Frailty and Malnutrition: Related and Distinct Syndrome Prevalence and Association among Community-Dwelling Older Adults: Singapore Longitudinal Ageing Studies

Wei, Kai; Nyunt, Ma Shwe Zin; Gao, Qi; Wee, Shiou‐Liang; Ng, Tze‐Pin

doi:10.1016/j.jamda.2017.06.017

Cited by 151 publications

(119 citation statements)

References 30 publications

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“…The connections and pathways between oral health with frailty have been long discussed . One mechanism that may link poor oral health and frailty is through diet, with those with poorer oral health eating less healthy foods, which then leads to increased frailty . We found a small but significant indirect effect of 0.01 (95% CI = 0.01‐0.03) through the pathways of poor diet on the association between poor oral health and increased frailty.…”

Section: Discussionmentioning

confidence: 99%

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Oral Health, Diet, and Frailty at Baseline of the Canadian Longitudinal Study on Aging

Bassim

Mayhew

Kanters

et al. 2020

J American Geriatrics Society

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OBJECTIVES: Poor diet due to poor oral health was proposed as a potential mediator of the association between poor oral health and frailty. This study explores the cross-sectional associations between poor oral health, poor diet, and frailty in Canadian adults, aged 45 to 85 years, and then tests whether the expected oral health-frailty association is changed by taking into account the pathway through poor diet. DESIGN: Cross-sectional study. SETTING: The baseline wave of the Canadian Longitudinal Study on Aging, a nationally representative population study. PARTICIPANTS: Data from 28 738 community-dwelling participants, aged 45 to 85 years. MEASUREMENTS: We characterized poor oral health (cumulative count of 24 items of oral health problems), poor diet (scale of poor food consumption from 7 healthy foods groups), and frailty (cumulative frailty index of 76 items). Regression-based path analyses were used to investigate associations between poor oral health, poor diet, and frailty, adjusted for age group, sex, income, smoking, living alone, education, physical activity, social support, and dental visit. RESULTS: Poorer oral health was associated with low income, smoking, low physical activity, low social support, and no dental visit. There were associations between poorer oral health and poorer diet (effect size β adjusted = .40; 95% confidence interval [CI] = .20-.61) and between poorer oral health and increased frailty (β adjusted = .85; 95% CI = .68-1.02). The indirect effect through the path of poor diet was approximately 0.01 (95% CI = 0.01-0.02) (ie, explaining 1% of the effect of poor oral health on frailty). CONCLUSIONS: Poor oral health was associated with poor diet and frailty. Each additional oral health problem was associated with an increase of approximately 1 frailty index point, even after full adjustment for poor diet. The indirect effect of poor oral health through poor diet was modest. Though poor oral health was associated with poorer diet quality, a more direct effect of poor oral health on increasing frailty may be indicated. J Am Geriatr Soc 68:959-966, 2020.

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Section: Discussionmentioning

confidence: 99%

“…Easier to chew foods are generally less nutrient dense, which could then contribute to a poorer diet . Poor diet and nutritional risk have long been implicated in the etiology and progression of frailty by influencing functional reserves and resiliency, and leading to loss of energy, functional decline, morbidity, and subsequent frailty …”

mentioning

confidence: 99%

Oral Health, Diet, and Frailty at Baseline of the Canadian Longitudinal Study on Aging

Bassim

Mayhew

Kanters

et al. 2020

J American Geriatrics Society

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“…Malnutrition is a strong predictor of frailty. One study found 90.7% of total malnourished individuals were either frail or prefrail, whereas only one third of total adequately nourished individuals were frail or prefrail …”

Section: Discussionmentioning

confidence: 99%

Measuring Frailty in Inpatient Rehabilitation

Roberts¹,

Aronow²,

Parker³

et al. 2019

PM&R

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Background In response to the global aging population, there has been increasing research on frailty. How frailty is conceptualized is shifting with the development of frailty models, especially in the acute care arena. Objective To explore frailty/vulnerability risk factors available at admission that were associated with salient patient outcomes within the context of inpatient rehabilitation. Design Methodologies in acute care are not easily adapted for a typical admission evaluation or a rehabilitation patient. In this study, the concept of frailty among patients admitted to rehabilitation was developed from risk factors available at admission that were associated with two patient outcomes, adverse hospital outcomes and 30‐day hospital readmissions. Setting: Inpatient rehabilitation. Patients Data were included on all patients (n = 768) discharged from an inpatient rehabilitation unit of an academic medical center from 1 January 2012 through 31 December 2012. Interventions Not applicable. Main Outcome Measure Adverse events within the inpatient rehabilitation stay and 30‐day hospital readmissions. Results Significant independent factors associated with adverse events in the rehabilitation unit included African American (1.77 OR; 95% CI 1.06‐2.96), Hispanic (3.17 OR; 95% CI 1.13‐8.94), having >9 total comorbid conditions (1.44 OR; 95% CI 1.244‐1.66), and sphincter control domain (including bladder and bowel management) ≤ 9 FIM (0.92 OR; 95% CI 0.86‐0.98). For 30‐day readmission three variables were found to be significant: onset ≥7 days (2.31 OR; 95% CI 1.28‐4.22), requiring a tube for feeding (3.45 OR; 95% CI 1.433‐11.12), and being obese (4.72 OR; 95% CI 1.433‐15.58). Conclusions The findings highlight the need for early admission screening and identification of risk factors which can provide the time in the rehabilitation setting for the clinical team to treat and prevent the potential for poor outcomes.

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“…While weight loss leads to the loss of muscle mass leading to sarcopenia, most persons with sarcopenia do not have excess weight loss as muscle loss is replaced by fat (5-8). Both weight loss and sarcopenia are major causes of the physical phenotype of frailty, but frailty should be considered a secondary nutritional condition (9)(10)(11)(12)(13)(14)(15)(16).…”

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confidence: 99%