Skip to main content
Top
Published in: BMC Geriatrics 1/2021

Open Access 01-12-2021 | Nutrition | Research

The correlation between nutrition and frailty and the receiver operating characteristic curve of different nutritional indexes for frailty

Authors: Hong Liang, Xiaoping Li, Xiaoye Lin, Yanmin Ju, Jiyan Leng

Published in: BMC Geriatrics | Issue 1/2021

Login to get access

Abstract

Background

Frailty is a kind of geriatric syndrome, which is very common in the elderly. Patients with malnutrition are at higher risk of frailty. This study explored the correlation between nutrition and frailty and compared the receiver operating characteristic curve of different nutritional indexes for frailty.

Methods

This cross-sectional study included 179 inpatients aged ≥65 years old. Frailty was measured using Fried Frailty Phenotype, handgrip strength was measured using JAMAR@Plus and the 4.57 m usual gait speed was measured using a stopwatch. Comprehensive nutritional assessment refers to the application of Mini Nutritional Assessment (MNA) to assess the nutritional status of patients.

Results

Compared with the non-frailty group, the upper arm circumference, calf circumference, hemoglobin, albumin, prealbumin, cholesterol and low density lipoprotein in the frailty group were lower (P < 0.05). Comprehensive nutritional assessment, whether as a categorical variable or a continuous variable, was significantly correlated with frailty (P < 0.05). Model1 showed that the risk of frailty in malnourished patients was 3.381 times higher than that in well nourished patients (P = 0.036). Model2 showed that the risk of frailty decreased by 13.8% for every 1 point increase in MNA score (P = 0.009). The area under the curves of albumin, prealbumin and hemoglobin was larger (AUC > 0.65), AUC was 0.718, 0.693 and 0.743, respectively.

