The Role of Nutritional Status on Polypharmacy, Cognition, and Functional Capacity of Institutionalized Elderly: A Systematic Review

Abstract

Adequate nutritional status is necessary for the proper management of polypharmacy, the prevention of cognitive decline, and the maintenance of functional capacity in activities of daily living. Although several studies validate this fact for the general elderly population, data on institutionalized seniors concerning this relation are scarce. A systematic review was performed according to the PRISMA guidelines, aiming to study the potential correlation between nutritional status and polypharmacy, cognitive decline, and functional performance in institutionalized elders. The search was limited to studies in English or Portuguese in the last decade. Inclusion criteria relied on the PICO method. Five studies explored the relationship of nutritional status with cognitive performance in the institutionalized elderly, and nine prospective observational studies reported significant positive associations between appropriate nutritional status and physical abilities. Nutritional status was primarily measured by MNA. Adequate nutritional status was described as an important parameter in preventing cognitive and functional decline in the institutionalized elderly. No studies were found describing the impact of nutritional status on the prevention of polypharmacy. Given the strong impact of malnutrition found in the studies in cognition and functional abilities in the institutionalized elderly, an evaluation of nutritional status of the elders is crucial to prevent health problems and allow early intervention programs in order to further prevent health decline.

Improving residents’ wellbeing in senior citizen homes with more individualized food services

“…It has been reported that the provision of good nutrition in senior citizen homes leads to better cognitive functioning as well as physical and mental health [17]- [20]. It has also been found that greater wellbeing 1176 (2023) 012016 IOP Publishing doi:10.1088/1755-1315/1176/1/012016 3 is based on greater food satisfaction including e.g.…”

Assessment of frailty, daily life activities, and nutrition of elderly immigrants: A household based cross-sectional study

“…[14,15] Studies have shown that the prevalence of in-adequate nutrition among the elderly ranges from 2% to 8% in the literature and from 20% to 60% in clinical settings. [14,[16][17][18] The decrease in biopsychosocial functional capacity and loss of abilities in the elderly result in a higher incidence of chronic health problems (hypertension, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, stroke, depression), increased dependency on social and psychological support, and the need for the assistance of others. [19,20] Physiological and psychosocial changes in old age, along with resulting issues, impact individuals' quality of life, [21] increase the risk of illness and death, and impose a significant societal cost from a social and economic perspective.…”

“…[14,15] Studies have shown that the prevalence of in-adequate nutrition among the elderly ranges from 2% to 8% in the literature and from 20% to 60% in clinical settings. [14,16–18]…”

Association of Anticholinergic Drug Burden With Cognitive and Functional Decline Over Time in Dementia With Lewy Bodies: 1-Year Follow-Up Study

“…[13][14][15] The risk of malnutrition is an important predictor of functional capacity in the elderly population. 16,17 In summary, medications with anticholinergic properties are consistently associated with worse outcomes such as impaired physical function, falls, malnutrition risk, and cognitive impairment in older adults. 13,14,[18][19][20] Despite increasing evidence of unexpected medical problems, the number of medications with high anticholinergic activity prescribed to older adults has increased.…”

“…Also, polypharmacy and anticholinergic drug burden had a significant link with malnutrition 13–15 . The risk of malnutrition is an important predictor of functional capacity in the elderly population 16,17 . In summary, medications with anticholinergic properties are consistently associated with worse outcomes such as impaired physical function, falls, malnutrition risk, and cognitive impairment in older adults 13,14,18–20 .…”