The physical functional capacity of frail elderly persons undergoing ambulatory rehabilitation is related to their nutritional status

Objectives: To estimate the prevalence of malnutrition in frail elders undergoing rehabilitation and the association between their nutritional status and physical function.Design: Observational study of new participants undergoing ambulatory rehabilitation.Setting: Two Geriatric Day Hospitals (GDH) in Montreal, Quebec.Participants: 121 women and 61 men.Intervention: Evaluation of nutritional status, body composition and physical function.Measurements: The nutritional status was assessed with a composite index based on anthropometric measurements and serum albumin, as well as using the Mini Nutritional Assessment (MNA) questionnaire. Patients were classified as well-nourished, having mild/at risk of malnutrition or malnourished. Body composition was estimated by bioimpedance and handgrip strength and gait speed by standard methods.Results: 13% of patients were found to be mildly malnourished, whereas 6% were malnourished. Malnourished patients were older and had worse cognition, lower BMI, and % body fat (all p<0.05). Malnourished patients and those with mild malnutrition had lower weight, triceps skinfold thickness, muscle and fat mass (all, p<0.003). Handgrip strength was different according to the nutritional status (p=0.034) and correlated with muscle mass (r=0.65, p<0.001). MNA classified 53% of patients as being at risk whereas 3% were malnourished and it correlated with gait speed (r=0.26, p=0.001).Conclusion: There is a high prevalence of patients in GDH at risk or with mild malnutrition. Being malnourished was associated with worse physical performance, which suggests that a nutritional intervention may be of benefit in improving their physical function.