Plant and animal protein intake and transitions from multimorbidity to frailty and mortality in older adults
Background: Multimorbidity is the most common chronic condition experienced among older adults. It is unknown which amount and source of protein influences the development of frailty and mortality in patients with multimorbidity. We aimed to examine the association of plant and animal sources of pro...
| Autores: | , , , , , , |
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| Tipo de recurso: | artículo |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Universidad Autónoma de Madrid |
| Repositorio: | Biblos-e Archivo. Repositorio Institucional de la UAM |
| Idioma: | inglés |
| OAI Identifier: | oai:repositorio.uam.es:10486/718301 |
| Acceso en línea: | http://hdl.handle.net/10486/718301 https://dx.doi.org/10.1002/jcsm.13729 |
| Access Level: | acceso abierto |
| Palabra clave: | Frailty Multimorbidity Older Adults Plant and Animal Proteins Transitions Medicina |
| Sumario: | Background: Multimorbidity is the most common chronic condition experienced among older adults. It is unknown which amount and source of protein influences the development of frailty and mortality in patients with multimorbidity. We aimed to examine the association of plant and animal sources of protein intake with frailty and mortality among this type of patients. Methods: This longitudinal study included 1868 participants aged ≥ 60 years from the Seniors-ENRICA cohort in Spain with multimorbidity, defined as having 2 or more clinician-diagnosed chronic diseases. Habitual diet was assessed at baseline (2008–2010) with a validated computerized diet history. Participants underwent repeated physical examinations (in 2013, 2015 and 2017) for assessment of frailty (≥ 3 criteria from the frailty phenotype: low physical activity, slow walking speed, muscle weak-ness, weight loss and exhaustion). All-cause mortality was assessed up to January 2022. Analyses were conducted using Cox proportional hazard models and multistate models adjusted for sociodemographic, lifestyle and other dietary factors. Results: Mean consumption of protein was 90.2 (standard deviation [SD]: 26.8) g/day, which represents 18.7% of the total energy intake and 1.23 (0.39) g per kg of body weight per day. Plant protein represented 6.16% of the energy intake, while animal protein represented 12.5%. During a median follow-up of 12.9 (range: 11.7–13.9) years, we documented 196 incident cases of frailty and 490 deaths; of these mortality cases, 83 individuals died after a frailty diagnosis. Higher intake of total protein was associated with decreased risk of frailty (hazard ratio [HR] for tertile 3 vs. tertile 1: 0.66; 95% confidence interval [CI]: 0.45, 0.96; p trend: 0.03). In multistate models, higher fish protein intake decreased the risk in the progression from multimorbidity to frailty (HR per 1- SD increment: 0.81 [95% CI: 0.68, 0.97]), and higher plant protein decreased the risk of progressing from multimorbidity to mortality (0.86 [0.75, 0.98]). In the progression from frailty to mortality, estimates for total, plant and animal protein showed increased risk (HR for 1 SD increment in total protein: 1.38 [1.05, 1.81]; HR for plant protein: 1.29 [1.01, 1.67]; HR for animal protein: 1.41 [1.04, 1.92]). No significant associations were found between meat pro-tein and dairy protein in any transition |
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