Individualized nutritional intervention combined with tailored resistance exercise in hospitalized frail older adults: A prospective, single-arm pilot before-and-after study.

Abstract

ObjectiveTo evaluate the preliminary effects of a screening-guided, individualized nutritional intervention combined with tailored resistance exercise on nutritional status, physical function, and frailty in hospitalized frail older adults and explore baseline factors associated with response magnitude.MethodsThis prospective, single-arm pilot before-and-after study enrolled 120 hospitalized frail older adults (mean age: 87.03 ± 5.65 years). Nutritional status was stratified using the Mini Nutritional Assessment-Short Form (MNA-SF). Patients at a risk of malnutrition or those with malnutrition (MNA-SF score ≤ 11) received individualized oral nutritional supplementation, whereas well-nourished patients (MNA-SF score ≥ 12) underwent weekly monitoring. Resistance exercise included standardized Theraband training, performed 3 times weekly for 20-30 min, with intensity individualized using the Borg Rating of Perceived Exertion. Outcomes were assessed at baseline and after 12 weeks. The minimal clinically important difference (MCID) for Short Physical Performance Battery (SPPB) was defined as an improvement of ≥1 point. Baseline factors associated with SPPB MCID achievement were analyzed using multivariate logistic regression.ResultsCompared with baseline, significant within-group changes were observed in serum transferrin, prealbumin, and albumin levels as well as MNA-SF scores (all p < 0.05). Significant within-group changes were also observed in SPPB, performance-oriented mobility assessment, activities of daily living, and instrumental activities of daily living scores; grip strength; and gait speed (all p < 0.05). In multivariate analysis, SPPB MCID achievement was associated with higher baseline educational level (adjusted odds ratio: 1.962, 95% confidence interval: 1.060-3.634, p = 0.032) and lower baseline performance-oriented mobility assessment score (adjusted odds ratio: 1.808, 95% confidence interval: 1.076-3.039, p = 0.025).ConclusionIn this single-arm pilot study, a screening-guided, individualized nutritional intervention combined with tailored resistance exercise was associated with within-group changes in nutritional status and physical function in hospitalized frail older adults. Higher educational level and lower baseline mobility function were associated with greater magnitude of response.