Malnutrition is associated with dynamic physical performance
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ORIGINAL ARTICLE
Malnutrition is associated with dynamic physical performance Keenan A. Ramsey1 · Carel G. M. Meskers1,2 · Marijke C. Trappenburg3,4 · Sjors Verlaan4 · Esmee M. Reijnierse5 · Anna C. Whittaker6 · Andrea B. Maier1,5 Received: 28 May 2019 / Accepted: 25 July 2019 © The Author(s) 2019
Abstract Background Malnutrition and poor physical performance are both conditions that increase in prevalence with age; however, their interrelation in a clinically relevant population has not been thoroughly studied. Aims This study aimed to determine the strength of the association between malnutrition and measures of both static and dynamic physical performance in a cohort of geriatric outpatients. Methods This cross-sectional study included 286 older adults (mean age 81.8, SD 7.2 years, and 40.6% male) who were referred to geriatric outpatient mobility clinics. The presence of malnutrition was determined using the Short Nutritional Assessment Questionnaire (SNAQ, cut-off ≥ 2 points). Measures of dynamic physical performance included timed up and go (TUG), 4-m walk test, and chair stand test (CST). Static performance encompassed balance tests and hand grip strength (HGS). Physical performance was standardized into sex-specific Z-scores. The association between malnutrition and each individual measure of physical performance was assessed using linear regression analysis. Results 19.9% of the cohort was identified as malnourished. Malnutrition was most strongly associated with CST and gait speed; less strong but significant associations were found between malnutrition and TUG. There was no significant association between malnutrition and HGS or balance. Discussion Physical performance was associated with malnutrition, specifically, dynamic rather than static measures. This may reflect muscle power being more impacted by nutritional status than muscle strength; however, this needs to be further addressed. Conclusions Malnutrition is associated with dynamic physical performance in geriatric outpatients, which should inform diagnosis and treatment/prevention strategies. Keywords Malnutrition · Physical performance · Community dwelling · Aged · Older adults
Introduction Malnutrition and poor physical performance are two highly prevalent conditions in older adults that are associated with poor health outcomes, such as higher morbidity, mortality, * Andrea B. Maier [email protected] 1
Department of Human Movement Sciences, @ AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
2
Department of Rehabilitation Medicine, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
3
Department of Internal Medicine, Section of Gerontology and Geriatrics, VU University Medical Center, Amsterdam UMC, Amsterdam, The Netherlands
and lower quality of life [1–4]. Both conditions may be highly interrelated and may potentiate each other. Muscle is a key linking substrate between malnutrition and physical performance. Decre
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