Malnutrition Risk In Older Adults Research Articles

Meta-analysis and moderator analysis of the prevalence of malnutrition and malnutrition risk among older adults with dementia

BackgroundAging and dementia are common and closely related health problems in older adults, affecting their ability to maintain a healthy diet and ultimately resulting in malnutrition. ObjectiveIn this study, we estimated the global prevalence of malnutrition and malnutrition risk in older adults with dementia. DesignMeta-analysis. Data sourcesEmbase, Ovid MEDLINE, PubMed, CINAHL, Scopus, and Web of Science were comprehensively searched for articles published from database inception to October 2022. MethodsPooled prevalence analysis was conducted using a generalized linear mixed model and a random-effects model. I2 and Cochran's Q statistics were used for identifying heterogeneity. Publication bias was evaluated using Peters' regression test and a funnel plot. Moderator analyses were conducted to investigate variations in the prevalence estimates of the included studies. All statistical analyses were conducted using R software. ResultsA total of 16 studies involving a total of 6513 older adults with dementia were included in the analysis. The results indicated that 32.52 % (95 % confidence interval: 19.55–45.49) of all included older adults with dementia had malnutrition, whereas 46.80 % (95 % confidence interval: 38.90–54.70) had a risk of malnutrition. The prevalence of malnutrition was found to be high among older patients living in institutionalized settings (46.59 %) and those with Alzheimer's disease (12.26 %). The factors moderating the prevalence of malnutrition included adequate vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. The prevalence of malnutrition risk was high among women (29.84 %) and patients with Alzheimer's disease (26.29 %). The factors moderating the prevalence of malnutrition risk included total cholesterol level, vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. ConclusionsApproximately one-third of older adults with dementia are malnourished and nearly half of older adults are at a risk of malnutrition. Encouraging collaboration among health-care professionals and ensuring early assessment and effective management of malnutrition are crucial for maintaining a favorable nutritional status in older adults with dementia. RegistrationThis study was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022369329). Tweetable abstractGlobally, approximately 32.52 % of older adults with dementia are malnourished and approximately 46.80 % are at a risk of malnutrition.

Adequacy of Nutrient Intake and Malnutrition Risk in Older Adults: Findings from the Diet and Healthy Aging Cohort Study.

There is a lack of data on the adequacy of nutrient intake and prevalence of malnutrition risk in Asian populations. The aim was to report on the nutrient intake and prevalence of malnutrition risk in a community sample of older adults in Singapore. Analysis was performed on 738 (n = 206 male, n = 532 male, aged 67.6 ± 6.0 years) adults 60 years and above. Intakes of macro- and micronutrients were evaluated against the Recommended Dietary Allowances (RDAs). Malnutrition risk was assessed using the Nutrition Screening Initiative Determine Your Nutritional Health checklist. It was found that 90.5% older adults exceeded the sugar intake, 68.5% males and 57.1% females exceeded the intake limit for saturated fat, and 33% males had inadequate dietary fiber intake when compared to the RDAs. Inadequate dietary calcium intake was found in 49.5% males and 55.3% females. There were 22.3% of older adults at moderate to high malnutrition risk. Singaporean older adults need to reduce their dietary intakes of sugar and saturated fat and increase their intakes in dietary fiber and calcium. Current findings provide public health awareness on the importance of healthy eating and will facilitate decision making by health promotors to deliver targeted nutrition care programs.

Dysphagia as a predictor of malnutrition risk in older adults: a brief review of literature

Dysphagia is known as any alteration of the swallowing process that affects the ability to eat a The use of mild and aromatic nd/or drink and presents in 30−40% of hospitalized patients. In the elderly, it is highly relevant due to its association with the development of frailty, malnutrition, and the high risk of morbidity and mortality. A set of factors has been proposed as a cause of dysphagia, such as anatomical and physiological alterations, neurological pathologies, drugs, and sarcopenia. Thickening liquids and texture-modified foods may be beneficial for patients with dysphagia, but they can also promote malnutrition if not prescribed properly. That is why nutritional support is key to avoid the risk of aspiration and malnutrition, which in turn, contribute to the development of dysphagia.

Malnutrition Risk, Rurality, and Falls among Community-Dwelling Older Adults.

