Nutritional Status, Body Composition, and Frailty in Community-Dwelling and Institutionalized Albanian Older Adults: A Cross-Sectional Study

Background: Albania has undergone a rapid demographic transition characterized by pronounced population aging. Comprehensive geriatric assessment—functional performance, validated nutritional screening tools, and systematic evaluation of morbidities—is essential for accurately characterizing frailty and identifying the risk of malnutrition in its early stages. The objective of the present study was to improve the assessment of the health status of Albanian older adults, both community-dwelling and residing in long-term care facilities, by addressing both functional and nutritional components. Methods: This observational study included Albanian older adults aged ≥ 65 years, both institutionalized and community-dwelling. Frailty and nutritional status were assessed using validated questionnaires (Grauer Geriatric Functional Evaluation and Mini Nutritional Assessment—MNA), alongside body composition analysis performed by bioelectrical impedance analysis (BIA). Results: Data for 123 older adults were analyzed (56.9% female; mean age 71.3 ± 7.4 years; 54.5% institutionalized vs. 45.5% community-dwelling). A high prevalence of frailty and multimorbidity was observed, particularly among institutionalized older adults. With regard to nutritional status, marked age-related differences were identified among females, with a pronounced deterioration in those aged over 75 years. Body-composition-derived parameters identified a substantially higher proportion of individuals at risk of malnutrition compared with other conventional anthropometric measures. Low body cell mass index (BCMI) and institutionalization were the factors with the strongest independent associations with frailty (AOR 5.02, 95% CI 1.69–14.87, p = 0.004, and AOR 5.71, 95% CI 1.76–18.54, p = 0.004, respectively), while low BCMI was the only variable associated with an increased risk of malnutrition (AOR 4.88, 95% CI 1.78–13.40, p = 0.002). Conclusions: These exploratory findings suggest that incorporating body composition parameters into geriatric assessment may provide complementary information alongside traditional screening tools to support the development of targeted preventive and therapeutic strategies.