Immersive ethical role-play in undergraduate nursing ethics education: a qualitative descriptive study.

Populations in various regions are ageing rapidly, and consequently, frailty, an age-related clinical syndrome, has become a public health concern for older adults. A recent study reported the prevalence of prefrailty and frailty among older individuals in Chinese communities was 43.9% and 10.1%, respectively []. Frailty has been linked to negative health outcomes, including disability, hospitalization, reduced quality of life, and mortality [–]. Frailty poses major challenges with respect to health care systems and the financial burden of society []. Notably, frailty onset and development are reversible. However, the factors related to frailty must be identified to strengthen early frailty management and control measures and promote healthy ageing [, ]. Frailty is a complex progress that affected by a range of physical, sociodemographic, cognitive, lifestyle and nutrition-related factors [, ]. Particularly, nutrition and diet are key modifiable factors influencing frailty [, ]. One study showed that there was a dose–effect relationship between nutritional risk and frailty []. Improved nutrition status was crucial to frailty criteria, which focused on increasing protein and energy intake were beneficial for slowing down the decline of muscle mass, walking speed, and weight loss []. Conversely, poor nutritional intake adversely affects daily life and worsens frailty progression. In one study involving patients with malnutrition, the combined prevalence of frailty and prefrailty was 90.7% []. Furthermore, healthy diet is the cornerstone for a healthy life, exerting observable effects on the ageing process among older adults []. For example, frequent consumption of fruit, vegetable, and whole grains may decelerate frailty onset []. A diet with the high protein and dietary total antioxidant capacity was inversely associated with the prevalence of frailty in older population []. Maintaining a moderate consumption of dairy products, especially fermented ones, as part of a well-balanced diet to promote healthy aging []. Moreover, in a study of 1,701 individuals, a proinflammatory diet was associated with an increased odds of frailty []. A prospective study also revealed that vegetarian diet was associated with a higher risk of frailty, compared to an omnivorous diet []. Dietary diversity is an important component of greater diet patterns and endorsed by dietary guidelines in many countries [, ], serves as an indicator of whether an individual has greater nutritional intake and reflects the consumption of multiple food groups within a specific time frame []. Individuals with greater dietary diversity could improve their nutrition status [], and increased dietary variety has been associated with a decreased likelihood of frailty among older adults [, ]. Hence, higher food group variety is important for frailty management in older adults. Additionally, nutrition-related education can improve individuals’ nutritional knowledge and understanding of food and nutrition []. Previous studies have reported that participants with greater exposure to nutritional education tend to have better nutritional status and health outcomes []. However, evidence remains inconsistent, as increased nutritional knowledge alone often fails to translate into healthier dietary practices []. Therefore, it is critical to identify key explanatory factors in the nutrition–frailty relationship to explore how nutritional factors ultimately influence frailty development.