Conclusions

Our results suggest that malnutrition is closely related to frailty. As for single nutritional indexes, albumin, prealbumin and hemoglobin were found to be associated with frailty. Further cohort studies are needed to verify their ability to screen for frailty.
Literature
1.
go back to reference Mousa A, Savva GM, Mitnitski A, Rockwood K, Jagger C, Brayne C, et al. Is frailty a stable predictor of mortality across time? Evidence from the cognitive function and ageing studies. Age Ageing. 2018;47(5):721–7.CrossRef Mousa A, Savva GM, Mitnitski A, Rockwood K, Jagger C, Brayne C, et al. Is frailty a stable predictor of mortality across time? Evidence from the cognitive function and ageing studies. Age Ageing. 2018;47(5):721–7.CrossRef
2.
go back to reference Dent E, Martin FC, Bergman H, Woo J, Romero-Ortuno R, Walston JD. Management of frailty: opportunities, challenges, and future directions. Lancet. 2019;394(10206):1376–86.CrossRef Dent E, Martin FC, Bergman H, Woo J, Romero-Ortuno R, Walston JD. Management of frailty: opportunities, challenges, and future directions. Lancet. 2019;394(10206):1376–86.CrossRef
3.
go back to reference Cesari M, Calvani R, Marzetti E. Frailty in older persons. Clin Geriatr Med. 2017;33(3):293–303.CrossRef Cesari M, Calvani R, Marzetti E. Frailty in older persons. Clin Geriatr Med. 2017;33(3):293–303.CrossRef
4.
go back to reference Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–7.CrossRef Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, et al. Frailty consensus: a call to action. J Am Med Dir Assoc. 2013;14(6):392–7.CrossRef
5.
go back to reference Baztán JJ, De la Puente M, Socorro A. Frailty, functional decline and mortality in hospitalized older adults. Geriatr Gerontol Int. 2017;17(4):664–6.CrossRef Baztán JJ, De la Puente M, Socorro A. Frailty, functional decline and mortality in hospitalized older adults. Geriatr Gerontol Int. 2017;17(4):664–6.CrossRef
6.
go back to reference Bonnefoy M, Berrut G, Lesourd B, Ferry M, Gilbert T, Guérin O, et al. Frailty and nutrition: searching for evidence. J Nutr Health Aging. 2015;19(3):250–7.CrossRef Bonnefoy M, Berrut G, Lesourd B, Ferry M, Gilbert T, Guérin O, et al. Frailty and nutrition: searching for evidence. J Nutr Health Aging. 2015;19(3):250–7.CrossRef
7.
go back to reference Artaza-Artabe I, Sáez-López P, Sánchez-Hernández N, Fernández-Gutierrez N, Malafarina V. The relationship between nutrition and frailty: effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas. 2016;93:89–99.CrossRef Artaza-Artabe I, Sáez-López P, Sánchez-Hernández N, Fernández-Gutierrez N, Malafarina V. The relationship between nutrition and frailty: effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas. 2016;93:89–99.CrossRef
8.
go back to reference Malafarina V, Uriz-Otano F, Iniesta R, Gil-Guerrero L. Sarcopenia in the elderly: diagnosis, physiopathology and treatment. Maturitas. 2012;71(2):109–14.CrossRef Malafarina V, Uriz-Otano F, Iniesta R, Gil-Guerrero L. Sarcopenia in the elderly: diagnosis, physiopathology and treatment. Maturitas. 2012;71(2):109–14.CrossRef
9.
go back to reference Marzban M, Nabipour I, Farhadi A, Ostovar A, Larijani B, Darabi AH, et al. Association between anemia, physical performance and cognitive function in Iranian elderly people: evidence from Bushehr Elderly Health (BEH) program. BMC Geriatr. 2021;21(1):329.CrossRef Marzban M, Nabipour I, Farhadi A, Ostovar A, Larijani B, Darabi AH, et al. Association between anemia, physical performance and cognitive function in Iranian elderly people: evidence from Bushehr Elderly Health (BEH) program. BMC Geriatr. 2021;21(1):329.CrossRef
10.
go back to reference da Silva VD, Tribess S, Meneguci J, Sasaki JE, Santos DAT, Carneiro JAO, et al. Time spent in sedentary behaviour as discriminant criterion for frailty in older adults. Int J Environ Res Public Health. 2018;15(7):1336.CrossRef da Silva VD, Tribess S, Meneguci J, Sasaki JE, Santos DAT, Carneiro JAO, et al. Time spent in sedentary behaviour as discriminant criterion for frailty in older adults. Int J Environ Res Public Health. 2018;15(7):1336.CrossRef
11.
go back to reference Mendes J, Amaral TF, Borges N, Santos A, Padrão P, Moreira P, et al. Handgrip strength values of Portuguese older adults: a population based study. BMC Geriatr. 2017;17(1):191.CrossRef Mendes J, Amaral TF, Borges N, Santos A, Padrão P, Moreira P, et al. Handgrip strength values of Portuguese older adults: a population based study. BMC Geriatr. 2017;17(1):191.CrossRef
12.
go back to reference Rodacki ALF, Boneti Moreira N, Pitta A, Wolf R, Melo Filho J, Rodacki CLN, et al. Is handgrip strength a useful measure to evaluate lower limb strength and functional performance in older women? Clin Interv Aging. 2020;15:1045–56.CrossRef Rodacki ALF, Boneti Moreira N, Pitta A, Wolf R, Melo Filho J, Rodacki CLN, et al. Is handgrip strength a useful measure to evaluate lower limb strength and functional performance in older women? Clin Interv Aging. 2020;15:1045–56.CrossRef
