Nutr Res Pract.  2023 Oct;17(5):1007-1018. 10.4162/nrp.2023.17.5.1007.

Can tailored home-delivered meal services alleviate self-rated frailty of the low-income older adults in Korea?

• Kim J
• Chang H

• KMID: 2546939
• DOI: http://doi.org/10.4162/nrp.2023.17.5.1007

Abstract

BACKGROUND/OBJECTIVES
This study aimed to examine whether the tailored homedelivered meal (HDM) services included nutrition counseling impacts alleviating self-rated frailty among low-income older adults in Korea.
SUBJECTS/METHODS
Pre- and post-test were implemented on May 27 and on November 25 in 2019 during 3 weeks, respectively, before and after the 6 months intervention program. Participants completed a questionnaire measuring frailty, malnutrition, food security, depression, and underlying diseases. Initially, 136 older adults were selected as participants for this study, they were recipients of a free meal program from 2 senior welfare centers in Seoul, the final sample size of those who completed the intervention program was 117 (female 70.9%, male 29.1%). Statistical analyses were conducted with IBM SPSS package program, paired t-test and χ 2 test to validate the test.
RESULTS
There were statistically significant differences in the score of the Tilburg Frailty Indicator (TFI) before and after receiving the tailored HDM services (pre-test 9.46, post-test 2.8, P < 0.01). The differences in the score of TFI by 3 risk groups at the pre-test decreased as a result of receiving these services.
CONCLUSIONS
The tailored HDM services alleviated the self-rated frailty of low-income older adults with limited mobility in a community setting. Based on the positive outcomes this study could be applied to developing social services for aging in place.

Keyword

Aged; meals; malnutrition; poverty; frailty

Reference

1. Korea Statistical Information Service (KOSIS). Estimated population by major age group (working age population, elderly population, etc.) [Internet]. Daejeon: Korea Statistical Information Service;2023. cited 2023 March 28. Available from: https://kosis.kr/statHtml/statHtml.do?orgId=101&tblId=DT_1BPA003&vw_cd=&list_id=&scrId=&seqNo=&lang_mode=ko&obj_var_id=&itm_id=&conn_path=K1.

2. Lee HC. Population aging and Korean society. Korea J. 2021; 61:5–20.

3. Cho H, Chang H, Kim J. Evaluation of nutritional status among the vulnerable elderly: Focused on the recipients of meals-on-wheels. J Korean Soc Food Sci Nutr. 2020; 49:521–530.

4. Kim J, Chon Y, Chang H. A study on the food security for low-income older adults: a case study on meals on wheels project in Seoul. J Korean Gerontol Soc. 2020; 40:617–638.

5. Ministry of Health and Welfare & Korea Institute for Health and Social Affairs. 2020 Korea National Survey on Aging [Internet]. Sejong: Ministry of Health and Welfare & Korea Institute for Health and Social Affairs;2020. cited 2022 December 22. Available from: https://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=366496.

6. Ministry of Health and Welfare. National Health and Nutrition Survey 20 years statistics at a glance [Internet]. Sejong: Ministry of Health and Welfare;2020. cited 2022 December 22. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=359797.

7. Han S. What kind of welfare state has Korea grown up in? Korea Soc Policy Rev. 2020; 27:153–185.

8. Jung H, Kim M, Lee Y, Won CW. Prevalence of physical frailty and its multidimensional risk factors in Korean community-dwelling older adults: Findings from Korean Frailty and Aging Cohort Study. Int J Environ Res Public Health. 2020; 17:7883. PMID: 33121159.

9. Hoogendijk EO, Heymans MW, Deeg DJ, Huisman M. Socioeconomic inequalities in frailty among older adults: results from a 10-year longitudinal study in the Netherlands. Gerontology. 2018; 64:157–164. PMID: 29055946.

10. O’Connell ML, Coppinger T, McCarthy AL. The role of nutrition and physical activity in frailty: a review. Clin Nutr ESPEN. 2020; 35:1–11. PMID: 31987100.

11. Hutchins-Wiese HL, Walsh SE. Frailty and nutrition risk screening in home-delivered meal clients. J Nutr Gerontol Geriatr. 2020; 39:114–130. PMID: 32009572.

12. Coelho T, Santos R, Paúl C, Gobbens RJ, Fernandes L. Portuguese version of the Tilburg Frailty Indicator: transcultural adaptation and psychometric validation. Geriatr Gerontol Int. 2015; 15:951–960. PMID: 25255891.

