Nutritional status in older adults admitted to an acute geriatric unit

Abstract

Objective: to describe the nutritional status of older adults hospitalized in an acute geriatric unit (AGU) and its association with mortality and days of hospitalization. Material and methods: a retrospective study in 1,084 adults older than 65 years, hospitalized in an AGU. The Mini Nutritional Assessment®-Short Form (MNA®-SF) and subjective global assessment (SGA) were used. The association between nutritional status, mortality, and long hospital stay (> 7 days) was analyzed using regression models and Cox hazard models. Results: mean age was 86.5 years: 58.7% were women. Mean MNA®-SF score was 8.9 (20.0%, well nourished; 48.2%, at nutritional risk, and 31.7% with malnutrition). Using the SGA, 22.1% were well nourished, 54.7% had moderate malnutrition, and 23.2% had severe malnutrition. Agreement between SGA and MNA®-SF was good (kappa, 0.654; p < 0.001), and correctly classified 78.5% of participants. Malnutrition was associated with poorer cognitive status, greater disability, worse ambulation, and lower levels of total protein, albumin, cholesterol, and transferrin. Patients with malnutrition in the MNA®-SF assessment had a higher adjusted mortality risk than those who were well nourished (HR, 1.80; 95% CI, 1.01-3.20), same as those with SGA C versus A (HR, 1.66; 95% CI, 0.96-2.86). Patients with SGA B and C presented a higher adjusted risk of long hospitalization as compared to well nourished subjects (OR, 1.42; 95% CI, 1.04-1.96 and OR, 1.73; 95% CI, 1.18-2.54, respectively. Patients with malnutrition per the MNA-SF® presented a higher adjusted risk of long hospitalization as compared to well nourished subjects (OR, 1.59; 95% CI, 1.09-2.33). Conclusions: nutritional risk and malnutrition are very common in older adults in AGUs, and are associated with higher mortality and longer hospital stay.