Independent and Joint Associations of Diet Quality and Rest–Activity Rhythm Phenotypes with Frailty Among Rural Older Adults
4 affiliations
- 1School of Physical Education, Shandong University, Jinan 250061, China
- 2Shandong Le Yue Dong Health Management Co., Ltd., Jinan 250101, China
- 3School of Nursing and Rehabilitation, Shandong University, Jinan 250012, China
- 4Department of Physical Education, Tianjin Medical University, Tianjin 300070, China
Abstract
Objectives: This study aimed to identify rest–activity rhythm (RAR) phenotypes and examine the independent and joint associations of RAR phenotypes and diet quality with frailty among rural older adults. Methods: This cross-sectional study included 1203 rural Chinese adults aged 65 to 85 years. Accelerometer-derived inter-daily stability, intra-daily variability, and relative amplitude were used to identify RAR phenotypes through latent profile analysis. Diet quality was assessed using the China Prime Diet Quality Score, and frailty was assessed using the Fried Frailty Phenotype. RAR phenotypes and median-dichotomized diet quality were combined into joint groups. Robust linear and ordered logistic regression examined associations with frailty score and severity, respectively. Subgroup and interaction analyses were conducted by sex and age group. Results: Five RAR phenotypes were identified. Compared with the robust-rhythm phenotype, the severely disrupted phenotype was associated with a 0.516-point higher frailty score and 148.6% higher odds of greater frailty severity, while the fragmented low-amplitude phenotype was associated with 49.3% higher odds. Each 10-point increase in diet quality score was associated with a 0.127-point lower frailty score and 29.3% lower odds of greater frailty severity. Joint analyses showed greater frailty in both typical-rhythm and fragmented low-amplitude phenotypes combined with lower diet quality (β = 0.229, OR = 2.020; β = 0.250, OR = 2.179, respectively), with the highest frailty score observed in the severely disrupted and lower-diet-quality group (β = 0.600; OR = 2.774). Severely disrupted combinations were associated with greater frailty whether diet quality was higher (β = 0.512; OR = 3.092) or lower (β = 0.600; OR = 2.774). No evidence of overall interaction by sex or age group was observed. Conclusions: Better diet quality and more robust RAR patterns were independently associated with lower frailty. Considering both factors may provide a broader perspective on behavioral factors related to frailty in older adults.
Related
- Kidney dysfunction under cardiometabolic stress promotes calorie-intake-independent wasting and frailty-like muscle phenotypes
- Telomere-Independent Associations of hTERT Promoter Polymorphisms with Metabolic Phenotypes and Diabetic Complications
- Physical activity phenotypes identified by latent class analysis and their associations with metabolic syndrome among Korean adults
- Independent Associations of Body Composition with Dance Training Experience, Physical Activity, and Sedentary Behavior Among Polish Folk Dancers: A Cross-Sectional Study
- Associations of Cognitive Function and Physical Activity with Frailty: A Community-Based Study of Older Adults.
BibTeX
@article{du2026independent,
title = {{Independent and Joint Associations of Diet Quality and Rest–Activity Rhythm Phenotypes with Frailty Among Rural Older Adults}},
author = {Litao Du and Lina Wang and Ke Chen and Qiang He and Yang Pan and Xianliang Zhang and Si Chen},
journal = {Nutrients},
year = {2026},
month = oct,
doi = {10.3390/nu18213489},
url = {https://www.mdpi.com/2072-6643/18/21/3489},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Independent and Joint Associations of Diet Quality and Rest–Activity Rhythm Phenotypes with Frailty Among Rural Older Adults
AU - Litao Du
AU - Lina Wang
AU - Ke Chen
AU - Qiang He
AU - Yang Pan
AU - Xianliang Zhang
AU - Si Chen
PY - 2026
DA - 2026/10/23
JO - Nutrients
DO - 10.3390/nu18213489
UR - https://www.mdpi.com/2072-6643/18/21/3489
AB - Objectives: This study aimed to identify rest–activity rhythm (RAR) phenotypes and examine the independent and joint associations of RAR phenotypes and diet quality with frailty among rural older adults. Methods: This cross-sectional study included 1203 rural Chinese adults aged 65 to 85 years. Accelerometer-derived inter-daily stability, intra-daily variability, and relative amplitude were used to identify RAR phenotypes through latent profile analysis. Diet quality was assessed using the China Prime Diet Quality Score, and frailty was assessed using the Fried Frailty Phenotype. RAR phenotypes and median-dichotomized diet quality were combined into joint groups. Robust linear and ordered logistic regression examined associations with frailty score and severity, respectively. Subgroup and interaction analyses were conducted by sex and age group. Results: Five RAR phenotypes were identified. Compared with the robust-rhythm phenotype, the severely disrupted phenotype was associated with a 0.516-point higher frailty score and 148.6% higher odds of greater frailty severity, while the fragmented low-amplitude phenotype was associated with 49.3% higher odds. Each 10-point increase in diet quality score was associated with a 0.127-point lower frailty score and 29.3% lower odds of greater frailty severity. Joint analyses showed greater frailty in both typical-rhythm and fragmented low-amplitude phenotypes combined with lower diet quality (β = 0.229, OR = 2.020; β = 0.250, OR = 2.179, respectively), with the highest frailty score observed in the severely disrupted and lower-diet-quality group (β = 0.600; OR = 2.774). Severely disrupted combinations were associated with greater frailty whether diet quality was higher (β = 0.512; OR = 3.092) or lower (β = 0.600; OR = 2.774). No evidence of overall interaction by sex or age group was observed. Conclusions: Better diet quality and more robust RAR patterns were independently associated with lower frailty. Considering both factors may provide a broader perspective on behavioral factors related to frailty in older adults.
SN - 2072-6643
ER -