Abstract
ObjectivesThe aim of this study was to examine how nutritional status modifies the association between frailty and health-related quality of life (HRQoL) among older nursing home residents. We also investigated how residents’ energy intake is linked to frailty score.Design and participantsA total of 486 older (> 65 years of age) nursing home residents living in Helsinki, Finland were included to this cross-sectional study.MethodsWe collected data on the residents’ background information, HRQoL by 15D, nutritional status by Mini Nutritional Assessment (MNA), frailty status (Fried’s phenotype criteria; pre-frail: 1–2 criteria and frail: 3–5) and energy intake (one- or two-day food records).ResultsThe frail residents were more often malnourished and had lower HRQoL than those in the prefrail group. Energy and protein intakes were significantly lower among frail women than prefrail women. Energy intake was linearly associated with frailty points. When residents in the frail and prefrail groups were divided according to their nutritional status, both nutritional status and frailty were associated with HRQoL, but there was no interaction.ConclusionsBoth nutritional status and frailty were associated with HRQoL, and lower energy intake indicated a higher frailty score. An adequate energy intake may promote residents’ HRQoL and prevent frailty in long-term care.
Highlights
Malnutrition is common among nursing home residents
The aim of this study was to investigate how nutritional status modifies the association between frailty and health-related quality of life (HRQoL) among older long-term care residents
We investigated how energy intake is associated with frailty score
Summary
Malnutrition is common among nursing home residents. In Zwienen-Pot et al.’s (2018) study only 18% of nursing home residents had adequate energy and protein intake [2]. The predictors of malnutrition among nursing home residents have been cognitive impairment, depression, functional impairment, and swallowing difficulties [7]. A meta-analysis found that 12 out of 15 studies of communityliving elderly people associated malnutrition with frailty [8]. Malnutrition and frailty share common risk factors such as weight loss and functional impairment [8]. Nutrition intake is associated with several frailty criteria, including low muscle strength, feelings of exhaustion, reduced physical activity and slow walking speed [10]. In turn, can reduce nutrition intake and have negative consequences for nutritional status [10]
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