Relationship between social frailty and malnutrition in community-dwelling older adults undergoing rehabilitation

Social frailty and malnutrition are considered major health issues in community-dwelling older adults undergoing rehabilitation. This study aimed to examine the relationship between social frailty and malnutrition among community-dwelling older adults undergoing rehabilitation.

This was a multicenter cross-sectional study. The study included older adults requiring Level 1 or 2 support who were undergoing rehabilitation within the Long-Term Care (LTC) system at three facilities between April 2022 and December 2023. This observational study assessed calf circumference, 5-m walking speed, and Timed Up and Go performance. Physical and social frailty were assessed using the Japanese version of Fried's Cardiovascular Health Study criteria, which incorporates Makizako's five-item questionnaire. Malnutrition was evaluated according to the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria. Logistic regression analysis was conducted to examine the independent association between each assessment and undernutrition.

In total, 211 older participants (median age: 81 years) were included in the study. Physical and social frailties were present in 29.3 % (62 cases) and 58.7 % (124 cases) of participants, respectively. In the crude model, social frailty was significantly associated with malnutrition (OR (odds ratio) = 2.42, 95%CI (confidential interval): 1.15-5.11, p = 0.020; E-value = 1.57). In the adjusted model, both physical frailty (adjusted OR = 1.18, 95 % CI: 1.03-3.31, p = 0.038) and social frailty (adjusted OR = 2.55, 95 % CI 1.22-5.34, p = 0.013) were independently associated with GLIM criteria for malnutrition.

This study demonstrates that social frailty is significantly associated with malnutrition. Notably, this is the first study to suggest that social frailty may contribute to malnutrition in older adults. These findings highlight the importance of assessing social frailty in older adults undergoing rehabilitation in LTC settings.