Objectives We aimed to assess the polypharmacy effect on appetite and malnutrition risk among Lebanese nursing home residents. We hypothesized that polypharmacy will be associated to lower appetite and increased of malnutrition. Methods A cross-sectional pilot study was carried out in two nursing homes in the North-Lebanon region. Fifty-three older adults (OA) aged 60 and above were recruited and were interviewed face-to-face. A general questionnaire was administered to gather information about their socio-demographics, dietary habits and physical activity routine. Appetite was evaluated by the Simplified Nutritional Appetite Questionnaire (SNAQ) validated for use with nursing homes residents. The participants' nutritional status was assessed using the Short Form of the Mini-Nutritional Assessment (MNA-SF). Polypharmacy was determined if OA were taking 5 or more medications. Information about attitudes towards the use, the number and the cost of medications was also collected. Differences in SNAQ and MNA scores based on polypharmacy were tested using Independent t-tests. Logistic regression was performed to assess the association between polypharmacy and nutritional status after adjusting for several factors. Results Our sample constituted of 49.1% females with an average age of 67.6 ± 3.8 and BMI of 22.3 ± 1.7 kg/m2. The majority were widowed (79.2%) and had a low level of education (85% elementary education). Regarding the MNA scores, 33% had a normal nutritional status while 59% were at risk of malnutrition and 8% were malnourished, with an average MNA score of 10.1 ± 2.2. The average SNAQ score was 11.0 ± 3.3, with 85% scoring ≤14, indicating an significant risk of at least 5% weight loss withing 6 months. Regarding medication use, 50.9% of OA take at least 5 drugs/d with an average of 4.3 ± 2 drugs. Independent t-tests showed that MNA scores were significantly lower in those taking 5 drugs/d vs those taking less (9.4 ± 2.5 vs 10.8 ± 1.6, P = .024) while no significant difference was observed for SNAQ scores (10.3 ± 2.9 vs 11.6 ± 3.6, P = .13). Logistic regressions did not show any significant association between polypharmacy and MNA or SNAQ categories. Conclusions Lower MNA scores were observed in OA taking ≥5 drugs/d indicating a higher risk of malnutrition with polypharmacy. This is significant since malnutrition can further worsen the aging process. Funding Sources N/A.

Discrepancies in the characteristics of the food components of a Mediterranean diet exist based on the country of origin. In Lebanon, a traditional Mediterranean diet emphasizes the high intakes of fruits (including dried), vegetables, burghol, and dairy products. Therefore, this cross-sectional study aimed to explore the association between adherence to the Lebanese Mediterranean diet (LMD) and frailty among older adults in Lebanon. A total of 112 community-dwelling older adults aged ≥65 years were recruited. Demographic and clinical characteristics were collected through face-to-face interviews. A 61-item food frequency questionnaire (FFQ) was used to collect dietary intake data, and adherence to LMD was calculated. Physical frailty was defined by the presence of three out of the five criterion: weight loss, weakness, exhaustion, slowness, and low activity. Binary logistic regression was used to examine the relationship between LMD adherence and frailty while adjusting for several confounders. The participants’ mean age was 73 ± 12.8 and 65% were females. Sixteen (14.3%) individuals were identified as frail. Frail individuals were significantly older (p = 0.001), depressed (p < 0.001), at risk of cognitive impairment (p = 0.006), and reported polypharmacy (p = 0.003). No significant association was found between LMD adherence and frailty in fully adjusted models (OR = 0.195; 95% CI: 0.033–1.154; p = 0.071 when categorical and OR = 0.856; 95% CI: 0.668–1.097; p = 0.218 when continuous). We also performed additional analyses with a modified frailty index where house chores were not considered as part of leisure activities of the physical activity criterion. The results showed that a higher LMD adherence was associated with a significantly decreased frailty prevalence (OR = 0.123, 95% CI: 0.022–0.676, p = 0.016 when categorical and OR = 0.773, 95% CI 0.608–0.983, p = 0.036). Larger, longitudinal studies are needed to clarify the relationship between the adherence to the Lebanese Mediterranean diet and frailty in Lebanese older adults.