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Nutrients
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Nutrition, Physical Activity, Frailty, and Cognitive Decline in Older Adults:...
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Nutrition, Physical Activity, Frailty, and Cognitive Decline in Older Adults: Addressing Age-Related Health

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Geriatric Nutrition".

Deadline for manuscript submissions: 15 January 2026 | Viewed by 3268

Special Issue Editors

Prof. Dr. Shuzo Kumagai

E-Mail Website
Guest Editor
Kumagai Institute of Health Policy, Fukuoka, Japan
Interests: physical activity epidemiology; exercise physiology; public health; health promotion; geriatrics; physical frailty;cognitive frailty; cognitive function; exercise intervention
Prof. Dr. Rengfei Shi

E-Mail Website
Guest Editor
School of Exercise and Health, Shanghai University of Sport, Shanghai,China
Interests: nutrition; dietary patterns; physical activity; obesity; sarcopenia; older adults
Dr. Si Chen

E-Mail Website
Guest Editor
School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
Interests: frailty; physical activity; sedentary behavior; dietary patterns; older adults

Special Issue Information

Dear Colleagues,

In an aging of the world, various changes will occur in lifestyle behavior in daily life. In particular, nutritional problems cause weight loss due to reductions in energy intake against the backdrop of various factors. Reductions in energy consumption due to a decrease in physical activity and an increase in sedentary behavior, and the associated decline in physical fitness and motor function that comes with this, induce the onset of frailty, which leads to cognitive decline and the onset of dementia. In this Special Issue, in addition to the involvement of nutrition and physical activity in the onset of frailty and cognitive decline, we focus on lifestyle factors as contributors to improvement and summarize the latest scientific findings. Specifically, the following contents are included:

  • Frailty, cognitive function, and lifestyle factors such as nutrition, physical activity, and sedentary behavior in the elderly, and proposals for health issues that need to be addressed;
  • The involvement and mechanisms of nutrition, physical activity, and sedentary behavior as factors in the development of frailty and cognitive decline;
  • The prevention and improvement of frailty and cognitive decline through nutrition and physical activity interventions, and their mechanisms.

Prof. Dr. Shuzo Kumagai
Prof. Dr. Rengfei Shi
Dr. Si Chen
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • nutrition
  • physical activity
  • sedentary behavior
  • physical frailty
  • cognitive frailty
  • cognitive function
  • mild cognitive impairment
  • dementia
  • Alzheimer’s disease
  • lifestyle
  • healthy life expectancy
  • exercise interventions
  • older adults
  • geriatrics

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Published Papers (4 papers)

