Factors associated with the overlap of frailty and nutrition in institutionalized older adults: A multicenter study

This multicenter cross-sectional study aimed to investigate the factors associated with the overlap of frailty and nutrition in older adults residing in nursing homes.

Older adults (n = 344, mean age ± SD = 77.7 ± 9.1) were selected from 17 nursing homes, 10 in Piracicaba and seven in João Pessoa, Brazil. The modified Fried's questionnaire and the Mini Nutrition Assessment Short-Form (MNA-SF) were used for screening frailty phenotypes and nutritional status, respectively. These variables overlapped into (1) frail and malnourished; (2) nonfrail and malnourished or frail and nourished; and (3) nonfrail and nourished. The independent variables were sex, age, mobility, number of medications, dependence for activities of daily living (ADL), maximal grip strength, muscle mass, body fat and body mass index (BMI). Spearman's correlation and Poisson regression were used to analyze the data (α = 0.05).

The Spearman's test demonstrated a moderate correlation (r²=-0.441) between frailty (mean ± SD = 2.8 ± 1.7) and nutritional status (mean ± SD = 10.5 ± 2.9). Regarding the overlap of frailty and nutrition, 139 participants (40.5 %) were frail and malnourished, 121 (35.3 %) were nonfrail and malnourished or frail and nourished, and 83 (24.2 %) were nonfrail and nourished. The Poisson regression showed association of the coexistence of frailty and malnutrition with age (PR = 1.009, 95 % CI = 1.003-1.016), number of medications (PR = 1.016, 95 % CI = 1.006-1.027), dependence for ADL (PR = 1.061, 95 % CI = 1.016-1.108), maximal grip strength (PR = 0.992, 95 % CI = 0.986-0.998) and BMI (PR = 0.997, 95 % CI = 0.996-0.998).

The findings showed that frailty and malnutrition were prevalent in institutionalized older adults and associated with advanced age, greater use of medicines, dependence for ADL, lower maximal grip strength and lower BMI.