Nutritional determinants of frailty in older adults: A systematic review

Abstract

BackgroundFrailty is a geriatric syndrome that affects multiple domains of human functioning. A variety of problems contributes to the development of this syndrome; poor nutritional status is an important determinant of this condition. The purpose of this systematic review was to examine recent evidence regarding the association between nutritional status and frailty syndrome in older adults.MethodsPubMed, Web of Science, and Scopus electronic databases were searched using specific key words, for observational papers that were published during the period from 2005 to February 2017 and that studied the association or relationship between nutritional status and frailty in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed to assess the quality of the included articles.ResultsOf the 2042 studies found, nineteen met the inclusion criteria. Of these studies, five provided data on micronutrients and frailty, and reported that frailty syndrome is associated with low intakes of specific micronutrients. Five studies provided data on macronutrients and frailty, and among those studies, four revealed that a higher protein intake was associated with a lower risk of frailty. Three studies examined the relationship between diet quality and frailty, and showed that the quality of the diet is inversely associated with the risk of being frail. Two studies provided data on the antioxidant capacity of the diet and frailty, and reported that a high dietary antioxidant capacity is associated with a lower risk of developing frailty. Finally, seven studies evaluated the relationship between scores on both the Mini Nutritional Assessment (MNA) and the MNA-SF (Short Form) and frailty, and revealed an association between malnutrition and/or the risk of malnutrition and frailty.ConclusionsThis systematic review confirms the importance of both quantitative (energy intake) and qualitative (nutrient quality) factors of nutrition in the development of frailty syndrome in older adults. However, more longitudinal studies on this topic are required to further understand the potential role of nutrition in the prevention, postponement, or even reversion of frailty syndrome.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-017-0496-2) contains supplementary material, which is available to authorized users.

Association between number of teeth, use of dentures and musculoskeletal frailty among older adults

“…19,24 The findings of the current analysis are generally in line with these studies. Others have argued that chewing inability, mainly resulting from inadequate dentition, negatively impacts nutritional intake.…”

“…Inadequate intake of nutrients related to frailty 19 was calculated according to the values of Recommended Dietary Intakes produced by the US Food and Drug Administration. Inadequate intake of nutrients related to frailty 19 was calculated according to the values of Recommended Dietary Intakes produced by the US Food and Drug Administration.…”

Low intake of vitamins B6, C, E and folate from dietary sources may lead to a higher risk of developing frailty in older adults

“…There is growing evidence that inadequate nutrition is a determining factor in the development of frailty among older adults, both in terms of the quantity of calories consumed and the quality of nutrients taken 1. Frailty leads to reduced quality of life, loss of function and independence, and increased morbidity and mortality 2.…”

Chapter 1 Frailty: Definition, diagnosis, epidemiology

“…26 These include amount of protein intake, 27-31 distribution of protein intake, 31 intake of specific micronutrients, 27,32-34 quality of diet (intake diversity) 35,36 and anti-oxidant capacity of the diet. In a systematic review, Lorenzo-López identified several nutritional determinants of frailty.…”