13.
go back to reference Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.CrossRef Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146–56.CrossRef
14.
go back to reference Guigoz Y. The mini nutritional assessment (MNA) review of the literature--what does it tell us? J Nutr Health Aging. 2006;10(6):466–85 discussion 85-7.PubMed Guigoz Y. The mini nutritional assessment (MNA) review of the literature--what does it tell us? J Nutr Health Aging. 2006;10(6):466–85 discussion 85-7.PubMed
15.
go back to reference Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutr Rev. 1996;54(1 Pt 2):S59–65.PubMed Guigoz Y, Vellas B, Garry PJ. Assessing the nutritional status of the elderly: the mini nutritional assessment as part of the geriatric evaluation. Nutr Rev. 1996;54(1 Pt 2):S59–65.PubMed
16.
go back to reference DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837–45.CrossRef DeLong ER, DeLong DM, Clarke-Pearson DL. Comparing the areas under two or more correlated receiver operating characteristic curves: a nonparametric approach. Biometrics. 1988;44(3):837–45.CrossRef
17.
go back to reference Lorenzo-López L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodríguez-Villamil JL, Millán-Calenti JC. Nutritional determinants of frailty in older adults: a systematic review. BMC Geriatr. 2017;17(1):108.CrossRef Lorenzo-López L, Maseda A, de Labra C, Regueiro-Folgueira L, Rodríguez-Villamil JL, Millán-Calenti JC. Nutritional determinants of frailty in older adults: a systematic review. BMC Geriatr. 2017;17(1):108.CrossRef
18.
go back to reference Talegawkar SA, Bandinelli S, Bandeen-Roche K, Chen P, Milaneschi Y, Tanaka T, et al. A higher adherence to a Mediterranean-style diet is inversely associated with the development of frailty in community-dwelling elderly men and women. J Nutr. 2012;142(12):2161–6.CrossRef Talegawkar SA, Bandinelli S, Bandeen-Roche K, Chen P, Milaneschi Y, Tanaka T, et al. A higher adherence to a Mediterranean-style diet is inversely associated with the development of frailty in community-dwelling elderly men and women. J Nutr. 2012;142(12):2161–6.CrossRef
19.
go back to reference Lu H, Daugherty A. Atherosclerosis. Arterioscler Thromb Vasc Biol. 2015;35(3):485–91.CrossRef Lu H, Daugherty A. Atherosclerosis. Arterioscler Thromb Vasc Biol. 2015;35(3):485–91.CrossRef
20.
go back to reference Tamura Y, Omura T, Toyoshima K, Araki A. Nutrition management in older adults with diabetes: a review on the importance of shifting prevention strategies from metabolic syndrome to frailty. Nutrients. 2020;12(11):3367.CrossRef Tamura Y, Omura T, Toyoshima K, Araki A. Nutrition management in older adults with diabetes: a review on the importance of shifting prevention strategies from metabolic syndrome to frailty. Nutrients. 2020;12(11):3367.CrossRef
21.
go back to reference Nascimento CM, Ingles M, Salvador-Pascual A, Cominetti MR, Gomez-Cabrera MC, Viña J. Sarcopenia, frailty and their prevention by exercise. Free Radic Biol Med. 2019;132:42–9.CrossRef Nascimento CM, Ingles M, Salvador-Pascual A, Cominetti MR, Gomez-Cabrera MC, Viña J. Sarcopenia, frailty and their prevention by exercise. Free Radic Biol Med. 2019;132:42–9.CrossRef
22.
go back to reference Onder G, Vetrano DL, Marengoni A, Bell JS, Johnell K, Palmer K. Accounting for frailty when treating chronic diseases. Eur J Intern Med. 2018;56:49–52.CrossRef Onder G, Vetrano DL, Marengoni A, Bell JS, Johnell K, Palmer K. Accounting for frailty when treating chronic diseases. Eur J Intern Med. 2018;56:49–52.CrossRef
23.
go back to reference Renne I, Gobbens RJ. Effects of frailty and chronic diseases on quality of life in Dutch community-dwelling older adults: a cross-sectional study. Clin Interv Aging. 2018;13:325–34.CrossRef Renne I, Gobbens RJ. Effects of frailty and chronic diseases on quality of life in Dutch community-dwelling older adults: a cross-sectional study. Clin Interv Aging. 2018;13:325–34.CrossRef
24.
go back to reference Palmer K, Vetrano DL, Marengoni A, Tummolo AM, Villani ER, Acampora N, et al. The relationship between anaemia and frailty: a systematic review and meta-analysis of observational studies. J Nutr Health Aging. 2018;22(8):965–74.CrossRef Palmer K, Vetrano DL, Marengoni A, Tummolo AM, Villani ER, Acampora N, et al. The relationship between anaemia and frailty: a systematic review and meta-analysis of observational studies. J Nutr Health Aging. 2018;22(8):965–74.CrossRef
25.
go back to reference Sanchis J, Núñez E, Ruiz V, Bonanad C, Fernández J, Cauli O, et al. Usefulness of clinical data and biomarkers for the identification of frailty after acute coronary syndromes. Can J Cardiol. 2015;31(12):1462–8.CrossRef Sanchis J, Núñez E, Ruiz V, Bonanad C, Fernández J, Cauli O, et al. Usefulness of clinical data and biomarkers for the identification of frailty after acute coronary syndromes. Can J Cardiol. 2015;31(12):1462–8.CrossRef
