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

Abstract

Background and Objectives Studies on longitudinal trajectories of diet and the influence on ageing in older adults are limited. We characterised diet quality trajectories over past two 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) years] and 4 [88 (85-97) years]. Diet quality was measured by adherence to the Dietary Approaches to Stop Hypertension (DASH) pattern, and group-based trajectory modelling 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, while 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 (OR), 95% confidence interval (CI): 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 older adult life course was associated with better cognitive and psychosocial well-being in adults aged ≥85 years.