Low Nutrient Intake Is an Essential Component of Frailty in Older Persons

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Abstract
Background. Poor nutrient intake is conceptualized to be a component of frailty, but this hypothesis has been little investigated. We examined the association between low energy and nutrient intake and frailty. Methods. We used data from 802 persons aged 65 years or older participating to the InCHIANTI (Invecchiare in Chianti, aging in the Chianti area) study. Frailty was defined by having at least two of the following criteria: low muscle strength, feeling of exhaustion, low walking speed, and reduced physical activity. The European Prospective Investigation into Cancer and nutrition (EPIC) questionnaire was used to estimate the daily intake of energy and nutrients. Low intake was defined using the value corresponding to the lowest sex-specific intake quintile of energy and specific nutrients. Adjusted logistic regression analyses were used to study the association of frailty and frailty criteria with low intakes of energy and nutrients. Results. Daily energy intake ≤21 kcal/kg was significantly associated with frailty (odds ratio [OR]: 1.24; 95% CI: 1.02–1.5). After adjusting for energy intake, a low intake of protein (OR: 1.98; 95% CI: 1.18–3.31); vitamins D (OR: 2.35; 95% CI: 1.48–3.73), E (OR: 2.06; 95% CI: 1.28–3.33), C (OR: 2.15; 95% CI: 1.34–3.45), and folate (OR: 1.84; 95% CI: 1.14–2.98); and having a low intake of more than three nutrients (OR: 2.12; 95% CI: 1.29–3.50) were significantly and independently related to frailty. Conclusions. This study provides evidence that low intakes of energy and selected nutrients are independently associated with frailty.