13. Buys DR, Campbell AD, Godfryd A, Flood K, Kitchin E, Kilgore ML, Allocca S, Locher JL. Meals enhancing nutrition after discharge: findings from a pilot randomized controlled trial. J Acad Nutr Diet. 2017; 117:599–608. PMID: 28065635.

14. Morris AM, Engelberg JK, Schmitthenner B, Dosa D, Gadbois E, Shield RR, Akobundu U, Thomas KS. Leveraging home-delivered meal programs to address unmet needs for at-risk older adults: preliminary data. J Am Geriatr Soc. 2019; 67:1946–1952. PMID: 31188480.

15. Blodgett J, Theou O, Kirkland S, Andreou P, Rockwood K. The association between sedentary behaviour, moderate-vigorous physical activity and frailty in NHANES cohorts. Maturitas. 2015; 80:187–191. PMID: 25542406.

16. Pérez-Zepeda MU, Castrejón-Pérez RC, Wynne-Bannister E, García-Peña C. Frailty and food insecurity in older adults. Public Health Nutr. 2016; 19:2844–2849. PMID: 27134079.

17. Schrager MA, Schrack JA, Simonsick EM, Ferrucci L. Association between energy availability and physical activity in older adults. Am J Phys Med Rehabil. 2014; 93:876–883. PMID: 24800719.

18. Jang SM, Bae JS, Lee KE. Meal and food provision services for community-dwelling vulnerable older adults perceived by health and welfare service providers in Seoul. J Korean Diet Assoc. 2019; 25:295–309.

19. Choi JH, Kim DH, Choi EH, Jung MJ, Lee HS, Lee MJ, Chang HJ, Lee KE, Kwak TK. Assessment of foodservice management practices according to types of elderly foodservice facilities. J Korean Soc Food Sci Nutr. 2019; 48:461–481.

20. Kim SH. Explaining institutional change through the policy mix model: a case study of the food bank program. Korean J Public Adm. 2019; 57:1–31.

21. Pooler JA, Hartline-Grafton H, DeBor M, Sudore RL, Seligman HK. Food insecurity: a key social determinant of health for older adults. J Am Geriatr Soc. 2019; 67:421–424. PMID: 30586154.

22. Gualtieri MC, Donley AM, Wright JD, Vega SS. Home delivered meals to older adults: A critical review of the literature. Home Healthc Now. 2018; 36:159–168. PMID: 29722706.

23. Ullevig SL, Sosa ET, Crixell S, Uc E, Greenwald B, Marceaux S, Friedman BJ. Impact of home-delivered meals on nutrition status and nutrient intake among older adults in central Texas. J Nutr Health Aging. 2018; 22:861–868. PMID: 30080232.

24. IJmker-Hemink VE, Dijxhoorn DN, Briseno Ozumbilla CM, Wanten GJ, van den Berg MG. Effective elements of home-delivered meal services to improve energy and protein intake: a systematic review. Nutrition. 2020; 69:110537. PMID: 31521950.

25. Buigues C, Padilla-Sánchez C, Garrido JF, Navarro-Martínez R, Ruiz-Ros V, Cauli O. The relationship between depression and frailty syndrome: a systematic review. Aging Ment Health. 2015; 19:762–772. PMID: 25319638.

26. Ge L, Yap CW, Heng BH. Prevalence of frailty and its association with depressive symptoms among older adults in Singapore. Aging Ment Health. 2019; 23:319–324. PMID: 29336608.

27. Lepore MJ, Rochford H. Addressing food insecurity and malnourishment among older adults: the critical role of Older Americans Act nutrition programs. Public Policy Aging Rep. 2019; 29:56–61.

28. Berkowitz SA, Shahid NN, Terranova J, Steiner B, Ruazol MP, Singh R, Delahanty LM, Wexler DJ. “I was able to eat what I am supposed to eat”-- patient reflections on a medically-tailored meal intervention: a qualitative analysis. BMC Endocr Disord. 2020; 20:10. PMID: 31959176.

29. Tapper EB, Baki J, Nikirk S, Hummel S, Asrani SK, Lok AS. Medically tailored meals for the management of symptomatic ascites: the SALTYFOOD pilot randomized clinical trial. Gastroenterol Rep (Oxf). 2020; 8:453–456. PMID: 33442478.

30. Ministry of Health and Welfare. The Korean Nutrition Society. Dietary Reference Intakes for Koreans 2020. Sejong: Ministry of Health and Welfare;2020.

