Association between cMIND Diet adherence and frailty among Chinese older adults: A 10-Year Longitudinal Study

Objective: Diet is an influencing factor of frailty. Domestic and international studies have focused on the effect of the Chinese Mediterranean-DASH Intervention for Neurodegenerative Delay (cMIND) dietary patterns on cognitive impairment. Both cognitive impairment and diet are significant factors influencing frailty, but the impact of cMIND on frailty remains unclear. The purpose of this study is to investigate the impact of the cMIND dietary pattern on frailty in older adults. Design: A longitudinal cohort survey study Methods: Longitudinal analysis was conducted using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2008 to 2018, involving 1,943 older adults aged 65 years and above. Adherence to the cMIND diet was assessed using a food frequency questionnaire, whereas frailty status was determined using the frailty index. The cMIND dietary scores were categorized into three groups based on tertiles: T1 (0-4), T2 (4.5-5.5), and T3 (6-12). Cox proportional hazards models were employed to examine the association between the two, and restricted cubic spline curves with four knots at the 5th, 35th, 65th, and 95th percentiles were used to explore potential nonlinear relationships between baseline cMIND scores and frailty index. Results: A total of 1,943 participants were included, with an average age of 74.91±7.27 years, including 982 females (50.5%) and 961 males (49.5%). Restricted cubic spline curves demonstrated a correlation between cMIND and frailty index in older participants ( p < 0.05). In the adjusted model, compared with participants in the lowest tertile of cMIND scores, those in the highest tertile exhibited a 20% reduction in frailty risk (HR = 0.80, 95% CI: 0.70-0.91, p < 0.001).Subgroup analysis showed that this protective effect was consistent across different age, gender, and education level groups (interaction p >0.05). Conclusion: Higher cMIND adherence is associated with lower frailty risk in the Chinese elderly population, highlighting the importance of the cMIND dietary pattern in delaying frailty.