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High Prevalence of Physical Frailty Among Community-Dwelling Malnourished Older Adults: A Systematic Review and Meta-Analysis
Vrije Univ Amsterdam Med Ctr, Sect Gerontol & Geriatr, Dept Internal Med, De Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands.;Nutricia Res, Nutricia Adv Med Nutr, Utrecht, Netherlands..
Nutricia Res, Nutricia Adv Med Nutr, Utrecht, Netherlands.;Texas A&M Univ, Dept Hlth & Kinesiol, Ctr Translat Res Aging & Longev, College Stn, TX USA..
Nutricia Res, Nutricia Adv Med Nutr, Utrecht, Netherlands..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.ORCID iD: 0000-0003-3705-0725
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2017 (English)In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 18, no 5, 374-382 p.Article, review/survey (Refereed) Published
Abstract [en]

Background: Malnutrition and frailty are two geriatric syndromes that significantly affect independent living and health in community-dwelling older adults. Although the pathophysiology of malnutrition and physical frailty share common pathways, it is unknown to what extent these syndromes overlap and how they relate to each other. Methods: A systematic review was performed resulting in a selection of 28 studies that assessed both malnutrition and frailty in community-dwelling older adults. Furthermore, a meta-analysis was performed on 10 studies that used Mini-Nutritional Assessment and the Fried frailty phenotype to estimate the prevalence of malnutrition within physical frailty and vice versa. Results: In the systematic review, 25 of the 28 studies used the Mini-Nutritional Assessment (long or short form) for malnutrition screening. For frailty assessment, 23 of the 28 studies focused on the physical frailty phenotype, of which 19 followed the original Fried phenotype. Fifteen studies analyzed the association between malnutrition and frailty, which was significant in 12 of these. The meta-analysis included 10 studies with a total of 5447 older adults. In this pooled population of community-dwelling older adults [ mean (standard deviation) age: 77.2 (6.7) years], 2.3% was characterized as malnourished and 19.1% as physically frail. The prevalence of malnutrition was significantly associated with the prevalence of physical frailty (P < .0001). However, the syndromes were not interchangeable: 68% of the malnourished older adults was physically frail, whereas only 8.4% of the physical frail population was malnourished. Conclusions: The systematic review and meta-analysis revealed that malnutrition and physical frailty in community-dwelling older adults are related, but not interchangeable geriatric syndromes. Two out of 3 malnourished older adults were physically frail, whereas close to 10% of the physically frail older adults was identified as malnourished.

Place, publisher, year, edition, pages
2017. Vol. 18, no 5, 374-382 p.
Keyword [en]
Malnutrition, frailty, community-dwelling
National Category
Nutrition and Dietetics Geriatrics
Identifiers
URN: urn:nbn:se:uu:diva-331370DOI: 10.1016/j.jamda.2016.12.074ISI: 000401108100003PubMedID: 28238676OAI: oai:DiVA.org:uu-331370DiVA: diva2:1150273
Available from: 2017-10-18 Created: 2017-10-18 Last updated: 2017-10-18Bibliographically approved

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