Coexisting severe frailty and malnutrition were found to be common among the oldest old in nursing homes, and were associated with a higher risk of all-cause mortality at 1 year, according to a small prospective Japanese study. “The results suggest that measuring both nutritional and frailty status may provide a more accurate indication of health status and the need [for] intervention than assessing either one alone,” according to Tomohiko Kamo, a researcher at the Sakurasono Nursing Home in Shizuoka, Japan, and his coauthors (Arch Gerontol Geriatr 2017;70:99–104). Between 2013 and 2014, the investigators prospectively observed 160 nursing home residents who were at least 85 years old and permanently living in one of two facilities. One in nine were women, with the average age across the study being 90.9 years. At baseline, more than three-quarters of the cohort were classified as severely frail, according to the Canadian Study of Health and Aging-Clinical Frailty Scale. Of the remaining participants, 6.3% were rated as mildly frail, 16.9% were rated moderately frail, and none were rated as non-frail. By the criteria of the Mini Nutritional Assessment–Short Form, 53.1% of the cohort was malnourished, 42.5% were at risk of malnutrition, and 4.4% were well nourished. Coexisting severe frailty and malnutrition were identified in 46.9% of participants. At 12 months, individuals with coexisting severe frailty and malnutrition were found to have lower survival rates. Out of the 26.3% of residents who had died, 86.7% were women, 93.3% were severely frail, and 75.6% had malnutrition. The average age at death was 92.1 years. An association at 1 year between mortality and coexisting severe frailty and malnutrition, and heart failure was significant (P < 0.001). The hazard ratio for coexisting severe frailty and malnutrition was 9.42, and 3.67 for heart failure. When adjusted for covariance, these three risk factors remained independent predictors of all-cause mortality: For coexisting severe frailty and malnutrition, the hazard ratio was 10.89, and for heart failure, 7.83. Whereas previous studies have evaluated prevalence rates of severe frailty or malnutrition in this cohort separately, the authors of this study wrote that theirs was the first study to quantify the overlap between the two conditions. Because individuals with these two conditions may be at higher risk of mortality than their healthier counterparts, “it is necessary to pay attention to both the functional and the nutritional status in the oldest old nursing home residents,” the authors wrote. Helen Jones is a NJ-based freelance writer.