Preliminary evaluation of home-delivered meals for reducing frailty in older adults at risk for mal-nutrition.

ABSTRACT

OBJECTIVE: To examine the potential benefit of home-delivered meals for reducing frailty levels among community-dwelling older adults at risk for malnutrition. DESIGN: A retrospective, single-group observational approach. SETTING: One large home-delivered meal agency in the Midwest United States. PARTICIPANTS: 1090 community-dwelling older adults who received home-delivered meal services, funded through the Older Americans Act, between June 2020 and December 2021. MEASUREMENT Frailty status was measured by the Home Care Frailty Scale (HCFS) which was routinely administered by agency staff to home-delivered meal clients as part of a quality improvement project. The HCFS was administered at the start of meal services, 3-months after meals began, and 6-months after meals began. RESULTS: At baseline, 55.4% of clients were found to be at high risk for malnutrition. While there was a significant and consistent decline in HCFS throughout the follow-up period for both high and low nutritional risk groups, the reduction in frailty from baseline to 6-months was greater for the high nutritional risk group (Δ = -1.9; 95% CI [-2.7, -1.1]; p < 0.001) compared to those with low nutritional risk (Δ = -1.5; 95% CI [-2.3, -0.7]; p < 0.001). Compared to those who lived alone, clients who lived with other individuals presented with higher levels of frailty at baseline and 3-month follow-up for both low and high malnutrition risk groups. CONCLUSION: Home-delivered meal clients are commonly at risk for both frailty and malnutrition. Home-delivered meal programs, which are intended to reduce malnutrition among older adults, may serve as a promising solution for reducing frailty in the vulnerable aging population.