Nutrition plays a gender-dependent role in disability in an elderly Sardinian population

Introduction: In the elderly population the disability rate is lower in men than in women, although in the latter life expectancy in
generally higher. In Sardinia island a remarkable gender equality in mortality has been reported (Poulain et al., 2004), but it is
not known if this also holds true for disability. We evaluated the disability level in a sample of elderly subjects and correlated it with
lifestyle and socio-demographic variables.
Subjects and Methods: One-hundred subjects (50% men, aged 78–93) recruited in the island’s main cities. A comprehensive
assessment was carried out in each participant: ADL, IADL, Barthel index, MMSE, Exton-Smith and Tinetti scale, km/wk and MNA. The
association of predictors with disability was performed by multiple linear regression analysis.
Results: Among women the strongest predictors of disability, as reflected by IADL, were MNA (p = 0.0001), SPMSQ (p = 0.004)
and Tinetti score (p = 0.001), whereas in males physical activity expressed as km/wk (p = 0.039), the Exton-Smith score (p = 0.0001)
and MMSE (p = 0.001) were the most important predictors.
Conclusion: These results suggest that IADL disability in males is mostly linked to cognitive and motor impairment, whereas
in women is influenced also by a concomitant malnutrition. We suggest that physical activity is a protective factor for disability in
men, while women lacking this protective mechanism are more vulnerable to a nutritional deficiency.