What Are the Risk Factors for Malnutrition in Older-Aged Institutionalized Adults?

Abstract

Malnutrition is common in older adults and is associated with functional impairment, reduced quality of life, and increased morbidity and mortality. The aim of this study was to explore the association between health (including depression), physical functioning, disability and cognitive decline, and risk of malnutrition. Participants were recruited from nursing homes in Italy and completed a detailed multidimensional geriatric evaluation. All the data analyses were completed using Stata Version 15.1. The study included 246 participants with an age range of 50 to 102 (80.4 ± 10.5). The sample was characterised by a high degree of cognitive and functional impairment, disability, and poor health and nutritional status (according to Mini Nutritional Assessment (MNA), 38.2% were at risk for malnutrition and 19.5% were malnourished). Using a stepwise linear regression model, age (B = −0.043, SE = 0.016, p = 0.010), depression (B = −0.133, SE = 0.052, p = 0.011), disability (B = 0.517, SE = 0.068, p < 0.001), and physical performance (B = −0.191, SE = 0.095, p = 0.045) remained significantly associated with the malnutrition risk in the final model (adjusted R-squared = 0.298). The logistic regression model incorporating age, depression, disability, and physical performance was found to have high discriminative accuracy (AUC = 0.747; 95%CI: 0.686 to 0.808) for predicting the risk of malnutrition. The results of the study confirm the need to assess nutritional status and to investigate the presence of risk factors associated with malnutrition in order to achieve effective prevention and plan a better intervention strategy.

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

“…Table 1 displays a descriptive review of the included articles (n = 8), summarizing the impact of nutritional status on cognitive capacity and functional ability [ 8 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. No studies were found to be associated with alterations in nutritional status and prevention of polypharmacy.…”

“…Table 1 shows the methods used as outcome measurements in the included papers. Five studies [ 8 , 30 , 33 , 35 , 36 ] used MNA (short or long form) to evaluate nutritional status, which used a standard <17 points (long form) or <7 points (short form) as a measure of nutritional status. One study used BMI (kg/m 2 ) to measure nutritional status [ 31 ], one used biochemical parameters, and another one used the geriatric nutritional risk index (GNRI) [ 34 ].…”

“…Cognitive function was measured in six studies [ 8 , 30 , 31 , 32 , 33 , 35 ]. The types of assessments differed slightly, with negligible variations in the cut-off value for the same type of assessment.…”

“…Among old, institutionalized subjects, alterations in nutritional status are frequently detected. The number of malnourished institutionalized elders is significant, ranging from 20% to 60%, depending on the criteria and methodology [ 8 , 9 , 10 , 11 ]. Moreover, this population is more vulnerable to depression, the use of anorexigenic drugs, and dependence on staff for feeding, which have been described as presenting a two- to three-fold increased risk for undernutrition [ 8 , 11 ].…”

Nutritional status of hospitalized elderly with coronary heart disease

“…Full agreement was observed in 75.7% of participants, with a kappa coefficient, a measure of agreement, of 0.44; this may be interpreted as "average" statistically significant agreement (p < 0.001). In their study of 246 older nursing home residents, Donini et al (2016) investigated agreement between nutritional status assessments made with the MNA, MNA-SF, MUST and NRS 2002. Agreement between the MNA and MUST or NRS 2002 was classified as "fair" (k = 0.270 and k = 0.291, respectively; p < 0.001).…”