Nursing diagnoses and hospital readmission of patients with respiratory diseases: Findings from a case-control study.

AIM: The rate of readmission after hospitalisation for respiratory diseases has become a common and challenging clinical problem. Social and functional patient variables could help identify cases at high risk of readmission. The aim was to identify the nursing diagnoses that were associated with readmission after hospitalisation for respiratory disease in Spain. DESIGN: Case-control study within the cohort of patients admitted for respiratory disease during 2016-19 in a tertiary public hospital in Spain (n = 3781). METHODS: Cases were patients who were readmitted within the first 30 days of discharge, and their controls were the remaining patients. All nursing diagnoses (n = 130) were collected from the electronic health record. They were then grouped into 29 informative diagnostic categories. Clinical confounder-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using logistic regression models. RESULTS: The readmission rate was 13.1%. The nursing diagnoses categories 'knowledge deficit' (OR: 1.61; 95%CI: 1.13-2.31), 'impaired skin integrity and risk of ulcer infection' (OR: 1.45; 95%CI: 1.06-1.97) and 'activity intolerance associated with fatigue' (OR: 1.56; 95%CI: 1.21-2.01) were associated with an increased risk of suffering an episode of hospital readmission rate at 30% after hospital discharge, and this was independent of sociodemographic background, care variables and comorbidity. PATIENT OR PUBLIC CONTRIBUTION: The nursing diagnoses assigned as part of the care plan of patients during hospital admission may be useful for predicting readmissions.

Association Between Speech Reception Threshold in Noise and Multimorbidity: The UK Biobank Study.

OBJECTIVE: To investigate the association between hearing function, as approached with the functional auditory capacity, and multimorbidity. STUDY DESIGN: Cross-sectional study. SETTING: The UK Biobank was established from 2006 to 2010 in the United Kingdom. This cross-sectional analysis included 165,524 participants who provided baseline information on hearing function. METHODS: Functional auditory capacity was measured with a digit triplet test. Three categories were defined according to the speech reception threshold in noise (SRTn): normal (SRTn < -5.5 dB signal-to-noise ratio [SNR]), insufficient (SRTn ≥ -5.5 to ≤ -3.5 dB SNR) and poor hearing function (SRTn > -3.5 dB SNR). To define multimorbidity, 9 chronic diseases were considered, including chronic obstructive pulmonary disease, dementia, Parkinson's disease, stroke, cancer, depression, osteoarthritis, coronary heart disease, and diabetes; multimorbidity was defined as the coexistence of 2 or more in the same individual. Analyses were conducted using logistic models adjusted for relevant confounders. RESULTS: Among the study participants, 54.5% were women, and the mean (range) age was 56.7 (39-72) years. The prevalence of insufficient and poor hearing function and multimorbidity was 13% and 13.2%, respectively. In comparison with having a normal SRTn, the odds ratio (95% confidence interval) of multimorbidity associated with insufficient SRTn was 1.13 (1.08-1.18), and with poor SRTn was 1.25 (1.14-1.37). CONCLUSION: Insufficient and poor hearing function was associated with multimorbidity. This association suggests common biological pathways for many of the considered morbidities.

Prospective Association Between Plasma Concentrations of Fatty Acids and Other Lipids, and Multimorbidity in Older Adults.

