Abstract
Objectives
The purpose of this systematic review and meta-analysis was to summarize the prevalence
of, and association between, physical frailty or sarcopenia and malnutrition in older
hospitalized adults.
Design
A systematic literature search was performed in 10 databases.
Setting and Participants
Articles were selected that evaluated physical frailty or sarcopenia and malnutrition
according to predefined criteria and cutoffs in older hospitalized patients.
Measures
Data were pooled in a meta-analysis to evaluate the prevalence of prefrailty and frailty
[together (pre-)frailty], sarcopenia, and risk of malnutrition and malnutrition [together
(risk of) malnutrition], and the association between either (pre-)frailty or sarcopenia
and (risk of) malnutrition.
Results
Forty-seven articles with 18,039 patients (55% female) were included in the systematic
review, and 39 articles (8868 patients, 62% female) were eligible for the meta-analysis.
Pooling 11 studies (2725 patients) revealed that 84% [95% confidence interval (CI):
77%, 91%, I2 = 98.4%] of patients were physically (pre-)frail. Pooling 15 studies (4014 patients)
revealed that 37% (95% CI: 26%, 48%, I2 = 98.6%) of patients had sarcopenia. Pooling 28 studies (7256 patients) revealed
a prevalence of 66% (95% CI: 58%, 73%, I2 = 98.6%) (risk of) malnutrition. Pooling 10 studies (2427 patients) revealed a high
association [odds ratio (OR): 5.77 (95% CI: 3.88, 8.58), P < .0001, I2 = 42.3%] and considerable overlap (49.7%) between physical (pre-)frailty and (risk
of) malnutrition. Pooling 7 studies (2506 patients) revealed a high association [OR:
4.06 (95% CI: 2.43, 6.80), P < .0001, I2 = 71.4%] and considerable overlap (41.6%) between sarcopenia and (risk of) malnutrition.
Conclusions and Implications
The association between and prevalence of (pre-)frailty or sarcopenia and (risk of)
malnutrition in older hospitalized adults is substantial. About half of the hospitalized
older adults suffer from 2 and perhaps 3 of these debilitating conditions. Therefore,
standardized screening for these conditions at hospital admission is highly warranted
to guide targeted nutritional and physical interventions.
Keywords
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Article info
Publication history
Published online: April 20, 2020
Footnotes
Funding sources: The project was financially supported by Danone Nutricia Research.
Conflict of interest statement: Y.C.L. and A.K. are employees, and G.C.L-M. a contractor, of Danone Nutricia Research Advanced Medical Nutrition. The authors declare no conflicts of interest.
Identification
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