Abstract
BackgroundMalnutrition in patients admitted to hospital may have detrimental effects on recovery and healing. Malnutrition is preceded by a state of malnutrition risk, yet malnutrition risk is often not detected during admission. The aim of the current study was to investigate the magnitude and potential predictors of malnutrition risk in older adults, at hospital admission.MethodsA cross-sectional was study conducted in 234 older adults (age ≥ 65 or ≥ 55 for Māori or Pacific ethnicity) at admission to hospital in Auckland, New Zealand. Assessment of malnutrition risk status was performed using the Mini Nutritional Assessment Short-Form (MNA®-SF), dysphagia risk by the Eating Assessment Tool (EAT-10), muscle strength by hand grip strength and cognitive status by the Montreal Cognitive Assessment (MoCA) tool.ResultsAmong 234 participants, mean age 83.6 ± 7.6 years, 46.6% were identified as at malnutrition risk and 26.9% malnourished. After adjusting for age, gender and ethnicity, the study identified [prevalence ratio (95% confidence interval)] high dysphagia risk [EAT-10 score: 0.98 (0.97–0.99)], low body mass index [kg/m2: 1.02 (1.02–1.03)], low muscle strength [hand grip strength, kg: 1.01 (1.00–1.02)] and decline in cognition [MoCA score: 1.01 (1.00–1.02)] as significant predictors of malnutrition risk in older adults at hospital admission.ConclusionAmong older adults recently admitted to the hospital, almost three-quarters were malnourished or at malnutrition risk. As the majority (88%) of participants were admitted from the community, this illustrates the need for routine nutrition screening both at hospital admission and in community-dwelling older adults. Factors such as dysphagia, unintentional weight loss, decline in muscle strength, and poor cognition may indicate increased risk of malnutrition.
Highlights
Malnutrition in patients admitted to hospital may have detrimental effects on recovery and healing
Eighty-eight percent of participants were admitted from the community and 41% had a body mass index (BMI) less than 23 kg/m2, which is below the proposed healthy cut-off point (BMI ≥23kg/m2) for older adults [45]
The insights from the aforementioned reports and findings from our study suggest the need for routine screening at hospital admission in New Zealand
Summary
Malnutrition in patients admitted to hospital may have detrimental effects on recovery and healing. The aim of the current study was to investigate the magnitude and potential predictors of malnutrition risk in older adults, at hospital admission. The current life expectancy at birth (81.7 years) for New Zealand is among the top life expectancies within the Organisation for Economic Co-operation and Development countries [1]. This raises the issue of whether efficient strategies have been put in place to ensure this growth in life expectancy will go along with good quality of life [2, 3]. The MNA®-SF is used globally and has a sensitivity of 89% and specificity of 82% for assessing malnutrition risk in older adults [22, 25]
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