Association of swallowing function and Mediterranean diet adherence among community-dwelling older adults: results from the DIAPELH Study.

BACKGROUND & AIMS: Swallowing difficulties may alter food choices and compromise dietary quality in older adults. This cross-sectional study examined the association between self-reported swallowing/eating function and Mediterranean diet adherence among community-dwelling older adults in the Peloponnese, Greece. METHODS: Older adults aged >60 years who had been free-living in the Peloponnese for at least five years were recruited. Swallowing/eating function was assessed using the Eating Assessment Tool-10 (EAT-10), with scores ≥3 indicating swallowing difficulties. Dietary intake was evaluated using a validated food frequency questionnaire, and Mediterranean diet adherence was assessed with the MedDietScore. Depressive symptomatology and healthy aging were assessed using the Geriatric Depression Scale and Successful Aging Index, respectively. RESULTS: N=680 older adults were included and 11.8% had EAT-10 scores ≥3. Compared with participants scoring <3 on the EAT-10, those scoring ≥3 were older (p<0.001), had lower MedDietScore values (35.5±3.9 vs. 36.7±4.1, p=0.01), lower median fish (p=0.023) and fruit (p=0.012) intake but also lower alcohol intake (p=0.007). After adjustments for several confounders, EAT-10 ≥3 was associated with a 1.55-point lower MedDietScore (b=-1.55±0.51, p=0.003), while each 5-point higher MedDietScore was associated with 36.8% lower odds of EAT-10 ≥3 (OR=0.632, p=0.006). CONCLUSIONS: Greater self-reported eating-function impairment was modestly associated with lower Mediterranean diet adherence among community-dwelling older adults. Eating-function screening may support more tailored Mediterranean diet guidance in older adults.