Diet‐related quality of life may directly and indirectly affect health‐related quality of life through protein intake and frailty in patients with osteoporosis: Results from a prospective cohort study
Yoshinari Matsumoto, Chie Wakano, Takashi Kimura, Eri Nishioka, Nana Yunoki, Masao KurokawaAim
We aimed to examine the direct and indirect associations between diet‐related quality of life (DRQOL) and health‐related quality of life (HRQOL) in patients with osteoporosis.
Methods
Cross‐sectional and longitudinal analyses were conducted using data from a 1‐year prospective cohort survey of 532 consecutive patients with osteoporosis. The DRQOL was assessed using a short version of the Diet‐Related Quality of Life Scale. Dietary intake statuses were assessed using the brief‐type self‐administered diet history questionnaire. Frailty was assessed using the Kihon Checklist (KCL). HRQOL was assessed using the EuroQol 5‐dimensions 5‐level (EQ‐5D‐5L) score. The association between the DRQOL scores and each item was analyzed using multivariable logistic regression, path analysis, and a cross‐lagged panel model.
Results
In the baseline cross‐sectional analysis, DRQOL scores at the ≥75th percentile of the cohort were associated with protein intake (odds ratio [OR] 2.18; 95% confidence intervals [CIs]: 1.20, 3.96), frailty (OR: 0.14; 95% CIs: 0.06, 0.33), and having a full EQ‐5D‐5L score (OR: 2.37; 95% CIs: 1.33, 4.21). In the path analysis, the DRQOL score was directly related to the EQ‐5D‐5L score and indirectly related via protein intake and the KCL score (standardized direct effect: 0.08, standardized indirect effect: 0.11). In the cross‐lagged panel model, DRQOL scores at baseline were indirectly positively associated with EQ‐5D‐5L scores at 1 year (standardized direct effect: −0.06, standardized indirect effect: 0.23).
Conclusions
The DRQOL in patients with osteoporosis may be directly and indirectly related to the HRQOL via protein intake and frailty. Geriatr Gerontol Int 2025; ••: ••–••.