Nutritional status and habitual dietary intake are associated with frail skin conditions in community-dwelling older people

J Nutr Health Aging Volume 21, Number 2, 2017

NUTRITIONAL STATUS AND HABITUAL DIETARY INTAKE ARE ASSOCIATED WITH FRAIL SKIN CONDITIONS IN COMMUNITY-DWELLING

OLDER PEOPLE

S. IIZAKA1, S. NAGATA2, H. SANADA3

1. School of Nutrition, College of Nursing and Nutrition, Shukutoku University, Chiba, Japan; 2. Departments of Community Nursing; 3. Departments of Gerontological Nursing/Wound Care Management; Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. Corresponding author: Shinji Iizaka, RN, PhD, School of Nutrition, College of Nursing and Nutrition, Shukutoku University. 673 Nitonacho, Chuo-ku, Chiba-shi, Chiba, Japan Phone:[phone] E-mail: [email protected]

Abstract: Objective: Prevention of frail skin is important in older people because frail skin is associated with

a risk of injury in this population. In this study, we investigated the association of nutritional status and habitual

dietary intake with skin conditions in community-dwelling older people. Design: Cross-sectional study. Setting:

Three community settings in Japan from autumn to winter. Participants: Older people aged 65 years without

care-need certification (n=118). Measurements: Malnutrition and obesity were evaluated to assess the nutritional

status. Nutrient and food group intakes per 1000 kcal were evaluated using a brief self-administered diet history

questionnaire. Dietary patterns based on food groups were evaluated by principal component analysis. Skin

condition parameters, including stratum corneum hydration, appearance of xerosis (specific symptom sum

score [SRRC score]), and dermal intensity by high-frequency ultrasonography, were measured on a lower leg.

Multiple linear regression analysis was performed with adjustment for confounders. Results: The mean (standard

deviation) age was 74.1 (4.8) years, and 83.1% of participants were female. A higher intake of plant fat (p=0.018)

was associated with a lower SRRC score. Higher intakes of -tocopherol (p=0.050) and vitamin C (p=0.017)

were associated with increased dermal intensity. A body mass index 25 (p=0.016) was associated with

decreased dermal intensity. A dietary pattern characterized by higher vegetable and fruit intake was associated

with a better skin condition. Conclusion: Plant fat, antioxidant vitamins, and a dietary pattern characterized by

vegetables and fruits showed positive and obesity showed negative associations for frail skin in community-

dwelling older people.

Key words: Aging, dermis, frailty, nutritional assessment, vitamin.

Introduction

Frailty increases vulnerability, functional impairment, and dependency in older people. Such frail people also have frail skin caused by...