Nutritional status as a mediator between the age-related muscle loss and frailty in community-dwelling older adults

Purpose: The purposes of the study were: a) to investigate the prevalence of sarcopenia, obesity and sarcopenic obesity (SO) in older adults, b) to explore the effect of nutrition as mediator of the association between these entities and frailty. Materials and Methods: Older adults (>= 65 years) were evaluated based on European Working Group on Sarcopenia in Older People criteria for the presence/absence of sarcopenia. Obesity was diagnosed by using Zoico methodology. FRAIL scale was used to evaluate frailty and nutritional status was assessed with Mini Nutritional Assessment (MNA). Results: Five-hundred-seventy individuals (68,9% female, mean age 74,41 +/- 6,57 years) were included. The prevalence of sarcopenia, obesity and SO were 18,6%, 28,9% and 11,2%, respectively. FRAIL scores were directly affected by having sarcopenia (13: 0.42, 95% CI: (0.21-0.67), p<0.001) and SO (13: 0.31, 95% CI: (0.06-0.59), p:0.015), whereas obesity had no direct effect on FRAIL (13: 0.1, 95% CI: (-0.08-0.3), p:0.26). MNA was a mediator (13: -0.35, 95% CI: (-0.12-(-0.08)), p<0.0001) in both sarcopenic (13: -0.69, 95% CI: (-3.34-(-1.69)), p<0.0001) and SO patients (13: -0.34, 95% CI: (-2.21-(-0.26)), p:0.013), but not in obese group (13: -0.01, 95% CI: (-0.08-0.04). After the Bonferroni corrections,only sarcopenia had an association with frailty with MNA being the mediator. Conclusion: The findings revealed that the frailty rate was higher in sarcopenia (20,8%) and SO (17,2%) groups than obese (5,5%) group. Frailty was associated with sarcopenia and SO, but not with obesity. Nutritional status was found to be a mediator of the association between age-related muscle loss and frailty To the best of our knowledge, this is the first study to report the mediator of the associations between age-related muscle loss and frailty.