Study reveals how to reduce frailty in nursing home residents

A University of Adelaide led study has defied a common misconception that nursing home residents experience a deterioration in their level of frailty and functional status.

"Our research, which included 548 residents from South Australian Resthaven aged care homes, found that nearly half of residents either remained stable or improved over 12 months," said Dr. Mark Q Thompson, Adjunct Titleholder at the University of Adelaide. The work is published in the journal Age and Ageing.

"This is the first time globally that frailty change has been examined in nursing home residents over 12 months.

"Our finding that deterioration is not inevitable is a major challenge to the idea held by some that the focus in this setting should be mainly on palliative care. Instead, opportunities for promoting function and well-being are likely to have positive effects, even in the frailest residents.

"Focusing on nutrition, exercise and diabetes management are important ways for maintaining the well-being and quality of life of frail residents living in residential aged care."

The researchers based the measurement of frailty change using the concept of minimally important difference (MID). MID is a score which represents a change in a health outcome that is considered meaningful to the older person as well as clinically.

"In our study, a 6% change in a resident's frailty was found to be meaningful," said Dr. Thompson.

"Interestingly, we found that stability and improvement in frailty status was possible even among the most-frail residents. Thirty-two percent remained stable over 12 months while 14% improved. Malnutrition and diabetes were identified as significant predictors of frailty status worsening.

"Therefore, a focus on nutrition, exercise, and diabetes management are important ways for maintaining the well-being and quality of life of frail residents living in residential aged care.

"Fixing these fundamentals of care is an important step in reducing the nutritional risk of aged care residents, and subsequently reducing the risk of worsening frailty."

This research builds on the findings of a previous study which found that aged care residents who move more and interact with their environment are more likely to live longer, have fewer falls and have a higher quality of life.