This study aimed to explore the association between the impaired nutritional status and frailty in acute hospitalised elderly patients by using two tools, the MNA®-SF (Mini Nutritional Assessment® short-form) and the SHARE-FI (Frailty Instrument for Primary Care of the Survey of Health, Ageing and Retirement in Europe).
Acute hospitalised, community-dwelling elderly patients were recruited at internal medicine wards in Vienna, Austria.
133 men (39%) and women (61%) aged 74 (65–97) years.
MNA®-SF was used to investigate malnutrition (<7 points) and patients at risk of malnutrition (8 to 11 points). By using the SHARE-FI, subjects were classified as frail, pre-frail or robust. A factor analysis was applied to identify overlaps between the MNA®-SF and SHARE-FI items. Internal consistency of different dimensions was assessed by using Cronbach’s Alpha.
Malnutrition or risk of malnutrition was found in 76.7% of the total sample and in 46.8% of robust, in 69.0% of pre-frail, and in 93.0% of frail participants. Frailty or prefrailty was found in 75.9% of the total sample and in 45.1% of the subjects with no risk of malnutrition, in 80.9% of subjects at risk of malnutrition, and in 94.1% of malnourished patients. The two used tools show overlaps in three dimensions: (1) nutrition problems, (2) mobility problems and (3) anthropometric items with a moderate to strong internal consistency (Cronbach’s Alpha of 0.670, 0.834 and 0.946, respectively). 64.7% of the total sample (79.5% of frail and 87.9% of malnourished subjects) would participate in a home-based muscle training and nutritional intervention program.
This study underlines the association and the overlap between frailty and impaired nutritional status. There is a high readiness to participate in a program to tackle the problems associated with malnutrition and frailty, especially in those, who would benefit most from it.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Soeters PB, Reijven PL, Van Bokhorst-De Van Der Schueren MA, Schols JM, Halfens RJ, Meijers JM, and Van Gemert WG. A rational approach to nutritional assessment. Clin Nutr 2008;27(5): 706–716.
Soeters PB and Schols AM. Advances in understanding and assessing malnutrition. Curr Opin Clin Nutr Metab Care 2009;12(5): 487–494.
Allison SP. Malnutrition, disease, and outcome. Nutrition 2000;16(7–8): 590–593.
Domer TE and Paeder A. Obesity paradox in elderly patients with cardiovascular diseases. Int J Cardiol 2012;155(1): 56–65.
Domer TE, Schwarz F, Kranz A, Freidl W, Rieder A, and Gisinger C. Body mass index and the risk of infections in institutionalised geriatric patients. Br J Nutr 2010;103(12): 1830–1835.
Locher JL, Roth DL, Ritchie CS, Cox K, Sawyer P, Bodner EV, and Altaian RM. Body mass index, weight loss, and mortality in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2007;62(12): 1389–1392.
Newman AB, Yanez D, Harris T, Duxbury A, Enright PL, Fried LP, and Cardiovascular Study Research G Weight change in old age and its association with mortality. J Am Geriatr Soc 2001;49(10): 1309–1318.
Kondrup J, Allison SP, Elia M, Vellas B, and Plauth M. ESPEN guidelines for nutrition screening 2002. Clin Nutr 2003;22(4): 415–421.
Bauer JM, Kaiser MJ, Anthony P, Guigoz Y, and Sieber CC. The Mini Nutritional Assessment-its history, today’s practice, and future perspectives. Nutr Clin Pract 2008;23(4): 388–396.
Vellas B, Villars H, Abellan G, Soto ME, Rolland Y, Guigoz Y, Morley JE, Chumlea W, Salva A, Rubenstein LZ, and Garry P. Overview of the MNA-Its history and challenges. J Nutr Health Aging 2006;10(6): 456–463.
Espinoza SE and Fried LP. Risk Factors for Frailty in the Older Adult. Clin Geriatrics 2007;15: 37–44.
Blaum CS, Xue QL, Michelon E, Semba RD, and Fried LP. The association between obesity and the frailty syndrome in older women: the Women’s Health and Aging Studies. J Am Geriatr Soc 2005;53(6): 927–934.
Villareal DT, Banks M, Siener C, Sinacore DR, and Klein S. Physical frailty and body composition in obese elderly men and women. Obes Res 2004;12(6): 913–920.
Woods NF, Lacroix AZ, Gray SL, Aragaki A, Cochrane BB, Brunner RL, Masaki K, Murray A, and Newman AB. Frailty: emergence and consequences in women aged 65 and older in the Women’s Health Initiative Observational Study. J Am Geriatr Soc 2005;53(8): 1321–1330.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, and Mcburnie MA. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56(3): M146–156.
Espinoza S and Walston JD. Frailty in older adults: insights and interventions. Cleve Clin J Med 2005;72(12): 1105–1112.
Fried LP, Ferrucci L, Darer J, Williamson JD, and Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004;59(3): 255–263.
