Abstract
BackgroundMalnutrition is common among older adults and is associated with adverse outcomes but remains undiagnosed on healthcare admissions. Older adults use emergency departments (EDs) more than any other age group. This study aimed to determine the prevalence and factors associated with malnutrition on admission and with adverse outcomes post-admission among older adults attending an Irish ED.MethodsSecondary analysis of data collected from a randomised controlled trial exploring the impact of a dedicated team of health and social care professionals on the care of older adults in the ED. Nutritional status was determined using the Mini Nutritional Assessment- short form. Patient parameters and outcomes included health related quality of life, functional ability, risk of adverse health outcomes, frailty, hospital admissions, falls history and clinical outcomes at index visit, 30-day and 6-month follow up. Aggregate anonymised participant data linked from index visit to 30-days and 6-month follow-up were used for statistical analysis.ResultsAmong 353 older adults (mean age 79.6 years (SD = 7.0); 59.2% (n = 209) female) the prevalence of malnutrition was 7.6% (n = 27) and ‘risk of malnutrition’ was 28% (n = 99). At baseline, those who were malnourished had poorer quality of life scores, functional ability, were more frail, more likely to have been hospitalised or had a fall recently, had longer waiting times and were more likely to be discharged home from the ED than those who had normal nutrition status. At 30-days, those who were malnourished were more likely to have reported another hospital admission, a nursing home admission, reduced quality of life and functional decline than older adults who had normal nutrition status at the baseline ED visit. Differences between the MNA SF and 6-month outcomes were similar but not statistically significant.ConclusionOver one-third of older adults admitted to an Irish ED are either malnourished or at risk of malnourishment. Malnutrition was associated with a longer stay in the ED, functional decline, poorer quality of life, increased risk of hospital admissions and a greater likelihood of admission to a nursing home at 30 days.Trial registrationProtocol registered in ClinicalTrials.gov, ID: NCT03739515, first posted November 13, 2018.
Highlights
Malnutrition is common among older adults and is associated with adverse outcomes but remains undiagnosed on healthcare admissions
When asked about the 3 months before Emergency Department (ED) attendance, weight loss was reported by 15.5% (n = 55) older adults with 5.9% (n = 21) stating a loss of body weight greater than 3 kg in the previous 3 months
A moderate to severe decline in food intake was reported by 20.4% (n = 72) older adults
Summary
Malnutrition is common among older adults and is associated with adverse outcomes but remains undiagnosed on healthcare admissions. In Ireland, census figures from 2011 to 2016 reported that the proportion of adults aged 65 years or older increased by 19.1% [2]. Further projections from the 2016 census predict that the number of adults aged over 65 years will increase significantly from a level of 629,800 to a potential 1.6 million by 2051, with the most dramatic increase occurring among those aged over 80 years [3]. For older adults with frailty, the proportion with at least one overnight hospital admission increased (from 23 to 31%) while the average number of nights spent in hospital more than doubled (from 2.7 nights to 6.5 nights) [6]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
