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. 2021 Jul 5;13(7):2316. doi: 10.3390/nu13072316

Table 4.

Summary of nutrition-related intervention studies targeting malnutrition, frailty or sarcopenia among community dwelling older ANZ adults *.

Study, Country Study Design Sample and Setting Intervention Assessment Outcomes (Intervention vs. Control)
Malnutrition
Leggo et al., 2008 [135] Pre/post intervention 1145 adults (76.5 ± 9.2 years; 31% male) recruited from 16 Australian organisations caring for HACC clients in Australia Adults identified as ‘at risk’ or ‘malnourished’ provided with at home, one-on-one individualized nutrition counselling from a dietitian for 6 months (median) MST, PG-SGA

  • Of the 15% at risk/malnourished, 44% agreed to dietetic referral

  • Nutrition status increased following intervention among the 34 patients followed up (82% had improved and 50% became well-nourished)
Hamirudin et al., 2016 [136] Mixed-method pre/post intervention 143 adults (≥75 years; % male NS) recruited from 3 General Practices in NSW, Australia Adults identified as ‘at risk’ or ‘malnourished’ provided with a resource kit a + other interventions (e.g., dietitian referral) by practice nurses for 6/12 months MNA-SF, interviews

  • 31% of adults at risk/malnourished at initial screen

  • MNA-SF scores significantly improved from 9.9 ± 5.1 to 11.4 ± 2.1 in intervention group, while MNA-SF scores in the control group declined from 13.3 ± 0.9 to 12 ± 1.5
Hamirudin et al., 2017 [137] Pre/post intervention 68 adults (85.5 ± 5.8 years; 47% male) recruited within 2 weeks post-discharge from hospitals in regional NSW, Australia All adults provided with tailored individual dietary advice b at home by a dietitian for 3 months MNA, body weight, BMI, diet history, food frequency checklist

  • Proportion of patients at risk/malnourished reduced from 61.8% at baseline to 23.5% at follow-up

  • Mean body weight (67.1±13.5 kg to 68.0 ± 13.7 kg), MNA score (21.9 ± 3.5 vs. 25.2 ± 3.1) significantly improved pre/post

  • Significant improvement in energy intake from ONS (+95.5  ± 388.2 kJ/day) and milk (+259.6 ± 659.8 kJ/day)

  • 10.3% were receiving MOW at both time points
Charlton et al., 2013 [138] Mixed-method pre/post pilot intervention 12 adults (81.3 ± 10.9 years; 58% male) recruited from two MOW services in NSW, Australia Provision of high protein, high-energy snacks five times a week, in addition to their usual MOW order, for 1 month MNA, body weight, BMI, 24h diet recall, food frequency checklist, interviews

  • Significant reduction in the proportion of adults at risk (17% to 8%) and malnourished (67% to 25%)

  • Mean body weight and BMI increased by mean of 0.75 ± 0.80 kg and 0.78 ± 1.16 kg/m2, respectively

  • Increased mean energy (+415 ± 1477 kJ /day) and protein (+7.2 ± 14.06 g/day) intakes
Frailty
Cameron et al., 2013 [139] RCT 216 adults meeting FFP criteria (83.3 ± 5.9 years; 32% male) recruited from 16 organisations caring for HACC clients in Australia Provision of an individualised, multifactorial, interdisciplinary exercise and nutrition program d for 12 months FFP, Short Physical Performance Battery

  • Frailty prevalence significantly reduced following intervention (absolute difference 14.7%)

  • Physical status remained stable in intervention group and declined in control group
Milte et al., 2016 [140] RCT 175 adults recovering from hip fracture (≥70 years; 23% male) recruited from 3 acute care and 1 rehabilitation setting in SA and NSW, Australia Provision of an individualized exercise and nutrition program e and fortnightly dietitian visit to review dietary intake and modify strategies for 6 months HRQoL, QALY, costs

  • Both groups saw a decrease in HRQoL score, but intervention group reported higher mean HRQoL

  • Programme associated with a small additional cost and a gain in QALY relative to usual care with social visits

ANZ: Australian and New Zealand; BMI: Body mass index; FFP: Cardiovascular Health Study Frailty Phenotype; g: grams; HACC: Home and Community Care; HRQoL: Health-related quality of life; kJ: kilojoules; MNA (+/− SF): Mini Nutritional Assessment (+/− Short Form); MOW: Meals on Wheels; NSW: New South Wales; NS: not specified; PG-SGA: Patient-Generated Subjective Global Assessment; RCT: Randomised Control Trial; SA: South Australia; QALY: Quality adjusted life years. * Exercise is commonly used and is effectives in treating and managing frailty and/or sarcopenia in older adults; however, given the focus of this review, only interventions using nutrition-related strategies alone or in combination with exercise are included here. a Kit included: leaflet on high-energy/-protein foods, ‘Eating Well’ booklet, local council directory of nutrition/support services for older persons in their area. b Strategies included: personalised dietetic advice, prescription of ONS, referral to a MOW service and/or referral to various community services. c Intervention included: community dietitian and/or speech therapist consults, needs assessment and service coordination, day care and/or home delivered meals. d Nutrition program included: dietitian evaluation, home-delivered meals, ONS prescribed. e Nutriton program included: Dietary counselling focusing on timing, size, and frequency of meals, recommendations of nutrient-rich foods and recipes, referral to community meal programmes, and provision of commercial oral nutritional supplements or commercial protein powders as deemed appropriate.