Department of Geriatric Medicine, Balikesir University, Balikesir, Turkey.
Department of Geriatric Medicine, Adana City Training and Research Hospital, Adana, Turkey.
Nutrition. 2024 Oct;126:112504. doi: 10.1016/j.nut.2024.112504. Epub 2024 Jun 2.
The aim of this study was to assess the relationship between cognitive and physical frailty and malnutrition in older adults.
The study was cross-sectional and observational. A total of 992 patients who applied to the geriatric outpatient clinic between January 2018 and December 2022 were included in the study. All patients underwent comprehensive geriatric assessment. Demographic characteristics, geriatric syndromes, comorbidities, and laboratory parameters were recorded. Fried's Frailty Scale was used to determine physical frailty. The Mini Nutritional Assessment Short Form was performed to determine nutritional status. Cognitive frailty was defined as the coexistence of physical frailty and mild cognitive impairment.
Of 992 patients participating in the study, 66% were female, and the mean age was 73.2 ± 7.4. The rate of physical frailty was 13.4%, and 96 patients were cognitively frail. Malnutrition rates were 18.8%, 12.5%, and 2.2% in the cognitive frailty, physical frailty, and healthy control groups, respectively. The healthy control group had a lower median age, fewer geriatric syndromes (excluding orthostatic hypotension), and lower rates of diabetes and hypertension than the frailty groups. The frequency of malnutrition was similar in the cognitive and physical frailty groups. The cognitive frailty group had higher median age, sarcopenia rate, and Timed Up and Go duration; were less likely to be female; and showed lower albumin, mobility, and functionality scores than the physical frailty group (P < 0.05). After adjusting for demographic characteristics, comorbidities, geriatric syndromes, and laboratory parameters, cognitive frailty showed a stronger relationship with malnutrition (odds ratio 1.96, confidence interval 1.13-5.04, P = 0.04).
Cognitive and physical frailty were found to be associated with malnutrition in older adults. Even after accounting for confounding factors, it appears that cognitive frailty is more closely related to nutritional status than physical frailty.
本研究旨在评估老年人认知和身体衰弱与营养不良之间的关系。
本研究为横断面观察性研究。纳入 2018 年 1 月至 2022 年 12 月期间在老年门诊就诊的 992 例患者。所有患者均接受全面老年评估。记录人口统计学特征、老年综合征、合并症和实验室参数。使用 Fried 衰弱量表评估身体衰弱，使用微型营养评估简表评估营养状况。认知衰弱定义为身体衰弱和轻度认知障碍共存。
在参与研究的 992 例患者中，66%为女性，平均年龄为 73.2±7.4 岁。身体衰弱的发生率为 13.4%，有 96 例患者存在认知衰弱。认知衰弱组、身体衰弱组和健康对照组的营养不良发生率分别为 18.8%、12.5%和 2.2%。健康对照组的中位年龄较低，合并的老年综合征（不包括直立性低血压）较少，糖尿病和高血压的发生率较低。认知衰弱组和身体衰弱组的营养不良发生率相似。认知衰弱组的中位年龄较高，肌少症发生率、起立-行走计时测试时间较长，女性比例较低，白蛋白、活动能力和功能评分较低（P＜0.05）。在校正人口统计学特征、合并症、老年综合征和实验室参数后，认知衰弱与营养不良的关系更强（比值比 1.96，95%置信区间 1.13-5.04，P=0.04）。
认知和身体衰弱与老年人的营养不良有关。即使考虑到混杂因素，认知衰弱与营养状况的关系似乎比身体衰弱更为密切。
