Correlation between nutritional status and comprehensive physical performance measures among older adults with undernourishment in residential institutions

Devinder KA Singh,1 Zahara A Manaf,2 Noor Aini M Yusoff,3 Nur A Muhammad,2 Mei Fang Phan,1 Suzana Shahar2 1Physiotherapy Program, School of Rehabilitation Sciences, 2Nutrition and Dietetics Program, School of Health Care Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, 3ASIA Metropolitan University, Cheras, Malaysia Purpose: The consequences of combined undernourishment and decreased physical ­performance in older adults are debilitating and increases cost of care. To date, the information regarding the association between nutritional status and physical performance does not provide a complete picture. Most studies used limited or self-reported measures to evaluate physical performance. The objective of this study was to examine the correlation between nutritional status and comprehensive physical performance measures among undernourished older adults who reside in residential institutions.Methods: Forty-seven older adults (26 males, 21 females) aged ≥60 (69.23±8.63) years who were identified as undernourished from two residential institutions participated in this study. A battery of physical performance tests (10 m gait speed test, dominant hand grip strength test, timed five-repetition sit-to-stand test, ten step test, arm curl test, scratch test, and respiratory muscle strength test), biochemical profiles (serum albumin, hemoglobin, serum ferritin, and prealbumin levels), and falls risk using the short-form Physiological Profile Approach were performed. The Functional Ability Questionnaire and Geriatric Depression Scale were also administered.Results: The results demonstrated that generally older adults with undernourishment scored poorly on the physical performance tests, had depression, and a high risk of falls. Biochemical results demonstrated that 10.9% of the participants were anemic, 63% had hypoalbuminemia (<3.5 g/dL), and 21.7% were at risk of protein energy malnutrition with prealbumin level (100–170 mg/L). A significant correlation (P<0.05) was demonstrated between hand grip strength and ferritin, between self-reported mobility dependence and prealbumin levels, and between self-reported mobility tiredness and body mass index.Conclusion: These results confirm that older adults with undernutrition have poor physical function, higher falls risk, and depression. Clinically, overall health that includes nutritional status, physical function, and depression level should be taken into consideration in the assessment and treatment of older adults residing at residential institutions. Keywords: undernutrition, physical performance, falls risks, older adult