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Research

14 pages, 331 KB  
Article
Association Between Dietary Adherence and Cognitive Function Among Rural Older Patients with Cardiometabolic Multimorbidity: The Moderating Role of Health Management
by Fangfang Hu, Lingzhong Xu and Wenzhe Qin
Nutrients 2025, 17(24), 3820; https://doi.org/10.3390/nu17243820 - 6 Dec 2025
Viewed by 258
Abstract
Background: Cardiometabolic multimorbidity (CMM) among rural older adults is becoming increasingly prevalent. Although previous studies have confirmed that dietary adherence significantly affects cognitive function, the mechanisms underlying this relationship remain insufficiently explored. This cross-sectional study aimed to examine the association between dietary adherence [...] Read more.
Background: Cardiometabolic multimorbidity (CMM) among rural older adults is becoming increasingly prevalent. Although previous studies have confirmed that dietary adherence significantly affects cognitive function, the mechanisms underlying this relationship remain insufficiently explored. This cross-sectional study aimed to examine the association between dietary adherence and cognitive function among rural older patients with CMM and further explored the moderating role of health management. Methods: The sample was selected using a multi-stage cluster random sampling method and a total of 1487 rural older patients with CMM were ultimately included. Hierarchical regression analysis was employed to examine the association between dietary adherence and cognitive function and test the moderating role of health management. Simple slope analysis was further employed to explore the moderation effect. Results: The cognitive function and dietary adherence scores of rural older patients with CMM were 20.790 ± 6.278 and 2.157 ± 0.286, respectively. Dietary adherence was significantly and positively associated with cognitive function (β = 2.000, p < 0.001) and health management moderated this relationship (β = 4.287, p = 0.009). Compared with rural older patients with CMM who did not receive health management, the positive predictive effect of dietary adherence on cognitive function was significantly stronger among those who received health management. Conclusions: Higher dietary adherence was positively associated with better cognitive function among rural older patients with CMM, and receiving health management further strengthened this association. These findings emphasized the importance of integrating dietary guidance within community-based health management interventions to promote cognitive function. Full article
(This article belongs to the Special Issue Nutrition, Physical Activity, Frailty, and Cognitive Decline in Older Adults: Addressing Age-Related Health)
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11 pages, 311 KB  
Article
Baduanjin Exercise, With or Without Vitamin D, Outperforms Vitamin D Alone in Reducing Frailty Among Institutionalized Older Adults: A Cluster-Based Randomized Controlled Trial
by Jing Gao, Ke Chen, Hui Xie, Ming Li and Si Chen
Nutrients 2025, 17(23), 3795; https://doi.org/10.3390/nu17233795 - 3 Dec 2025
Viewed by 275
Abstract
Background: Frailty is a common condition among older adults residing in long-term care facilities and is associated with adverse health outcomes. Physical exercise and vitamin D supplementation have been proposed as preventive and therapeutic strategies, yet the combined effects of the two interventions [...] Read more.
Background: Frailty is a common condition among older adults residing in long-term care facilities and is associated with adverse health outcomes. Physical exercise and vitamin D supplementation have been proposed as preventive and therapeutic strategies, yet the combined effects of the two interventions remain uncertain. This cluster-based randomized controlled trial evaluated the independent and combined effects of Baduanjin exercise and vitamin D supplementation on frailty among residents of long-term care facilities. Methods: Sixty-four participants from three long-term care facilities in Jinan, China, were cluster-based randomized into a Baduanjin group (n = 23), a vitamin D group (n = 17), or a combined group (n = 24) for a 3-month intervention. The primary outcome was the frailty phenotype score, and the secondary outcome was serum 1,25(OH)2D3 concentration. Group comparisons were conducted using analysis of covariance (ANCOVA). Results: After the 3-month intervention, frailty phenotype scores were significantly lower in the Baduanjin (1.43 ± 0.90, p < 0.05) and combined (1.08 ± 1.10, p < 0.05) groups compared with the vitamin D group (2.65 ± 0.79), while no significant difference was observed between the Baduanjin and combined groups (p = 0.470). No significant between-group differences were found in the changes in 1,25(OH)2D3 levels (p = 0.215), whereas they were significantly increased from baseline in both the vitamin D (from 15.04 ± 2.67 to 18.43 ± 3.70, p < 0.05) and combined groups (from 14.77 ± 2.15 to 16.86 ± 2.50, p < 0.05). Conclusions: Baduanjin exercise, either alone or combined with vitamin D supplementation, effectively mitigated frailty among older adults residing in long-term care facilities. Full article
(This article belongs to the Special Issue Nutrition, Physical Activity, Frailty, and Cognitive Decline in Older Adults: Addressing Age-Related Health)
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17 pages, 384 KB  
Article
Validating a Revised Oral Frailty 5-Item Checklist (OF-5) to Detect Pre-Symptomatic Brain Changes in Cognitively Unimpaired Older Adults
by Makoto Murahashi, Kenjiro Ono, Moeko Noguchi-Shinohara, Mai Ishimiya-Jokaji, Kentaro Ide, Toshihiro Kawano, Shusuke Tokuchi, Risako Suzuki, Mikana Isa, Shuichi Kawashiri and Hiroyuki Nakamura
Nutrients 2025, 17(19), 3058; https://doi.org/10.3390/nu17193058 - 25 Sep 2025
Viewed by 875
Abstract
