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. 2025 Oct 10;25(1):767.
doi: 10.1186/s12877-025-06463-x.

Risk of malnutrition, food insecurity, dietary quality, and associated factors among Malawian older adults at hospital admission: a cross-sectional study

Getrude Mphwanthe  1 , Clare Reynolds  2 , Clare Corish  2 , Lustia Mndoliro  3 , Triza Columbus  3 , Jonathan Misolo  3 , Felistace Mtande  3 , Sarah Browne  2
Affiliations

Risk of malnutrition, food insecurity, dietary quality, and associated factors among Malawian older adults at hospital admission: a cross-sectional study

Getrude Mphwanthe et al. BMC Geriatr. .

Abstract

Background: Malnutrition adversely affects health outcomes and healthcare costs; however, limited data are available on the prevalence and burden of malnutrition in older adults at hospital admission in developing countries. Therefore, this study aimed to undertake malnutrition screening among older adults at hospital admission and examine the relationship between nutritional status and a range of health and socio-ecological factors.

Methods: This cross-sectional study was conducted in a large public referral hospital in Malawi, targeting older adults (aged ≥ 60 years). Participants were screened for risk of malnutrition using the Mini Nutritional Assessment-Short Form (MNA-SF) within 24-48 h of hospital admission. Those at risk of malnutrition/malnourished using the screening tool (MNA-SF) were subsequently assessed to determine a malnutrition diagnosis using the Global Leadership Initiative on Malnutrition (GLIM). Physical function was assessed using the Katz Index of Independence in Activities of Daily Living (Katz Index ADL) and handgrip strength, appetite using the Simplified Nutritional Appetite Questionnaire (SNAQ), food insecurity using a 12-month food insecurity experience scale, and dietary quality with a 30-day food frequency questionnaire. Logistic regression examined the factors associated with the risk of malnutrition/ malnutrition.

Results: The mean age of 315 older adults was 66.83 ± 6.78 years (range: 60-93 years), and 58.4% (n = 184) were male. Using the MNA-SF, the prevalence of malnutrition risk was 39.7%, and 40.3% were malnourished. Of those who were at risk of malnutrition/malnourished using the MNA-SF, 75% were diagnosed with malnutrition utilizing the GLIM criteria. Risk of malnutrition/malnutrition, screened using MNA-SF, was associated with poor appetite (AOR 2.581; 95% CI 1.310-5.086; p = 0.006), severe functional impairment (AOR 5.182; 95% CI: 1.469-18.279; p = 0.011), polypharmacy (AOR 2.673; 95% CI:1.112-6.426; p = 0.028), and severe food insecurity (AOR 2.293; 95% CI 1.015-5.176; p = 0.046).

Conclusion: During the study period in 2023, the majority of older adults admitted to a large public hospital in Malawi were at risk of malnutrition/malnourished, with multiple associated factors. Routine malnutrition screening using validated tools on admission, subsequent diagnosis of malnutrition using the GLIM criteria, and the availability of adequate nutrition support, including inpatient and discharge care pathways, are needed to prevent further deterioration of nutritional status in this vulnerable population.

Keywords: Dietary quality; Food insecurity; MNA-SF; Malnutrition; Older adults.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the National Committee on Research in the Social Sciences and Humanities, National Commission for Science and Technology in Malawi, protocol approval No: P.05/23/756. Kamuzu Central Hospital granted permission to conduct the study, and participants provided informed consent. Consent for publication: Not Applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Participant recruitment procedure
Fig. 2
Fig. 2
Percentage of participants responding “yes” to the eight FIES questions by nutritional status using MNA-SF
Fig. 3
Fig. 3
Frequency of consumption of different food groups in participants at risk of malnutrition/malnourished using MNA-SF
See this image and copyright information in PMC

References

    1. Visser J, Cederholm T, Philips L, Blaauw R. Prevalence and related assessment practices of adult hospital malnutrition: A scoping review. Clin Nutr ESPEN. 2024;63(5):121–32. - PubMed
    1. Kalu ME, Ojembe BU, Akinrolie O, Okoh AC, Adandom II, Nwankwo HC, et al. Setting priorities for ageing research in africa: A systematic mapping review of 512 studies from sub-Saharan Africa. J Global Health. 2021;11:15002.
    1. Velkoff VA, Kowal PR. Aging in sub-Saharan Africa: The changing demography of the region. In: National Research Council (US) Committee on Population; Cohen B, Menken J, editors. Aging in sub-Saharan Africa: Recommendations for furthering research. Washington (DC): National Academies Press (US); 2006 . 2. https://www.ncbi.nlm.nih.gov/books/NBK20301/.
    1. Norman K, Pichard C, Lochs H, Pirlich M. Prognostic impact of disease-related malnutrition. Clin Nutr. 2008;27(1):5–15. - PubMed
    1. Dent E, Wright OR, Woo J, Hoogendijk EO. Malnutrition in older adults. Lancet. 2023;401(10380):951–66. - PubMed

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