Malnutrition and Physical Frailty among Nursing Home Residents: A Cross-Sectional Study in China

Objectives To assess the association between malnutrition and physical frailty among nursing home older adults in China. Design and setting A cross-sectional study in 15 nursing homes in Changsha, China. Participants A total of 705 nursing home residents who were aged 60 and older. Measurements Physical frailty was identified based on the following five components: slow gait speed, low physical activity, weight loss, exhaustion, and low grip strength. Nutritional status was assessed using the Mini Nutritional Assessment. Multinomial logistic regression models were used to analyze the association between nutritional status and physical frailty. Results The mean (SD) age of the participants was 82.5 (8.1) years old (range, 60-106 years), and 226 (32%) was men. Of those participants, 5.1% and 55.6% were malnourished and at risk of malnutrition, respectively; 60.3% and 36.2% were identified as being frail and prefrail, respectively. Compared with participants who were well-nourished, those who were at risk of malnutrition or malnourished were two times more likely to be physically frail (adjusted odds ratio 2.66, 95% confidence interval 1.01 to 7.00), after adjustment for age, education level, cognitive status, depressive symptoms, and disability in activities of daily living. No significant association was observed between malnutrition and physical prefrailty. Conclusion Our findings suggest that poor nutritional status and physical frailty are highly prevalent in nursing home older adults in China, and that poor nutritional status is associated with increased odds of physical frailty.