31. Lyons BP. Nutrition education intervention with community-dwelling older adults: research challenges and opportunities. J Community Health. 2014; 39:810–818. PMID: 24368631.

32. Gobbens RJ, van Assen MA, Luijkx KG, Wijnen-Sponselee MT, Schols JM. The Tilburg Frailty Indicator: psychometric properties. J Am Med Dir Assoc. 2010; 11:344–355. PMID: 20511102.

33. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res. 2004; 57:297–305. PMID: 15507257.

34. Han C, Lim YH, Hong YC. The association between oxidative stress and depressive symptom scores in elderly population: a repeated panel study. J Prev Med Public Health. 2016; 49:260–274. PMID: 27744668.

35. Abellan Van Kan G, Vellas B. Is the Mini Nutritional Assessment an appropriate tool to assess frailty in older adults? J Nutr Health Aging. 2011; 15:159–161. PMID: 21369660.

36. Vellas B, Villars H, Abellan G, Soto ME, Rolland Y, Guigoz Y, Morley JE, Chumlea W, Salva A, Rubenstein LZ, et al. Overview of the MNA--its history and challenges. J Nutr Health Aging. 2006; 10:456–463. PMID: 17183418.

37. Choi JH, Lee Y, Lee ES, Lee HS, Chang HJ, Lee KE, Yi NY, Kwak TK. Investigation of food safety knowledge, attitudes, and behavior for analyzing food safety risk factors in the elderly. J Korean Soc Food Sci Nutr. 2016; 45:746–756.

38. Saint Ville A, Po JY, Sen A, Bui A, Melgar-Quiñonez H. Food security and the food insecurity experience scale (FIES): ensuring progress by 2030. Food Secur. 2019; 11:483–491.

39. Roh HW, Hong CH, Lee Y, Oh BH, Lee KS, Chang KJ, Kang DR, Kim J, Lee S, Back JH, et al. Participation in physical, social, and religious activity and risk of depression in the elderly: a community-based three-year longitudinal study in Korea. PLoS One. 2015; 10:e0132838. PMID: 26172441.

40. Macgowan M, Vakharia SP. Teaching standards–based group work competencies to social work students: an empirical examination. Res Soc Work Pract. 2012; 22:380–388.

41. Berkowitz SA, Terranova J, Hill C, Ajayi T, Linsky T, Tishler LW, DeWalt DA. Meal delivery programs reduce the use of costly health care in dually eligible medicare and medicaid beneficiaries. Health Aff (Millwood). 2018; 37:535–542. PMID: 29608345.

42. Singer C. Health effects of social isolation and loneliness. J Aging Life Care. 2018; 28:4–8.

43. Zhu H, An R. Impact of home-delivered meal programs on diet and nutrition among older adults: a review. Nutr Health. 2013; 22:89–103. PMID: 24916974.

44. Noh EY, Park YH, Cho B, Huh I, Lim KC, Ryu SI, Han AR, Lee S. Effectiveness of a community-based integrated service model for older adults living alone: a nonrandomized prospective study. Geriatr Nurs. 2021; 42:1488–1496. PMID: 34706291.

45. Artaza-Artabe I, Sáez-López P, Sánchez-Hernández N, Fernández-Gutierrez N, Malafarina V. The relationship between nutrition and frailty: Effects of protein intake, nutritional supplementation, vitamin D and exercise on muscle metabolism in the elderly. A systematic review. Maturitas. 2016; 93:89–99. PMID: 27125943.

46. Boulos C, Salameh P, Barberger-Gateau P. Malnutrition and frailty in community dwelling older adults living in a rural setting. Clin Nutr. 2016; 35:138–143. PMID: 25649256.

47. Soysal P, Veronese N, Thompson T, Kahl KG, Fernandes BS, Prina AM, Solmi M, Schofield P, Koyanagi A, Tseng PT, et al. Relationship between depression and frailty in older adults: a systematic review and meta-analysis. Ageing Res Rev. 2017; 36:78–87. PMID: 28366616.

48. Ellwood WM, Downer S, Leib EB, Greenwald R, Farthing-Nichol D, Luk E, Mendle A. Food Is Medicine Opportunities in Public and Private Health Care for Supporting Nutritional Counseling and Medically-Tailored, Home-Delivered Meals. Cambridge (MA): Center for Health Law and Policy Innovation, Harvard Law School;2014.