Abstract
Malnutrition is correlated with poor cognition; however, an understanding of the association between nutrition risk, which precedes malnutrition, and cognition is lacking. This study aimed to determine if nutrition risk measured with the SCREEN-8 tool is associated with cognitive performance among cognitively healthy adults aged 55+, after adjusting for demographic and lifestyle covariates. Sex- and age-stratified analyses were also explored. Baseline data from the Canadian Longitudinal Study on Aging was used. Cognition was determined using a 6-measure composite score based on four executive functions and two memory tasks, taking into account age, sex, and education. Multivariable linear regression was performed while adjusting for body mass index (BMI), lifestyle, and health covariates in the entire sample (n = 11 378) and then stratified by sex and age. Approximately half of participants were female (54.5%) aged 65+ (54.1%). Greater nutrition risk was associated with poorer cognitive performance in the entire sample (F[1, 11 368] = 5.36, p = 0.021) and among participants aged 55-64 (n = 5227; F[1, 5217] = 5.45, p = 0.020). Sex differences in lifestyle and health factors associated with cognition were apparent, but nutrition risk was not associated with cognition in sex-stratified models. Based on this analysis, there may be an association between nutrition risk and cognitive performance in older adults. When screening for either cognitive impairment or nutrition risk, complementary assessments for these conditions is warranted, as early intervention may provide benefit.
Keywords: lifestyle factors; CLSA; cognition; nutrition risk; older adults; sex-stratification.
Plain Language Summary
This study is about how nutrition risk is related to low function and strength in older adults. When someone does not eat enough food or experiences nutrition challenges, it can mean they are at nutrition risk. Nutrition risk can be caused by factors like chewing and swallowing concerns and poor appetite. Older adults at nutrition risk may also experience sarcopenia or frailty. Sarcopenia is loss of muscle strength and mass. Frailty means reduced ability to function because of poor health. Being frail, malnourished, and having sarcopenia are all related to factors such as age, body mass index, physical activity, education and living alone. Because of this overlap we wanted to see if nutrition risk is associated with strength and function in persons 55 years and older. To answer this question, we looked at participants living in the community from a large study called the Canadian Longitudinal Study on Aging. We found that persons with higher nutrition risk performed more poorly on strength and function tests than persons who were not at nutrition risk. Based on these results, we suggest that regularly assessing for nutrition risk in the community is important for older adult health and wellbeing.