PROMISS and the Health ABC Study

The Health, Aging and Body Composition (Health ABC) Study is one of the longitudinal studies contributing to work package 1 of PROMISS. The Health ABC cohort consists of 3,075 black and white US older adults aged 70 years and over, who were generally well-functioning at baseline. The main focus of the Health ABC study is to determine risk factors for functional decline and loss of independence in healthier older people.

 Since the start of PROMISS in April 2016, several researchers have used the Health ABC data to investigate associations of dietary intake with appetite, malnutrition and mobility limitation in US older adults. In the first paper, entitled Protein intake and mobility limitation in community-dwelling older adults: the Health ABC Study, it was hypothesized that older adults with low protein intake would have a greater risk of developing mobility limitations than those with higher protein intake. The results confirmed the hypothesis: it was shown that older adults with a lower protein intake (<0.7 and 0.7-<1.0 kg/kg body weight/d) had a higher risk of developing mobility limitations in the following 6 years compared to older adults with the highest protein intake (≥1.0 g/kg body weight/d).

The second paper, entitled Poor appetite and dietary intake in community-dwelling older adults, focused on differences in food intake in community-dwelling older adults with different appetite levels. This study showed that 21.8% of the participants had a poor appetite. Those participants consumed less protein, dietary fiber, whole grains, fruits and vegetables, but consumed more dairy foods, fats, sweets and sodas compared to the participants with a very good appetite.

The association between diet quality and protein-energy malnutrition was investigated in the third paper, entitled Prospective associations of poor diet quality with long-term incidence of protein-energy malnutrition in community-dwelling older adults: the Health, Aging and Body Composition Study.” This study showed that the majority of the participants consumed a diet of insufficient quality and that 40% of the participants had a protein intake below the recommended daily intake. Furthermore, in 4 years almost 25% of the participants developed protein-energy malnutrition. It was observed that a higher protein intake may reduce the risk of developing persistent protein-energy malnutrition.

Researchers of work package 1 of PROMISS are currently working on a two other studies by using data from the Health ABC Study. In the first one, those data will be used in a multi-cohort paper on determining the prevalence of low protein intake in community-dwelling older adults. In a second paper, the association between poor diet quality and the risk of developing frailty in (initially non-frail) community-dwelling older adults will be investigated.