Oral Nutritional Supplementation Improves Cognitive Function and Reduces Frailty in Malnourished Older Adults

Abstract

Malnutrition in older adults is associated with cognitive
decline and frailty. Improving nutritional status might be an effective
approach to mitigate cognitive decline and frailty. This study assessed
the effect of an oral nutritional supplement (ONS) on cognitive
function and frailty in malnourished older adults. Methods: This is an
open-labeled, parallel-group, randomized controlled trial. Fifty older
adults (age ≥60 years) with/or at risk of malnutrition (Mini Nutrition
Assessment score ≤11) were randomized into an intervention (IG) or
control (CG) group (1:1 ratio). Participants in the IG received 200
mL of an ONS (57 g/day [247 kcal/serving, 12 g protein]) before
bedtime for 12 weeks, whereas the CG received 200 mL of water.
Cognitive function, frailty, and ability to perform activities of daily
living (ADLs) were assessed at baseline and after 12 weeks using
the Montreal Cognitive Assessment (MoCA), a five-criteria frailty
assessment, and the Barthel Index (BI), respectively. Results: A sample
of 42 older adults (IG: n = 20, and CG: n = 22) completed the study.
The IG experienced a significant improvement in the MoCA score
compared to the CG (ΔMoCA score:1.90 ± 2.34 vs. −1.50 ± 3.33; p
< 0.001). The five-criteria frailty assessment score in the IG declined
significantly from 3.30 ± 0.92 to 2.35 ± 1.20 (p = 0.002), indicating
an improvement in frailty status. In contrast, there was no significant
change in the frailty status of the CG participants (p = 0.67). The
IG also exhibited a significant improvement in performing their
ADLs compared to the CG (ΔBI score: 0.30 ± 0.47 vs. −0.18 ± 0.66;
p < 0.001). Conclusion: Regular ONS as a bedtime meal for 12 weeks
may effectively improve cognitive function and reduce frailty in older
adults with malnutrition, likely due to the indirect effects of improved
nutritional status.