Relationship Between Dietary Variety and Frailty in Older Japanese Women During the Period of Restriction on Outings Due to COVID-19

Abstract

Objective This study investigated the relationship between diet and frailty in community-dwelling older adults during the period of restriction on outings due to COVID-19. A population of 322 women aged 65 years or older living in the community was recruited for the study, of whom 253 were analyzed. Method A mail survey was carried out in May 2020, targeting adults aged 65 years or older. The survey included questions regarding sex, age, height, weight, and social participation. Dietary variety score and frailty score were also calculated. Results Mean age for the 253 participants was 80.0±6.4 years. Dietary variety score and frailty score were significantly correlated under linear regression analysis (β :-0.224, P < 0.001). In multivariate regression analysis, these factors remained significantly correlated in Model 2 , which was adjusted for age (β :-0.229, P < 0.001), and Model 3, which was adjusted for age, BMI, and other confounding factors (β :-0.208, P = 0.001). Conclusion Diet was correlated with frailty in older adults living in the community during the period of restriction on outings due to COVID-19.

Food Access, Diet Quality, and Nutritional Status of Older Adults During COVID-19: A Scoping Review

“…Measures of food security and access included measures of reported difficulty obtaining groceries ( 49 ) and the USDA six-item short form validated food security module to measure food security before and since COVID-19 ( 44 ). Measures of dietary habits, dietary variety, and food group intake included the Dietary Quality Index (DQI) for dietary habits ( 40 ), patterns of dietary change ( 42 ), dietary variety ( 45 ), and compliance with dietary guidelines and recommendations ( 47 ). Diet in these studies were measured by the DQI Questionnaire ( 40 ), specific questions on food group changes ( 42 ), a questionnaire on dietary intake and habits ( 45 ), and a Food Frequency Questionnaire [FFQ; ( 47 )].…”

“…Third, the correlational studies ( n = 2) examined the relationship between dietary variety and frailty ( 45 ) and between meal size and frailty ( 48 ) during COVID-19 restrictions and stay-at-home orders. In these studies, less dietary variety ( 45 ) and smaller meal size ( 48 ) were significantly positively associated with frailty among community-dwelling older adults during the COVID-19 outing restrictions.…”

“…This scoping review identified two hybrid spheres of influence. Six articles focused on the intrapersonal/environmental spheres of influence, specifically an individual's access to resources and response to COVID-19 lockdown restrictions or institutional practices that can affect nutrition, access to nutritional therapy, and potential health consequences among community-dwelling and hospitalized adults ( 26 , 42 , 45 , 47 – 49 ). Only one article involved the interpersonal/environmental spheres of influence, specifically how a statewide stay-at-home orders, policies and COVID-19 impacted food insecurity and disrupted food access; the latter was associated with many adverse individual and public health outcomes ( 44 ).…”

“…This could be due to differential risk factors among study samples, but could also reflect social vulnerabilities to food insecurities more generally. The findings of the studies in our analysis draw attention to risk factors beyond age and gender that are associated with higher risk of undernutrition during COVID-19, including frailty, functional limitations, or being underweight ( 45 , 48 , 49 ), living alone ( 49 ), or experiencing job loss ( 44 ). Therefore, the findings from in-scope studies suggested that the pandemic may have impacted different older adult age groups in different ways and may be useful in developing and informing ongoing interventions to target specific populations at risk of food insecurity or nutritional risk.…”

“…The linkage between these different spheres of influence at the intrapersonal, interpersonal, and environmental levels is complex. However, it is necessary to gain deeper insight into how individuals' interactions with varying spheres of influence are affected by stay-at-home policies to safeguard residents during the COVID-19 pandemic ( 26 , 42 , 45 , 47 – 49 ). It is vital that future research evaluate the efficacy of COVID-19 multilevel interventions that address food insecurity and downstream public health impacts through food-support programs, screening measures, nutritional, and behavioral counseling ( 20 , 35 ) on older adult populations.…”