Factors associated with hypoalbuminemia and malnutrition risk in older inpatients: A detailed analysis of demographic and clinical characteristics

Abstract

Malnutrition and hypoalbuminemia are critical health challenges among hospitalized older adults, contributing to increased morbidity, prolonged hospital stays, and higher mortality risks. In this cross-sectional study, we aimed to determine the prevalence and factors associated with hypoalbuminemia and malnutrition risk in older inpatients at Military Hospital 354, Hanoi, Vietnam, from January–June 2025. A total of 264 patients aged 65 and older were recruited from geriatric, internal medicine, and rehabilitation wards. Hypoalbuminemia was defined as serum albumin levels <35 g/L, and malnutrition risk was assessed using the Mini Nutritional Assessment-Short Form (MNA-SF; score < 12). Data on demographic (age, sex, education, cohabitation) and clinical/biochemical factors (primary diagnosis, hemoglobin, lymphocyte, zinc, ferritin) were collected within 48 hours of admission. The prevalence of hypoalbuminemia was 33.0%, and 73.5% of patients were malnourished or at risk of malnutrition. Multivariable logistic regression identified older age (AOR 1.09, 95% CI 1.01–1.18) and male sex (AOR 2.17, 95% CI 1.14–4.17) as significant factors associated with malnutrition risk, while female sex was protective for both hypoalbuminemia (AOR 0.48, 95% CI 0.27–0.86) and malnutrition risk (AOR 0.46, 95% CI 0.24–0.88). Higher lymphocyte counts were associated with hypoalbuminemia (AOR 1.24, 95% CI 1.00–1.53). Spearman’s correlations revealed strong positive associations between zinc and ferritin (r = 0.74, p < 0.01) and negative correlations of age with zinc (r = −0.43) and ferritin (r = −0.33). These findings highlight the high burden of nutritional deficits in Vietnam’s older inpatients and underscore the need for routine MNA-SF and albumin screening to guide early interventions, particularly targeting micronutrient deficiencies in resource-constrained settings.