimize attrition bias.ResultsAt T1, the study included 1770 participants (mean [SD] age, 74.6 [6.2] years; 943 women [53%]). On average, participants with higher HEI-2015 scores had healthier lifestyles and higher socioeconomic status at T1. During a median follow-up duration of 12.6 years (IQR, 7.6-13.2 years), 893 deaths occurred. Among the 596 T2 participants analyzed (mean [SD] age, 84.1 [4.4] years; 334 [56%] women), 242 (40%) met successful aging criteria. After adjustment for sociodemographic and lifestyle risk factors, a higher HEI-2015 score was inversely associated with mortality (hazard ratios, 0.85; 95% CI, 0.72-0.99 in the upper tertile and 0.83; 95% CI, 0.71-0.98 in the middle tertile vs the lower tertile; P = .04 for trend) and was positively associated with successful aging (odds ratios, 1.73; 95% CI, 1.10-2.72 in the upper tertile and 1.30; 95% CI, 0.83-2.03 in the middle tertile vs the lower tertile; P = .03 for trend).Conclusions and relevanceIn this cohort study of older adults in Israel, improved diet quality was associated with increased longevity and successful aging in a dose-dependent manner. These data contribute to the body of literature that suggests diet quality is associated with aging in the older age group.

Project description:INTRODUCTION:The number of older people diagnosed with amnestic mild cognitive impairment (aMCI), the prodromal state of Alzheimer's disease (AD), is increasing worldwide. However, some patients with aMCI never convert to the AD type of dementia, with some remaining stable and others reverting to normal. This overdiagnosis bias has been largely overlooked and gone unexplained. There is ample evidence in the laboratory that negative ageing stereotypes (eg, the culturally shared belief that ageing inescapably causes severe cognitive decline) contribute to the deteriorating cognitive performances of healthy older adults, leading them to perform below their true abilities. The study described here is intended to test for the first time whether such stereotypes also impair patients' cognitive performances during neuropsychological examinations in memory clinics, resulting in overdiagnosis of aMCI. METHODS AND ANALYSIS:The ongoing study is a 4-year randomised clinical trial comparing patients' physiological stress and cognitive performances during neuropsychological testing in memory clinics. A total of 260 patients attending their first cognitive evaluation will be randomised to either a standard condition of test administration, assumed here to implicitly activate negative ageing stereotypes or a reduced-threat instruction condition designed to alleviate the anxiety arising from these stereotypes. Both groups will be tested with the same test battery and stress biomarkers. For 30 patients diagnosed with aMCI in each group (n=60), biomarkers of neurodegeneration and amyloidopathy will be used to distinguish between aMCI with normal versus abnormal AD biomarkers. A 9-month follow-up will be performed on all patients to identify those whose cognitive performances remain stable, deteriorate or improve. ETHICS AND DISSEMINATION:This protocol has been approved by the French National Agency for Medicines and Health Products Safety and the Sud-Est I French Ethics Committee (2017-A00946-47). Results will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER:NCT03138018.

Dataset Information

Diet quality in relation to healthy ageing: the Israeli Longitudinal Study on Aging (ILSA)-a study protocol.

Publications

Diet quality in relation to healthy ageing: the Israeli Longitudinal Study on Aging (ILSA)-a study protocol.

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