A key focus for supporting healthy aging in senior living communities is to help residents maintain their independence. Frailty is a common condition often associated with aging, characterized by reduced strength, endurance, and overall physiological function. These issues, in turn, increase vulnerability to other chronic or acute health concerns. Frailty can be caused by a combination of factors and leads to greater dependency, higher risks of falls, hospitalizations, and increased health care costs.

If your team observes a resident developing at least three of these five symptoms, he or she should be evaluated for frailty. Addressing these issues can improve the well-being of your community's residents and enhance their quality of life.

1. Significant weight loss within a year
2. Exhaustion
3. Weaker grip strength
4. Slower walking pace
5. Low physical activity levels

Is There a Connection Between Diet and Frailty?

Research has shown that what older adults eat can significantly influence their risk of becoming frail. Specifically, lower intakes of energy and protein, as well as insufficient amounts of key nutrients like folic acid, and vitamins C, D, and E, are linked to higher chances of frailty among older adults. In addition, diets high in ultra-processed foods, which are known to increase inflammation, may triple the risk.

Conversely, nutrition may also have a positive effect. For example, a diet rich in protein can improve muscle mass and strength. Following the Mediterranean diet, which is rich in fruits, vegetables, legumes, and olive oil, is also thought to play a role in treating the condition. The Mediterranean diet is high in antioxidants like β-carotene and vitamins C and E, and it’s recommended that residents try to consume five servings of fruits and vegetables daily (even up to ten servings/day).

Is It Frailty, Malnutrition, or Both?

Malnutrition refers to deficiencies, excesses, or imbalances in a person's intake of energy and/or nutrients. In some people, this can lead to frailty. Studies indicate that older adults who are malnourished or at risk of malnutrition are four times more likely to become frail. Currently, separate tools are used to assess malnutrition and frailty. However, a deeper understanding of how these conditions intersect could enhance care strategies for residents who have both.

Treating and Preventing Frailty

Most of the current research shows a definite relationship between nutrition and frailty, but there may not be a one-size-fits-all approach to treatment or prevention. Most experts agree, however, that a healthy diet is an important component. This includes:

• Adequate calories.
• Adequate protein intake, balanced throughout the day.
• Plentiful fruits and vegetables.
• High fiber.
• Low saturated fats and sugars.

Encourage your frontline dining, housekeeping, and CNA staff to watch for signs of frailty—they are the people who often interact the most with residents and can proactively engage clinicians for intervention. In addition, your community’s registered dietitian is an excellent resource for assessing both frailty and malnutrition. Working together, the entire community team can help support healthy aging and help residents maintain active, independent lifestyles.

Phyllis Famularo, DCN, RD, FAND, LDN, serves as a senior manager of nutrition services for Sodexo Seniors and has worked with the older adult population nutrition in the Northeast for over 30 years. She is a registered dietitian nutritionist with a doctorate in clinical nutrition from Rutgers University and is a board member of Dietetics in Healthcare Communities.
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