Biological mechanisms that lead to multimorbidity are mostly unknown, and metabolomic profiles are promising to explain different pathways in the aging process. The aim of this study was to assess the prospective association between plasma fatty acids and other lipids, and multimorbidity in older adults. Data were obtained from the Spanish Seniors-ENRICA 2 cohort, comprising noninstitutionalized adults ≥65 years old. Blood samples were obtained at baseline and after a 2-year follow-up period for a total of 1 488 subjects. Morbidity was also collected at baseline and end of the follow-up from electronic health records. Multimorbidity was defined as a quantitative score, after weighting morbidities (from a list of 60 mutually exclusive chronic conditions) by their regression coefficients on physical functioning. Generalized estimating equation models were employed to assess the longitudinal association between fatty acids and other lipids, and multimorbidity, and stratified analyses by diet quality, measured with the Alternative Healthy Eating Index-2010, were also conducted. Among study participants, higher concentrations of omega-6 fatty acids [coef. per 1-SD increase (95% CI) = -0.76 (-1.23, -0.30)], phosphoglycerides [-1.26 (-1.77, -0.74)], total cholines [-1.48 (-1.99, -0.96)], phosphatidylcholines [-1.23 (-1.74, -0.71)], and sphingomyelins [-1.65 (-2.12, -1.18)], were associated with lower multimorbidity scores. The strongest associations were observed for those with a higher diet quality. Higher plasma concentrations of omega-6 fatty acids, phosphoglycerides, total cholines, phosphatidylcholines, and sphingomyelins were prospectively associated with lower multimorbidity in older adults, although diet quality could modulate the associations found. These lipids may serve as risk markers for multimorbidity.

Dietary Micronutrient Adequacy and Risk of Multimorbidity in Community-dwelling Older Adults.

BACKGROUND: Multimorbidity refers to the coexistence of multiple chronic health conditions. The effect of nutritional adequacy on multimorbidity is mostly unknown. OBJECTIVE: The aim of this study was to assess the prospective association between dietary micronutrient adequacy and multimorbidity among community-dwelling older adults. METHODS: This cohort study included 1461 adults aged ≥65 y from the Seniors-ENRICA II cohort. Habitual diet was assessed at baseline (2015-2017) with a validated computerized diet history. The intakes of 10 micronutrients (calcium, magnesium, potassium, vitamins A, C, D, E, zinc, iodine, and folate) were expressed as percentages relative to the dietary reference intakes, with higher scores indicating greater adequacy. Dietary micronutrient adequacy was computed as the average of all the nutrient scores. Information on medical diagnosis was obtained from the electronic health records up to December 2021. Conditions were grouped into a comprehensive list of 60 categories and occurrence of multimorbidity was defined as having ≥6 chronic conditions. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders. RESULTS: The mean age was 71.0 y (SD: 4.2) and 57.8% of participants were males. During a median follow-up of 4.79 y, we documented 561 incident cases of multimorbidity. Participants in the highest (85.8%-97.7%) versus the lowest tertile (40.1%-78.7%) of dietary micronutrient adequacy had a low risk of multimorbidity [fully adjusted hazard ratio (95% confidence interval): 0.75 (0.59-0.95); P-trend: 0.02]. A 1-SD increment in minerals and vitamins adequacy was associated with a low risk of multimorbidity, although estimates were attenuated after additional adjustment for the opposite subindex [minerals subindex: 0.86 (0.74-1.00); vitamins subindex: 0.89 (0.76-1.04)]. No differences were observed by strata of sociodemographic and lifestyle factors. CONCLUSION: A high micronutrient index score was associated with low risk of multimorbidity. Improving the dietary micronutrient adequacy could prevent multimorbidity among older adults. CLINICAL TRIAL REGISTRY: clinicaltrials.govNCT03541135.

Multimorbidity Patterns in Older Adults: the Role of Social Variables and Lifestyle Behaviors.

INTRODUCTION: While some condition clusters represent the chance co-occurrence of common individual conditions, others may represent shared causal factors. The aims of this study were to identify multimorbidity patterns in older adults and to explore the relationship between social variables, lifestyle behaviors, and the multimorbidity patterns identified. METHODS: This was a cross-sectional design. Data came from 3,273 individuals aged ≥65 from the Seniors-ENRICA-2 cohort; information on 60 chronic disease categories, categorized according to the 2nd edition of the International Classification of Primary Care and the 10th edition of the International Classification of Diseases, was obtained from clinical record linkage. To identify multimorbidity patterns, an exploratory factor analysis was conducted over chronic disease categories with a prevalence >5%, using Oblimin rotation and Kaiser's eigenvalues-greater-than-one rule. The association between multimorbidity patterns and their potential determinants was assessed with multivariable linear regression. RESULTS: The three-factor solution (Musculoskeletal diseases and mental disorders, Cardiometabolic diseases, and Cardiopulmonary diseases) explained 64.5% of the total variance. Being older, lower occupational category, higher levels of loneliness, lower levels of physical activity, and higher body mass index were associated with higher scores in the multimorbidity patterns identified. Female sex was linked to the Musculoskeletal diseases and mental disorders pattern, while being male was revealed to the two remaining multimorbidity patterns. A high diet quality was inversely related to Cardiometabolic diseases, while optimal sleep duration was inversely related to Cardiopulmonary diseases. CONCLUSION: Three multimorbidity patterns were identified in older adults. Multimorbidity patterns were differently associated with social variables and lifestyles behavioral factors.

