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Frailty and nutritional status in older people: the Mini Nutritional Assessment as a screening tool for the identification of frail subjects

Authors Valentini A, Federici M, Cianfarani MA, Tarantino U, Bertoli A

Received 1 February 2018

Accepted for publication 23 March 2018

Published 13 July 2018 Volume 2018:13 Pages 1237—1244

DOI https://doi.org/10.2147/CIA.S164174

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 3

Editor who approved publication: Dr Richard Walker


Alessia Valentini,1 Massimo Federici,1 Maria Assunta Cianfarani,1 Umberto Tarantino,2 Aldo Bertoli1

1Department of Systems Medicine, University of Rome “Tor Vergata”, Rome, Italy; 2Department of Orthopaedics and Traumatology, University of Rome “Tor Vergata”, Rome, Italy

Introduction: Frailty is a condition characterized by reduced resistance to low-level stress events, resulting from the progressive decline of multiple physiological systems observed with aging. Many factors can contribute to the pathogenesis of frailty, and nutritional status appears to play a key role. The objective of the study was to investigate the relationship between nutritional status, evaluated using Mini Nutritional Assessment (MNA), and frailty among older people.
Patients and methods: An observational study was carried out at the University Hospital “Tor Vergata” in Rome among patients aged 65 years or older, with or without hip fracture. The study sample included 62 patients hospitalized for a hip fracture and 50 outpatients without fracture. All subjects underwent blood sampling for laboratory assays and received a multidimensional geriatric evaluation comprising Activity of Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Mini–Mental State Examination (MMSE), Geriatric Depression Scale (GDS), and MNA. Comorbidity was assessed using the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Muscle strength was measured by handgrip dynamometry, and frailty score was calculated using the Survey of Health, Ageing and Retirement in Europe-Frailty Index (SHARE-FI).
Results: Approximately 38% of the study population was frail, with the prevalence of frailty being greater among hospitalized older patients. Among frail subjects, 65% were at risk of malnutrition (RMN) and 10% were malnourished. The prevalence and RMN progressively diminished in the pre-frail group and not frail group. Nutritional status was closely associated with the degree of frailty, and in a logistic regression, MNA was the best variable predicting both pre-frailty and frailty.
Discussion and conclusion: Malnutrition contributes to the development of frailty. MNA can generate vital information to help identify a substantial part of both frail and pre-frail patients at low cost and care.

Keywords: frailty, malnutrition, Mini Nutritional Assessment, older people
 
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