Frailty is a geriatric syndrome that leads to increased risk of hospitalization, disability, and death. The effect of plant-based diets defined by the quality of their plant foods is unclear. Our objective is to study the association between two plant-based diet indices and the occurrence of frailty among community-dwelling older adults in Spain. We analyzed data from 1880 individuals aged ≥ 60 years from the Spanish Seniors ENRICA-1 cohort. We used a validated diet history to build two indices: (a) the healthful Plant-based Diet Index (hPDI) where healthy plant foods received positive scores, whereas less-healthy plant foods and animal foods received reverse scores; and (b) the unhealthful Plant-based Diet Index (uPDI), with positive scores to less-healthy plant foods and reverse scores to animal and healthy plant foods. Incident frailty was defined with the Fried phenotype. Study associations were summarized with odds ratios (OR) and 95% confidence intervals (CI) obtained from multivariable logistic models. After 3.3 years of follow-up, 136 incident frailty cases were ascertained. Comparing the highest vs. the lowest tertile of adherence, the OR [95% CI] for frailty was 0.43 (0.25–0.74; p-trend = .003) for the hPDI, and 2.89 (1.73–4.84; p-trend < .001) for the uPDI. Higher consumption of healthy plant foods was inversely associated with frailty (0.39 [0.23–0.66; p-trend < 0.001]); higher consumption of unhealthy plant foods was associated with higher frailty risk (2.40 [1.23–4.71; p-trend = .01]). In older adults, the hPDI was associated with lower risk of frailty, while the opposite was found for the uPDI.

虚弱是一种老年综合症，会增加住院、残疾和死亡的风险。以植物性食物的质量来定义的植物性饮食的效果尚不清楚。我们的目标是研究两种植物性饮食指数与西班牙社区老年人虚弱发生率之间的关联。我们分析了西班牙老年人 ENRICA-1 队列中 1880 名年龄≥60 岁的人的数据。我们使用经过验证的饮食历史来构建两个指数：(a) 健康的植物性饮食指数 (hPDI)，其中健康的植物性食物获得正分，而不健康的植物性食物和动物性食物获得相反的分数；(b) 不健康的植物性饮食指数 (uPDI)，对不健康的植物性食物得分为正，对动物性和健康植物性食物得分相反。事件虚弱是用 Fried 表型定义的。研究关联用从多变量逻辑模型获得的比值比 (OR) 和 95% 置信区间 (CI) 进行总结。经过 3.3 年的随访，确定了 136 例衰弱事件。比较最高和最低的依从性三分位数，衰弱的 OR [95% CI] 为 0.43（0.25–0.74；hPDI 的p- trend = .003)，uPDI 的 p-trend = .003) 和 2.89 (1.73–4.84; p- trend < .001)。较高的健康植物性食物摄入量与虚弱呈负相关（0.39 [0.23–0.66；p -trend < 0.001]）；不健康植物性食物的摄入量增加与虚弱风险增加相关 (2.40 [1.23–4.71; p -trend = .01])。在老年人中，hPDI 与较低的虚弱风险相关，而 uPDI 则相反。