Prevalence of malnutrition risk and poor food intake in older adults in Indian hospitals: A prospective observational nutritionDay study with novel mapping of malnutrition risk to the Malnutrition Screening Tool

Abstract

Aim Current literature regarding the prevalence and consequences of poor dietary intake and risk of malnutrition in older adults is limited to wealthier regions including the United States, Europe and Australasia. With a rapidly ageing population in India, this prospective observational study aimed to evaluate hospital food intake and malnutrition risk and their impact on hospital length of stay, readmission rates and in‐hospital mortality of older adults in Indian hospitals. Methods Data collected during nutritionDay worldwide audits (2014‐2016), in five urban, private hospitals in India included baseline demographic and clinical data on patients aged ≥60 years. Proportion of food consumed at one main meal was recorded and data on length of stay, readmissions and in‐hospital mortality were collected 30 days post‐baseline. Results A total of 262 participants (mean age: 69 ± 8 years; 65% males) were recruited. Mapped malnutrition risk (mapped Malnutrition Screening Tool [mMST] score ≥ 2) on admission was 31% and increased to 44% during the course of hospitalisation. Over one quarter of participants consumed ≤50% of their meal (28%). Over half the participants were found to be eating poorly (59%) and those identified as at risk of malnutrition were not offered additional nutrition support. The median LOS was 8 days (range: 1‐92), 30‐day readmission rates were 7% and in‐hospital mortality was 0.4%. Malnutrition risk and poor food intake were not associated with health‐related outcomes. Conclusion Older adults in Indian acute care hospitals have a noticeable prevalence of malnutrition risk and poor food intake. There is an opportunity for future research to focus on identifying and managing nutritional issues.

Memórias Sobre Alimentação De Idosos Hospitalizados

“…Daí decorre o fato de que, com o envelhecimento ocorrem limitações siológicas, com alterações no processo mastigatório e digestório, além das DCNT, que de nem o repertório alimentar do idoso. Outras questões também podem ser relacionadas, como a mobilidade, autonomia, condição nanceira e a composição familiar (8)(9)(10)19) .…”

“…Representações negativas sobre a comida de hospital também é encontrada em pesquisas realizadas em outros países (8,9) . Essas questões são amparadas principalmente pelas diferenças no modo de preparo, no sabor, na falta de apetite, no comer sem sentir fome, nas interferências de medicamentos e de patologias, podendo levar a consequências como o prolongamento da hospitalização e a desnutrição (8)(9)(10) . Entende-se que é preciso manter ou resgatar o prazer de comer que deve se estender também ao hospital, possibilitando bem-estar e satisfação aos idosos.…”

“…A desnutrição é comum entre pessoas acima de 65 anos, variando de 10 a 50% entre pacientes hospitalizados (7) . A ingesta alimentar inadequada tem sido relacionada à maior morbidade, mortalidade, aumento dos custos com a saúde, risco de enfraquecimento muscular, debilidade da imunidade, depressão e declínio funcional e cognitivo (7)(8)(9)(10) . Estudo realizado na China com idosos em pós-operatório concluiu que a avaliação precoce do estado nutricional ajuda a identi car aqueles que estão em risco de sofrer delirium e prolongamento da hospitalização, ao passo que a oferta alimentar adequada pode atenuar tais riscos (7) .…”

Prevalence of malnutrition risk and its association with mortality: nutritionDay Latin America survey results

“…In combination, responses were mapped to the Malnutrition Screening Tool (MST), a validated predictor of malnutrition risk in hospitalized patients; the MST score could only be determined in N ¼ 14,515 patients, i.e., those who provided answers to these questions. Patients were identified as "at risk of malnutrition" if their responses corresponded to an MST score 2 [31,32]. To report meal intake during the week before hospitalization and on nDay, patients used simple categories (all, about a half, about a quarter, nothing), according to Olin et al [33].…”

Advances in assessing dietary intake: Lessons from technology and nutritional epidemiology

“…While the study found no statistically significant relationship between mortality, ICU length of stay or rate of mechanical ventilation, the hospital length of stay was significantly 1 week longer in the 36% of patients malnourished upon admission (according to the PG‐SGA after adjusting for APACHE score, age and number of comorbidities). The paper by Wright and colleagues 14 reported a 31% malnutrition risk rate in older (60 years+) patients admitted predominantly for elective reasons to a private hospital in India, however, the proportion at risk increased to 44% during the hospital admission, with over half the at‐risk patients still being provided with a standard diet. Measurement of dietary intake and nutritional status exposes issues in our hospitals and communities and provides opportunities for advocacy in nutrition and dietetics.…”