Nursing Homes Must Be Proactive in Helping Frail Residents Reach Optimal Physical and Nutritional Status

Physical frailty is prevalent among older adults living in nursing homes and assisted living facilities, as well as in the community. It is a medical syndrome with a variety of causes and contributors that is characterized by a decrease in strength, endurance, and weakened physiologic function that enhances a person’s vulnerability for needing increased dependency. Frailty has been associated with health-related detrimental events like mortality, disability in necessary activities of daily living (ADLs), and mobility disability, hospitalization, institutionalization, and falls in community-dwelling older adults. Unfortunately, there have not been many studies that have analyzed the commonality of frailty in institutionalized older adults and few interventions have focused on this vulnerable population.

Exercise and proper nutrition are known to be effective interventions among frail older adults living in community settings. For institutionalized older adults, physical exercise has shown to improve function, as well as strength, flexibility, balance, and mood. However, average effects are small and are not certain to be applicable to all residents. In regards to nutritional supplementation, protein supplementation has been shown to help improve physical performance in frail older adults, and with muscle mass increase when combined with resistance exercise. Furthermore, low vitamin D levels have exacerbated the risk of mortality in nursing home residents, and supplementation in this population has helped reduce the rate of falls.

There are not many studies that have explored the effects of both physical exercise and nutrition in this population, and no particular studies that have analyzed the combined intervention of physical exercise with nutrition supplementation fortified with vitamin D, calcium, and fiber, in frail older adults residing in institutional settings. A recent study was performed to evaluate how this combined intervention would improve functional and nutritional status, as well as quality of life. The results of a hyperproteic, hypercaloric oral nutritional supplement fortified with prebiotic fiber, vitamin D, and calcium, along with a standardized physical intervention that focused on functional status, strength, nutritional status and quality of life of frail older adult nursing home residents were assessed. After 12 weeks, results showed that the function, nutritional status, and quality of life in these residents significantly improved. Treating frailty in older adults is a realistic therapeutic goal that long-term care providers must strive to reach.