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Shan Hai,1 Qi Gao,2 Xinyi Gwee,2 Denise Qian Ling Chua,2 Keng Bee Yap,3 Tze Pin Ng2 1Gerontology and Geriatrics Centre, West China Hospital of Sichuan University, Chengdu, People’s Republic of China; 2Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; 3Department of Medicine, Ng Teng Fong General Hospital, SingaporeCorrespondence: Tze Pin NgDepartment of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Level 9, NUHS Tower Block, 1E Kent Ridge Road, 119228, SingaporeTel +65 6772 4518; +65 6772 3478Fax +65 6777 2191Email pcmngtp@nus.edu.sgPurpose: Malnutrition and population ageing are doubly global healthcare challenges. It is widely recognized that disability is a major contributor to malnutrition among older people, but the importance of reducing malnutrition risk (MR) for disability prevention is given little attention. We investigated the association between MR and risk of incident disability and functional decline among community-dwelling older persons.Materials and Methods: Prospective cohort study of community-dwelling older adults aged 55 and above (Singapore Longitudinal Ageing Study) with 3– 5 years follow-up. MR was measured at baseline using an appropriate and validated index (ENIGMA); physical and functional measures at baseline and follow-up included instrumental and basic activity of daily living (ADL), knee extension (KES), gait velocity (GV), timed up-and-go (TUG).Results: Compared to low MR, mild-moderate MR (OR = 1.43, 95% CI = 1.02– 2.01) and severe MR (OR=1.74, 95% CI=1.10– 2.74) were associated with higher risks of incident disability. Severe MR was associated with functional decline (OR = 1.69, 95% CI = 1.11– 2.57). Estimates were adjusted for demographic, social, lifestyle behaviour and health variables. In particular, eating difficulty was associated with incident disability and functional decline, and low lymphocyte with functional decline. Severe MR and low albumin were associated with 37% worse GV and 126% worse TUG declines; consuming few vegetables or fruits with 34% worse KES decline; polypharmacy with 56% worse TUG decline.Conclusion: Malnutrition risk increased the risk of incident disability and functional decline in non-disabled persons, it worsened physical performance declines. Further studies should investigate the effectiveness of nutritional interventions in reducing the risk of disability among older people.Keywords: malnutrition, functionality, ageing, prospective cohort study

Tze Pin Ng,1 Qi Gao,1 Xinyi Gwee,1 Denise QL Chua,1 Wan C Tan2 1Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore; 2Centre for Heart Lung Innovation, Department of Medicine, University of British Columbia, Vancouver, BC, CanadaCorrespondence: Tze Pin NgGerontology Research Programme, Department of Psychological Medicine, National University of Singapore, NUHS Tower Block, 9 th Floor, 1E Kent Ridge Road, 119228, SingaporeTel +65-67723478Fax +65-67772191 Email pcmngtp@nus.edu.sgObjective: The anti-oxidant and anti-inflammatory actions of phytochemicals and the smooth muscle relaxant actions of theophylline present in tea may confer pulmonary protection and reduce COPD risk. We investigated tea consumption (black, oolong, or green) association with COPD risks in a population-based cohort study of older adults aged ≥ 55.Methods: GOLD criteria was used to identify prevalent and incident cases of COPD (FEV1/FVC < 0.70) among 4617 participants and 920 participants free of COPD at baseline who were assessed at follow-up 4.5 years later.Results: Prevalent cases of COPD consumed less tea than their non-COPD counterparts. Estimated odds ratio (OR) and 95% confidence intervals (95% CI) of association with prevalent COPD, adjusted for age, sex, ethnicity, housing type, smoking, alcohol, physical activity and BMI declined across tea consumption levels (p-trend=0.048), and was lowest for ≥ 3 cups/day (OR=0.77, 95% CI=0.61– 0.96). The cumulated incidence of COPD declined across tea consumption categories (p-trend=0.012) and the lowest OR of association (OR=0.35, 95% CI=0.17– 0.69) with consuming ≥ 3 cups/day after co-variate adjustment.Conclusion: Different kinds of tea showed similar non-significant trends of associations but appeared to be strongest for green tea. Tea consumption in this Asian population was associated with lowered COPD prevalence and incidence.Keywords: phytochemical, polyphenols, theophylline, epidemiological, longitudinal