Combined effect of eating alone and a poor nutritional status on cognitive decline among older adults in Taiwan

Background and Objectives: Nutritional status is not only associated with older individuals’ physical health but also has an impact on their cognitive functioning. Evidence indicates that a socially integrated lifestyle in the later stages of life protects against cognitive decline and dementia. This study tested the combined effect of two hazards, the risk of malnutrition and eating meals alone, on the cognitive changes among a representative sample of older Taiwanese individuals over an 8-year period. Methods and Study Design: Data were taken from the Taiwan Longitudinal Survey on Aging. In 1999, 2584 respondents aged 65 years were surveyed, and follow-up surveys were performed in 2003 and 2007. The Short Portable Mental Status Questionnaire (SPMSQ) and Mini Nutritional Assessment were used to evaluate participants’ cognitive functioning and nutritional status, respectively. Nutritional status and eating alone data assessed at baseline were combined to predict changes in SPMSQ scores longitudinally. Generalized estimating equations were used to evaluate the longitudinal changes from baseline to 2007. Results: Findings suggest that nutritional status was a salient predictor for cognitive decline among the older Taiwanese adults over the 8-year period. Female respondents who had a compromised nutritional status at baseline and who were eating their meals alone exhibited a greater decrease in SPMSQ scores compared with those who had a normal nutritional status and who were eating their meals with others. Conclusion: Nutritional programs for the elderly should focus on what they eat as well as who they eat their meals with to prevent social isolation, especially among older women.