While there is concern about high glycemic dietary load and overnutrition in our general population, there is also interest in understanding undernutrition among older people (New centre in Singapore to conduct Asia's largest study on undernutrition among the elderly, ST Online; Aug 31).

The report estimated that a third of live-at-home elderly people who are hospitalised are undernourished.

My fellow researchers and I recently reported in the Journal Of The American Medical Directors Association that of the 6,000 seniors who live at home and are involved in the Singapore Longitudinal Ageing Studies, 3 per cent were malnourished and 28 per cent were at risk of malnutrition.

Importantly, the malnutrition syndrome in older people here contributes to the state of being or becoming physically frail (observable characteristics are shrinking, weakness, slowness, exhaustion and/or low activity).

In the same cohort of older people, 5 per cent were frail and 46 per cent pre-frail, and the vast majority (91 per cent) of those who were malnourished were either frail or pre-frail.

It is well known that such frailty predisposes older people to adverse health outcomes, including more frequent hospitalisation, earlier functional disability, admission to nursing homes and death.

The prevalence of malnutrition in older people in Singapore is similar to that reported in other populations, including in the West.

But the contribution of poor nutrition to frailty among older Singaporean adults is greater and should be noted in nutritional approaches to prevent frailty and disability.

Undernutrition in older people is often related to low protein intake, and common reasons for this include illness that causes one to change eating habits, inadequate amount or variety of food intake, tooth or mouth problems, low disposable income to spend on food, and reduced social contact.

Community kitchen initiatives such as the Share A Pot and Our Kitchen programmes are good ways to facilitate healthier eating, activities and community in older people.

Wee Shiou Liang (Dr)