Prevalence of Frailty and Its Relationships with Malnutrition in Free Elderly People Living in Tehran, Iran, 2021–2022

Background and objectives: Up-to-date, no studies have assessed phenotypes of frail in the elderly people living in Tehran and their relationships with nutritional statuses. The aim of this study was to investigate prevalence of frailty and its relationships with malnutrition in elderly people living in Tehran, 2021–2022. Materials and Methods: In this cross-sectional study, 508 elderly people over 60 years old living in Tehran were selected using systematic random cluster sampling method. General information were collected using general questionnaires, physical function using two-part questionnaire of activities of daily living and daily activity with the help of instrumental activities of daily living tool validated for the elderly and quality of life using valid 12-item SF12 questionnaires. The 12-item questionnaires were a summary of the 36-item quality of life questionnaires; validity and reliability of which were verified in the Iranian society. Frailty was carried out using Fried et al. 5-indices, including 1) slow walking, 2) muscle weakness, 3) fatigue, 4) low physical activity and 5) unintentional weight loss. Muscle strength was assessed using hand grip dynamometer. Malnutrition assessment was carried out using standard 2-part MNA questionnaires (mini nutritional assessment). Anthropometric measurements (height and weight) were carried out using standard methods and body mass index was calculated.  Results: The mean and standard deviation of the age of the elderly people were 71.09 y ±6.88. The number of men and women participating in the study was almost equal (50.6% men and 49.4% women). In total, 51.4% of the participants were pre-frail and 23% were frail. More than half of the participants had low muscle strength (54.3%). After adjusting effects of confounders in comparison with healthy individuals, the probability of frailty in people at risk of malnutrition (95% CI: 1.63–5.67; OR = 3.04) and the probability of pre-frailty in the two groups of at risk of malnutrition (95% CI: 5–11/21–04; OR = 10.37) and malnutrition (95% CI: 5.31–5.31; OR = 7.18) were significantly higher (p < 0.05). Conclusion: In this study, nutritional status was strongly associated to frailty. Identifying nutritional problems associated with muscle weakness and malnutrition can be used in health and nutrition planning.