Content area
Full text
Introduction
The number of people aged 80 years and older will reach more than 350 million by the year 2050, and 80% of older adults will be living in low- and middle-income countries (1). In Mexico, in 2019, approximately 15.4 million people were 60 years old and older, which is more than 12% of the county’s population. This proportion is increasing, and by the year 2050, more than 1 in 5 people in Mexico will be over 60 years old (2). The demand for geriatric health services will increase, and the number of those living in nursing homes will probably also increase. Furthermore, the health status of older adults living in this type of residence is generally more compromised than their community-dwelling counterparts, and residents of long-term facilities are frequently care-dependent and have poor nutrition and oral health status (3).
Frailty is a medical syndrome resulting from declining function across multiple physiologic systems. This is a state of increased vulnerability to adverse health outcomes and mortality (4). Frailty is the result of poor homeostasis after external stressors (5). Multiple criteria for the clinical identification of frailty have been proposed; nevertheless, according to Morley (4), most of them are based on a physical deficit model or a specific phenotype model. The Frailty Index is based on the deficit model, which comprises the deficiencies and chronic conditions of the patient, and the physical phenotype model, which is based on five components (undernourishment/weight loss, poor endurance, generalized weakness, unsteady gait, and low/reduced physical activity) (6). The pathophysiologic changes associated with the frailty phenotype have been explored in recent years, and encompass the dysregulation of multiple systems and decreased resilience in frail older adults (7).
Although frailty is considered as an extreme consequence of the normal aging process, age is not the only determining factor for its appearance (8). Frailty and malnutrition are closely related, i.e., a high prevalence of malnutrition has been reported among frail patients and vice versa (9, 10). The simultaneous presence of both conditions is associated with poor quality of life and increased risk of mortality (11). Malnutrition develops slowly, progressively, and silently and is a clinical condition that is highly prevalent in older adults living in nursing homes (12). Additionally, malnutrition is associated...