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

The association between frailty and malnutrition is widely noted, but the common and distinct aspects of this relationship are not well understood. We investigated the prevalence of prefrailty/frailty and malnutrition/nutritional risk; their overlapping prevalence; compared their sociodemographic, physical, and mental health risk factors; and assessed their association, independently of other risk factors. Cross-sectional study of population-based cohort (Singapore Longitudinal Ageing Study [SLAS]-1 [enrolled 2003-2005] and SLAS-2 [enrolled 2010-2013]) of community-dwelling older Singaporeans aged ≥55 (n = 6045). Mini Nutritional Assessment (MNA)-Short Form (SF), Nutritional Screening Initiative (NSI) Determine Checklist, Fried physical frailty phenotype. The overall prevalence of MNA malnutrition was 2.8%, and at risk of malnutrition was 27.6%; the prevalence of frailty and prefrailty were 4.5%, and 46.0% respectively. Only 26.5% of participants who were malnourished were frail, but 64.2% were prefrail (totally 90.7% prefrail or frail). The prevalence of malnutrition among frail participants was 16.1%, higher than in other studies (10%); nearly one-third of the whole population sample had normal nutrition while being prefrail (27.7%) or frail (1.5%). The prevalence of risk factors for prefrailty/frailty and malnutrition/nutritional risk were remarkably similar. MNA at risk of malnutrition and malnutrition were highly significantly associated with prefrailty (odds ratio [OR] 2.11 and 6.71) and frailty (OR 2.72 and 17.4), after adjusting for many other risk factors. The OR estimates were substantially lower with NSI moderate and high nutritional risk for prefrailty (OR 1.39 and 1.74) and frailty (OR 1.27 and 1.93), but remain significantly elevated. Frailty and malnutrition are related but distinct conditions in community-dwelling older adults. The contribution of poor nutrition to frailty in this population is notably greater. Both frail/prefrail elderly and those who are malnourished/at nutritional risk should be identified early and offered suitable interventions.

Wei K ，Nyunt MSZ ，Gao Q ，Wee SL ，Ng TP ... -  《-》

Strong Relationship between Malnutrition and Cognitive Frailty in the Singapore Longitudinal Ageing Studies (SLAS-1 and SLAS-2).

Chye L ，Wei K ，Nyunt MSZ ，Gao Q ，Wee SL ，Ng TP ... -  《-》

Association of Frailty and Malnutrition With Long-term Functional and Mortality Outcomes Among Community-Dwelling Older Adults: Results From the Singapore Longitudinal Aging Study 1.

Wei K ，Nyunt MS ，Gao Q ，Wee SL ，Yap KB ，Ng TP ... -  《JAMA Network Open》

Multidomain Geriatric Screen and Physical Fitness Assessment Identify Prefrailty/Frailty and Potentially Modifiable Risk Factors in Community-Dwelling Older Adults.

Tay LB ，Chua MP ，Tay EL ，Chan HN ，Mah SM ，Latib A ，Wong CQ ，Ng YS ... -  《-》

Long-term changes in nutritional status are associated with functional and mortality outcomes among community-living older adults.

Older adults who are malnourished are at high risk for adverse functional and mortality outcomes. The aim of this study was to assess the long-term changes in nutritional status among community-living older adults and their associations with adverse health outcomes. This was a population-based observational cohort study (Singapore Longitudinal Aging Study, SLAS 1), with a 4- to 5-y follow-up of 2075 community-living adults ≥60 y of age. Nutritional status (Mini Nutritional Assessment Short-Form [MNA-SF] and Nutritional Screening Initiative [NSI]), instrumental/basic activities of daily living (IADLs/ADLs) and quality of life (QoL) were assessed at both baseline and at the 4- to 5-y follow-up. The 10-y mortality was assessed from the date of 4- to 5-y follow-up to March 2017. Estimates of associations between changes in nutritional status and adverse health outcomes were analyzed using multinomial logistic regression or Cox proportional hazards regression, and indicated by odds ratios/hazard ratios (ORs/HRs) and 95% confidence intervals (CIs). Nutritional status was dynamic from baseline to the 4- to 5-y follow-up according to both MNA-SF and NSI. Compared with persistent normal nutrition, nutritional deterioration was associated with increased incident IADL/ADL disability (MNA-SF: OR, 3.22; 95% CI, 1.13-9.16), poor QoL (MNA-SF: OR, 4.53; 95% CI 2.13-9.64), and mortality (MNA-SF: HR, 4.76; 95% CI, 2.82-8.03; NSI: HR, 1.99; 95% CI, 1.27-3.14); nutritional improvement was associated with decreased incident IADL/ADL disability (NSI: OR, 0.17; 95% CI, 0.05-0.59); persistent poor nutrition (MNA-SF at risk/malnourished or NSI moderate/high nutritional risk) was associated with elevated incidence of poor QoL (MNA-SF: OR, 1.92,; 95% CI, 1.05-3.52; NSI: OR, 2.31; 95% CI, 1.19-4.49) and mortality (MNA-SF: HR, 2.57; 95% CI, 1.59-4.15; NSI: HR 1.97; 95% CI, 1.17-3.32). Compared with persistent poor nutrition, nutritional improvement was also associated with decreased incidence of mortality (MNA-SF: HR, 0.43; 95% CI, 0.23-0.80). Changes in nutritional status are associated with adverse health outcomes, and should be monitored with simple screening tools to identify older adults at high risk for adverse functional and mortality outcomes for selective nutritional interventions.

Wei K ，Nyunt MSZ ，Gao Q ，Wee SL ，Ng TP ... -  《-》