Association Between Nutritional Risk and Physical Function Improvements in Cardiovascular Disease Patients With Frailty in a Community-Based Care Ward

BACKGROUND: We investigated the association between nutritional risk and improvement in physical function during hospitalization among patients with cardiovascular disease, particularly those with heart failure, admitted to a community-based care ward. METHODS AND RESULTS: We retrospectively analyzed 84 patients who underwent cardiac rehabilitation in a community-based care ward between July 2023 and May 2025. Nutritional risk on admission was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF). Patients were classified into 2 groups: non-malnourished (normal/at risk; MNA-SF ≥8, n=43) and malnourished (MNA-SF ≤7, n=41). The primary outcome was no improvement in physical function (change in Short Physical Performance Battery (SPPB) [∆SPPB] ≤0). Sensitivity analysis used an alternative definition (∆SPPB ≤2). The association between malnutrition and outcome was analyzed using modified Poisson regression adjusted for propensity score. Overall, 21 patients (25.0%) showed no improvement in physical function (∆SPPB ≤0), whereas 53 (63.1%) showed no improvement using the alternative definition. Malnutrition was not associated with no improvement in physical function in the primary analysis (adjusted risk ratio: 1.16; 95% cconfidence interval [CI]: 0.52-2.64; P=0.71), whereas a significant association was observed in sensitivity analysis (adjusted risk ratio: 2.3; 95% CI: 1.19-4.42; P<0.001). CONCLUSIONS: Nutritional risk was not associated with no improvement in physical function in the primary analysis, although an association was observed in sensitivity analyses using the alternative definition.