Impact of a posteriori dietary patterns on frailty trajectories in stroke patients: a six-month longitudinal study

Abstract

While dietary interventions offer a practical approach for frailty management, evidence regarding empirically derived a posteriori dietary patterns’ impact on frailty trajectories in stroke patients remains lacking. This study aimed to explore the impact of a posteriori dietary patterns on frailty trajectories, providing empirical evidence for developing frailty prevention strategies based on nutritional management in stroke patients. In this longitudinal study, 341 stroke patients were assessed for frailty at discharge and followed up at 1, 2, 3, and 6 months, and diet evaluations were performed at the 6-month follow-up. Latent class growth modeling identified frailty trajectories, factor analysis derived dietary patterns, and multivariate logistic regression examined their associations. Three frailty trajectories were identified: stable non-frail (46.1%, n = 157), pre-frail recovery (37.5%, n = 128), and persistent frailty (16.4%, n = 56). Four major dietary patterns were derived. The impact of different dietary patterns on frailty trajectories showed that compared to the “alcoholic beverages–red meat–processed meat” pattern, adherence to the “seafood–freshwater food–soy products” (OR = 0.15, 95% CI = 0.05–0.50, P = 0.002), “nuts–fruits–dairy products” (OR = 0.18, 95% CI = 0.05–0.59, P = 0.005), and “dark-colored vegetables–light-colored vegetables” (OR = 0.17, 95% CI = 0.06–0.53, P = 0.002) patterns significantly reduced the likelihood of persistent frailty. In analyses evaluating dietary pattern adherence, higher adherence to the “alcoholic beverages–red meat–processed meat” pattern increased persistent frailty risk, while higher adherence to the “seafood–freshwater food–soy products” and “nuts–fruits–dairy products” patterns reduced this risk. The study underscores the clinical value of identifying distinct frailty trajectories to guide personalized management, and the nutritional guidance may serve as a promising target for preventing and managing frailty in stroke patients.