Association between neighborhood physical characteristics and mental health among older adults in Spain.

The aim was to assess the impact of neighborhood physical environment on mental health among non-institutionalized older adults. A cross-sectional analysis was conducted over a representative sample of 5,071 people ≥65 years from the Spanish National Health Survey. The survey included nine items addressing the self-perceived degree of discomfort due to neighborhood physical problems. Participants were categorized into groups with "no problems", "some problems" (somewhat discomfort on 1-4 items) and "many problems" (somewhat discomfort on ≥5 items or very much discomfort on ≥1 item). Mental health status was assessed using the General Health Questionnaire, consisting of 12 items assessing the severity of a psychological distress over the past few weeks. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regressions. A dose-response association (p-trend<0.001) was found between living in neighborhoods with some (OR: 1.41; 95% CI: 1.14-1.75) or many problems (OR: 1.93; 95% CI: 1.55-2.42) affecting the physical environment with poor mental health of community dwelling older adults. Integrating and articulating health considerations into public policymaking regarding housing and the residential environment can have broad implications for healthy aging.

Prospective Association Between Plasma Amino Acids and Multimorbidity in Older Adults.

BACKGROUND: Some amino acids have been associated with aging-related disorders and risk of physical impairment. The aim of this study was to assess the association between plasma concentrations of 9 amino acids, including branched-chain and aromatic amino acids, and multimorbidity. METHODS: This research uses longitudinal data from the Seniors-ENRICA 2 study, a population-based cohort from Spain that comprises noninstitutionalized adults older than 65. Blood samples were extracted at baseline and after a follow-up period of 2 years for a total of 1 488 subjects. Participants' information was linked with electronic health records. Chronic diseases were grouped into a list of 60 mutually exclusive conditions. A quantitative measure of multimorbidity, weighting morbidities by their regression coefficients on physical functioning, was employed and ranged from 0 to 100. Generalized estimating equation models were used to explore the relationship between plasma amino acids and multimorbidity, adjusting for sociodemographics, socioeconomic status, and lifestyle behaviors. RESULTS: The mean age of participants at baseline was 73.6 (SD = 4.2) years, 49.6% were women. Higher concentrations of glutamine (coef. per mmol/l [95% confidence interval] = 10.1 [3.7, 16.6]), isoleucine (50.3 [21.7, 78.9]), and valine (15.5 [3.1, 28.0]) were significantly associated with higher multimorbidity scores, after adjusting for potential confounders. Body mass index could have influenced the relationship between isoleucine and multimorbidity (p = .016). CONCLUSIONS: Amino acids could play a role in regulating aging-related diseases. Glutamine and branched-chain amino acids as isoleucine and valine are prospectively associated and could serve as risk markers for multimorbidity in older adults.

Prospective association between dietary magnesium intake and physical performance in older women and men.

