Longitudinal Dietary Trajectories With Cognitive and Psychosocial Well-Being in Chinese Adults Aged 85 Years and Older in Singapore

Jun S Lai; Grand H-L Cheng; Yap-Seng Chong; Mary F-F Chong; Woon-Puay Koh

doi:10.1093/geroni/igad036

Longitudinal Dietary Trajectories With Cognitive and Psychosocial Well-Being in Chinese Adults Aged 85 Years and Older in Singapore

Innov Aging. 2023 Apr 26;7(4):igad036. doi: 10.1093/geroni/igad036. eCollection 2023.

Authors

Jun S Lai¹, Grand H-L Cheng², Yap-Seng Chong^{1

3}, Mary F-F Chong^{1

4}, Woon-Puay Koh^{1

5}

Affiliations

¹ Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore, Singapore.
² Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
³ Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
⁴ Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore.
⁵ Healthy Longevity Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Abstract

Background and objectives: Studies on longitudinal trajectories of diet and the influence on aging in older adults are limited. We characterized diet quality trajectories over the past 2 decades among adults aged ≥85 years and examined their associations with cognitive and psychosocial outcomes.

Research design and methods: We used data from 861 participants in the population-based Singapore Chinese Health Study. Dietary intakes were assessed at baseline (mean age [range]: 65 [60-74] years) and at follow-ups 3 (85 [81-95]) and 4 (88 [85-97]) years. Diet quality was measured by adherence to the Dietary Approaches to Stop Hypertension pattern, and group-based trajectory modeling was used to derive diet quality trajectories. At Follow-up 4, we assessed cognition using the Singapore-modified Mini-Mental State Examination, depressive symptoms using the 15-item Geriatric Depression Scale, social engagement, and self-rated health. Multivariable logistic regression models examined associations of diet quality trajectories with these outcomes.

Results: About 49.7% had a trajectory with consistently low diet quality scores, whereas 50.3% had a trajectory with consistently high diet quality scores. Compared to the "consistently low" trajectory, the "consistently high" trajectory had 29% and 26% lower likelihoods of cognitive impairment and depressive symptoms, respectively (odds ratio, 95% confidence interval: 0.71 [0.51, 0.99] and 0.74 [0.55, 0.99], respectively); as well as 47% higher likelihood of social engagement (1.47 [1.09, 1.98]). No statistically significant association was observed between the trajectories and self-rated health.

Discussion and implications: Maintaining high diet quality throughout the older adult life course was associated with better cognitive and psychosocial well-being in adults aged ≥85 years.

Keywords: Cognitive impairment; Depressive symptoms; Diet quality; Longitudinal; Social engagement.

Abstract

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