Strong Relationship between Malnutrition and Cognitive Frailty in the Singapore Longitudinal Ageing Studies (SLAS-1 and SLAS-2).
BACKGROUND
Physical frailty is well known to be strongly associated with malnutrition, but the combined impact of physical frailty and cognitive impairment among non-demented older persons (cognitive frailty) on malnutrition prevalence is not well documented.


DESIGN
Cross-sectional cohort study.


SETTING AND PARTICIPANTS
Community-dwelling older Singaporeans aged ≥55y (n=5414) without dementia in the Singapore Longitudinal Ageing Study (SLAS-1 and SLAS-2).


MEASUREMENTS
The Mini Nutritional Assessment - short form (MNA-SF) and Nutrition Screening Initiative (NSI) Determine Checklist were used to determine their nutritional status. Participants were categorized as cognitive normal (CN) or cognitive impaired (CI) by Mini Mental State Examination (MMSE<=23), as pre-frail (PF) (score=1-2) or frail (F) (score=3-5) using Fried's criteria, and as cognitive pre-frail (PF+CI) or cognitive frail (F+CI).


RESULTS
The prevalence of cognitive frailty was 1.6%, and cognitive pre-frailty was 5.5% (total, 7.1%). The prevalence of MNA malnutrition was 2.4%, and NSI high nutritional risk was 6.3%. The prevalence of MNA malnutrition was lowest among Robust-CN and highest among Frail-CI (0.5% in Robust-CN, 0.6% in Robust-CI, 2.8% in Pre-frail-CN, 7.3% in Pre-frail-CI, 15.4% in Frail-CN, and 23.1% in Frail-CI). Similarly, the prevalence of NSI high nutritional risk was lowest in Robust-CN (3.7%) and highest in Frail-CI (13.6%). Adjusted for sociodemographic and health status, pre-frailty/frailty-CI versus Robust-CN was associated with the highest odds ratio of association with MNA malnutrition (OR=8.16, p<0.001), although not the highest with NSI high nutritional risk (OR=1.48, p=0.017).


CONCLUSIONS
An extraordinary high prevalence of malnutrition was observed among older adults with cognitive frailty who should be specially targeted for active intervention.
['Chye|L|L|', 'Wei|K|K|', 'Nyunt|M S Z|MSZ|', 'Gao|Q|Q|', 'Wee|S L|SL|', 'Ng|T P|TP|']
D000368:Aged D000369:Aged, 80 and over D000375:Aging D016022:Case-Control Studies D060825:Cognitive Dysfunction D015897:Comorbidity D003430:Cross-Sectional Studies D005260:Female D016330:Frail Elderly D015577:Geriatric Assessment D006801:Humans D008137:Longitudinal Studies D008297:Male D044342:Malnutrition D000073216:Mental Status and Dementia Tests D008875:Middle Aged D015596:Nutrition Assessment D009752:Nutritional Status D015995:Prevalence D012846:Singapore
Malnutrition Cognitive Frailty Nutritional Risk