PURPOSE: Magnesium is a profuse intracellular cation with a key role in muscle function and cellular senescence. The aim was to examine the prospective association between 5 year changes in dietary intake of magnesium and changes in physical performance among older men and women. METHODS: Prospective study conducted over 863 community-dwellers aged ≥ 65 years from the Seniors-ENRICA cohort (Spain). In 2012 and 2017, a validated computerized face-to-face diet history was used to record the consumption of up to 880 foods. From these data, we estimated changes in dietary magnesium intake. The Short Physical Performance Battery (SPPB) was also conducted in both time points and we obtained changes in the score during follow-up, with positive values indicating physical performance improvement. RESULTS: Over 5 years of follow-up, an increase in magnesium intake was associated with an increment in the SPPB score among older women [multivariate ß (95% confidence interval): 1.01 (0.49; 1.52), p-trend: 0.001]. In addition, changes from non-adherence to adherence to both estimated average requirement and recommended dietary allowance during follow-up period were associated with an increment in SPPB score among older women [1.14 (0.36; 1.92) and 0.84 (0.22; 1.47), respectively]. No significant associations between changes in magnesium intake and changes in SPPB score were observed in men. CONCLUSIONS: Both increase of magnesium intake and change from non-adherence to adherence to dietary reference magnesium intake was prospectively associated with better physical performance among older women, but not among men.

Association of Zinc Intake With Risk of Impaired Physical Function and Frailty Among Older Adults.

BACKGROUND: Zinc could be a target nutrient in the prevention of physical impairment and frailty in older adults due to its anti-inflammatory/antioxidant properties. However, prospective studies evaluating this inquiry are scarce. Thus, we aimed to assess the association between zinc intake and impaired lower-extremity function (ILEF) and frailty among community-dwelling older adults. METHODS: We examined 2 963 adults aged ≥60 and older from the Seniors-ENRICA cohort. At baseline (2008-2010) and subsequent follow-up (2012), zinc intake (mg/d) was estimated with a validated computerized face-to-face diet history and adjusted for total energy intake. From 2012 to 2017, the occurrence of ILEF was ascertained with the Short Physical Performance Battery, and of frailty according to the Fried phenotype criteria. Analyses were conducted using Cox proportional hazard models adjusted for relevant confounders, including lifestyle, comorbidity, and dietary factors. RESULTS: During follow-up, we identified 515 incident cases of ILEF and 241 of frailty. Compared with participants in the lowest tertile of zinc intake (3.99-8.36 mg/d), those in the highest tertile (9.51-21.2 mg/d) had a lower risk of ILEF (fully adjusted hazard ratio [95% confidence interval]: 0.75 [0.58-0.97]; p for trend: .03] and of frailty (0.63 [0.44-0.92]; p for trend: .02). No differences in the association were seen by strata of sociodemographic and lifestyle factors. CONCLUSIONS: Higher zinc intake was prospectively associated with a lower risk of ILEF and frailty among older adults, suggesting that adequate zinc intake, which can be achieved through a healthy diet, may help preserve physical function and reduce the progression to frailty.

Sleep patterns and physical function in older adults attending primary health care.

BACKGROUND: Sleep disturbances may contribute to physical function impairment among older adults. OBJECTIVE: To examine the associations between sleep quality and duration and impaired physical function among older adults. METHODS: Cross-sectional study involving 392 non-institutionalized adults aged ≥65 years, who were recruited from primary health care centres in Spain. Sleep quality and duration were assessed with the Pittsburgh Sleep Quality Index (PSQI). The FRAIL scale was used to identify physical frailty, the short physical performance battery to assess lower extremity functional impairment (LEFI) and grip strength was measured using a hand-held dynamometer to assess muscle weakness. Statistical analyses were performed with logistic regression models adjusted for potential confounders. RESULTS: Participants with poor sleep quality (PSQI global score ≥10) were more likely to have functional limitations; the odds ratio (95% confidence interval) was 2.90 (1.10-7.64) for physical frailty, 2.73 (1.34-5.58) for LEFI and 2.32 (1.14-4.75) for muscle weakness. Sleep quality components associated with frailty were sleep disturbances, use of sleeping medication and daytime dysfunction. The only quality component associated with LEFI was poor sleep efficiency, while subjective poor sleep quality and daytime dysfunction were linked to muscle weakness. No associations were observed between night-time sleep duration and physical function indicators. CONCLUSIONS: Poor self-reported sleep quality, but not sleep duration, was associated with an increased frequency of physical frailty, LEFI and muscle weakness. Interventions to improve sleep quality could contribute to healthy ageing.

