Effect of individually tailored nutritional counseling on frailty status in older adults with protein-energy malnutrition or risk of it: an intervention study among home care clients.

Abstract

Background: Frailty and protein-energy malnutrition (PEM) are common in older home care clients. In this study, we evaluate the effect of individually tailored dietary counseling on frailty status among home care clients with PEM or its risk aged 75 or older with a follow-up of six months.

Methods: This intervention study is part of the non-randomized population-based Nutrition, Oral Health and Medication (NutOrMed) study in Finland. The frailty was assessed using the abbreviated Comprehensive Geriatric Assessment (aCGA) and included 15 questions from three different domains: cognitive status (MMSE), functional status (ADL, IADL) and depression (GDS-15). The study population consisted of persons with PEM or its risk (intervention group n = 90, control group n = 55). PEM or its risk was defined by MNA score <24 and/or plasma albumin <35 g/l. Registered nutritionist gave individually tailored nutritional counseling for participants at the baseline and nutritional treatment included conventional food items.

Results: The mean age was 83.9 in the intervention and 84.3 in the control group. At the baseline frailty prevalence was 74.4% (n = 67) and after six-month 61.1% (n = 55) in the intervention group and, respectively 74.5% (n = 41) and 80.0% (n = 44) in the control group. The intervention decreased significantly (p < 0.001) the prevalence of frailty in the intervention group, while it increased in the control group.

Conclusions: Individually tailored nutritional counseling reduces the prevalence of frailty among vulnerable home care clients with PEM or its risk. In the nutritional treatment of frailty, adequate intake of protein and energy should be a cornerstone of treatment.