Research
Open Access
Effectiveness of nutrition interventions and combined nutrition and physical activity interventions in older adults with frailty or prefrailty: a systematic review and meta-analysis
Megan Racey, Muhammad Usman Ali, Diana Sherifali, Donna Fitzpatrick-Lewis, Ruth Lewis, Milos Jovkovic, Leah Gramlich, Heather Keller, Jayna Holroyd-Leduc, Anik Giguère, Ada Tang, Danielle Bouchard, Jeanette Prorok, Perry Kim, Amanda Lorbergs and John Muscedere; for the Canadian Frailty Network
July 13, 2021 9 (3) E744-E756; DOI: https://doi.org/10.9778/cmajo.20200248
Megan Racey
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
PhDMuhammad Usman Ali
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
MD MScDiana Sherifali
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
RN PhDDonna Fitzpatrick-Lewis
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
MSWRuth Lewis
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
BAMilos Jovkovic
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
MScLeah Gramlich
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
MDHeather Keller
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
RD PhDJayna Holroyd-Leduc
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
MDAnik Giguère
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
PhDAda Tang
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
PhDDanielle Bouchard
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
PhDJeanette Prorok
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
PhDPerry Kim
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
PhDAmanda Lorbergs
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
PhDJohn Muscedere
McMaster Evidence Review and Synthesis Team (Racey, Ali, Sherifali, Fitzpatrick-Lewis, Lewis, Jovkovic); School of Nursing (Racey, Sherifali, Fitzpatrick-Lewis), Department of Clinical Epidemiology & Biostatistics (Ali) and School of Rehabilitation Science (Tang), Faculty of Health Sciences, McMaster University, Hamilton, Ont.; University of Alberta (Gramlich); Nutrition Services (Gramlich), Alberta Health Services, Edmonton, Alta.; Schlegel–University of Waterloo Research Institute for Aging (Keller); Department of Kinesiology (Keller), University of Waterloo, Waterloo, Ont.; Cumming School of Medicine (Holroyd-Leduc), University of Calgary, Calgary, Alta.; Department of Family and Emergency Medicine (Giguère), Laval University, Québec, Que.; Faculty of Kinesiology (Bouchard), University of New Brunswick; Cardiometabolic Exercise & Lifestyle Laboratory (Bouchard), Fredericton, NB; Canadian Frailty Network (Prorok, Kim, Lorbergs), Kingston, Ont.
MDOnline appendices
Files in this Data Supplement:
- Appendix 1: Frailty and Nutrition Search Strategies
- Appendix 2: Data Analysis Plan
- Appendix 3: Meta Analysis Statistical Methods
- Appendix 4: Demographic and Characteristics of Included Studies
- Appendix 5: Risk of Bias
- Appendix 6: GRADE Tables for All Outcomes by Intervention Category
- Appendix 7: Funnel Plots
- Appendix 8: Meta-analysis Forest Plots for Non-Significant Outcomes
- Reviewer Comments
- Original Submission
- PRISMA Checklist