Habitual dietary fat intake and risk of muscle weakness and lower-extremity functional impairment in older adults: A prospective cohort study.

BACKGROUND & AIMS: Fatty acid supplementation increases muscle mass and function in older adults, but the effect of habitual dietary intake is uncertain. Therefore, the objective of this study was to examine the association between habitual dietary fat intake and risk of muscle weakness and lower-extremity functional impairment (LEFI) in older adults. METHODS: Prospective study with 1873 individuals aged ≥60 years from the Seniors-ENRICA cohort. In 2008-10 and 2012, a validated face-to-face diet history was used to record the one-year consumption of up to 880 foods. Then, fatty acids, other nutrients and energy intake were estimated using standard food composition tables. Means of intake between these years were calculated to represent cumulative consumption over the follow-up. Study participants were followed up through 2015 to assess incident muscle weakness (lowest quintile of grip strength) and incident LEFI (Short Physical Performance Battery score ≤6). Analyses were performed with Cox regression and adjusted for the main confounders, including other types of fatty acids. RESULTS: Over a median follow-up of 5.2 years, 331 participants developed muscle weakness and 397 LEFI. Intake of saturated fatty acids (SFA) did not show an association with muscle weakness but was associated with higher risk of LEFI (multivariable hazard ratio (HR) for tertile 3 vs. tertile 1: 1.15; 95% confidence interval: 1.05-2.01; p-trend = 0.02). This association was mostly due to consumption of Spanish cold cuts and pastry and, to a lesser extent, dairy. Monounsaturated fatty acids (MUFA) intake was associated with lower risk of muscle weakness (HR t3 vs. t1: 0.73; 0.54-0.99; p trend = 0.04), and intake of n-3 polyunsaturated fatty acids (PUFA) was associated with reduced risk of both muscle weakness (0.70; 0.52-0.95; p-trend = 0.02) and LEFI (0.49; 0.35-0.68; p-trend <0.001). Olive oil and blue fish, the main sources of MUFA and PUFA, were also associated with lower risk of muscle weakness and LEFI. CONCLUSIONS: Habitual intake of SFA was associated with increased risk of LEFI. By contrast, habitual intake of MUFA and PUFA were associated with lower risk of physical performance impairment.

Consumo de frutos secos y función cognitiva: una revisión sistemática / Nut consumption and cognitive function: a systematic review

Los patrones dietéticos ricos en antioxidantes podrían contribuir a la prevención y el tratamiento de las fases previas de demencia. Los frutos secos tienen una apreciable carga antioxidante y hay evidencia de sus efectos beneficiosos sobre la incidencia de varias enfermedades crónicas y las tasas de mortalidad general. Además, son ricos en ácidos grasos polinsaturados, que también parecen desempeñar un papel positivo en la neurogénesis. El objetivo de esta revisión fue resumir la evidencia de los estudios relacionados con los efectos del consumo de frutos secos sobre la función cognitiva en personas adultas. Se realizó una búsqueda sistemática de artículos publicados en PubMed, Scopus y Web of Science. Un total de 19 artículos cumplieron los criterios de inclusión (siete transversales, cuatro de cohortes y ocho experimentales), que fueron extraídos y revisados de forma independiente por dos revisores. La evidencia proveniente de los estudios transversales y de cohortes resultó incierta, por la disparidad de resultados y su riesgo de sesgo. Sin embargo, en la mayoría de estudios experimentales se observó un efecto protector del consumo de frutos secos sobre alguna dimensión de la función cognitiva, y la calidad metodológica de estos fue aceptable. Además, los efectos parecen independientes del tipo de fruto seco, la cantidad ingerida, la edad y el estado basal de los consumidores. En resumen, estos resultados sugieren que incluir el consumo diario moderado de algún fruto seco en la dieta saludable de las personas adultas podría tener efectos beneficiosos sobre su función cognitiva. No obstante, son necesarios más estudios observacionales longitudinales y experimentales bien diseñados, que proporcionen firmeza a esta evidencia, hasta la fecha sugestiva y de una calidad moderadamente baja

