Dataset Information

Nutritional determinants of frailty in older adults: A systematic review.

ABSTRACT:

Background

Frailty is a geriatric syndrome that affects multiple domains of human functioning. A variety of problems contributes to the development of this syndrome; poor nutritional status is an important determinant of this condition. The purpose of this systematic review was to examine recent evidence regarding the association between nutritional status and frailty syndrome in older adults.

Methods

PubMed, Web of Science, and Scopus electronic databases were searched using specific key words, for observational papers that were published during the period from 2005 to February 2017 and that studied the association or relationship between nutritional status and frailty in older adults. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement was followed to assess the quality of the included articles.

Results

Of the 2042 studies found, nineteen met the inclusion criteria. Of these studies, five provided data on micronutrients and frailty, and reported that frailty syndrome is associated with low intakes of specific micronutrients. Five studies provided data on macronutrients and frailty, and among those studies, four revealed that a higher protein intake was associated with a lower risk of frailty. Three studies examined the relationship between diet quality and frailty, and showed that the quality of the diet is inversely associated with the risk of being frail. Two studies provided data on the antioxidant capacity of the diet and frailty, and reported that a high dietary antioxidant capacity is associated with a lower risk of developing frailty. Finally, seven studies evaluated the relationship between scores on both the Mini Nutritional Assessment (MNA) and the MNA-SF (Short Form) and frailty, and revealed an association between malnutrition and/or the risk of malnutrition and frailty.

Conclusions

This systematic review confirms the importance of both quantitative (energy intake) and qualitative (nutrient quality) factors of nutrition in the development of frailty syndrome in older adults. However, more longitudinal studies on this topic are required to further understand the potential role of nutrition in the prevention, postponement, or even reversion of frailty syndrome.

SUBMITTER: Lorenzo-Lopez L

PROVIDER: S-EPMC5433026 | biostudies-literature | 2017 May

REPOSITORIES: biostudies-literature

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Publications

Nutritional determinants of frailty in older adults: A systematic review.

Lorenzo-López Laura L Maseda Ana A de Labra Carmen C Regueiro-Folgueira Laura L Rodríguez-Villamil José L JL Millán-Calenti José C JC

BMC geriatrics 20170515 1

<h4>Background</h4>Frailty is a geriatric syndrome that affects multiple domains of human functioning. A variety of problems contributes to the development of this syndrome; poor nutritional status is an important determinant of this condition. The purpose of this systematic review was to examine recent evidence regarding the association between nutritional status and frailty syndrome in older adults.<h4>Methods</h4>PubMed, Web of Science, and Scopus electronic databases were searched using spec ...[more]

PMID: 28506216

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Project description:BackgroundFrailty has been defined as a clinical syndrome of multicausal origin characterized by a reduction of physiologic reserves that increase the vulnerability of an individual to adverse outcomes such as the development of functional dependence and death. Considered one of the most important geriatric syndromes, frailty's prevention and management represent important goals for gerontology and geriatrics. Although nutrition plays an important role within the multifactorial susceptibility for this syndrome, up to the present no systematic review specifically addressed the effectiveness of nutritional interventions for the treatment of frailty. Therefore, we propose the present systematic review with the aim to assess the effectiveness of nutritional interventions for the treatment of frailty in older adults living in the community or in long-term care facilities.MethodsWe will search Medline (via Pubmed), Embase, Cinahl, Central, Lilacs, Web of Science, and sources of gray literature. We will accept trials whereby the unit of randomization consisted of individuals or clusters of individuals. Our primary outcome is all-cause mortality. Secondary outcomes are quality of life, functional status, cognitive function, frailty status, body composition, and physical activity. Risk of bias will be assessed using the Cochrane Collaboration tool. We will analyze the overall strength of the evidence for each outcome using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Two independent researchers will conduct all evaluations and any disagreements will be resolved through the participation of a 3rd author. If possible, we will perform random-effects meta-analyses and subgroup analyses concerning specific details of nutritional interventions (e.g., components and duration), research scenario, risk of bias, and criteria used to diagnose frailty.ConclusionIn this systematic review protocol we outline the details of the aims and methods of a systematic review on the effectiveness of nutritional interventions for the management of frailty in older adults living in the community or in long-term care facilities". We believe this wording to be more objective and balanced than the previous one. We understand that it is not ideal to propose changes to the text after manuscripts have been accepted. However, we feel that the new wording of the conclusion section of the abstract is more consistent with the overall content of the main text of the review than its previous version. Hence, we hope you may accept our request.

Project description:Frailty is a dynamic process in which there is a reduction in the physical, psychological and/or social function associated with aging. The aim of this study was to identify instruments for the detection of frailty in older adults, characterizing their components, application scenarios, ability to identify pre-frailty and clinimetric properties evaluated. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), under registration number CRD42017039318. A total of 14 electronic sources were searched to identify studies that investigated instruments for the detection of frailty or that presented the construction and/or clinimetric evaluation of the instrument, according to criteria established by the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). 96 studies were included in the qualitative synthesis: 51 instruments for the detection of frailty were identified, with predominantly physical domains; 40 were constructed and/or validated for use in the older adult community population, 28 only highlighted the distinction between frail and non-frail individuals and 23 presented three or more levels of frailty. The FRAGIRE, FRAIL Scale, Edmonton Frail Scale and IVCF-20 instruments were the most frequently analyzed in relation to clinimetric properties. It was concluded that: (I) there is a large number of instruments for measuring the same construct, which makes it difficult for researchers and clinicians to choose the most appropriate; (II) the FRAGIRE and CFAI stand out due to their multidimensional aspects, including an environmental assessment; however, (III) the need for standardization of the scales was identified, since the use of different instruments in clinical trials may prevent the comparability of the results in systematic reviews and; (IV) considering the different instruments identified in this review, the choice of researchers/clinicians should be guided by the issues related to the translation and validation for their location and the suitability for their context.

Dataset Information

Nutritional determinants of frailty in older adults: A systematic review.

Background

Methods

Results

Conclusions

Publications

Nutritional determinants of frailty in older adults: A systematic review.

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