Frail Older Adults Are Much More Likely to Be Food Insufficient

A national study of older Americans shows those who have limited mobility and low physical activity—scientifically categorized as “frail”—are five times more likely to report that they often don’t have enough to eat, defined as “food insufficiency,” than older adults who were not frail.

The nationally representative study of more than 4,700 adults aged 60 and older in the United States uses data from the Third National Health and Nutrition Examination Survey. The results are online in the British Journal of Nutrition.

Lead author Ellen Smit, PhD, RD, an epidemiologist at Oregon State University, says food insufficiency occurs when people report that they sometimes or often do not have enough food to eat. Food-insufficient older adults have been shown to have poor dietary intake, nutritional status and health status.

“Although little is known about food insufficiency as it relates to frailty, conceivably we thought if food insufficiency is associated with poorer nutritional status, it may also be associated with physical functioning and frailty,” she says.

Frailty is a state of decreased physical functioning and a significant complication of aging that increases the risk for incident falls, fractures, disability, healthcare expenditures, and premature mortality. People in this study are diagnosed as frail when they meet two of the following criteria: slow walking, muscular weakness, exhaustion, and low physical activity.

Smit says as the population ages, with more than 20% of Americans expected to be older than 65 by 2030, the need for identifying clinical and population-based strategies to decrease the prevalence and consequences of frailty are needed. In her study, almost 50% of people were either frail, or “pre-frail,” meaning that they were at risk for decreased physical functioning.

Frail people were older, less educated, at lower income levels, more likely to be female, more likely to be smokers, and less likely to be white than adults who were not frail. Frail people were also more likely to be either underweight or obese, while at the same time eating fewer calories than people who were not frail.

“We need to target interventions on promoting availability and access to nutritious foods among frail older adults,” Smit says. “It is also important to improve nutritional status while not necessarily increasing body weight.”

Frail adults may have difficulty leaving the house, for instance, and accessing fresh fruits and vegetables. Smit says communities could work on identifying programs or nonprofit organizations that can deliver nutritious meals or fresh produce to older frail adults.

Source: Oregon State University

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