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. 2020 Feb;23(3):446-456.
doi: 10.1017/S1368980019002271. Epub 2019 Aug 27.

Malnutrition and related risk factors in older adults from different health-care settings: an enable study

Eva Kiesswetter  1 , Miriam G Colombo  2   3 , Christa Meisinger  2   4 , Annette Peters  2 , Barbara Thorand  2 , Rolf Holle  5 , Karl-Heinz Ladwig  2   6 , Holger Schulz  2 , Eva Grill  7 , Rebecca Diekmann  8 , Eva Schrader  1 , Peter Stehle  9 , Cornel C Sieber  1 , Dorothee Volkert  1
Affiliations

Malnutrition and related risk factors in older adults from different health-care settings: an enable study

Eva Kiesswetter et al. Public Health Nutr. 2020 Feb.

Abstract

Objective: The origin of malnutrition in older age is multifactorial and risk factors may vary according to health and living situation. The present study aimed to identify setting-specific risk profiles of malnutrition in older adults and to investigate the association of the number of individual risk factors with malnutrition.

Design: Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m2 and/or weight loss of >3 kg in the previous 3-6 months. Associations between factors of six domains (demographics, health, mental function, physical function, dietary intake-related problems, dietary behaviour), the number of individual risk factors and malnutrition were analysed using logistic regression.

Setting: Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH).

Participants: CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all ≥65 years.

Results: Malnutrition prevalence was lower in CD (11 %) than in the other settings (16-19 %). In the CD sample, poor appetite, difficulties with eating, respiratory and gastrointestinal diseases were associated with malnutrition; in GDH patients, poor appetite and respiratory diseases; in HC receivers, younger age, poor appetite and nausea; and in NH residents, older age and mobility limitations. In all settings the likelihood of malnutrition increased with the number of potential individual risk factors.

Conclusions: The study indicates a varying relevance of certain risk factors of malnutrition in different settings. However, the relationship of the number of individual risk factors with malnutrition in all settings implies comprehensive approaches to identify persons at risk of malnutrition early.

Keywords: Malnutrition; Older people; Risk factor; Setting.

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Figures

Fig. 1
Fig. 1
Prevalence of malnutrition (formula image, weight loss >3 kg in the previous 3–6 months; formula image, BMI < 20 kg/m2 plus weight loss >3 kg in the previous 3–6 months; formula image, BMI < 20 kg/m2) in the samples of community-dwelling older adults (n 1073), patients of a geriatric day hospital (n 180), receivers of home care (n 335) and nursing home residents (n 197); secondary data analysis of studies conducted among adults aged ≥65 years, Germany, in 2009, 2012, 2010 and 2007, respectively. *P < 0·05 (χ 2 test)
Fig. 2
Fig. 2
Association between the number of potential risk factors (n 20) and malnutrition in the samples of community-dwelling older adults (n 1073), patients of a geriatric day hospital (n 180), receivers of home care (n 335) and nursing home residents (n 197); secondary data analysis of studies conducted among adults aged ≥65 years, Germany, in 2009, 2012, 2010 and 2007, respectively. OR with their 95 % CI represented by vertical bars, adjusted for age and gender
See this image and copyright information in PMC

References

    1. Marshall S, Bauer J & Isenring E (2014) The consequences of malnutrition following discharge from rehabilitation to the community: a systematic review of current evidence in older adults. J Hum Nutr Diet 27, 133–141. - PubMed
    1. Kiesswetter E, Pohlhausen S, Uhlig K et al. (2014) Prognostic differences of the Mini Nutritional Assessment short form and long form in relation to 1-year functional decline and mortality in community-dwelling older adults receiving home care. J Am Geriatr Soc 62, 512–517. - PubMed
    1. Yang Y, Brown CJ, Burgio KL et al. (2011) Undernutrition at baseline and health services utilization and mortality over a 1-year period in older adults receiving Medicare home health services. J Am Med Dir Assoc 12, 287–294. - PMC - PubMed
    1. Sullivan DH, Bopp MM & Roberson PK (2002) Protein–energy undernutrition and life-threatening complications among the hospitalized elderly. J Gen Intern Med 17, 923–932. - PMC - PubMed
    1. Cereda E, Pedrolli C, Klersy C et al. (2016) Nutritional status in older persons according to healthcare setting: a systematic review and meta-analysis of prevalence data using MNA(R). Clin Nutr 35, 1282–1290. - PubMed

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