Frailty, Sarcopenia, and Malnutrition Frequently (Co-)occur in Hospitalized Older Adults: A Systematic Review and Meta-analysis

Ligthart‐Melis, Gerdien C.; Luiking, Yvette C.; Kakourou, Alexia; Cederholm, Tommy; Maier, Andrea B.; Schueren, Marian A.E. de van der

doi:10.1016/j.jamda.2020.03.006

Cited by 196 publications

(153 citation statements)

References 97 publications

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“…Among the non-frail older adults, 78.4% were found to have normal nutritional status. These findings substantiate the correlation and overlap between frailty and malnutrition, as reported in previous studies [63,65].…”

Section: Discussionsupporting

confidence: 92%

“…Additionally, frailty as a related concept to physical function could have influenced the observed relationship between nutritional status and physical function in the present study. A recent systematic review and meta-analysis found a strong positive association and considerable overlap, of 47%, between frailty and malnutrition of hospitalised older adults [63]. As earlier explained, physical frailty affecting mobility could have adverse consequences on how older adults shop for food and prepare healthy meals, which could further exacerbate their nutritional status, and in a cyclical manner, worsen their frailty status.…”

Section: Discussionmentioning

confidence: 95%

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The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults

2020

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Background: There are limited longitudinal data regarding nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n = 100) and 8-months' follow-up (n = 81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom. Methods: Multiple-pass 24-h dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Linear and multinomial regressions were used to predict relationships between physical function, nutritional status and nutrient intake. Results: Complete data were collected at baseline (n = 100) and 8-months' follow-up (n = 81). Mean (SD) age was 70 (8.1) years (60% male), with 62% being obese. Statistically significant decreases in intakes of vitamin B6, vitamin B1, iron, folate, and magnesium occurred over time. Daily intake of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes (RNI). SPPB (Z =-4.01, p < 0.001) and nutritional status (Z =-2.37, p = 0.018) declined over time. Higher SPPB scores at baseline (OR = 0.54 95% CI 0.35, 0.81) were associated with a slower decline in nutritional status. Conclusion: The observed declines and inadequate nutrient intakes in the absence of weight loss in just 8 months may pose serious challenges to healthy ageing, identifying an urgent need to re-evaluate and tailor appropriate dietary advice for this population. Additionally, the associations of nutrition and physical function observed in this study serves as an essential resource to design and implement community/faith-based interventions targeting early screening of nutritional status and physical function to ensure most older adults are assessed and treated accordingly.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 95%

The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults

2020

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show abstract

“…Among the non-frail older adults, 78.4% were found to have normal nutritional status. These ndings substantiate the correlation and overlap between frailty and malnutrition, as reported in previous studies [62,64].…”

Section: Discussionsupporting

confidence: 92%

“…Additionally, frailty as a related concept to physical function could have in uenced the observed relationship between nutritional status and physical function in the present study. A recent systematic review and meta-analysis found a strong positive association and considerable overlap, of 47%, between frailty and malnutrition of hospitalised older adults [62]. As earlier explained, physical frailty affecting mobility could have adverse consequences on how older adults shop for food and prepare healthy meals, which could further exacerbate their nutritional status, and in a cyclical manner, worsen their frailty status.…”

Section: Discussionmentioning

confidence: 95%

The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults

Asamane

Greig

Thompson

2020

Preprint

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Abstract Background: There are limited longitudinal data regarding nutrient intake, nutritional status and physical function in community-dwelling ethnically diverse older adults. This study explored these variables and their relationship at baseline (n=100) and 8-months’ follow-up (n=81) among community-dwelling ethnically diverse older adults (≥60 years) in Birmingham, United Kingdom. Methods: Multiple-pass 24-hour dietary recalls and the Mini Nutritional Assessment-Short Form assessed nutritional intake and status, respectively. Short Physical Performance Battery (SPPB) and handgrip strength measured physical function. Linear and multinomial regressions were used to predict relationships between physical function, nutritional status and nutrient intake. Results: Complete data were collected at baseline (n=100) and 8-months’ follow-up (n=81). Mean (SD) age was 70 (8.1) years (60% male), with 62% being obese. Statistically significant decreases in intakes of vitamin B6, vitamin B1, iron, folate, and magnesium occurred over time. Daily intake of all micronutrients except vitamin B12, phosphorus and manganese were below the Recommended Nutrient Intakes (RNI). SPPB (Z=-4.01, p<0.001) and nutritional status (Z=-2.37, p=0.018) declined over time. Higher SPPB scores at baseline (OR=0.54 95% CI 0.35, 0.81) were associated with a slower decline in nutritional status. Conclusion: The observed declines and inadequate nutrient intakes in the absence of weight loss in just eight months may pose serious challenges to healthy ageing, identifying an urgent need to re-evaluate and tailor appropriate dietary advice for this population. Additionally, the associations of nutrition and physical function observed in this study serves as an essential resource to design and implement community/faith-based interventions targeting early screening of nutritional status and physical function to ensure most older adults are assessed and treated accordingly.

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“…Frailty is a state of vulnerability with limited reserve capacity in major organ systems; it involves weight loss, fatigue, low physical activity, slowness and weakness [94]. Frailty is associated with a higher risk of adverse outcomes such as falls, fractures, hospitalization and disability [94][95][96]. In older inpatients, frailty was found to be a risk factor for increased length of hospital stay and mortality [97,98] as well as postoperative complications [99].…”

Section: Omega-3 Lcpufas and Sarcopenia And Frailty In Older Peoplementioning

confidence: 99%

Expert Opinion on Benefits of Long-Chain Omega-3 Fatty Acids (DHA and EPA) in Aging and Clinical Nutrition

et al. 2020

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Life expectancy is increasing and so is the prevalence of age-related non-communicable diseases (NCDs). Consequently, older people and patients present with multi-morbidities and more complex needs, putting significant pressure on healthcare systems. Effective nutrition interventions could be an important tool to address patient needs, improve clinical outcomes and reduce healthcare costs. Inflammation plays a central role in NCDs, so targeting it is relevant to disease prevention and treatment. The long-chain omega-3 polyunsaturated fatty acids (omega-3 LCPUFAs) docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are known to reduce inflammation and promote its resolution, suggesting a beneficial role in various therapeutic areas. An expert group reviewed the data on omega-3 LCPUFAs in specific patient populations and medical conditions. Evidence for benefits in cognitive health, age- and disease-related decline in muscle mass, cancer treatment, surgical patients and critical illness was identified. Use of DHA and EPA in some conditions is already included in some relevant guidelines. However, it is important to note that data on the effects of omega-3 LCPUFAs are still inconsistent in many areas (e.g., cognitive decline) due to a range of factors that vary amongst the trials performed to date; these factors include dose, timing and duration; baseline omega-3 LCPUFA status; and intake of other nutrients. Well-designed intervention studies are required to optimize the effects of DHA and EPA in specific patient populations and to develop more personalized strategies for their use.

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Frailty, Sarcopenia, and Malnutrition Frequently (Co-)occur in Hospitalized Older Adults: A Systematic Review and Meta-analysis

Cited by 196 publications

References 97 publications

The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults

The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults

The association between nutrient intake, nutritional status and physical function of community-dwelling ethnically diverse older adults

Expert Opinion on Benefits of Long-Chain Omega-3 Fatty Acids (DHA and EPA) in Aging and Clinical Nutrition

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