Abstract
BACKGROUND: Malnutrition among older adults in China demands greater attention due to its significant implications for both health and functional ability. However, the relationship between nutritional status and health-related quality of life (HRQoL), especially in the context of chronic diseases, remains underexplored in the Chinese elderly population. METHODS: This large-scale cross-sectional study aimed to evaluate the association between nutritional status and HRQoL, stratified by chronic disease status, among 41,859 community-dwelling adults aged ≥ 65 years from 31 provinces in mainland China. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), while HRQoL was measured using the SF-36 questionnaire; chronic disease status was based on physician diagnosis. Multiple linear regression was employed to examine the association between MNA and HRQoL, with subgroups defined by Latent Class Analysis (LCA) based on comorbidity patterns. RESULTS: Results revealed significant positive associations between MNA scores and SF-36 total and domain scores among participants with chronic diseases (e.g., Total: β = 0.32, 95% CI: 0.04-0.60), but not among those without chronic diseases. LCA identified four comorbidity patterns: cardiovascular-rich, metabolic-rich, musculoskeletal-rich, and relatively healthy. Significant MNA-HRQoL associations were found in the cardiovascular (β = 0.58, p = 0.025), metabolic (β = 0.76, p = 0.022), and musculoskeletal (β = 1.01, p = 0.021) groups, but not in the relatively healthy group. CONCLUSIONS: These findings underscore the critical role of nutritional status in HRQoL among Chinese older adults with chronic diseases and highlight the need for tailored nutritional interventions in geriatric chronic disease management.