Singapore Institute of Technology
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Nutritional and Frailty State Transitions in the Singapore Longitudinal Aging Study

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journal contribution
posted on 2023-02-28, 00:54 authored by Kai Wei, Fen Shermaine Thein, Ma Shwe Zin Nyunt, Qi Gao, Shiou Liang WeeShiou Liang Wee, Tze-Pin Ng


Malnutrition is a major determinant of the physical frailty syndrome. Dynamic transitions in frailty states over time is well documented, but few studies have documented temporal changes in nutritional states and whether they influence frailty outcomes.


Longitudinal cohort study.

Setting and Participants

Community-dwelling older Singaporeans aged ≥55y with a 5-year follow-up (n=1162) in the Singapore Longitudinal Ageing Study 2 (SLAS-2).


The Mini Nutritional Assessment Short-Form (MNA-SF) was used to determine nutritional status, and the Fried’s criteria (shrinking, weakness, slowness, exhaustion and inactivity) was used to assess physical frailty phenotype at both baseline and follow-up. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were adjusted for multiple baseline co-variables.


At baseline, being at risk of malnutrition/malnourished was associated with increased odds of prevalent prefrailty (OR=2.76, 95% CI=1.86-4.10) and frailty (OR=4.10, 95% CI=1.41-11.9). Baseline robust individuals who were persistently at risk of malnutrition/malnourished showed an increased odds of conversion to being pre-frail/ frail at follow-up (OR=3.45, 95% CI=1.00-11.9). Among baseline pre-frail/frail individuals, reversion to being robust were significantly less likely among those who were persistently at risk of malnutrition/malnourished (OR=0.26, 95% CI=0.10-0.67) and those whose baseline normal nutrition worsened at follow-up (OR=0.20, 95% CI=0.06-0.74).


Changes in nutritional states are associated with frailty state transitions, and monitoring changes in nutritional status is recommended for the prevention and severity reduction of frailty among older people in the community.


Journal/Conference/Book title

Journal of Nutrition, Health and Aging

Publication date



  • Post-print

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This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at:

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