title: Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions.
abstract: OBJECTIVE
  The consequences of combined undernourishment and decreased physical performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions.
  
  
  METHODS
  Forty-seven older adults (26 males, 21 females) aged ≥ 60 (69.23 ± 8.63) years who were identified as undernourished from two residential institutions participated in this study. A battery of physical performance tests (10 m gait speed test, dominant hand grip strength test, timed five-repetition sit-to-stand test, ten step test, arm curl test, scratch test, and respiratory muscle strength test), biochemical profiles (serum albumin, hemoglobin, serum ferritin, and prealbumin levels), and falls risk using the short-form Physiological Profile Approach were performed. The Functional Ability Questionnaire and Geriatric Depression Scale were also administered.
  
  
  RESULTS
  The results demonstrated that generally older adults with undernourishment scored poorly on the physical performance tests, had depression, and a high risk of falls. Biochemical results demonstrated that 10.9% of the participants were anemic, 63% had hypoalbuminemia (<3.5 g/dL), and 21.7% were at risk of protein energy malnutrition with prealbumin level (100-170 mg/L). A significant correlation (P<0.05) was demonstrated between hand grip strength and ferritin, between self-reported mobility dependence and prealbumin levels, and between self-reported mobility tiredness and body mass index.
  
  
  CONCLUSIONS
  These results confirm that older adults with undernutrition have poor physical function, higher falls risk, and depression. Clinically, overall health that includes nutritional status, physical function, and depression level should be taken into consideration in the assessment and treatment of older adults residing at residential institutions.
authors.affiliation: Physiotherapy Program, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Devinder K A
authors.initials: DK
authors.lastname: Singh
authors.affiliation: Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Zahara A
authors.initials: ZA
authors.lastname: Manaf
authors.affiliation: ASIA Metropolitan University, Cheras, Malaysia.
authors.forename: Noor Aini M
authors.initials: NA
authors.lastname: Yusoff
authors.affiliation: Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Nur A
authors.initials: NA
authors.lastname: Muhammad
authors.affiliation: Physiotherapy Program, School of Rehabilitation Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Mei Fang
authors.initials: MF
authors.lastname: Phan
authors.affiliation: Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
authors.forename: Suzana
authors.initials: S
authors.lastname: Shahar
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005080:Exercise Test; D005260:Female; D015577:Geriatric Assessment; D006707:Homes for the Aged; D006801:Humans; D008296:Malaysia; D008297:Male; D044342:Malnutrition / Q000503:physiopathology*; D008875:Middle Aged; D009752:Nutritional Status; D011795:Surveys and Questionnaires
keywords: falls risks; older adults; physical performance; undernutrition