Strong Relationship between Malnutrition and Cognitive Frailty in the Singapore Longitudinal Ageing Studies (SLAS-1 and SLAS-2)

  • L. Chye
  • K. Wei
  • M. S. Z. Nyunt
  • Q. Gao
  • S. L. Wee
  • Tze-Pin NgEmail author
Original Research



Physical frailty is well known to be strongly associated with malnutrition, but the combined impact of physical frailty and cognitive impairment among non-demented older persons (cognitive frailty) on malnutrition prevalence is not well documented.


Cross-sectional cohort study.

Setting and Participants

Community-dwelling older Singaporeans aged ≥55y (n=5414) without dementia in the Singapore Longitudinal Ageing Study (SLAS-1 and SLAS-2).


The Mini Nutritional Assessment–short form (MNA-SF) and Nutrition Screening Initiative (NSI) Determine Checklist were used to determine their nutritional status. Participants were categorized as cognitive normal (CN) or cognitive impaired (CI) by Mini Mental State Examination (MMSE<=23), as pre-frail (PF) (score=1-2) or frail (F) (score=3-5) using Fried’s criteria, and as cognitive pre-frail (PF+CI) or cognitive frail (F+CI).


The prevalence of cognitive frailty was 1.6%, and cognitive pre-frailty was 5.5% (total, 7.1%). The prevalence of MNA malnutrition was 2.4%, and NSI high nutritional risk was 6.3%. The prevalence of MNA malnutrition was lowest among Robust-CN and highest among Frail-CI (0.5% in Robust- CN, 0.6% in Robust-CI, 2.8% in Pre-frail-CN, 7.3% in Prefrail- CI, 15.4% in Frail-CN, and 23.1% in Frail-CI). Similarly, the prevalence of NSI high nutritional risk was lowest in Robust-CN (3.7%) and highest in Frail-CI (13.6%). Adjusted for sociodemographic and health status, pre-frailty/frailty-CI versus Robust-CN was associated with the highest odds ratio of association with MNA malnutrition (OR=8.16, p<0.001), although not the highest with NSI high nutritional risk (OR=1.48, p=0.017).


An extraordinary high prevalence of malnutrition was observed among older adults with cognitive frailty who should be specially targeted for active intervention.

Key words

Cognitive Frailty Malnutrition Nutritional Risk 


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Supplementary material

42414_2017_46_MOESM1_ESM.pdf (30 kb)
SUPPLEMENTARY TABLE 1. Derivation of MNA using SLAS available data
42414_2017_46_MOESM2_ESM.pdf (46 kb)
SUPPLEMENTARY TABLE 2. Demographic and Clinical Characteristics by Frailty, Cognition and Nutritional Status
42414_2017_46_MOESM3_ESM.pdf (37 kb)
SUPPLEMENTARY TABLE 3. Prevalence of Nutritional Screening Index (NSI) Questions by Frailty-Cognition Subgroups


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Copyright information

© Serdi and Springer Nature Switzerland AG 2017

Authors and Affiliations

  • L. Chye
    • 1
  • K. Wei
    • 1
  • M. S. Z. Nyunt
    • 2
  • Q. Gao
    • 2
  • S. L. Wee
    • 1
  • Tze-Pin Ng
    • 2
    Email author
  1. 1.Geriatric Education and Research InstituteSingaporeSingapore
  2. 2.Gerontology Research ProgrammeNational University of Singapore, Department of Psychological MedicineSingaporeSingapore

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