Association between the Dietary Inflammatory Index and Risk of Frailty in Older Individuals with Poor Nutritional Status

Both inflammation and poor nutritional status are major risk factors of frailty, and the dietary inflammatory index (DII) has been suggested as being associated with the risk of frailty. The present study aimed to investigate whether DII scores were positively associated with the risk of frailty in older individuals, particularly those with poor nutritional status. In total, 321 community-dwelling older individuals aged 70-85 years were recruited and categorized as non-frail, pre-frail, and frail according to the Cardiovascular Health Study index. DII scores were calculated based on 24-h dietary recall, and nutritional status was assessed using the Mini Nutritional Assessment. Multinomial logistic regression analysis showed that DII scores were positively associated with the risk of frailty in older individuals (odds ratio, OR 1.64, 95% confidence interval, 95% CI 1.25-2.17), particularly those with poor nutritional status (OR 1.68, 95% CI 1.21-2.34). Among the frailty criteria, weight loss (OR 1.29, 95% CI 1.03-1.60), low walking speed (OR 1.33, 95% CI 1.10-1.61), and low grip strength (OR 1.34, 95% CI 1.13-1.60) were associated with DII scores. In addition, the optimal DII cut-off score for frailty was >= 0.93 (sensitivity 71%; specificity: 72%; area under the receiver operating characteristic curve, AUC = 0.792). The present study showed that a pro-inflammatory diet was associated with increased risk of frailty, particularly in older individuals with poor nutritional status. Future randomized controlled trials with a low DII diet for the prevention of frailty are needed to confirm our finding.