Abstract
Understanding how changes in nutritional status influence musculoskeletal recovery after falling remains unclear. We explored associations between changes in nutritional status and musculoskeletal health in 106 community-dwelling older adults aged ≥65 years, who attended the Falls and Fractures Clinic at Sunshine Hospital in St Albans, Australia after falling. At baseline and after 6 months, individuals were assessed for Mini Nutritional Assessment (MNA®), grip strength, gait speed, Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB), and bone turnover marker levels. Associations were examined using multiple linear regression, adjusted for baseline covariates and post-fall care plans. Over 6 months, the prevalence of malnutrition or risk thereof decreased from 29% to 15% using MNA <24/30. Specifically, 20 individuals (19%) improved, 7 (7%) deteriorated, and 73 (69%) maintained nutritional status, including 65 (61%) who remained well-nourished and 8 (8%) who remained malnourished/at risk. A 1-point increase in MNA score over 6 months was associated with an increase of 0.20 points (95% confidence interval 0.10, 0.31, p < 0.001) in SPPB score. Improvement in nutritional status was associated with improvement in physical performance, providing a basis for interventional studies to ascertain causality and evaluate nutritional models of care for post-fall functional recovery in older adults.
Highlights
About a third of community-dwelling older adults aged ≥65 years in Western countries fall each year and the frequency of falls and fall-related injuries increase with age [1]
Compared to well-nourished older adults, risk of experiencing falls has been shown in a meta-analysis of prospective studies to be 45% higher in malnourished individuals or those at risk of malnutrition (n = 9510) [4], based on the validated Mini Nutritional Assessment (MNA® ) tool [5]
This study aimed to investigate changes in nutritional status in older adults with a history of falling using the validated MNA®, and to determine associations between changes in nutritional status and relevant musculoskeletal outcomes
Summary
About a third of community-dwelling older adults aged ≥65 years in Western countries fall each year and the frequency of falls and fall-related injuries (fractures or head trauma) increase with age [1]. Investigating modifiable risk factors of falls is a key priority area for healthcare systems, which strive to identify conditions that prevent falls. Poor nutritional status has been considered an important modifiable risk factor for falls [3]. Compared to well-nourished older adults, risk of experiencing falls has been shown in a meta-analysis of prospective studies to be 45% higher in malnourished individuals or those at risk of malnutrition (n = 9510) [4], based on the validated Mini Nutritional Assessment (MNA® ) tool [5].
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