Co-occurrence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients: a multicentre observational study

The co-occurrence of frailty, sarcopenia and malnutrition has been well studied in inpatient and nursing home settings, which are associated with a higher risk of all-cause mortality. However, multicentre data from community-dwelling outpatient settings are lacking. Therefore, we aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap, and the associated factors in community-dwelling older outpatients. We collected data from community-dwelling outpatients aged 60 years in Indonesian geriatric care centres to conduct this cross-sectional study with bivariate and multivariable analyses. Frailty, possible sarcopenia and malnutrition diagnoses were based on the FRAIL scale, AWGS 2019 consensus and MNA-SF, respectively. The prevalence of frailty, possible sarcopenia and malnutrition in community-dwelling older outpatients was 13.6%, 45.5% and 5.3%, respectively, while the prevalence of their co-occurrence was 3.3%. The prevalence was associated with transient ischaemic attack (TIA) and cerebrovascular accident (OR, 5.53; 95% CI: 1.48-20.61), cognitive impairment (OR, 3.70; 95% CI: 1.21-11.31), and dependent functional capacity (OR, 11.62; 95% CI: 3.38-39.99). The three evaluated syndromes were found to overlap in 24.1%, 7.2% and 61.3% of subjects with frailty, possible sarcopenia and malnutrition, respectively. Of these subjects, a substantial proportion were female or had low educational attainment, diabetes mellitus, hypertension, cognitive impairment, multimorbidity or dependent functional status. Approximately 1 in 30 community-dwelling older outpatients had overlapping frailty, possible sarcopenia and malnutrition. The condition is associated with TIA and cerebrovascular accident, cognitive impairment and dependent functional capacity. Standardized screening in community-dwelling older population is necessary.