The moderating role of anti-inflammatory diet on the relationship between chronic obstructive pulmonary disease and frailty in older adults: a nationwide cross-sectional and longitudinal study.

内容摘要

To explore the moderating role of anti-inflammatory diet on the association between chronic obstructive pulmonary disease (COPD) and frailty, and to provide evidence-based basis for the management of frailty and nutritional intervention strategies for COPD patients. Based on the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2011 to 2018, 2,473 older adults aged 65 and above were included. A cross-sectional and longitudinal combined design was adopted to assess the relationships between COPD (based on self-reported diagnosis), anti-inflammatory diet (scored by a 10-item food frequency questionnaire), and frailty (defined by a frailty index&#x2009;&#x2265;&#x2009;0.20). A multivariate logistic regression model was used to analyze the moderating effect of anti-inflammatory diet on the association between COPD and frailty. The cross-sectional analysis showed that the odds of frailty in COPD patients significantly increased (OR&#x2009;=&#x2009;5.29, 95% CI: 3.64-7.65), while the high anti-inflammatory diet score group (Q4) was associated with a 40% reduction in the odds of frailty (OR&#x2009;=&#x2009;0.60, 95% CI: 0.36-0.97), and the interaction was significant (P&#x2009;<&#x2009;0.001). In the longitudinal analysis, the risk of new-onset frailty in COPD patients increased by 58% (OR&#x2009;=&#x2009;1.58, 95% CI: 1.11-2.23), and the risk of persistent frailty increased by 6.8 times (OR&#x2009;=&#x2009;6.80, 95% CI: 4.24-10.9); the high anti-inflammatory diet score group was associated with a 51% reduction in the risk of persistent frailty (OR&#x2009;=&#x2009;0.49, 95% CI: 0.26-0.89), and significantly regulated the strength of the association between COPD and persistent frailty (interaction P&#x2009;=&#x2009;0.003). Stratified analysis further indicated that compared with the low anti-inflammatory diet score group, the impact of COPD on persistent frailty was relatively weakened in the high anti-inflammatory diet score group. COPD is an important risk factor for the occurrence and persistence of frailty in older adults. Anti-inflammatory diets may provide independent protection against persistent frailty and might attenuate the adverse impact of COPD on persistent frailty risk, though further direct comparative analyses are warranted. It is recommended to incorporate anti-inflammatory diet intervention into the comprehensive management plan for COPD patients to reduce the risk of frailty occurrence and progression.