MALNUTRITION AND PHYSICAL PERFORMANCE IN NURSING HOME RESIDENTS: RESULTS FROM THE INCUR STUDY

Objectives: to investigate the association between malnutrition and physical performance in nursing home residents. Design: cross sectional study. Setting and Participants: a total of 499 older people (73.1% women) enrolled in the Incidence of pNeumonia and related ConseqUences in nursing home Residents (INCUR) cohort study. Methods: the nutritional status was defined using the Mini Nutritional Assessment–Short Form (MNA-SF), whereas the physical performance was measured with the Short Physical Performance Battery (SPPB). Unadjusted and adjusted (for age, sex, education, Abbreviated Mental Test score and Charlson Comorbidy Index) linear regression analyses were used to assess the association between MNA-SF and SPPB (primary outcome). The MNA-SF items which seemed most strongly related to the SPPB (and its subtasks) were also explored. Finally, we explored the association of the MNA-SF with each subtest of the SPPB. Results: the mean age of the sample was 85.80 (standard deviation, SD 7.20). The mean SPPB score was 3.05 (SD 2.65) and the mean MNA-SF score 10.35 (SD 2.22). Higher scores of MNA-SF were associated with better physical performance. Food intake deficiency, mobility impairment, and recent psychological stress or acute disease were the items of the MNA-SF most strongly associated with the SPPB, even after adjustment for potential confounders. Among the three subtests of the SPPB, the MNA-SF showed the strongest and most consistent association with the gait speed. Conclusions and Implications: among nursing home residents, the MNA-SF and three of its sub-items (food intake deficiency, mobility impairment, and recent psychological stress) are significantly correlated with physical performance, independently of potential confounders. In particular, the association was evident for the gait speed subtask of the SPPB.