Abellan Van Kan G and Vellas B. Is the Mini Nutritional Assessment an appropriate tool to assess frailty in older adults? J Nutr Health Aging 2011;15(3): 159–161.
Bollwein J, Volkert D, Diekmann R, Kaiser MJ, Uter W, Vidal K, Sieber CC, and Bauer JM. Nutritional Status According to the Mini Nutritional Assessment (MNA(R)) and Frailty in Community Dwelling Older Persons: A Close Relationship. J Nutr Health Aging 2013;17(4): 351–356.
Dale O and Salo M. The Helsinki Declaration, research guidelines and regulations: present and future editorial aspects. Acta Anaesthesiol Scand 1996;40(7): 771–772.
Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony P, Charlton KE, Maggio M, Tsai AC, Grathwohl D, Vellas B, Sieber CC, and Group MN-I. Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 2009;13(9): 782–788.
Rubenstein LZ, Harker JO, Salva A, Guigoz Y, and Vellas B. Screening for undernutrition in geriatric practice: developing the short-form mini-nutritional assessment (MNA-SF). J Gerontol A Biol Sci Med Sci 2001;56(6): M366–372.
Ranhoff AH, Gjoen AU, and Mowe M. Screening for malnutrition in elderly acute medical patients: the usefulness of MNA-SF. J Nutr Health Aging 2005;9(4): 221–225.
Romero-Ortuno R, Walsh CD, Lawlor BA, and Kenny RA. A frailty instrument for primary care: findings from the Survey of Health, Ageing and Retirement in Europe (SHARE). BMC Geriatr 2010;10: 57.
Romero-Ortuno R. The Frailty Instrument for primary care of the Survey of Health, Ageing and Retirement in Europe predicts mortality similarly to a frailty index based on comprehensive geriatric assessment. Geriatr Gerontol Int 2013;13(2): 497–504.
Andela RM, Dijkstra A, Slaets JP, and Sanderman R. Prevalence of frailty on clinical wards: description and implications. Int J Nurs Pract 2010;6(1): 14–19.
Santos-Eggimann B, Cuenoud P, Spagnoli J, and Junod J. Prevalence of frailty in middle-aged and older community-dwelling Europeans living in 10 countries. J Gerontol A Biol Sci Med Sci 2009;64(6): 675–681.
Calvo I, Olivar J, Martinez E, Rico A, Diaz J, and Gimena M. MNA(R) Mini Nutritional Assessment as a nutritional screening tool for hospitalized older adults; rationales and feasibility. Nutr Hosp 2012;27(5): 1619–1625.
Johansson Y, Bachrach-Lindstrom M, Carstensen J, and Ek AC. Malnutrition in a home-living older population: prevalence, incidence and risk factors. A prospective study. J Clin Nurs 2009;18(9): 1354–1364.
Guigoz Y. The Mini Nutritional Assessment (MNA) review of the literature-What does it tell us? J Nutr Health Aging 2006;10(6): 466–485.
Morley JE. Anorexia of aging: a true geriatric syndrome. J Nutr Health Aging 2012;16(5): 422–425.
Morley JE Anorexia, weight loss, and frailty. J Am Med Dir Assoc 2010;11(4): 225–228.
Montero-Odasso M, Muir S, Hall M, Doherty T, Kloseck M, Beauchet O, and Speechley M. Gait variability is associated with frailty in community-dwelling older adults. J Gerontol A Biol Sci Med Sci 2011;66(5): 568–576.
Chevalier S, Saoud F, Gray-Donald K, and Morals JA. The physical functional capacity of frail elderly persons undergoing ambulatory rehabilitation is related to their nutritional status. J Nutr Health Aging 2008;12(10): 721–726.
Schroll M. Aging, food patterns and disability. Forum Nutr 2003;56:256–258.
Rosenberg IH. Sarcopenia: origins and clinical relevance. Clin Geriatr Med 2011;27(3): 337–339.
Neelemaat F. Post-discharge nutritional support in malnourished ill elderly patients -effectiveness and cost-effectiveness. Departments of Nutrition and Dietetics, Internal Medicine and EMGO Institute for Health and Care Research, VU University Medical Center, 2012.
Lackinger C, Haider S, Luger E, Kapan A, Schindler K, and Dorner T. Gesundheitsförderung via Trainings- und Ernährungsintervention durch “Buddies” bei älteren und hochbetagten Personen mit Malnutrition und/oder Frailty im extramuralen Bereich. In 16. Wissenschaftliche Tagung der ÖGPH, Österreichische Gesellschaft für Public Health, St. Pölten, Austria, 2013.
About this article
Cite this article
Dorner, T.E., Luger, E., Tschinderle, J. et al. Association between nutritional status (MNA®-SF) and frailty (SHARE-FI) in acute hospitalised elderly patients. J Nutr Health Aging 18, 264–269 (2014). https://doi.org/10.1007/s12603-013-0406-z