Presentation (CTI)

OBJECTIVES: To assess whether national frailty guidelines integrate nutrition as an actionable strategy and provide practical implementation guidance.
BACKGROUND: Frailty in older adults' increases the risk of falls, fractures, and healthcare burden. Frailty increases vulnerability to even minor physical challenges, making falls both more likely and more harmful. As the population ages, costs are rising: for example, in the UK, fragility fractures cost over £1.8 billion annually. International guidance emphasizes recommends multimodal interventions, including nutritional support. Nutrition is a cost-effective key part of this multimodal approach. Yet it remains unclear to what extent national frailty guidelines across Europe effectively incorporate and operationalise nutritional interventions, highlighting a critical gap with significant cost and outcome implications.
METHODS: National frailty guidelines and geriatrics society recommendations (2015-2024) from France, Germany, Italy, Spain, and the UK were reviewed. Guidelines were assessed against seven predefined criteria, including nutritional assessment, intervention, care setting, and implementation detail. A comparative dashboard was developed to identify patterns and inconsistencies.
RESULTS: Nutrition is considered within the context of frailty, typically through comprehensive geriatric assessment across the countries. However, France, Germany, and Italy provide more structured guidance and clearer implementation pathways. In contrast, the UK and Spain include limited direction on nutritional interventions, particularly in community settings and in relation to fall prevention. Physical activity is often emphasized, while nutrition remains underutilised.
CONCLUSIONS: Despite broad recognition, nutrition is rarely positioned as a core fall-prevention strategy. Strengthening nutrition assessment and intervention could improve outcomes and reduce healthcare burden. In the UK, modelling of a coordinated fracture prevention programme estimated potential savings of £2.1 million over five years. With the economic burden of falls continuing to grow, now is the time to act. Implementing best practice in nutritional intervention for frail older adults appears both achievable and cost-effective. Further exploration and quantification are recommended.