Relationship between social frailty and malnutrition in community-dwelling older adults undergoing rehabilitation

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-07-16 DOI:10.1016/j.clnesp.2025.07.019

Norito Kobayashi , Shohei Tokuno , Masafumi Nozoe , Yasushi Miura

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引用次数: 0

Abstract

Background & aims

Social frailty and malnutrition are considered major health issues in community-dwelling older adults undergoing rehabilitation. This study aimed to examine the relationship between social frailty and malnutrition among community-dwelling older adults undergoing rehabilitation.

Methods

This was a multicenter cross-sectional study. The study included older adults requiring Level 1 or 2 support who were undergoing rehabilitation within the Long-Term Care (LTC) system at three facilities between April 2022 and December 2023. This observational study assessed calf circumference, 5-m walking speed, and Timed Up and Go performance. Physical and social frailty were assessed using the Japanese version of Fried's Cardiovascular Health Study criteria, which incorporates Makizako's five-item questionnaire. Malnutrition was evaluated according to the Global Leadership Initiative on Malnutrition (GLIM) diagnostic criteria. Logistic regression analysis was conducted to examine the independent association between each assessment and undernutrition.

Results

In total, 211 older participants (median age: 81 years) were included in the study. Physical and social frailties were present in 29.3 % (62 cases) and 58.7 % (124 cases) of participants, respectively. In the crude model, social frailty was significantly associated with malnutrition (OR (odds ratio) = 2.42, 95%CI (confidential interval): 1.15–5.11, p = 0.020; E-value = 1.57). In the adjusted model, both physical frailty (adjusted OR = 1.18, 95 % CI: 1.03–3.31, p = 0.038) and social frailty (adjusted OR = 2.55, 95 % CI 1.22–5.34, p = 0.013) were independently associated with GLIM criteria for malnutrition.

Conclusions

This study demonstrates that social frailty is significantly associated with malnutrition. Notably, this is the first study to suggest that social frailty may contribute to malnutrition in older adults. These findings highlight the importance of assessing social frailty in older adults undergoing rehabilitation in LTC settings.

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社区居住老年人康复过程中社会脆弱与营养不良的关系。

背景与目的：社会脆弱和营养不良被认为是社区居住的接受康复的老年人的主要健康问题。本研究旨在探讨社区居住长者康复过程中社会脆弱与营养不良的关系。方法：这是一项多中心横断面研究。该研究包括需要1级或2级支持的老年人，他们在2022年4月至2023年12月期间在三家机构的长期护理（LTC）系统中接受康复治疗。这项观察性研究评估了小腿围、5米步行速度和计时起身和行走表现。身体和社会脆弱性的评估采用了日本版的弗里德心血管健康研究标准，其中包括Makizako的五项问卷。根据全球营养不良领导倡议（GLIM）诊断标准对营养不良进行评估。进行了Logistic回归分析，以检验每个评估与营养不良之间的独立关联。结果：共有211名老年参与者（中位年龄：81岁）被纳入研究。身体和社会弱点分别占29.3%（62例）和58.7%（124例）。在粗模型中，社会脆弱与营养不良显著相关(OR（优势比）= 2.42,95%CI（可信区间）：1.15-5.11,p = 0.020；e值= 1.57)。在调整后的模型中，身体虚弱（调整后的OR = 1.18, 95% CI: 1.03-3.31, p = 0.038）和社会虚弱（调整后的OR = 2.55, 95% CI 1.22-5.34, p = 0.013）与营养不良的GLIM标准独立相关。结论：本研究表明，社会脆弱与营养不良显著相关。值得注意的是，这是第一个表明社会脆弱可能导致老年人营养不良的研究。这些发现强调了评估在LTC环境中接受康复的老年人社会脆弱性的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.