Abstract
Background: While malnutrition is an important cause of morbidity and mortality in older people, it is commonly under-recognised. We know little on the views of community-dwelling older people and their carers regarding the management of malnutrition. The aim of the study was: (a) to explore views and dietary practices of older people at risk of malnutrition and their carers; (b) to identify gaps in knowledge, barriers and facilitators to healthy eating in later life; (c) to explore potential interventions for malnutrition in primary care. Methods: A qualitative study was performed using semi-structured interviews with participants recruited from four general practices and a carers’ focus group in London. Community-dwelling people aged ≥75, identified as malnourished or at risk of malnutrition (n = 24), and informal carers of older people (n = 9) were interviewed. Data were analysed using thematic analysis. Results: Older people at risk of malnutrition rarely recognise appetite or weight loss as a problem. Commonly held perceptions include that being thin is healthy and ‘snacking’ is unhealthy. Changes in household composition, physical or mental health conditions and cognitive impairment can lead to inadequate food intake. Most carers demonstrate an awareness of malnutrition, but also a lack of knowledge of what constitutes a nutritious diet. Although older people rarely seek any help, most would value advice from their GP/practice nurse, a dietitian or another trained professional. Conclusion: Older people at risk of malnutrition and their carers lack knowledge on nutritional requirements in later life but are receptive to intervention. Training for health professionals in delivering tailored dietary advice should be considered.
Highlights
Malnutrition can be a significant cause of morbidity and mortality in later life [1,2], and estimates suggest it affects 1.3 million people over 65 in the UK [3]
The aim of this study is: (a) to explore the views and dietary practices of older people at risk of malnutrition and their carers, (b) to identify gaps in knowledge, facilitators and barriers to healthy eating in later life, and (c) to explore potential interventions to support nutrition in the older population that could be provided in primary care
Participants were: (a) community-dwelling people aged ≥75 years old, malnourished or at risk of malnutrition (BMI < 20 or estimated to be low by a clinician using their knowledge of the patient); housebound people with a low body mass index (BMI); documented weight loss or reduced appetite; identified through electronic primary care medical records searches and further screened by a General Practitioner (GP); (b) informal carers of older people providing assistance with shopping and/or meal preparation at least weekly, identified via the older person or via a carers’ association
Summary
Christina Avgerinou 1, *, Cini Bhanu 1 , Kate Walters 1 , Helen Croker 2 , Ann Liljas 1 , Jennifer Rea 1 , Yehudit Bauernfreund 1 , Maggie Kirby-Barr 3 , Jane Hopkins 3 , Amber Appleton 1 and.
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