Objective: Oral frailty is associated with an increased risk of cognitive decline, yet practical tools for early identification remain limited. The Oral Frailty 5-item Checklist (OF-5), recently standardized in Japan, does not account for severe tooth loss, which is a known risk factor [...] Read more.
Objective: Oral frailty is associated with an increased risk of cognitive decline, yet practical tools for early identification remain limited. The Oral Frailty 5-item Checklist (OF-5), recently standardized in Japan, does not account for severe tooth loss, which is a known risk factor for brain atrophy. We developed a revised version of the OF-5 that includes the criterion of having nine or fewer teeth. This study aimed to validate the revised OF-5 as a screening tool for detecting early brain structural changes related to dementia risk in cognitively unimpaired older adults. Methods: We analyzed 732 cognitively unimpaired participants from a population-based Japanese cohort (baseline 2016–2018). Oral frailty was assessed using both the original OF-5 and the revised OF-5. Brain volumes were measured by MRI and processed with FreeSurfer. Associations between oral frailty status and regional brain volumes were tested using multivariable-adjusted models, with further adjustment for nutrient intake and food consumption. Results: The revised OF-5, which adds severe tooth loss (≥9 teeth) as a criterion, showed greater sensitivity in detecting dementia-related brain changes than the original version. With the original OF-5, oral frailty was associated only with reduced fusiform gyrus volume (1.088% vs. 1.109% of estimated total intracranial volume [eTIV]; p < 0.05). In contrast, the revised OF-5 detected broader changes: orally frail participants showed significantly higher white matter hyperintensity (WMH) volume (0.366% vs. 0.302% of eTIV; p < 0.05) and smaller volumes in the medial temporal lobe (1.824% vs. 1.856%), pars triangularis (0.401% vs. 0.412%), and fusiform gyrus (1.080% vs. 1.111%)—all p < 0.05 (FWE-corrected). These associations persisted after adjusting for nutrient intake and food consumption. Conclusions: The revised OF-5 improves identification of pre-symptomatic brain changes in cognitively healthy older adults, independent of nutrition. It may serve as a simple and practical tool for early screening of dementia risk in clinical and community settings. Full article
(This article belongs to the Special Issue Nutrition, Physical Activity, Frailty, and Cognitive Decline in Older Adults: Addressing Age-Related Health)
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18 pages, 825 KB  
Article
Composite Meal-Related Behaviors and Health Indicators: Insight from Large-Scale Nationwide Data on Korean Adults
by Seongryu Bae and Hyuntae Park
Nutrients 2025, 17(18), 2982; https://doi.org/10.3390/nu17182982 - 17 Sep 2025
Cited by 1 | Viewed by 788
Abstract
Objectives: Multidimensional dietary patterns provide a more comprehensive assessment of meal-related behavior than single behaviors, yet evidence on their variation across adulthood and association with health factors relevant to healthy aging is limited. This study examined meal-related behavior pattern distribution by age and [...] Read more.
Objectives: Multidimensional dietary patterns provide a more comprehensive assessment of meal-related behavior than single behaviors, yet evidence on their variation across adulthood and association with health factors relevant to healthy aging is limited. This study examined meal-related behavior pattern distribution by age and identified predictors of unhealthy patterns. Methods: Data from 47,332 adults aged ≥ 18 years in the Korea National Health and Nutrition Examination Survey (2014–2022) were analyzed. Participants were divided into three age groups: young adults (18–39 years), middle-aged adults (40–64 years), and older adults (≥65 years). Within each age group, participants were further classified into three categories based on their adherence to three key meal-related behaviors: High adherence (all three behaviors: regular breakfast, shared mealtimes, and infrequent eating out), Moderate adherence (two behaviors), or Low adherence (one or none). Group differences in sociodemographic, clinical variables, nutrient intake, biochemical markers, and lifestyle factors were tested using ANOVA and Pearson’s chi-square, and predictors were identified with multinomial logistic regression. Results: Older adults most frequently showed the High adherence group (51.1%) but had the lowest prevalence of shared mealtimes (66.3%), suggesting social vulnerabilities despite healthy individual habits. Young adults had the highest Low pattern prevalence, which was primarily driven by infrequent breakfast and frequent eating out. Across all ages, poorer patterns were consistently associated with living alone, prolonged sedentary time, and adverse metabolic profiles. Middle-aged adults exhibited moderate adherence to healthy behaviors but showed the highest prevalence of chronic disease. In older adults, poorer patterns were associated with lower intakes of energy, carbohydrate, protein, and dietary fiber intake, alongside higher rates of living alone and sedentary behavior. Conclusions: Composite meal-related behaviors differed across age groups as follows: Young adults most frequently exhibited low adherence, middle-aged adults showed moderate adherence but bore the highest burden of chronic diseases, while older adults demonstrated high breakfast adherence and low frequency of eating out, but faced nutritional insufficiency and social vulnerability. These findings suggest the need for personalized interventions for each age group. Full article
(This article belongs to the Special Issue Nutrition, Physical Activity, Frailty, and Cognitive Decline in Older Adults: Addressing Age-Related Health)
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