We aimed to evaluate if malnutrition and rurality are associated with fall risk and future falls in community-dwelling older adults. Prospective Cohort. Community, Vermont. Older adults receiving home support services who completed a health risk assessment (n=3,300; Mean age 79.6 years ±8.4, 75% female). Additional analysis was completed with a subset of 2,043 participants with two-years of consecutive health assessments. Fall Risk Questionnaire, DETERMINE Nutrition Risk Questionnaire, and fall history. Independently, high malnutrition risk and rurality were associated with fall risk (p<0.001) and high malnutrition risk was associated with rurality (p<0.001). After adjusting for age, sex, and physical function, individuals with high nutrition risk had a 66% increase in the odds of falling over the next year, but rurality was not significantly associated with a new fall. These findings suggest that falls are associated with malnutrition risk, but the relationship between falls and rurality is less evident. Further research is needed to identify services that may best alleviate malnutrition risk in older adults and aspects of nutrition that are most protective against fall risk.

The association between dietary patterns and nutritional status in community-dwelling older adults-the PEN-3S study.

Diet plays a key role in the ageing process. Despite this, little is known about the effect of dietary patterns on older adults' nutritional status. The main aim of this study was to analyse the association between a posteriori derived dietary patterns (DPs) and nutritional status among community dwellers aged ≥65. Cross-sectional study including a representative sample of the community-dwelling Portuguese population aged ≥65 (n = 849, mean age 74.1 years old). Data were collected through computer-assisted, face-to-face interviews. Dietary patterns were derived a posteriori based on two 24-h recalls by a latent class transition model. Nutritional status was assessed by the Mini Nutritional Assessment (MNA®) and measured body mass index (BMI). Associations were estimated by regression models. MNA score was reversed and log-transformed considering its skewed distribution. Two DPs were identified: 22.0% of the studied population followed a 'Protein-based foods' DP (highest consumption of legumes, meats and sweets), and 59.1% followed a 'Mediterranean' DP (highest consumption of vegetables, fruits, dairy, cereals/tubers, bread, fishery and olive oil). Moreover, 18.9% switched between those patterns ('In-between' DP). After adjustment, the 'Protein-based foods' DP was associated with better MNA score (EXP(β) = 0.716, 95% CI 0.533, 0.962), compared to the 'Mediterranean' DP, particularly for total energy intake up to 2200 kcal/day. No significant associations were found between DPs and BMI. A protein-based pattern is associated with lower malnutrition risk in older adults, when considering an adequate energy intake. This should be taken into account when designing and disseminating food-based guidelines for healthy ageing.

Malnutrition risks and their associated factors among home-living older Chinese adults in Hong Kong: hidden problems in an affluent Chinese community

BackgroundAlthough China is undergoing rapid economic development, it is facing an ageing population. No data exists on malnutrition risks of older adults in an affluent Chinese society. The aim of this study is to examine these risks and identify their associated factors among home-living older Chinese adults in Hong Kong.MethodsThis is a cross-sectional study, to which home-living subjects aged 60 or above were recruited, between May and September 2017, from a non-governmental community organisation located in three different districts of Hong Kong. Nutritional status was assessed by the Mini Nutritional Assessment (MNA), and its associated factors examined included socio-demographic characteristics, lifestyle, health status and diet. Multivariable logistic regression analysis was performed to identify factors associated with malnutrition risks (MNA < 24).ResultsSix hundred thirteen subjects (mean age: 78.5 ± 7.4; 54.0% females) completed the survey. Nearly 30% (n = 179) were at risk of malnutrition. By multivariable logistic regression, subjects (1) whose vision was only fair or unclear, (2) with poor usual appetite and (3) with main meal skipping behaviour had significantly higher malnutrition risk (all p < 0.05).ConclusionsIn this affluent Chinese society, the malnutrition risk in older adults is close to the global average, which is a matter for much concern. Interventions are therefore warranted that target vulnerable groups with poor vision, appetite, and meal skipping behaviour.Trial registrationNot applicable.

Dysphagia risk, low muscle strength and poor cognition predict malnutrition risk in older adults at hospital admission

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.

Self-Reported Health Status and Malnutrition Risk in Home-Dwelling Korean Older Adult Women.

The current cross-sectional study described the prevalence of malnutrition risk and identified its associated factors in home-dwelling Korean older adult women. Nutritional status was assessed by the Nutrition Screening Initiative. Multinomial logistic regression analysis determined predictors of nutritional risk. Of 168 participants (mean age = 76.34 years, SD = 6.51 years), approximately 69.6% were classified as being at moderate/high risk for malnutrition. Results showed that higher levels of physical (odds ratio [OR] = 0.34, 95% confidence interval [CI] [0.12, 0.92]) and emotional (OR = 0.31, 95% CI [0.13, 0.74]) function were associated with decreased risk of malnutrition. In addition, higher levels of bodily pain were associated with increased risk of malnutrition (OR = 2.75, 95% CI [1.35, 5.59]). The findings emphasize the importance of nutritional assessment with comprehensive geriatric assessment. Future longitudinal studies including various sociodemographic backgrounds should examine the effects of self-reported health status on malnutrition risk in older adults. [Res Gerontol Nurs. 2017; 10(2):77-85.].

