Frailty and nutritional status in institutionalized elderly patients with neurodegenerative disorders

Abstract

Introduction Frailty is a geriatric syndrome defined as a state of increased vulnerability to negative health outcomes that is considered the most powerful predictor of disability, dependence, institutionalization and death, and so considered a major health burden. Malnutrition has been described to be independently associated with frailty.

Objectives Primary objective was to describe the frequency of frailty in institutionalized patients with neurodegenerative disorders. Secondary objectives were to describe the frequency of undernutrition and to evaluate the correlation between frailty and nutritional status.

Methods A cross-sectional observational pilot study was performed. All patients aged 65 years and older with at least one neurodegenerative disorder admitted in CNS- Campus Neurológico were included. A nutritional assessment, through the Mini Nutritional Assessment (MNA), anthropometric measurements and the Edinburgh Feeding Evaluation in Dementia Questionnaire (EdFED-Q), and a frailty assessment, through the Marigliano-Cacciafesta Polypathological Scale (MCPS) and the Clinical Frailty Scale (CFS), were conducted.

Results 76 participants were included with a mean age of 76±6.8 years. Parkinsonian syndromes represented 82.9% of the sample. The frequency of frailty was 71.1%. Patients with atypical parkinsonism were significantly frailer than patients with Parkinson’s disease (PD) (85.7 and 60%, respectively). 69.3% of the patients with dementia were frail. The frequency of undernutrition (and risk of) was 73.7%. Although not statistically significant, undernutrition was more frequent in dementia syndromes, followed by atypical parkinsonism and PD (30.8, 21.2 and 10%, respectively). Significant correlations were found between all the nutritional assessment parameters and the MCPS, being the strongest with the MNA and the EdFED-Q.

Conclusions The prevalence of frailty in institutionalized patients with neurodegenerative disorders is high, along with the prevalence of undernutrition. Frailty and nutritional status parameters share significant correlations.