Nutritional status and functionality in geriatric rehabilitation patients: a systematic review and meta-analysis

Key summary pointsAim This systematic review and meta-analysis aims to characterize the nutritional status of geriatric rehabilitation patients and its association with functional parameters. Findings Malnutrition is prevalent in a relevant percentage of geriatric rehabilitation patients, whereas body mass index (BMI) is in the normal to overweight range. Furthermore, data suggest that protein and energy intake is reduced and vitamin D deficiency is prevalent in this population. Decreased physical function is associated with malnutrition according to Mini-Nutritional Assessment (MNA) and MNA short form, whereas BMI did not show any clear association. Message Nutritional status is reduced in a relevant percentage of geriatric rehabilitation patients and associated with decreased physical function which emphasizes the need for screening and targeted interventions. Purpose Since there is only limited evidence available for geriatric rehabilitation patients, this systematic review and meta-analysis aims to characterize the nutritional status in this population and its relationship with functionality. Methods Eight databases were searched for full-text articles reporting baseline nutritional intake and status of adults >= 60 years in rehabilitation settings. Pooled estimates were calculated for prevalence of malnutrition and risk of malnutrition based on the Mini Nutritional Assessment (MNA) and for mean body mass index (BMI). Associations between nutritional status (MNA, MNA short form and BMI) and functional status (Barthel Index and Functional Independence Measure) and prevalence of sarcopenia were reviewed. Results 62 out of 1717 references were eligible for inclusion. Pooled prevalence [95% confidence interval (CI)] of malnutrition and risk of malnutrition were 13 (5-20) % and 47 (40-54) %. Pooled estimate (95% CI) for BMI was 23.8 (23.2-24.5) kg/m(2). Existing data suggest a risk for low protein and energy intake and vitamin D deficiency. Functional status differed widely. Seven out of ten studies reported significant associations between reduced nutritional status and reduced functionality, whilst two out of seven studies reported significant associations between higher BMI and functionality. Prevalence of sarcopenia was high with 40-76% in this population. Conclusions Although geriatric rehabilitation populations and settings were heterogeneous, a relevant percentage of geriatric rehabilitation patients were affected by a reduced nutritional status. Nutritional status was associated with decreased functionality. This emphasizes the need for screening for malnutrition and targeted nutritional intervention.