Frailty is increasingly recognised as a key determinant of treatment tolerance, quality of life and survival in older adults with cancer. Many of the domains assessed in frailty screening, including unintentional weight loss, low muscle strength, fatigue, reduced physical activity and slow walking speed, are linked to nutritional status. Malnutrition affects up to 66% of older people with cancer, while sarcopenia occurs in 15 to 55%, making nutrition a critical and modifiable factor in both the identification and management of frailty.
Nutrition-related treatment toxicities such as nausea, vomiting and mucositis increase malnutrition risk. This is compounded by common age-related changes including reduced appetite, altered taste and smell, and early satiety. A person experiencing frailty with cancer can also experience various social and physical changes which can further impact nutrition status.
Geriatric screening and comprehensive assessment are essential for optimising care, with nutrition forming a critical component. This presentation will outline practical strategies for the multidisciplinary team (MDT) to screen, assess and support people with cancer who are frail or at risk of frailty. Emphasis will be placed on understanding individual priorities (what matters most) to guide tailored nutrition interventions.
Key strategies include routine nutrition screening using validated tools, identification and management of nutrition-impact symptoms, and individualised nutrition care such as dietary counselling, oral nutrition supplements and liberalised diets. Screening for functional impairments, fatigue and food insecurity that may limit nutritional intake will also be addressed.
This presentation will highlight the pivotal role of dietitians within the MDT and demonstrate how collaborative, nutrition-focused care can improve outcomes for frail people with cancer.