Mediating effects of physical activities and cognitive function on the relationship between dietary diversity and all-cause mortality in community-dwelling older adults.

IF 4.5 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Global Health Pub Date : 2024-10-25 DOI:10.7189/jogh.14.04169
Chi Zhang, Anying Bai, Guoqing Fan, Ji Shen, Yuting Kang, Pengjun Zhang
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Abstract

Background: Although dietary diversity (DD) has been confirmed to be associated with multiple health outcomes and longevity in older people, the related mechanisms have not been elucidated. In this study, we explored the mediating roles of physical activities and cognitive function in the relationship between DD and all-cause mortality.

Methods: We recruited 34 068 community-dwelling older adults aged ≥60 years from the Chinese Longitudinal Healthy Longevity Study and followed them up until 2018. Dietary diversity score (DDS) was assessed by the intake frequency of nine food sources. We evaluated physical activities and cognitive function using the Katz index and Mini-Mental State Examination. We explored the mediating roles of physical activities and cognitive function between DDS and all-cause mortality using mediated analyses in Cox proportional risk regression models.

Results: A total of 25 362 deaths were recorded during 148 188.03 person-years of follow-up. Participants with physical disability and cognitive impairment had lower DDS than the normal group (P < 0.001). After controlling for all covariates, DDS, physical activities, and cognitive functioning were negatively associated with all-cause mortality. Physical activities and cognitive function mediated 18.29% (95% confidence interval (CI) = 12.90-23.10) and 27.84% (95% CI = 17.52-37.56) of the total effect of DDS on mortality, respectively.

Conclusions: Physical activities and cognitive function mediated the association between DDS and all-cause mortality. Maintaining DD may benefit early death prevention by reducing physical disability and cognitive impairment in community-dwelling older people.

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体育活动和认知功能对社区老年人饮食多样性与全因死亡率之间关系的中介效应。
背景:尽管饮食多样性(DD)已被证实与老年人的多种健康结果和长寿有关,但相关机制尚未阐明。在这项研究中,我们探讨了体育活动和认知功能在 DD 与全因死亡率之间关系中的中介作用:我们从中国健康长寿纵向研究中招募了 34 068 名年龄≥60 岁的社区老年人,并随访至 2018 年。膳食多样性评分(DDS)通过九种食物来源的摄入频率进行评估。我们使用卡茨指数和迷你精神状态检查评估了身体活动和认知功能。我们利用考克斯比例风险回归模型中的中介分析,探讨了体力活动和认知功能在 DDS 与全因死亡率之间的中介作用:在148 188.03人年的随访中,共有25 362人死亡。肢体残疾和认知障碍参与者的 DDS 值低于正常组(P体力活动和认知功能是 DDS 与全因死亡率之间关系的中介。通过减少社区老年人的肢体残疾和认知障碍,保持肢体残疾可能有利于预防早期死亡。
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来源期刊
Journal of Global Health
Journal of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH -
CiteScore
6.10
自引率
2.80%
发文量
240
审稿时长
6 weeks
期刊介绍: Journal of Global Health is a peer-reviewed journal published by the Edinburgh University Global Health Society, a not-for-profit organization registered in the UK. We publish editorials, news, viewpoints, original research and review articles in two issues per year.
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