Risk of Malnutrition in Older Adults Who Receive Care at an Urban Dental Clinic

After this presentation, the learner will describe how the Self-MNA can be used to assess malnutrition risk in older adults, and the feasibility of the Self-MNA in a clinic setting.

Associations Between Tooth Loss, With or Without Dental Prostheses, and Malnutrition Risk in Older Adults

A systematic review was conducted to investigate the associations between missing teeth, teeth replaced with dental prostheses, and malnutrition risk, as determined by the Mini Nutritional Assessment (MNA), among community-dwelling older adults. A comprehensive search strategy was designed to identify studies published between 2000 and 2014 that met inclusion criteria. Searches were conducted in Medline, CINAHL, and Cochrane Libraries. Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines were followed and risk-of-bias analyses were performed. Study data were abstracted and synthesized in narrative and summary tables. Of the 8 studies that met inclusion criteria, 5 found significant associations between MNA score and tooth loss. Those with fewer teeth/limited occlusion had lower MNA scores, hence were at greater risk for malnutrition than those with a greater number of teeth and/or more occluding teeth pairs. Provision of dentures to older adults was associated with significant increases in MNA scores. The studies reviewed support associations between tooth loss, replacement with prostheses, and malnutrition risk; individuals with more missing teeth and limited occlusion were at increased risk of malnutrition. Additional high-quality research seems warranted to substantiate a causal relationship between dental and nutritional status. Inadequate oral health and poor nutritional status are associated with increased mortality risk in older adults. Efforts to optimize oral health and nutritional status of older adults are needed.

Financial Strain Is Associated with Malnutrition Risk in Community-Dwelling Older Women.

This study examined the relationship between financial strain, or difficulty acquiring necessities, and malnutrition risk in a community dwelling sample of frail and nonfrail women aged 70-79 in the Women's Health and Aging Study (n = 679). Malnutrition risk was measured with a modified version of the Mini-Nutritional Assessment Short Form (MNA-SF) and defined as a score <11, financial strain was measured by (1) sufficiency of money on a monthly basis and (2) adequacy of income for food, and income was measured by ordinal categories. Mean (SD) modified MNA-SF score was 12.2 (1.80), and 14.7% of women had malnutrition risk. Women who usually did not have enough money to make ends meet had more than four-fold increased odds of malnutrition risk (OR = 4.54; 95% CI: 2.26, 9.14) compared to their counterparts who had some money left over each month. This was only slightly attenuated after control for income and education, (OR = 4.08; 95% CI: 1.95, 8.52) remaining robust. These results show an association between financial strain and malnutrition risk, independent of income, in older women. Self-reported financial strain may be preferable to income as a screener for malnutrition risk in older adults in clinical and research settings.

Nutritional screening in community-dwelling older adults: a systematic literature review.

Nutrition screening is a process used to quickly identify those who may be at risk of malnutrition so that a full nutrition assessment and appropriate nutrition intervention can be provided. While many nutrition screening tools have been developed, few have been evaluated for use in older adults in the community setting. The aim of this paper is to determine the most appropriate nutrition screening tool/s, in terms of validity and reliability, for identifying malnutrition risk in older adults living in the community. Electronic databases MEDLINE, PUBMED, CINAHL and the Cochrane Library were searched for nutrition screening tools to identify malnutrition or under-nutrition for adults greater than 65 years living in the community. Ten screening tools were found for use in community-dwelling older adults and subjected to validity and/or reliability testing: Mini Nutritional Assessment-Short Form (MNA-SF), Malnutrition Universal Screening Tool (MUST), Nutrition Screening Initiative (NSI), which includes the DETERMINE Checklist and Level I and II Screen, Australian Nutritional Screening Initiative (ANSI), Seniors in the Community: Risk Evaluation for Eating and Nutrition (SCREEN I and SCREEN II), Short Nutritional Assessment Questionnaire (SNAQ), Simplified Nutritional Appetite Questionnaire (SNAQ), and two unnamed tools. MNA-SF appears to be the most appropriate nutrition screening tool for use in community-dwelling older adults although MUST and SCREEN II also have evidence to support their use. Further research into the acceptability of screening tools focusing on the outcomes of nutrition screening and appropriate nutrition intervention are required.