Antioxidant-rich diet patterns could contribute to the prevention and treatment of early stages of dementia. Nuts have an appreciable antioxidant load and there is evidence of their positive effects on several chronic diseases incidence and death rates. Moreover, they are rich in polyunsaturated fatty acids, which might also play a positive role in neurogenesis. The aim of this systematic review was to summarize the evidence from studies related to the effects of nut consumption on cognitive function among adults. We conducted a systematic search of articles published in PubMed, Scopus and Web of Science. A total of 19 articles met the inclusion criteria (seven cross-sectional, four prospective cohorts and eight experimental); these were independently extracted and reviewed by two reviewers. The evidence from the cross-sectional and cohort studies was uncertain, due to the disparity of results and risk of bias. However, in most experimental studies a protective effect of nut consumption on some dimension of cognitive function was observed and the methodological quality of these studies was acceptable. In addition, the effects appear to be independent of nut type, amount of intake, age and baseline status of subjects. In summary, these results suggest that the inclusion of daily nut consumption in the healthy diet pattern of adults could have positive effects on their cognitive function. Nevertheless, more well-designed longitudinal and experimental studies are needed to provide strength to this suggestive evidence

[Nut consumption and cognitive function: a systematic review]. / Consumo de frutos secos y función cognitiva: una revisión sistemática.

INTRODUCTION: Antioxidant-rich diet patterns could contribute to the prevention and treatment of early stages of dementia. Nuts have an appreciable antioxidant load and there is evidence of their positive effects on several chronic diseases incidence and death rates. Moreover, they are rich in polyunsaturated fatty acids, which might also play a positive role in neurogenesis. The aim of this systematic review was to summarize the evidence from studies related to the effects of nut consumption on cognitive function among adults. We conducted a systematic search of articles published in PubMed, Scopus and Web of Science. A total of 19 articles met the inclusion criteria (seven cross-sectional, four prospective cohorts and eight experimental); these were independently extracted and reviewed by two reviewers. The evidence from the cross-sectional and cohort studies was uncertain, due to the disparity of results and risk of bias. However, in most experimental studies a protective effect of nut consumption on some dimension of cognitive function was observed and the methodological quality of these studies was acceptable. In addition, the effects appear to be independent of nut type, amount of intake, age and baseline status of subjects. In summary, these results suggest that the inclusion of daily nut consumption in the healthy diet pattern of adults could have positive effects on their cognitive function. Nevertheless, more well-designed longitudinal and experimental studies are needed to provide strength to this suggestive evidence.

INTRODUCCIÓN: Los patrones dietéticos ricos en antioxidantes podrían contribuir a la prevención y el tratamiento de las fases previas de demencia. Los frutos secos tienen una apreciable carga antioxidante y hay evidencia de sus efectos beneficiosos sobre la incidencia de varias enfermedades crónicas y las tasas de mortalidad general. Además, son ricos en ácidos grasos polinsaturados, que también parecen desempeñar un papel positivo en la neurogénesis. El objetivo de esta revisión fue resumir la evidencia de los estudios relacionados con los efectos del consumo de frutos secos sobre la función cognitiva en personas adultas. Se realizó una búsqueda sistemática de artículos publicados en PubMed, Scopus y Web of Science. Un total de 19 artículos cumplieron los criterios de inclusión (siete transversales, cuatro de cohortes y ocho experimentales), que fueron extraídos y revisados de forma independiente por dos revisores. La evidencia proveniente de los estudios transversales y de cohortes resultó incierta, por la disparidad de resultados y su riesgo de sesgo. Sin embargo, en la mayoría de estudios experimentales se observó un efecto protector del consumo de frutos secos sobre alguna dimensión de la función cognitiva, y la calidad metodológica de estos fue aceptable. Además, los efectos parecen independientes del tipo de fruto seco, la cantidad ingerida, la edad y el estado basal de los consumidores. En resumen, estos resultados sugieren que incluir el consumo diario moderado de algún fruto seco en la dieta saludable de las personas adultas podría tener efectos beneficiosos sobre su función cognitiva. No obstante, son necesarios más estudios observacionales longitudinales y experimentales bien diseñados, que proporcionen firmeza a esta evidencia, hasta la fecha sugestiva y de una calidad moderadamente baja.

