Individualized nutritional intervention combined with tailored resistance exercise in hospitalized frail older adults: A prospective, single-arm pilot before-and-after study.
Chen L, Xu L, et al. • The Journal of international medical research • 2026
A screening-guided, individualized nutritional intervention combined with tailored resistance exercise was associated with within-group changes in nutritional status and physical function in hospitalized frail older adults, with higher educational level and lower baseline mobility function associated with greater magnitude of response.
Key Findings
Results
Significant within-group improvements in nutritional biomarkers were observed after 12 weeks of the combined intervention.
Serum transferrin, prealbumin, and albumin levels all showed significant within-group changes (all p < 0.05)
MNA-SF scores also showed significant within-group improvement (p < 0.05)
The study enrolled 120 hospitalized frail older adults with a mean age of 87.03 ± 5.65 years
Patients with MNA-SF score ≤ 11 received individualized oral nutritional supplementation; those with MNA-SF score ≥ 12 underwent weekly monitoring
Results
Significant within-group improvements in physical function, mobility, and daily living activities were observed after 12 weeks.
Significant within-group changes were observed in Short Physical Performance Battery (SPPB) scores (p < 0.05)
Performance-oriented mobility assessment, activities of daily living (ADL), and instrumental activities of daily living (IADL) scores all improved significantly (all p < 0.05)
Grip strength and gait speed also showed significant within-group changes (all p < 0.05)
The resistance exercise program consisted of standardized Theraband training performed 3 times weekly for 20–30 minutes, with intensity individualized using the Borg Rating of Perceived Exertion
Results
Higher baseline educational level was independently associated with achieving the minimal clinically important difference (MCID) in SPPB score.
The MCID for SPPB was defined as an improvement of ≥ 1 point
Higher baseline educational level was associated with SPPB MCID achievement: adjusted odds ratio 1.962 (95% CI: 1.060–3.634, p = 0.032)
This association was identified through multivariate logistic regression analysis
Results
Lower baseline performance-oriented mobility assessment score was independently associated with achieving the SPPB MCID.
Lower baseline performance-oriented mobility assessment score was associated with greater SPPB MCID achievement: adjusted odds ratio 1.808 (95% CI: 1.076–3.039, p = 0.025)
This suggests that patients with worse baseline mobility function showed a greater magnitude of response to the intervention
Both baseline factors were identified through multivariate logistic regression
Methods
The study used a screening-guided nutritional stratification approach to individualize nutritional interventions in hospitalized frail older adults.
Nutritional status was stratified using the Mini Nutritional Assessment-Short Form (MNA-SF)
Patients at risk of malnutrition or with malnutrition (MNA-SF score ≤ 11) received individualized oral nutritional supplementation
Well-nourished patients (MNA-SF score ≥ 12) underwent weekly monitoring only
The study design was a prospective, single-arm pilot before-and-after study with outcomes assessed at baseline and after 12 weeks
What This Means
This research suggests that a structured program combining personalized nutrition support and tailored resistance exercise can improve nutritional health and physical function in very elderly hospitalized patients who are considered frail. The study followed 120 patients with an average age of 87 years over 12 weeks. Patients who were malnourished or at risk received customized oral nutritional supplements, while all patients participated in resistance band exercises three times per week. After 12 weeks, blood markers of nutritional status improved, and patients showed better scores on tests of physical performance, mobility, grip strength, walking speed, and ability to perform daily tasks.
The research also found that not all patients benefited equally. Those with higher levels of education and those who had worse mobility at the start of the program were more likely to show meaningful improvements in physical performance. This suggests that certain patient characteristics at the time of hospitalization may help clinicians identify who is most likely to respond to this type of combined intervention.
Because this was a single-arm pilot study with no control group, it is not possible to determine how much of the improvement was due to the intervention versus natural recovery or other factors during hospitalization. The findings provide preliminary evidence that screening-guided, individualized nutrition combined with resistance exercise may be feasible and potentially beneficial for frail hospitalized older adults, and they support the need for larger randomized controlled trials to confirm these results.
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Chen L, Xu L, Si C, Hu Z, Wang Y, Hong X. (2026). Individualized nutritional intervention combined with tailored resistance exercise in hospitalized frail older adults: A prospective, single-arm pilot before-and-after study.. The Journal of international medical research. https://doi.org/10.1177/03000605261484797