Associations between nutritional frailty and 8‐year all‐cause mortality in older adults: The Salus in Apulia Study
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- Roberta Zupo
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Fabio Castellana
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Vito Guerra
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Rossella Donghia
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Ilaria Bortone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Chiara Griseta
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Luisa Lampignano
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Vittorio Dibello
- Department of Orofacial Pain and Dysfunction Academic Centre for Dentistry Amsterdam (ACTA) University of Amsterdam and Vrije Universiteit Amsterdam Amsterdam The Netherlands
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- Madia Lozupone
- Department of Basic Medicine Neuroscience, and Sense Organs, University of Bari Aldo Moro Bari Italy
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- Hélio José Coelho‐Júnior
- University of Campinas Campinas Brazil
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- Vincenzo Solfrizzi
- “C. Frugoni” Internal and Geriatric Medicine and Memory Unit University of Bari Aldo Moro Bari Italy
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- Gianluigi Giannelli
- Scientific Direction Research Hospital National Institute of Gastroenterology “Saverio de Bellis” Castellana Grotte Bari Italy
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- Giovanni De Pergola
- Scientific Direction Research Hospital National Institute of Gastroenterology “Saverio de Bellis” Castellana Grotte Bari Italy
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- Heiner Boeing
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Rodolfo Sardone
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
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- Francesco Panza
- Unit of Data Sciences and Technology Innovation for Population Health, National Institute of Gastroenterology “Saverio de Bellis”, Research Hospital, Castellana Grotte, 70013 Bari, Italy
抄録
<jats:title>Abstract</jats:title><jats:sec><jats:title>Introduction</jats:title><jats:p>Preventive nutritional management of frailty, a multidimensional intermediate status in the ageing process, may reduce the risk of adverse health‐related outcomes. We investigated the ability of a measure combining physical frailty with nutritional imbalance, defined as nutritional frailty, to predict all‐cause mortality over a period of up to 8 years.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We analysed data on 1,943 older adults from the population‐based ‘Salus in Apulia Study’. Physical frailty was operationalized using Cardiovascular Health Study criteria and cognitive frailty by combining physical frailty with cognitive impairment. A novel five‐item construct was built to assess the extent of nutritional imbalance identified with a machine learning algorithm. Cox models and Kaplan–Meier survival probability analyses of physical frailty, nutritional imbalance (two or more of the following: low body mass index, low skeletal muscle index, ≥2.3 g/day sodium intake, <3.35 g/day potassium intake and <9.9 g/day iron intake), cognitive frailty and the novel nutritional frailty phenotype (physical frailty plus nutritional imbalance) were applied to assess all‐cause mortality risk, adjusted for age, sex, education and multimorbidity.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The overall prevalence of nutritional frailty was 4.52% (95% confidence interval, CI:3.55–5.44), being more frequent in males. Subjects with nutritional frailty were at higher risk for all‐cause mortality [hazard ratio (HR):2.31; 95%CI:1.41–3.79] than those with physical frailty (HR:1.45,95% CI:1.0–2.02), nutritional imbalance (HR:1.39; 95%CI:1.05–1.83) and cognitive frailty (HR:1.06; 95%CI:0.56–2.01).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Efforts to identify, manage and prevent frailty should include the nutritional domain. The nutritional frailty phenotype may highlight major nutritional determinants that could drive survival and health trajectories in older adults.</jats:p></jats:sec>
収録刊行物
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- Journal of Internal Medicine
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Journal of Internal Medicine 290 (5), 1071-1082, 2021-09-10
Wiley