Exploring the complex associations among risks of malnutrition, sarcopenia, and frailty in community-dwelling older adults.

IF 3.7 1区 医学 Q2 GERIATRICS & GERONTOLOGY European Review of Aging and Physical Activity Pub Date : 2024-07-09 DOI:10.1186/s11556-024-00354-7
Halil Ibrahim Celik, Ferda Koc, Kübra Siyasal, Büsra Ay, Nazlı Bengu Ilter, Ozge Mengi Celik
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Abstract

Background: Malnutrition, sarcopenia, and frailty are age-related conditions that are associated with multiple health-related negative outcomes. However, the complex associations between them remain to be elucidated. The aims of the study were to explore: (1) whether the risk of sarcopenia has a mediator effect on the association between risks of malnutrition and frailty; and (2) whether physical activity (PA) level modulates this mediator effect in community-dwelling older adults.

Methods: This cross-sectional study involved 593 older adults (62.73% female; mean age = 71.35 ± 5.86 years). The Mini Nutritional Assessment-Short Form (MNA-SF), the SARC-F Questionnaire, and the FRAIL Questionnaire were used to assess the risks of malnutrition, sarcopenia, and frailty, respectively. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was employed to assess PA level. Using the Hayes PROCESS macro (Models 4 and 7), mediation and moderated mediation analyses were performed.

Results: The mediation analysis demonstrated that the MNA-SF had a significant effect on the SARC-F (B=-0.325; p < 0.001) and the SARC-F, in turn, had a significant effect on the FRAIL (B = 0.341; p < 0.001). The total (B=-0.171; p < 0.001), direct (B=-0.061; p = 0.001), and indirect (B=-0.111; bootstrap CI did not include zero, which indicates a significant effect) effects of MNA-SF on FRAIL were significant, showing that 65% of the association between the MNA-SF and FRAIL was explained by the SARC-F acting as a mediator. The moderated mediation analysis demonstrated that the association between MNA and SARC-F was moderated by the PA level (B = 0.253; p = 0.016). The SARC-F mediated and relatively enhanced the association between MNA-SF and FRAIL only in older adults with a moderate PA level (B=-0.120; CI: -0.154 to -0.085).

Conclusions: The SARC-F partially mediates the association between the MNA-SF and the FRAIL, indicating that malnutrition affects frailty through an indirect path via sarcopenia. Furthermore, the PA level moderates this mediator effect, with sarcopenia serving as a mediator in older adults with moderate a PA level but not in those with a low PA level. These findings reveal that it may be beneficial to consider PA level in combination with malnutrition and sarcopenia in the management and prevention of frailty in community-dwelling older adults.

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探索社区老年人营养不良、肌肉疏松症和虚弱风险之间的复杂关联。
背景:营养不良、肌肉疏松症和虚弱是与年龄相关的疾病,与多种健康相关的负面结果有关。然而,它们之间的复杂关联仍有待阐明。本研究旨在探讨:(1) 肌肉疏松症风险是否对营养不良风险与虚弱之间的关联具有中介效应;(2) 体力活动(PA)水平是否会调节社区老年人的这种中介效应:这项横断面研究涉及 593 名老年人(62.73% 为女性;平均年龄 = 71.35 ± 5.86 岁)。迷你营养评估简表(MNA-SF)、SARC-F 问卷和 FRAIL 问卷分别用于评估营养不良、肌肉疏松症和虚弱的风险。国际体力活动问卷简表(IPAQ-SF)用于评估体力活动水平。使用 Hayes PROCESS 宏(模型 4 和 7)进行了中介分析和调节中介分析:结果:中介分析表明,MNA-SF 对 SARC-F 有显著影响(B=-0.325;P 结论:SARC-F 对 MNA-SF 有部分中介作用:SARC-F对MNA-SF和FRAIL之间的关联有部分调节作用,表明营养不良通过肌肉疏松症的间接途径对虚弱产生影响。此外,PA 水平对这一中介效应起到调节作用,中等 PA 水平的老年人中,肌肉疏松症起到中介作用,而低 PA 水平的老年人中,肌肉疏松症则不起中介作用。这些研究结果表明,在管理和预防社区老年人的虚弱时,将 PA 水平与营养不良和肌肉疏松症结合起来考虑可能是有益的。
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来源期刊
CiteScore
8.60
自引率
1.60%
发文量
29
审稿时长
>12 weeks
期刊介绍: European Review of Aging and Physical Activity (EURAPA) disseminates research on the biomedical and behavioural aspects of physical activity and aging. The main issues addressed by EURAPA are the impact of physical activity or exercise on cognitive, physical, and psycho-social functioning of older people, physical activity patterns in advanced age, and the relationship between physical activity and health.
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