Nutritional and Frail Status Transitions in the Singapore Longitudinal Ageing Study

​Background
Malnutrition is a major determinant of the physical frailty syndrome. Dynamic transitions in frailty states over time is well documents, but few studies have documented temporal changes in nutritional states and whether they influence frailty outcomes.

Design
Longitudinal cohort study.

Setting and Participants

Community-dwelling older Singaporeans aged ≥55y with a 5-year follow-up (n=1162) in the Singapore Longitudinal Ageing Study 2 (SLAS-2).

Measurement

The Mini Nutritional Assessment Short-Form (MNA-SF) was used to determine nutritional status, and the Fried's criteria (shrinking, weakness, slowness, exhaustion and inactivity) was used to assess physical frailty phenotype at both baseline and follow-up. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were adjusted for multiple baseline co-variables.

Results
At baseline, being at risk of malnutrition/malnourished was associated with increased odds of prevalent prefrailty (OR=2.76, 95% CI=1.86-4.10) and frailty (OR=4.10, 95% CI=1.41-11.9). Baseline robust individuals who were persistently at risk of malnutrition/malnourished showed an increased odds of conversion to being pre-frail/frail individuals, reversion to being robust were significantly less likely among those who were persistently at risk of malnutrition/malnourished (OR=0.26, 95% CI=0.10-0.67) and those whose baseline normal nutrition worsened at follow-up (OR=0.20, 95% CI=0.06-0.74).

Conclusion
Changes in nutritional states are associated with frailty state transitions, and monitoring changes in nutritional status is recommended for the preventon and severity reduction of frailty among older people in the community.

SOURCE:
Journal of Nutrition, Health & Aging

DOI:
https://doi.org/10.1007/s12603-018-1096-3

AUTHOR(S):
Wei K, Thein, S.F, Nyunt M, Gao Q, Wee S.L, Ng T.P