Malnutrition in hospitalised older adults: A multi-centre observational study of prevalence, associations and outcomes

Abstract

Malnutrition is common in older adults, and is associated with high healthcare costs and adverse outcomes, particularly in hospital settings (1,2) . The prevalence and correlates of malnutrition in hospitalised older adults are currently not clear; much of the existing research in this area is limited methodologically; studies are typically based on small samples and/or narrow populations (3,4) , exclude people with dementia (3,4) , are uni-centre (5) , and/or use tools not designed for use with older adults (5) . The present study addresses this gap, investigating the prevalence, correlates and outcomes of malnutrition in older adults on admission to hospital. In total, 606 (70+ years) older adults were included in a prospective cohort study across six hospitals in the Republic of Ireland. All elective and acute admissions to any speciality were eligible. Day-case admissions and those moribund on admission were excluded. All participants were clinically assessed for dementia on admission (see Timmons et al. (6)). Socio-demographic and clinical data, including nutritional status (Mini-Nutritional Assessment – short form (7) , was collected within 36 hours of admission. Outcome data was collected prospectively on length of stay, in-hospital mortality and institutionalisation. The mean age was 79·7; 51 % were female; 29 % were elective admissions; 67 % were admitted to a medical specialty. Nutrition scores were available for 602/606; 37 % had a 'normal' status, 45 % were 'at-risk', and 18 % were 'malnourished'. Malnutrition was more common in females, acute admissions, older patients and those who were widowed/ separated. Dementia, functional dependency, comorbidity and frailty independently predicted a) malnutrition and b) being at-risk of malnutrition (p < ·001). Malnutrition was also associated with an increased length of stay (p < ·001), institutionalisation (p < 0·001) and in-hospital mortality (p