The dietary inflammatory index (DII®) and its association with cognition, frailty, and risk of disabilities in older adults: A systematic review

Beatriz Martins Vicente; Marcus Vinicius Lucio Dos Santos Quaresma; Camila Maria de Melo; Sandra Maria Lima Ribeiro

doi:10.1016/j.clnesp.2020.10.003

The dietary inflammatory index (DII®) and its association with cognition, frailty, and risk of disabilities in older adults: A systematic review

Clin Nutr ESPEN. 2020 Dec:40:7-16. doi: 10.1016/j.clnesp.2020.10.003. Epub 2020 Oct 21.

Authors

Beatriz Martins Vicente¹, Marcus Vinicius Lucio Dos Santos Quaresma², Camila Maria de Melo³, Sandra Maria Lima Ribeiro⁴

Affiliations

¹ Department of Nutrition, School of Public Health, University of São Paulo, SP, Brazil.
² Department of Nutrition, School of Public Health, University of São Paulo, SP, Brazil; São Camilo University Center, São Paulo, SP, Brazil.
³ Federal University of Lavras, Minas Gerais, MG, Brazil.
⁴ Department of Nutrition, School of Public Health, University of São Paulo, SP, Brazil; School of Arts, Sciences and Humanities, University of São Paulo, SP, Brazil. Electronic address: smlribeiro@usp.br.

PMID: 33183575
DOI: 10.1016/j.clnesp.2020.10.003

Abstract

Background & aims: Systemic inflammation is considered an important issue in older adults and is associated with adverse health outcomes, such as frailty and cognitive impairment. Diet is a critical associated factor, and the dietary inflammatory index (DII®) is proposed as a promising tool to identify the association between diet and health outcomes. Our aims were: (i) to investigate the association between the DII® and frailty, cognition, and the consequent risk of disability in older adults; (ii) to discuss particularities of the use of DII® with older adults.

Methods: The research question was based on the PICOS strategy: Population = older adults; Intervention or Exposure = DII; Comparison = any comparator; Outcomes = frailty, cognition, and risk of disability; Type of study = cohort, cross-sectional or case-control studies. We searched publications in two electronic databases (PUBMED and Web of Science) up to May 20th, 2020.

Results: Seven studies met our criteria. Three investigated cognition (one cohort and two cross-sectional), and four investigated frailty or risk of disability (one cohort and three cross-sectional); none of the studies investigated both outcomes (frailty and cognition) simultaneously. The studies presented some issues, mainly concerning: (i) the collection of dietary data and calculation of the DII; (ii) the study design; (iii) calculation of the sample size; (iv) eligibility criteria; (v) time for follow-up; (vi) and choice of covariates.

Conclusion: despite the issues, the use of DII resulted in a significant association, or predictive value, with variables related to frailty and cognitive decline. Further studies, with sensitivity analysis of the different components of this index, are needed. DII showed to be a promising tool in the investigation of geriatric syndromes. This systematic review was registered in PROSPERO (CRD42020155672).

Keywords: Aging; Cognition; Dietary inflammatory index; Disabilities; Frailty.

Publication types

Review
Systematic Review

MeSH terms

Aged
Aging
Cognition*
Cross-Sectional Studies
Diet
Disabled Persons
Frailty* / diagnosis
Frailty* / epidemiology
Humans
Inflammation*