Frailty, Nutrition, and Quality of Life in Urban-Dwelling Older Adults Facing Vulnerability: Observational Study in Primary Heath Care Settings in Underpopulated Areas.

Abstract

To investigate the predictive relationships between frailty, nutritional factors, and Quality of Life (QoL) on the vulnerability of older adults enrolled in Primary Health Care (PHC) in an urban area. This was a cross-sectional study conducted with community-dwelling older adults. Participants receiving care in PHC in two Brazilian municipalities located in a sparsely populated region were recruited. The instruments used were Vulnerable Elders Survey (VES-13), Mini Nutritional Assessment (MNA), Edmonton Frailty Scale (EFS), and Medical Outcomes Study Short Form-36 (SF-36). Association analyses, Spearman's correlation, and binary logistic regression were used. A total of 323 individuals were included. Binary logistic regression revealed frailty (EFS) as the main predictor of vulnerability (R² = 0.20; p < 0.001; OR = 1.35 [95% CI: 1.24-1.48]), with functional independence (R² = 0.25; p < 0.001; OR = 3.9 [95% CI: 2.74-5.73]) and functional performance (R² = 0.17; p < 0.001; OR = 3.21 [95% CI: 2.21-4.67]) being the domains that most strongly increased the odds of vulnerability. Impaired nutrition showed a consistent predictive association (R² = 0.11; p < 0.001; OR = 0.82 [95% CI: 0.76-0.89]). Frailty and poor nutritional status were predictors of vulnerability, with particular emphasis on physical-functional aspects. QoL showed a moderate to strong correlation with vulnerability, especially in the physical domains.