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Malnutrition and related risk factors in older adults from different health-care settings: an enable study

Kiesswetter, Eva, Colombo, Miriam G, Meisinger, Christa, Peters, Annette, Thorand, Barbara, Holle, Rolf, Ladwig, Karl-Heinz, Schulz, Holger, Grill, Eva, Diekmann, Rebecca, Schrader, Eva, Stehle, Peter, Sieber, Cornel C, Volkert, Dorothee
Public health nutrition 2020 v.23 no.3 pp. 446-456
appetite, at-risk population, body mass index, cross-sectional studies, demographic statistics, elderly, gastrointestinal diseases, health services, hospitals, malnutrition, nausea, nursing homes, nutritional behavior, patients, regression analysis, respiratory tract diseases, risk factors, weight loss
The origin of malnutrition in older age is multifactorial and risk factors may vary according to health and living situation. The present study aimed to identify setting-specific risk profiles of malnutrition in older adults and to investigate the association of the number of individual risk factors with malnutrition. Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m² and/or weight loss of >3 kg in the previous 3–6 months. Associations between factors of six domains (demographics, health, mental function, physical function, dietary intake-related problems, dietary behaviour), the number of individual risk factors and malnutrition were analysed using logistic regression. Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH). CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all ≥65 years. Malnutrition prevalence was lower in CD (11 %) than in the other settings (16–19 %). In the CD sample, poor appetite, difficulties with eating, respiratory and gastrointestinal diseases were associated with malnutrition; in GDH patients, poor appetite and respiratory diseases; in HC receivers, younger age, poor appetite and nausea; and in NH residents, older age and mobility limitations. In all settings the likelihood of malnutrition increased with the number of potential individual risk factors. The study indicates a varying relevance of certain risk factors of malnutrition in different settings. However, the relationship of the number of individual risk factors with malnutrition in all settings implies comprehensive approaches to identify persons at risk of malnutrition early.