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Relationship between Physical Frailty, Nutritional Risk Factors And Protein Intake In Community-Dwelling Older Adults

Susi Fris Buhl

Physical frailty is described as “a medical syndrome with various underlying causes and contributions marked by decreasing strength, endurance, and physiologic function that increases an individual’s vulnerability for increasing dependency and/or mortality.” Physical fragility is linked to early mortality, functional decline, increased risk of fractures and falls, hospitalization, poor quality of life, and disability. There isn’t currently a single operational definition of physical frailty, but a number of assessment tools have been used, including the SHARE-FI75+, the Deficit Frailty Scale, and the Physical Frailty Phenotype [1,2]. The domains of weakness, slowness, low physical activity, low appetite and weight loss, and exhaustion/fatigue are frequently shared by these tools. Usually, a pre-frail condition with fewer domains is evident before physical frailty. In older persons living in the community, physical prefrail and frail conditions are very common (41% and 10%, respectively), and prevalence rises with age. Demographic predictions predict an increase in the number of older adults in Europe (65 and older), along with a significant rise in the number of people aged 80 and beyond. As a result, the prevalence of physical pre-frailty and frailty may rise in tandem with the growing older population [3].

Malnutrition is described as “a state resulting from lack of intake or uptake of nutrition that leads to altered body composition (decreased fat free mass) and body cell mass leading to diminished physical and mental function and impaired clinical outcome from disease” and is thought to be one of the main risk factors linked to physical frailty. Physical frailty is categorized as a nutrition-related condition by the European Society for Clinical Nutrition and Metabolism, or ESPEN. Depending on the criteria or screening procedures used, the incidence of malnutrition in community-dwelling older individuals ranges from 4.6% to 17.2%. Reduced appetite, unintentional weight loss, poor dental health, dysphagia, low and high Body Mass Index (BMI), and recent illness are significant risk factors for malnutrition. Similar to physical frailty, the risk of malnutrition rises with age in community-dwelling adults, and many very old adults (80 years or older) are at risk [4].

Malnutrition and physical fragility have a complicated relationship. Results from cross-sectional studies and prospective cohorts have shown that reduced protein intake is related with a decreased risk of frailty, while malnutrition and risk of malnutrition (assessed by nutritional screening methods) are associated with physical frailty. Despite the connection between physical frailty and malnutrition that has been shown, it has recently been determined that more research is required to fully understand which nutritional risk factors are connected to physical frailty in independent community-dwelling adults. This is very important because physical frailty may be reversible, and if modifiable risk factors are discovered early on, functional deterioration associated with physical frailty may be avoided. Therefore, it is advised to use efficient screening techniques to identify physical frailty risk early on and the risk factors that go along with it. In order to identify risk factors for physical frailty early, large-scale screening strategies should be I straightforward and simple to administer by health care professionals with different educational backgrounds, ii) time-effective as multiple topics are covered in a condensed amount of time, and iii) non-invasive and not reliant on specialized equipment [5-7].