Relationship between physical frailty, nutritional risk factors and protein intake in community-dwelling older adults.

BACKGROUND & AIMS: Physical frailty may compromise physical function and reduce self-reliance in community-dwelling older adults. We investigated if nutritional risk factors and protein intake were associated with physical frailty in community-dwelling adults. METHODS: This cross-sectional study combined data from two studies in community-dwelling adults ≥65 years. Variables included physical frailty (SHARE-FI75+), nutritional risk factors (dysphagia, poor dental status, illness, unintentional weight loss, low and high BMI), chronic diseases, physical function, and protein intake (4-day food records). Logistic regression analyses were performed to investigate the association between physical frailty, number of nutritional risk factors and specific nutritional risk factors, and between physical frailty and protein intake. RESULTS: A total of 1430 participants were included in the study of these n = 860 were ≥80 years. Having one, two or more nutritional risk factors increased odds of physical pre-frail/frail condition (adjusted OR 1.39 95% CI 1.07-1.80; OR 2.67 1.76-4.04, respectively). Unintentional weight loss, poor dental status, dysphagia, and high BMI independently increased odds of physical pre-frail/frail condition. In participants ≥80 years two or more nutritional risk factors were associated with physical pre-frail/frail condition (adjusted OR 2.56 95%CI 1.45-4.52) and high BMI increased odds of physical pre-frail/frail condition independently. Higher intakes of protein did not significantly reduce odds of physical pre-frail/frail condition (adjusted OR 0.23 95% CI 0.05-1.09) in this sample of community-dwelling adults ≥80 years. CONCLUSION: Nutritional risk factors were independently associated with physical pre-frail/frail condition in community-dwelling older adults. Tackling nutritional risk factors offers an opportunity in primary prevention of malnutrition and physical frailty.

Does physical performance and muscle strength predict future personal and nursing care services in community-dwelling older adults aged 75+?

AIM: The objective of this study was to investigate if grip strength or the short physical performance battery could predict the rate of receiving two different types of home care services: (a) personal care and (b) home nursing care for community-dwelling older adults aged 75+ years. METHODS: A secondary data analysis of a prospective cohort study including 323 community-dwelling older adults. Measures of grip strength and the short physical performance battery were incorporated in a nationally regulated preventive home visit programme. Referral to personal and home nursing care were obtained from an administrative database with an average follow-up of 4.1 years. The rate of receiving the individual home care services and the study measures were determined using multivariable Cox proportional hazards models controlling for a priori selected covariates (age, sex, living status, obesity, smoking and prior use of home care). RESULTS: The mean age was 81.7 years with 58.8% being women. The rate of receiving personal care differed between the short physical performance battery groups but not between the grip strength groups after adjusting for all covariates with hazard ratios (95% confidence intervals) of 1.90 (1.29-2.81) and 1.41 (0.95-2.08), respectively. The rate of receiving home nursing care differed between both the short physical performance battery and grip strength groups after adjusting for all covariates with hazard ratios of 2.03 (1.41-2.94) and 1.48 (1.01-2.16), respectively. CONCLUSIONS: The short physical performance battery was associated with the rate of receiving both personal care and home nursing care. The short physical performance battery can be used to predict home care needs of community-dwelling older adults aged 75+ years.