Combined effects of diet quality scores and frailty on all-cause mortality and life expectancy in middle-aged and older adults
File(s)
Published version
Author(s)
Yang, Yang
Liu, Huaicun
Chen, Liangkai
Filippidis, Filippos T
Type
Journal Article
Abstract
Background: Frailty is known to elevate the risk of all-cause mortality and shorten life expectancy. Although the effects of diet on health are well documented, the specific interaction between diet quality and frailty remains unexplored. This research aims to examine the combined effects of various diet quality scores and frailty on all-cause mortality and life expectancy among middle-aged and older adults. Methods: A total of 151,628 participants were sourced from the UK Biobank for analysis. Frailty phenotype (FP) and frailty index (FI), as two different approaches, were used to assess frailty status. Diet quality was evaluated through seven diet quality scores: the Alternate Healthy Eating Index (AHEI), Dietary Approaches to Stop Hypertension (DASH) score, Mediterranean diet (MED) score, Dietary Inflammatory Index (DII), and three plant-based diet indices (overall PDI, healthful PDI, and unhealthful PDI). Cox proportional hazards models were applied to calculate adjusted hazard ratios (HRs) for overall mortality and predict life expectancy differences. Results: Over a median follow-up period of 12.2 years, 8231 deaths were identified. After accounting for potential confounding factors, frail individuals in the unhealthier tertile of diet scores exhibited markedly elevated mortality risks, ranging from 1.99 to 2.07 based on the frailty index and 2.79 to 3.06 based on the frailty phenotype, compared to their robust counterparts in the healthier tertile. Regardless of frailty categories, a healthier diet was associated with longer life expectancy and with lower mortality risk in a dose–response relationship. Conclusions: The healthier tertile of diet scores was found to mitigate the detrimental effects of frailty, emphasizing diet quality as a modifiable factor in promoting healthier aging. Evidence suggests that it is never too late to adopt healthier dietary habits for significant health benefits.
Date Issued
2025-09-30
Date Acceptance
2025-09-28
Citation
Nutrients, 2025, 17 (19)
ISSN
2072-6643
Publisher
MDPI AG
Journal / Book Title
Nutrients
Volume
17
Issue
19
Copyright Statement
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/ licenses/by/4.0/).
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/41097191
PII: nu17193115
Subjects
UK Biobank
diet quality score
frailty
life expectancy
mortality
Humans
Life Expectancy
Aged
Male
Female
Frailty
Middle Aged
Diet
Diet, Healthy
Mortality
Proportional Hazards Models
Frail Elderly
Cause of Death
Diet, Mediterranean
Aged, 80 and over
Risk Factors
United Kingdom
Publication Status
Published
Coverage Spatial
Switzerland
Article Number
3115
Date Publish Online
2025-09-30