Physical Frailty

Malnutrition and physical frailty

Malnutrition

Malnutrition has adverse effects on tissue/body form and function, such as body weight and body composition, and on clinical outcomes.1 These latter include physical and psycho-social consequences such as impaired immune response, impaired wound healing, reduced muscle strength and fatigue, apathy and depression. Malnutrition in hospitalised patients is associated with higher complication rates, longer hospital stays and increased mortality risk.2    

The impact of physical frailty on older people

Physical Frailty is seen as a geriatric syndrome with multiple causes and contributors characterised by diminished strength, endurance and reduced physiologic function, and increasing an individual’s vulnerability for developing disability.3,4 Malnutrition, inactivity and comorbidities have a particularly high adverse impact in older persons and are risk factors for sarcopenia and physical frailty.It is thought that up to 21% of community-dwelling elderly are physically frail.5Frail people are vulnerable to minor stressors such as a fall, which can lead to disproportionate changes in their health status, and puts them at risk of adverse effects such as fractures.6 The loss of muscle mass, strength and function, called sarcopenia, is considered by experts in the field as a key factor in the development of physical frailty.7 As one of the main causes of functional decline in the elderly, sarcopenia has a high clinical impact, affecting the status and recovery of a person’s mobility, independence and quality of life.

Frail adults have 6 x the mortality rate of non-frail patients.3

1.
Elia M. BAPEN. 2000.  Ref Type: Report.
2.
Medical Nutrition International Industry (MNI) (2018). Better care through better nutrition: Value and effects of Medical Nutrition. Retrieved from: https://medicalnutritionindustry.com/files/user_upload/documents/medical_nutrition/2018_MNI_Dossier_Final_web.pdf.
3.
Fried LP et al. Journal of Gerontology. 2001;56A(3):M146-M156.
4.
Morley J et al. Frailty consensus: a call to action. JAMDA 2013: 14(6),392-7.
5.
Santos-Eggimann B, et al. J Gerontol A Biol Sci Med Sci 2009, 64(6):675-681.
6.
Lancet. 2013 March 2; 381(9868): 752–762. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4098658/.
7.
Landi F, et al. Clin Geriatr Med. 2015 Aug;31(3):367-74 https://www.ncbi.nlm.nih.gov/pubmed/26195096.