Network Analysis of Food Intake Patterns and Frailty Dimensions in Chinese Older Adults: A National Cross-Sectional...

Background: Frailty is a public health concern in older adults. However, associations between food intake patterns and frailty dimensions remain insufficiently understood. This study aimed to construct a network linking food intake patterns with frailty dimensions, identify nodes with high centrality and bridge nodes, and provide evidence for frailty identification and factors that may be associated with frailty in older adults. Methods: We included 14,140 older adults from the 2017-2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). Food intake was assessed using a validated food frequency questionnaire, and patterns were extracted by exploratory factor analysis. Frailty was assessed using a frailty index based on 35 health-related deficits and classified into three dimensions: basic status (BS), basic ability (BA), and medical history (MH). Network analysis with a Gaussian graphical model was used to construct a partial correlation network and identify central and bridge nodes. Results: Four food intake patterns were identified: FD-1 (legumes-eggs-milk pattern), FD-2 (fruits-vegetables pattern), FD-3 (garlic-nuts-salt-preserved vegetables pattern), and FD-4 (meat-fish pattern). FD-1 and FD-2 showed high strength centrality, indicating strong connections within the network. The strongest cross-network association was negative between FD-2 and BS. FD-3 was negatively associated with BA, whereas FD-4 was weakly positively associated with MH. BA had the highest bridge strength, while FD-1 showed high bridge closeness and betweenness. Conclusions: Food intake patterns showed complex associations with frailty dimensions. FD-1, FD-2, and BA emerged as potential nodes of interest. Future studies are warranted to investigate whether dietary strategies centered on FD-1 and FD-2 are associated with preserved function and reduced frailty risk in older adults.