Meal-related difficulties and weight loss in older people: Longitudinal data from MAPT study

Clin Nutr. 2020 Nov;39(11):3483-3488. doi: 10.1016/j.clnu.2020.03.011. Epub 2020 Mar 16.


Background: Difficulties with meal-related activities (preparing meals and food shopping) may influence food intake, and contribute to nutritional risk among elderly people. All known studies on this topic had a cross-sectional design, thereby no causal relationships could be derived. We aim to investigate if difficulties with meal-related activities can contribute to subsequent weight loss in community-dwelling older people.

Methods: We used data of older subjects from the MAPT Study (n = 1531, median age = 74 years, 64% women), who provided prospective data on weight every 6 months and cognitive, physical condition, and functional capacities every year during a 3-year period. Difficulties preparing meals and shopping were evaluated each year with the Alzheimer's Disease Cooperative Study-Activities of Daily Living Prevention Instrument (ADCS ADL-PI) Scale. The risk of losing weight (≥5% or ≥ 3 kg in the following year) was estimated using a time-dependent Cox regression model.

Results: During the 3-year follow-up, a total of 851 subjects experienced at least a 5% or 3 kg weight loss. Two hundred thirty-seven subjects declared having difficulties with meal preparation at least once, and 133 declared having difficulties shopping. Subjects reporting any meal-related difficulties were older (p < 0.001), had more depressive symptoms (p < 0.001), and a lower physical function (p < 0.001) compared to those without difficulties. They also had a lower cognitive score (preparing meals: p < 0.001; shopping: p = 0.005) and a lower body mass index (preparing meals: p = 0.005; shopping: p = 0.023) at the end of the study. Meal-related activities were not associated with weight loss in unadjusted analysis and after adjustment for sex, age, depression, physical and cognitive status.

Conclusion: Difficulties preparing meals and shopping had no effect on weight loss in community-dwelling older people, despite their association with advanced age, functional decline, and depressive symptoms.

Keywords: Activities of daily living; Cooking; Elderly; Meal preparation; Shopping; Weight loss.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology*
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Cognition
  • Cooking*
  • Cross-Sectional Studies
  • Depression / physiopathology
  • Depression / psychology
  • Eating / psychology
  • Female
  • Food Preferences / psychology
  • Functional Status
  • Health Behavior*
  • Humans
  • Independent Living / psychology
  • Longitudinal Studies
  • Male
  • Meals / psychology*
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Weight Loss*