Dietary deterioration from midlife to late life, intrinsic capacity decline, and mortality: a 10-year CLHLS study
- 1epartment of Traditional Chinese Medicine, The Third People's Hospital of Yunnan Province, Kunming, China
Abstract
BackgroundIntrinsic capacity (IC), the WHO composite of physical and mental capacities, is a central endpoint for healthy ageing. Whether dietary patterns measured across midlife and late life predict IC decline and mortality in very old populations remains unclear.MethodsWe analysed 16,068 Chinese adults aged ≥65 years from the CLHLS (2008–2018; 9,359 deaths over 63,132 person-years). Eight harmonised food groups were scored from recalled midlife (≈age 60) and late-life (2008 baseline) reports, cross-classified into stable-high, improved, worsened, and stable-low groups, and separately clustered into data-driven latent classes. Outcomes were all-cause mortality, repeated IC trajectories (IPCW-weighted GEE), incident IC impairment, and observed 10-year IC status.ResultsRelative to stable-high, the worsened (HR 1.135, 95% CI 1.055–1.222) and stable-low (HR 1.056, 1.008–1.107) groups had higher mortality after disease burden was entered categorically; each 10-point higher late-life score was associated with lower mortality (HR 0.969, 0.943–0.996), whereas recalled midlife score showed no independent association. The stable-low group declined faster in IC (group-by-year p = 0.028), and data-driven low-quality classes declined four- to eightfold faster than the diverse class. No dietary pattern independently predicted incident IC impairment once death was handled as a competing event. By 2018, mortality showed the clearest gradient (28–30% dead in diverse classes vs. 47–48% in poor classes).ConclusionIn this nationwide cohort of older adults, varied dietary profiles were associated with modestly lower mortality and slower IC decline. The mortality association was more evident for late-life diet than for recalled midlife diet, and this pattern was retained in complete-diet-item sensitivity analyses; however, these estimates are not a formal test of a difference between life-stage associations. Associations with incident IC impairment were not consistently supported in the competing-event analysis.
Related
- Association Between Dietary Diversity and Intrinsic Capacity Among Chinese Older Adults: A Cross-Sectional Study Based on the CLHLS 2018
- Criterion validity of brief, comprehensive, and latent measures of intrinsic capacity against frailty, disability, and mortality in older adults.
- Midlife mobility limitation and later-life functional deterioration: A 15-year study from Taiwan
- Association of dietary total antioxidant capacity, dietary inflammatory index, and dietary phytochemical index with sarcopenia in middle-aged and older Iranian women: a case-control study
- Intrinsic capacity patterns and their association with early postoperative functional outcomes in older adults undergoing total knee arthroplasty
BibTeX
@article{cun2026dietary,
title = {{Dietary deterioration from midlife to late life, intrinsic capacity decline, and mortality: a 10-year CLHLS study}},
author = {Dejun Cun and Guobin Xia and Jing Chen and Ye Zhang},
journal = {Frontiers in Nutrition},
year = {2026},
month = nov,
doi = {10.3389/fnut.2026.2001769},
url = {https://doi.org/10.3389/fnut.2026.2001769},
note = {CC BY},
}
RIS
TY - JOUR
TI - Dietary deterioration from midlife to late life, intrinsic capacity decline, and mortality: a 10-year CLHLS study
AU - Dejun Cun
AU - Guobin Xia
AU - Jing Chen
AU - Ye Zhang
PY - 2026
DA - 2026/11/02
JO - Frontiers in Nutrition
DO - 10.3389/fnut.2026.2001769
UR - https://doi.org/10.3389/fnut.2026.2001769
AB - BackgroundIntrinsic capacity (IC), the WHO composite of physical and mental capacities, is a central endpoint for healthy ageing. Whether dietary patterns measured across midlife and late life predict IC decline and mortality in very old populations remains unclear.MethodsWe analysed 16,068 Chinese adults aged ≥65 years from the CLHLS (2008–2018; 9,359 deaths over 63,132 person-years). Eight harmonised food groups were scored from recalled midlife (≈age 60) and late-life (2008 baseline) reports, cross-classified into stable-high, improved, worsened, and stable-low groups, and separately clustered into data-driven latent classes. Outcomes were all-cause mortality, repeated IC trajectories (IPCW-weighted GEE), incident IC impairment, and observed 10-year IC status.ResultsRelative to stable-high, the worsened (HR 1.135, 95% CI 1.055–1.222) and stable-low (HR 1.056, 1.008–1.107) groups had higher mortality after disease burden was entered categorically; each 10-point higher late-life score was associated with lower mortality (HR 0.969, 0.943–0.996), whereas recalled midlife score showed no independent association. The stable-low group declined faster in IC (group-by-year p = 0.028), and data-driven low-quality classes declined four- to eightfold faster than the diverse class. No dietary pattern independently predicted incident IC impairment once death was handled as a competing event. By 2018, mortality showed the clearest gradient (28–30% dead in diverse classes vs. 47–48% in poor classes).ConclusionIn this nationwide cohort of older adults, varied dietary profiles were associated with modestly lower mortality and slower IC decline. The mortality association was more evident for late-life diet than for recalled midlife diet, and this pattern was retained in complete-diet-item sensitivity analyses; however, these estimates are not a formal test of a difference between life-stage associations. Associations with incident IC impairment were not consistently supported in the competing-event analysis.
SN - 2296-861X
ER -