Relationships Between Nutrition Risk and Frailty in Candidates for Lung Transplant

Abstract

Background: Healthcare teams evaluating candidates for lung transplant seek to identify and address modifiable factors to improve their clinical outcomes. Frailty may be a modifiable factor, and poor nutrition may be a contributor to frailty. This study evaluated the relationship between nutrition risk and frailty in lung transplant candidates.

Methods: This was a secondary analysis of data from 62 adult lung transplant candidates. Nutrition risk was assessed with the Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN-14) questionnaire, and frailty was measured using two methods: physical frailty with the Fried frailty index (FFI) and multidimensional frailty using a cumulative deficits frailty index (CDFI), where higher scores on a 0-1 scale denote increasing frailty. Pearson correlation, independent-samples t-test, and Fisher's exact tests analyzed associations between SCREEN-14 and both FFI and CDFI scores.

Results: Most participants were at high nutrition risk (83.9%) and were pre-frail (69.4%) or frail (17.7%) when assessed using FFI. Mean CDFI score was 0.26. Higher nutrition risk was associated with a higher degree of frailty as measured using FFI (r = -0.303; p = 0.017) but not CDFI. Participants at high nutrition risk were significantly more likely to be pre-frail or frail by FFI than those at low nutrition risk (92.3% vs. 60.0%, respectively; p = 0.019).

Conclusions: High nutrition risk is highly prevalent and associated with physical frailty in lung transplant candidates. Future studies should investigate how to best identify nutrition risk and whether interventions that reduce this risk also decrease frailty.

Keywords: Fried frailty phenotype; SCREEN‐14; cumulative deficits frailty index; frailty; lung transplantation; nutrition risk.