Nutrition and Frailty: A Review of Clinical Intervention Studies

Abstract

Frailty is one of the major health concerns in aging. It is considered a geriatric syndrome characterized by muscle weakness, sarcopenia and fatigue. It is also associated with several adverse health outcomes, including disability. Literature shows that there are a number of studies conducted to define the relationship between frailty and nutrition. The majority is from cross sectional, longitudinal, and cohort studies. Few intervention studies using micronutrients, macronutrients, nutritional supplement, or food regimens have been found. This review examines the nutrition intervention studies targeted towards older adults with frailty, and evaluates the effectiveness of nutrition interventions on frailty indicators. Twenty-four intervention studies from six electronic databases met the inclusion criteria. Sixteen were randomized controlled clinical trials; one was a quasi-experimental design, whilst the rest were controlled trials. Participants included in the studies differed in terms of age and frailty status. The studies were inconsistent in intervention type, duration, and targeted outcomes. Most of the studies indicated that modification of nutrition quality, either by giving supplements or by improving diet intake, could improve strength, walking speed, and nutritional status in majority of frail or pre-frail older adults. However, there was limited evidence on the effectiveness of intervention on inflammatory status and other biomarkers related to frailty due to limited number of studies targeting frailty biomarkers as a major outcome.

Assessment of Frailty and Association With Progression of Benign Prostatic Hyperplasia Symptoms and Serious Adverse Events Among Men Using Drug Therapy

“…On the basis of current clinical guidelines, patients for whom maximal medical BPH therapy with combination therapy fails should be considered for more aggressive surgical interventions targeting the same mechanism of prostatic obstruction. 37 [39][40][41][42][43] Other interventions are designed to improve specific components of the frailty phenotype, such as resistance training to increase or maintain muscle mass among older adults, 44,45 or to target frailty by interfering with upstream mechanisms of biological aging. [46][47][48] Although targeting frailty may represent a novel approach to preventing or treating LUTS in older men, most frailty intervention studies have not measured LUTS severity, so it remains unknown whether preventing or reversing frailty will prevent LUTS progression.…”

“…Consistent with this hypothesis, we observed evidence of a possible interaction between frailty status and treatment where frailty was most associated with clinical BPH progression among men receiving either combination therapy or doxazosin monotherapy. Frailty interventions often include physical activity, nutrition, multicomponent interventions, or individually tailored geriatric care models . Other interventions are designed to improve specific components of the frailty phenotype, such as resistance training to increase or maintain muscle mass among older adults, or to target frailty by interfering with upstream mechanisms of biological aging .…”

Effectiveness of nutrition interventions and combined nutrition and physical activity interventions in older adults with frailty or prefrailty: a systematic review and meta-analysis

“… 9 , 49 Others included a broader mix of interventions, 5 , 6 , 50 which made their assessment more heterogeneous than our review. Some reviews lacked meta-analyses 11 , 51 , 52 or focused on only a few specific outcomes, such as physical performance, 11 body composition, leg strength and walking speed. 53 Some reviews of nutrition interventions included participants who were malnourished or sarcopenic and not necessarily frail.…”

Comparative effectiveness of different modes of exercise interventions in diabetics with frailty in China: a systematic review and a network meta-analysis

“…Diabetes-related hormone deficiency [ 11 ], neuropathy [ 12 ], chronic inflammation [ 13 ] and insulin resistance [ 14 ] can slow down protein synthesis and increase muscle loss, which will increase the incidence of sarcopenia in patients, and accelerate the occurrence of frailty [ 7 ]. In addition, patients with diabetes are often at risk of malnutrition, which will lead to the decline of muscle and bone quality, weaken the body’s immunity, reduce the body’s activity, and make patients prone to frailty symptoms [ 15 ].…”