Nutritional status, physical function shape health outcomes in older adults

Both nutritional status and physical function act independently and interactively to influence the health outcomes in older adults, according to a Singapore study.

“These findings underscore the need for integrated interventions targeting both nutritional status and physical function to promote healthy ageing and reduce frailty,” the researchers said.

Overall, 699 community-dwelling older adults (aged ≥60 years) from the Population Health Index Survey were followed over 3 years. The researchers assessed nutritional status using the Mini Nutritional Assessment and measured physical function using the Late-Life Function and Disability Instrument.

The independent and interaction effects of nutritional status and physical function on health outcomes (ie, frailty, depression, loneliness, health-related quality of life [HRQoL], and self-reported health [SRH]) were explored using mixed-effect models, with adjustments for sociodemographic and lifestyle covariates. [Am J Clin Nutr 2025;122:811-819]

Undernourished older adults were more likely to have frailty (odds ratio [OR], 8.94, 95 percent confidence interval [CI], 4.48‒17.87), depression (OR, 14.94, 95 percent CI, 7.63‒29.23), and loneliness (OR, 5.13, 95 percent CI, 2.77‒9.53), lower HRQoL (β, ‒0.10, 95 percent CI, ‒0.13 to ‒0.07), and SRH (β, ‒8.27, 95 percent CI, ‒10.81 to ‒5.73) than well-nourished individuals.

Likewise, those with lower physical function are more likely to have poorer health outcomes. Notably, the inclusion of both nutritional status and physical function in the model attenuated the associations for nutritional status.

“Although their interaction term was not associated with most health outcomes, a significant interaction was found for HRQoL, where the negative impact of undernutrition on EQ-5D scores was greater among those with impaired physical function (interaction term β, –0.12, 95 percent CI, –0.17 to –0.07),” the researchers said.

Health and wellness

These findings are consistent with those of previous cross-sectional studies reporting the beneficial effects of nutritional status and physical function on health and well-being among older adults. [Front Nutr 2022;9:1113060; J Nutr Gerontol Geriatr 2024;43:116-133; J Nutr Gerontol Geriatr 2020;39:131-142; Psychogeriatrics 2024;24:1065-1074; Eur. Geriatr. Med 2021;12:1247-1256]

Two recent longitudinal studies have also shown similar findings, linking nutritional status with HRQoL and physical function with SRH. [Front Public Health 2022;10:923767; Nutrients 2024;16:1713]

Moreover, the current findings “showed that when both factors were included in the same model, their associations with health outcomes attenuated but remained significant,” the researchers said.

“The attenuation suggests that nutritional status and physical function share some predictive variance and may partially confound each other, reflecting the biological and functional interdependence between nutrition and physical capacity in ageing,” they added.

However, the persistent independent associations suggest that nutritional status and physical function “are distinct and important determinants of health, supporting the need for integrated assessment and intervention strategies targeting both domains,” according to the researchers.

“Future research should explore the potential mediating role of physical function in the association between nutritional status and health outcomes, and vice versa, while also developing and evaluating integrated interventions that effectively target both factors to optimize health outcomes in ageing populations,” they added.