Habitual Meat Consumption and Changes in Sleep Duration and Quality in Older Adults.

Dietary proteins are sources of some amino acid precursors of two neurotransmitters relevant for biological rhythms, serotonin and melatonin, which are involved in sleep and alertness. Meat is the main source of proteins in many countries. Furthermore, meat consumption is of special interest because it provides high-quality protein as well as saturated and trans fatty acids. However, its effect on sleep patterns is unclear. Thereby, the aim was to examine the association of habitual meat consumption with changes in sleep duration and with sleep quality in older adults. We used data from 1,341 participants in the Seniors-ENRICA cohort aged ≥60 years, followed from 2012 through 2015. Habitual meat consumption was assessed at baseline with a validated diet history. Sleep duration and quality were ascertained both in 2012 and 2015. Analyses were performed with logistic regression and adjusted for socio-demographic variables, lifestyle, morbidity, sleep duration and poor sleep indicators at baseline. During follow-up, 9.0% of individuals increased and 7.9% decreased their sleep duration by ≥2 hours/night. Compared with individuals in the lowest tertile of meat consumption (<87 g/d), those in the highest tertile (≥128 g/d) showed increased incidence of a large decrease (≥2 h) in sleep duration (OR: 1.93; 95% CI:1.01-3.72; p-trend:0.04). Higher consumption of meat was also associated with incidence of snoring (OR:2.06; 95% CI:1.17-3.60; p-trend:0.01) and poor general sleep quality (OR:1.71; 95% CI:1.04-2.82; p-trend:0.03). Each 100 g/d increment in meat intake was associated with a 60% higher risk of both large sleep duration changes and poor sleep quality (OR:1.60; 95% CI:1.07-2.40). Results were in the same direction for red and processed meat and for white meat separately, and among individuals with physical impairment. Higher meat consumption (≥128 g/d) was associated with changes in sleep duration and with poor sleep in older adults.

Prospective Association Between Nut Consumption and Physical Function in Older Men and Women.

BACKGROUND: The beneficial effect of nut consumption preventing cardio-metabolic diseases and cancer suggests that nuts might also protect from physical function impairment in older people since aging-related functional decline shares biological pathways with these chronic diseases. The objective was to examine the association between nut consumption and impairment of physical function in older adults. METHODS: Prospective study with 3,289 individuals aged ≥60 years from the Seniors-ENRICA cohort. In 2008-2010 and 2012 nut consumption was measured with a validated diet history. Participants were followed-up until 2015 to ascertain incident impaired physical function, specifically impaired agility, mobility, grip strength, gait speed, and overall physical function. Statistical analyses were performed with Cox regression and adjusted for the main confounders, including a wide set of socioeconomic, lifestyle, dietary, and morbidity variables. RESULTS: Overall, 65.7% of participants consumed any type of nuts. The mean intake among nut consumers was 15.1 g/d in men and 14.6 g/d in women. Median consumption of nuts was 11.5 g/d in both sexes. Men consuming ≥11.5 g/d of nuts had a lower risk of impaired agility and mobility than those who did not consume nuts; the hazard ratios (95% confidence interval (CI); p for linear trend) were 0.59 (0.39-0.90; p = .01) and 0.50 (0.29-0.90; p = .02), respectively. In women, compared with nonconsumers, the hazard ratio (95% CI; p for linear trend) of impaired overall physical function for nut intake ≥11.5 g/d was 0.65 (0.48-0.87; p = .004). No association was observed between nut consumption and low grip strength and slow gait speed. CONCLUSIONS: Nut consumption was associated with half the risk of impaired agility and mobility in men and with a lower risk of overall physical function impairment in women. The suggested protective effect of nut consumption on physical functioning merits further examination.