Mediterranean Diet May Lessen Frailty Risk in Older Adults

Troy Brown, RN

January 11, 2018

Older adults who follow a Mediterranean diet are less likely to become frail, according to new data published online January 11 in the Journal of the American Geriatrics Society.

"This systematic review and meta-analysis shows the first pooled evidence that greater adherence to a Mediterranean diet is associated with significantly lower risk of incident frailty in community-dwelling older people," write Gotaro Kojima, MD, from the Department of Primary Care and Population Health, University College London, United Kingdom, and colleagues.

The review included four prospective cohort studies involving 5789 community-dwelling adults aged 60 years and older who were followed for a mean of 3.9 years. The studies used the Mediterranean Diet Score (MDS) to measure adherence to the diet. Scores on the scale range from 0 to 9, with higher scores indicating greater adherence.

Higher adherence to the diet was associated with significantly lower risks for incident frailty when compared with low adherence, defined as an MDS of 0 to 3. Specifically, older adults with moderate adherence (MDS, 4-5) had a 38% reduced risk for frailty in the pooled analysis (P = .001), whereas those with a high adherence (MDS, 6-9) had a 56% reduction in risk (P < .001).

When the researchers used a random effects model to repeat the meta-analyses, they found similar results.

The investigators found no significant heterogeneity nor evidence of publication bias among the four studies included. However, they note several limitations of their meta-analysis: "Only a small number (n = 4) of studies were identified, probably because frailty research in relation to diet has only recently emerged," the authors write.

"In addition, further information on which components of the Mediterranean diet are associated with frailty (e.g. fruit and vegetable, red wine) and which components of frailty are most affected (e.g. measure of muscle strength, exhaustion or weight loss) would give further insight. Adherence to a Mediterranean diet was measured using the MDS in all the studies included. Although the MDS may be a good indicator of adherence to a Mediterranean diet in Mediterranean populations, its relevance to non-Mediterranean populations is contested," the researchers explain.

The diet includes foods high in antioxidants, and oxidative stress is one risk factor for developing frailty. The Mediterranean diet is associated with low levels of inflammatory markers, and inflammation is also linked to frailty.

"Adherence to a Mediterranean diet has been associated with better cognitive function, lower rates of cognitive decline, and lower risks of Alzheimer's disease and dementia. Moreover, the Mediterranean diet has been associated with lower incidence of cardiovascular disease and certain types of cancers, such as colorectal cancer," the authors write.

"Related topics warranting future research include a focus on which components or combination of foods contributes to the decrease in frailty. We now also need studies to confirm these findings and determine whether increasing adherence to a Mediterranean diet can reduce the risk of frailty, including in non-Mediterranean populations," they conclude.

The authors have disclosed no relevant financial relationships.

J Am Geriatr Soc. Published online January 11, 2018. Abstract

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