Time-course assessment of oral intake function and its impact on end-of-life in older individuals over 90 years with frailty.

Abstract

Aim: The study investigates end-of-life trajectories, focusing on the degree of oral intake function in older individuals with frailty aged over 90 years.

Methods: This retrospective observational study examined individuals aged 90 years and older who passed away at a long-term chronic care hospital and related facilities in Japan. We assessed their Clinical Frailty Scale (CFS) and Function Oral Intake Scale (FOIS), categorizing them into two groups-"preserved CFS" (CFS score ≤7) and "poor CFS" (CFS score ≥8)-considering evaluations conducted 6 months before death. We examined the transitional progression of their CFS and FOIS scores, along with a time-course assessment of low FOIS scores (≤3) in each group at various intervals.

Results: Among 66 cases, 38 were in the preserved CFS group, and 28 were in the poor CFS group. The CFS and FOIS scores of the preserved CFS group declined rapidly towards the end-of-life, with approximately half experiencing significant declines within 3 months. In contrast, both the CFS and the FOIS scores of the poor CFS group declined gradually within 6 months. The percentage of low FOIS score (≤3) was lower at 12 and 6 months than at 1 month prior to death in the preserved CFS group.

Conclusions: The end-of-life trajectories in older individuals with frailty aged over 90 years were heterogeneous. Clinicians should carefully monitor the degree of frailty and changes in food intake as crucial indications of the end-of-life phase, providing optimal support to manage potential vicious cycles. Geriatr Gerontol Int 2025; 25: 96-101.