title: High Prevalence of Physical Frailty Among Community-Dwelling Malnourished Older Adults-A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Malnutrition and frailty are two geriatric syndromes that significantly affect independent living and health in community-dwelling older adults. Although the pathophysiology of malnutrition and physical frailty share common pathways, it is unknown to what extent these syndromes overlap and how they relate to each other.
  
  
  METHODS
  A systematic review was performed resulting in a selection of 28 studies that assessed both malnutrition and frailty in community-dwelling older adults. Furthermore, a meta-analysis was performed on 10 studies that used Mini- Nutritional Assessment and the Fried frailty phenotype to estimate the prevalence of malnutrition within physical frailty and vice versa.
  
  
  RESULTS
  In the systematic review, 25 of the 28 studies used the Mini-Nutritional Assessment (long or short form) for malnutrition screening. For frailty assessment, 23 of the 28 studies focused on the physical frailty phenotype, of which 19 followed the original Fried phenotype. Fifteen studies analyzed the association between malnutrition and frailty, which was significant in 12 of these. The meta-analysis included 10 studies with a total of 5447 older adults. In this pooled population of community-dwelling older adults [mean (standard deviation) age: 77.2 (6.7) years], 2.3% was characterized as malnourished and 19.1% as physically frail. The prevalence of malnutrition was significantly associated with the prevalence of physical frailty (P < .0001). However, the syndromes were not interchangeable: 68% of the malnourished older adults was physically frail, whereas only 8.4% of the physical frail population was malnourished.
  
  
  CONCLUSIONS
  The systematic review and meta-analysis revealed that malnutrition and physical frailty in community-dwelling older adults are related, but not interchangeable geriatric syndromes. Two out of 3 malnourished older adults were physically frail, whereas close to 10% of the physically frail older adults was identified as malnourished.
authors.affiliation: Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam, The Netherlands; Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands. Electronic address: G.Verlaan@vumc.nl.
authors.forename: Sjors
authors.initials: S
authors.lastname: Verlaan
authors.affiliation: Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands; Department of Health and Kinesiology, Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, TX.
authors.forename: Gerdien C
authors.initials: GC
authors.lastname: Ligthart-Melis
authors.affiliation: Nutricia Research, Nutricia Advanced Medical Nutrition, Utrecht, The Netherlands.
authors.forename: Sander L J
authors.initials: SLJ
authors.lastname: Wijers
authors.affiliation: Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Department of Geriatric Medicine, Uppsala University Hospital, Uppsala, Sweden.
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
authors.affiliation: Department of Medicine and Aged Care, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia; Department of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University, Amsterdam, The Netherlands.
authors.forename: Andrea B
authors.initials: AB
authors.lastname: Maier
authors.affiliation: Department of Internal Medicine, Section Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands; Department of Nutrition, Sports and Health, Faculty of Health and Social Studies, HAN University of Applied Sciences, Nijmegen, The Netherlands.
authors.forename: Marian A E
authors.initials: MAE
authors.lastname: de van der Schueren
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D000073496:Frailty / Q000453:epidemiology*; D006801:Humans; D057187:Independent Living; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence
keywords: Malnutrition; community-dwelling; frailty