Low Protein Intake Is Associated with Frailty in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

Nutrients. 2018 Sep 19;10(9):1334. doi: 10.3390/nu10091334.


(1) Background: Several factors have been suggested to be associated with the physiopathology of frailty in older adults, and nutrition (especially protein intake) has been attributed fundamental importance in this context. The objective of this study was to conduct a systematic review and meta-analysis to investigate the relationship between protein intake and frailty status in older adults. (2) Methods: A search of scientific studies was conducted in the main databases (Medline, Scopus, Cochrane library), and in the reference lists of selected articles. The search terms included synonyms and Medical Subject Headings and involved the use of Boolean operators which allowed the combination of words and search terms. Observational studies-cross-sectional and longitudinal-that met the eligibility criteria were included in the review. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects were performed. Publication bias was measured using the Strengthening the Reporting of Observational Studies in Epidemiology instrument. (3) Results: In the final sample, 10 articles, seven cross-sectional and three longitudinal, were included in the present study. Overall, studies investigated a total of 50,284 older adults from three different continents between 2006 and 2018. Four cross-sectional studies were included in the meta-analyses. The results demonstrated that a high protein intake was negatively associated with frailty status in older adults (odds ratio: 0.67, confidence interval = 0.56 to 0.82, p = 0.0001). (4) Conclusions: Our findings suggest that a high consumption of dietary protein is inversely associated with frailty in older adults.

Keywords: frailty; older adults; protein intake.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging*
  • Diet, Protein-Restricted / adverse effects*
  • Dietary Proteins / administration & dosage*
  • Female
  • Frail Elderly*
  • Frailty / diagnosis
  • Frailty / epidemiology*
  • Frailty / physiopathology
  • Frailty / prevention & control
  • Geriatric Assessment
  • Humans
  • Male
  • Middle Aged
  • Nutritional Status*
  • Observational Studies as Topic
  • Recommended Dietary Allowances
  • Risk Factors


  • Dietary Proteins