26.
go back to reference Mailliez A, Guilbaud A, Puisieux F, Dauchet L, Boulanger É. Circulating biomarkers characterizing physical frailty: CRP, hemoglobin, albumin, 25OHD and free testosterone as best biomarkers. Results of a meta-analysis. Exp Gerontol. 2020;139:111014.CrossRef Mailliez A, Guilbaud A, Puisieux F, Dauchet L, Boulanger É. Circulating biomarkers characterizing physical frailty: CRP, hemoglobin, albumin, 25OHD and free testosterone as best biomarkers. Results of a meta-analysis. Exp Gerontol. 2020;139:111014.CrossRef
27.
go back to reference Hubbard RE, O'Mahony MS, Savva GM, Calver BL, Woodhouse KW. Inflammation and frailty measures in older people. J Cell Mol Med. 2009;13(9b):3103–9.CrossRef Hubbard RE, O'Mahony MS, Savva GM, Calver BL, Woodhouse KW. Inflammation and frailty measures in older people. J Cell Mol Med. 2009;13(9b):3103–9.CrossRef
28.
go back to reference Kelaiditi E, Guyonnet S, Cesari M. Is nutrition important to postpone frailty? Curr Opin Clin Nutr Metab Care. 2015;18(1):37–42.CrossRef Kelaiditi E, Guyonnet S, Cesari M. Is nutrition important to postpone frailty? Curr Opin Clin Nutr Metab Care. 2015;18(1):37–42.CrossRef
29.
go back to reference Bartali B, Frongillo EA, Bandinelli S, Lauretani F, Semba RD, Fried LP, et al. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci. 2006;61(6):589–93.CrossRef Bartali B, Frongillo EA, Bandinelli S, Lauretani F, Semba RD, Fried LP, et al. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci. 2006;61(6):589–93.CrossRef
30.
go back to reference Soysal P, Stubbs B, Lucato P, Luchini C, Solmi M, Peluso R, et al. Inflammation and frailty in the elderly: a systematic review and meta-analysis. Ageing Res Rev. 2016;31:1–8.CrossRef Soysal P, Stubbs B, Lucato P, Luchini C, Solmi M, Peluso R, et al. Inflammation and frailty in the elderly: a systematic review and meta-analysis. Ageing Res Rev. 2016;31:1–8.CrossRef
31.
go back to reference Darvin K, Randolph A, Ovalles S, Halade D, Breeding L, Richardson A, et al. Plasma protein biomarkers of the geriatric syndrome of frailty. J Gerontol A Biol Sci Med Sci. 2014;69(2):182–6.CrossRef Darvin K, Randolph A, Ovalles S, Halade D, Breeding L, Richardson A, et al. Plasma protein biomarkers of the geriatric syndrome of frailty. J Gerontol A Biol Sci Med Sci. 2014;69(2):182–6.CrossRef
32.
go back to reference Liu CK, Lyass A, Larson MG, Massaro JM, Wang N, D'Agostino RB Sr, et al. Biomarkers of oxidative stress are associated with frailty: the Framingham offspring study. Age (Dordr). 2016;38(1):1.CrossRef Liu CK, Lyass A, Larson MG, Massaro JM, Wang N, D'Agostino RB Sr, et al. Biomarkers of oxidative stress are associated with frailty: the Framingham offspring study. Age (Dordr). 2016;38(1):1.CrossRef
33.
go back to reference Saedi AA, Feehan J, Phu S, Duque G. Current and emerging biomarkers of frailty in the elderly. Clin Interv Aging. 2019;14:389–98.CrossRef Saedi AA, Feehan J, Phu S, Duque G. Current and emerging biomarkers of frailty in the elderly. Clin Interv Aging. 2019;14:389–98.CrossRef
34.
go back to reference García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, Rodríguez-Mañas L, Rodríguez-Artalejo F. Diabetes and risk of frailty and its potential mechanisms: a prospective cohort study of older adults. J Am Med Dir Assoc. 2015;16(9):748–54.CrossRef García-Esquinas E, Graciani A, Guallar-Castillón P, López-García E, Rodríguez-Mañas L, Rodríguez-Artalejo F. Diabetes and risk of frailty and its potential mechanisms: a prospective cohort study of older adults. J Am Med Dir Assoc. 2015;16(9):748–54.CrossRef
35.
go back to reference Abdelhafiz AH, Rodríguez-Mañas L, Morley JE, Sinclair AJ. Hypoglycemia in older people - a less well recognized risk factor for frailty. Aging Dis. 2015;6(2):156–67.CrossRef Abdelhafiz AH, Rodríguez-Mañas L, Morley JE, Sinclair AJ. Hypoglycemia in older people - a less well recognized risk factor for frailty. Aging Dis. 2015;6(2):156–67.CrossRef
36.
go back to reference Chang SF. Frailty is a major related factor for at risk of malnutrition in community-dwelling older adults. J Nurs Scholarsh. 2017;49(1):63–72.CrossRef Chang SF. Frailty is a major related factor for at risk of malnutrition in community-dwelling older adults. J Nurs Scholarsh. 2017;49(1):63–72.CrossRef
Metadata
Title
The correlation between nutrition and frailty and the receiver operating characteristic curve of different nutritional indexes for frailty
Authors
Hong Liang
Xiaoping Li
Xiaoye Lin
Yanmin Ju
Jiyan Leng
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Geriatrics / Issue 1/2021
Electronic ISSN: 1471-2318
DOI
https://doi.org/10.1186/s12877-021-02580-5

Other articles of this Issue 1/2021

BMC Geriatrics 1/2021 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.