Melanie Streicher1, Judith van Zwienen-Pot2, Laura Bardon3,4, Gabriele Nagel5, Ruth Teh6, Christine Meisinger7,8, Miriam Colombo7, Gabriel Torbahn1, Eva Kiesswetter1, Marion Flechtner-Mors9, Michael Denkinger10, Dietrich Rothenbacher5, Barbara Thorand7, Karl-Heinz Ladwig7, Clare A Corish3,11, Michelle Clarke3,4, Ngaire Kerse12, Marama Muru-Lanning13, Eileen R Gibney3,4, Eibhlís M O'Connor14, Marjolein Visser15, Dorothee Volkert1. 1. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Nuremberg, Germany. 2. Department of Internal Medicine, Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands. 3. Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland. 4. School of Agricultural and Food Science, University College Dublin, Dublin, Republic of Ireland. 5. Institute of Epidemiology and Medical Biometry, Ulm University, Germany. 6. Department of General Practice and Primary Health Care, School of Population Health, University of Auckland, Neuherberg, Germany. 7. Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany. 8. Department of Epidemiology, University Center for Health Sciences at the Klinikum Augsburg, Ludwig-Maximilians-Universität München, Augsburg, Germany. 9. Division of Sports and Rehabilitation Medicine, Medical Center, University of Ulm, Ulm, Germany. 10. Agaplesion Bethesda Hospital, Ulm, Geriatric Research Unit, Ulm University and Geriatric Center Ulm/Alb-Donau, Ulm, Germany. 11. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland. 12. School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. 13. James Henare Māori Research Centre, University of Auckland, Auckland, New Zealand. 14. Department of Biological Sciences, and Health Research Institute, University of Limerick, Limerick, Ireland. 15. Department of Health Sciences, Faculty of Science, Amsterdam Public Health Institute, Vrije Universiteit, Amsterdam, The Netherlands.
Abstract
OBJECTIVES: To identify determinants of incident malnutrition in community-dwelling older adults. DESIGN: Meta-analysis of 6 community-based longitudinal datasets with follow-up of 1 to 3 years. SETTING: Datasets from MaNuEL (MalNutrition in the Elderly) partners were included: 3 studies from Germany and 1 each from Ireland, the Netherlands, and New Zealand. PARTICIPANTS: community-dwelling adults aged 65 and older (N=4,844). MEASUREMENT: The same definition of incident malnutrition was used for all cohorts (body mass index < 20.0 kg/m2 at follow-up or weight loss ≥10 % between baseline and follow-up). Twenty-one potential baseline determinants from 7 domains (demographic, nutritional, lifestyle, social, psychological, physical functioning, medical) and 2 follow-up variables (hospitalization, falls) were harmonized for all studies. Binary logistic regression analyses were performed to assess the association between each variable, adjusted for specific confounders, and incident malnutrition. Combined odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects meta-analyses. RESULTS: Studies included between 209 and 1,841 participants without malnutrition at baseline; mean age ranged from 71.7 to 84.6. Incidence of malnutrition varied from 5.1% and 17.2%. Meta-analyses identified 6 variables as independent determinants of incident malnutrition; with increasing age, the risk of developing malnutrition increased continuously. Unmarried, separated, or divorced participants were more likely to develop malnutrition than married participants, whereas no association was found for widowed participants. Participants with difficulty walking (OR=1.41, 95% CI=1.06-1.89) or difficulty climbing stairs (OR=1.45, 95% CI=1.14-1.85) and those who were hospitalized before baseline (OR=1.49, 95% CI=1.25-1.76) and during follow-up (OR=2.02, 95% CI=1.41-2.88) had higher odds of incident malnutrition. CONCLUSION: In this harmonized meta-analysis based on prospective data of older, community-dwelling adults, age, marital status, limitations with walking and climbing stairs, and hospitalization were identified as determinants of incident malnutrition. J Am Geriatr Soc 66:2335-2343, 2018.
OBJECTIVES: To identify determinants of incident malnutrition in community-dwelling older adults. DESIGN: Meta-analysis of 6 community-based longitudinal datasets with follow-up of 1 to 3 years. SETTING: Datasets from MaNuEL (MalNutrition in the Elderly) partners were included: 3 studies from Germany and 1 each from Ireland, the Netherlands, and New Zealand. PARTICIPANTS: community-dwelling adults aged 65 and older (N=4,844). MEASUREMENT: The same definition of incident malnutrition was used for all cohorts (body mass index < 20.0 kg/m2 at follow-up or weight loss ≥10 % between baseline and follow-up). Twenty-one potential baseline determinants from 7 domains (demographic, nutritional, lifestyle, social, psychological, physical functioning, medical) and 2 follow-up variables (hospitalization, falls) were harmonized for all studies. Binary logistic regression analyses were performed to assess the association between each variable, adjusted for specific confounders, and incident malnutrition. Combined odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects meta-analyses. RESULTS: Studies included between 209 and 1,841 participants without malnutrition at baseline; mean age ranged from 71.7 to 84.6. Incidence of malnutrition varied from 5.1% and 17.2%. Meta-analyses identified 6 variables as independent determinants of incident malnutrition; with increasing age, the risk of developing malnutrition increased continuously. Unmarried, separated, or divorced participants were more likely to develop malnutrition than married participants, whereas no association was found for widowed participants. Participants with difficulty walking (OR=1.41, 95% CI=1.06-1.89) or difficulty climbing stairs (OR=1.45, 95% CI=1.14-1.85) and those who were hospitalized before baseline (OR=1.49, 95% CI=1.25-1.76) and during follow-up (OR=2.02, 95% CI=1.41-2.88) had higher odds of incident malnutrition. CONCLUSION: In this harmonized meta-analysis based on prospective data of older, community-dwelling adults, age, marital status, limitations with walking and climbing stairs, and hospitalization were identified as determinants of incident malnutrition. J Am Geriatr Soc 66:2335-2343, 2018.
Authors: D Volkert; M Visser; C A Corish; C Geisler; L de Groot; A J Cruz-Jentoft; C Lohrmann; E M O'Connor; K Schindler; M A E de van der Schueren Journal: Eur Geriatr Med Date: 2019-11-20 Impact factor: 1.710
Authors: Jos W Borkent; Elke Naumann; Emmelyne Vasse; Ellen van der Heijden; Marian A E de van der Schueren Journal: Int J Environ Res Public Health Date: 2019-05-04 Impact factor: 3.390
Authors: Eva Kiesswetter; Miriam G Colombo; Christa Meisinger; Annette Peters; Barbara Thorand; Rolf Holle; Karl-Heinz Ladwig; Holger Schulz; Eva Grill; Rebecca Diekmann; Eva Schrader; Peter Stehle; Cornel C Sieber; Dorothee Volkert Journal: Public Health Nutr Date: 2019-08-27 Impact factor: 4.022