Social frailty and appetite status and their associations with physical, nutritional, and lifestyle factors in community-dwelling older women attending a day-care service.

Everything was measured at one time point, so the study shows associations, not cause and effect. The authors say the findings do not indicate causality. Only 45 women, all from a single day-care centre in Tokushima Prefecture, and only 5 of them were in the robust group. The authors think that imbalance explains why phase angle did not differ between the robust and frail groups. Men were dropped from the analysis, so this says nothing about older men. Anyone who could not stand safely for the body composition measurement was excluded, so the most disabled day-care users are not represented. Physical activity levels, what people ate and how often meals were eaten alone were not recorded, so the study cannot say whether living alone or eating alone drives appetite or muscle loss. Nutrition and appetite were judged with short screening questionnaires rather than full assessment.

The authors declare no conflicts of interest related to the study. No funding source is reported. The study was presented at the 11th Annual Meeting of the Japanese Society of Nutrition and Swallowing Physical Therapy.

Do not read this as proof that living alone or being socially frail causes muscle loss or poor appetite. Everything was measured once, in 45 women at one centre, and the authors state the findings do not indicate causality. The women with appetite loss in this study actually had more people living with them, not fewer, and appetite scores did not differ between the frailty groups.