4.3 Article

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

Journal

PUBLIC HEALTH NUTRITION
Volume 23, Issue 3, Pages 446-456

Publisher

CAMBRIDGE UNIV PRESS
DOI: 10.1017/S1368980019002271

Keywords

Malnutrition; Risk factor; Older people; Setting

Funding

  1. German Ministry for Education and Research [01EA1409C]
  2. Helmholtz Zentrum Munchen -German Research Center for Environmental Health - German Federal Ministry of Education and Research
  3. State of Bavaria
  4. German Federal Ministry of Education and Research as part of the 'Health in old age' programme [FKZ 01ET0713, 01ET1003A]
  5. German Federal Ministry of Food, Agriculture and Consumer Protection [114-02.05-20.0099/09-D]

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Objective: 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. Design: Data of four cross-sectional studies were harmonized and uniformly analysed. Malnutrition was defined as BMI < 20 kg/m(2) 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. Setting: Community (CD), geriatric day hospital (GDH), home care (HC), nursing home (NH). Participants: CD older adults (n 1073), GDH patients (n 180), HC receivers (n 335) and NH residents (n 197), all >= 65 years. Results: 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. Conclusions: 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.

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