The relationship between cognitive frailty, physical frailty and malnutrition in Turkish older adults

Objective: The aim of the study was to compare the relationship between cognitive and physical frailty and malnutrition in older adults. Research Methods & Procedures: The study was handled as a cross-sectional and observational study. 992 patients who applied to the geriatric outpatient clinic between January 2018 and December 2022 were included in the study. All patients underwent comprehensive geriatric assessment. Demographic characteristics, geriatric syndromes, comorbidities and laboratory parameters of the patients were recorded. The Fried frailty scale was used to determine physical frailty. Mini nutritional assessment-short form (MNA-SF) was performed for nutritional status. Cognitive frailty was defined as the coexistence of physical frailty and mild cognitive impairment (MCI). Results: Out of 992 patients participating in the study, 66% were female and the mean age was 73.2 ± 7.4. The rate of physical frailty was 13.4% and 96 were cognitively frail. Among these groups, the rates of malnutrition were 18.8%, 12.5%, and 2.2% in cognitive frailty, physical frailty and healthy control groups, respectively. The healthy control group had a lower median age, fewer geriatric syndromes (excluding orthostatic hypotension), and lower rates of diabetes and hypertension than the frailty groups. The frequency of malnutrition was similar between both cognitive and physical frailty groups. The cognitive frailty group had a higher median age, sarcopenia rate, timed up and go duration, and lower female sex, albumin, mobility, and functionality scores compared to the physical frailty group (p<0.05). After adjusting for demographic characteristics, comorbidities, geriatric syndromes, and laboratory parameters, cognitive frailty had a greater relationship with malnutrition (OR:1.96 CI:1.13-5.04; p=0.04). Conclusions: Cognitive frailty and physical frailty were found to be associated with malnutrition in older adults. Even after accounting for confounding factors, it appears that cognitive frailty is more closely related to nutritional status than physical frailty.