TABLE 3.
HRs (95% CIs) for the associations of indicators of diet quality with 4-y incidence of PEM and 3-y incidence of persistent PEM in the well-nourished, community-dwelling older adults of the Health ABC Study cohort1
| Risk of developing PEM (4-y follow-up)2 | Risk of developing persistent PEM (3-y follow-up)3 | |||||
|---|---|---|---|---|---|---|
| Crude model | Model 14 | Model 25 | Crude model | Model 14 | Model 25 | |
| Healthy Eating Index score | ||||||
| Good (>80) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| Needs improvement (51–80) | 0.99 (0.80, 1.22) | 0.91 (0.73, 1.13) | 0.93 (0.75, 1.16) | 1.09 (0.75, 1.59) | 0.94 (0.63, 1.38) | 0.95 (0.64, 1.41) |
| Poor (<51) | 1.32 (0.93, 1.87) | 1.11 (0.77, 1.60) | 1.15 (0.80, 1.66) | 1.30 (0.69, 2.46) | 0.92 (0.47, 1.81) | 0.94 (0.48, 1.85) |
| Energy intake per 100-kcal/d lower intake | 0.99 (0.97, 1.00)* | 0.98 (0.97, 0.99)# | 0.98 (0.97, 0.99)# | 0.98 (0.96, 1.00) | 0.97 (0.95, 1.00)* | 0.97 (0.95, 0.99)* |
| Energy intake in quartiles (kcal/d)6 | ||||||
| Q1: 1122 (441–1356) | 0.77 (0.60, 0.98)* | 0.72 (0.57, 0.93)* | 0.71 (0.55, 0.91)# | 0.63 (0.41, 0.96)* | 0.59 (0.38, 0.91)* | 0.56 (0.36, 0.87)* |
| Q2: 1557 (1356–1744) | 0.90 (0.71, 1.14) | 0.88 (0.69, 1.11) | 0.86 (0.67, 1.09) | 0.86 (0.58, 1.28) | 0.83 (0.55, 1.25) | 0.82 (0.54, 1.23) |
| Q3: 1954 (1744–2211) | 0.94 (0.75, 1.19) | 0.95 (0.75, 1.21) | 0.93 (0.73, 1.18) | 0.88 (0.59, 1.29) | 0.88 (0.59, 1.32) | 0.87 (0.59, 1.30) |
| Q4: 2610 (2211–3956) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) | 1.00 (ref) |
| Protein intake per 10-g/d lower intake | 0.98 (0.95, 1.01) | 0.99 (0.94, 1.05) | 1.00 (0.94, 1.06) | 1.01 (0.95, 1.07) | 1.14 (1.03, 1.28)* | 1.15 (1.03, 1.29)* |
| Low compared with high protein intake7 | 0.86 (0.72, 1.03) | 0.94 (0.75, 1.18) | 0.95 (0.76, 1.20) | 0.96 (0.71, 1.29) | 1.26 (0.85, 1.87) | 1.30 (0.87, 1.93) |
1HRs (95% CIs) were obtained from Cox proportional hazards analysis. *P < 0.05; #P < 0.01; $P < 0.001. Health ABC, Health, Aging, and Body Composition; PEM, protein-energy malnutrition; Q, quartile; ref, reference.
2 n cases/total n: 543/2166 (differs from original sample size due to missing covariates).
3 n cases/total n: 181/2135 (differs from original sample size due to missing covariates).
4Adjusted for age, sex, race, study site, educational level, income, living arrangement, physical activity, smoking status, appetite, biting or chewing difficulty, and energy intake. By using energy intake as the independent variable, models 1 and 2 were not additionally adjusted for energy intake.
5Additionally adjusted for history or presence of cancer, diabetes, cardiovascular disease, chronic pulmonary disease and osteoporosis, estimated glomerular filtration rate, cognitive function, depression, and health status.
6Values are medians (minimum–maximum).
7HRs reflect the association for low (<0.8 g ⋅ kg adjusted body weight−1 ⋅ d−1) compared with high (≥0.8 g ⋅ kg adjusted body weight−1 ⋅ d−1) protein intake.