The associations between diet quality, Body Mass Index (BMI) and Health and Activity Limitation Index (HALEX) in the Geisinger Rural Aging Study (GRAS)

Objectives: To determine the associations between diet quality, body mass index (BMI), and health-related quality of life (HRQOL) as assessed by the health and activity limitation index (HALex) in older adults. Design: Multivariate linear regression models were used to analyze associations between Dietary Screening Tool (DST) scores, BMI and HALex score, after controlling for gender, age, education, living situation, smoking, disease burden and self-vs. proxy reporting. Setting: Geisinger Rural Aging Study, Pennsylvania. Participants: 5,993 GRAS participants were mailed HRQOL and DST questionnaires with 4,009 (1,722 male, 2,287 female; mean age 81.5 ± 4.4) providing complete data. Results: HALex scores were significantly lower for participants with dietary intakes categorized as unhealthy (<60) (0.70, 95% CI 0.69,0.72, p<0.05) or borderline (60-75) (0.71, 95% CI 0.70,0.73, p<0.05) compared to those scoring in the healthy range (>75) (0.75, 95% CI 0.73,0.77) based on DST scores. HALex scores were significantly lower for underweight (0.67, 95% CI 0.63,0.72, p<0.05), obese class II (0.68, 95% Cl 0.66,0.71, p<0.05) and class III participants (0.62 95% CI 0.57,0.67, p<0.05) compared to those with BMI 18.5-24.9. Conclusions: Poor diet quality, as assessed by the DST, is associated with lower HRQOL in adults ≥ 74 years of age.