Maike Wolters1, Dorothee Volkert2, Melanie Streicher2, Eva Kiesswetter2, Gabriel Torbahn2, Eibhlís M O'Connor3, Mary O'Keeffe3, Mary Kelly3, Eileen O'Herlihy4, Paul W O'Toole4, Suzanne Timmons5, Emma O'Shea5, Patricia Kearney6, Judith van Zwienen-Pot7, Marjolein Visser8, Isabelle Maitre9, Virginie Van Wymelbeke10, Claire Sulmont-Rossé11, Gabriele Nagel12, Marion Flechtner-Mors13, Sabine Goisser14, Ruth Teh15, Antje Hebestreit16. 1. Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany. Electronic address: wolters@leibniz-bips.de. 2. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, 90408 Nuremberg, Germany. 3. Dept Biological Sciences, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland. 4. School of Microbiology and APC Microbiome Ireland, University College Cork, Cork, T12 Y337, Ireland. 5. Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, Cork, Ireland. 6. Dept Epidemiology and Public Health, University College Cork, Cork, Ireland. 7. Department of Internal Medicine, Nutrition and Dietetics, VU University Medical Center, de Boelelaan 1117, 1081 HV Amsterdam, the Netherlands. 8. Department of Health Sciences, Faculty Sciences, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. 9. USC 1422 GRAPPE, Ecole Supérieure d'Agricultures (ESA), SFR 4207 QUASAV, INRA, 55 Rue Rabelais, F-49007 Angers, France. 10. Centre Hospitalier Universitaire Dijon Bourgogne, Centre Champmaillot, Unité de Recherche Pôle Personnes Âgées, 2 Rue Jules Violle, F-21000 Dijon, France; Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, 9(E) Boulevard Jeanne d'Arc, F-21000 Dijon, France. 11. Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRA, Université Bourgogne Franche-Comté, 9(E) Boulevard Jeanne d'Arc, F-21000 Dijon, France. 12. Institute of Epidemiology and Medical Biometry, Ulm University, Helmholtzstr. 22, 89081 Ulm, Germany. 13. Medical Center, Division of Sports and Rehabilitation Medicine, University of Ulm, Leimgrubenweg 14, 89075 Ulm, Germany. 14. Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstr. 60, 90408 Nuremberg, Germany; Network Aging Research, Heidelberg University, Bergheimer Straße 20, 69115 Heidelberg, Germany. 15. General Practice and Primary Health Care, School of Population Health, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand. 16. Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstr. 30, 28359 Bremen, Germany.
Abstract
BACKGROUND & AIMS: Malnutrition is widespread among older people and related to poor outcome. Reported prevalences vary widely, also because of different diagnostic criteria used. This study aimed to describe prevalences in several populations of older persons in different settings using harmonized definitions. METHODS: Available studies within the Joint Programming Initiative (JPI) Knowledge Hub 'Malnutrition in the Elderly' (MaNuEL) were used to calculate and compare prevalences of malnutrition indicators: low BMI (<20 kg/m2; age-specific BMI <20 if age 65-<70 and <22 kg/m2 if age ≥70 years), previous weight loss (WL), moderate and severe decrease in food intake, and combined BMI <20 kg/m2 and/or WL in participants aged ≥65 years. RESULTS: Fifteen samples with in total 5956 participants (59.3% women) were included: 7 consisting of community-dwelling persons, 2 studies in geriatric day hospitals, 3 studies in hospitalized patients and 3 in nursing homes. Mean age of participants ranged between 67 and 87 years. Up to 4.2% of community-dwelling persons had a BMI <20 kg/m2, 1.6 and 9% of geriatric day hospital patients, 4.5-9.4% of hospital patients and 3.8-18.2% of nursing home residents. Using age-specific cut-offs doubled these prevalences. WL was reported in 2.3-10.5% of community-dwelling persons, 6% and 12.6% of geriatric day hospital patients, 5-14% of hospitalized patients and 4.5-7.7% of nursing home residents. Severe decrease in food intake was recorded in up to 9.6% of community-dwelling persons, 1.5% and 12% of geriatric day hospital patients, 3.4-34.2% of hospitalized patients and 1.5-8.2% of nursing home residents. The criteria age-specific BMI and WL showed opposing prevalences across all settings. Compared to women, low BMI and moderate decrease in food intake showed low prevalences in men but similar prevalences were observed for weight loss and severe decrease in food intake. In half of the study samples, participants in a younger age group had a higher prevalence of WL compared to those of an older age group. Prevalence of BMI <20 kg/m2 and WL at the same time did not exceed 2.6% in all samples. The highest prevalences were observed based on combined definitions when only one of the three criteria had to be present. CONCLUSIONS: Prevalences for different criteria vary between and within the settings which might be explained by varying functional status. The criteria used strongly affect prevalence and it may be preferable to look at each criterion separately as each may indicate a nutritional problem.
BACKGROUND & AIMS: Malnutrition is widespread among older people and related to poor outcome. Reported prevalences vary widely, also because of different diagnostic criteria used. This study aimed to describe prevalences in several populations of older persons in different settings using harmonized definitions. METHODS: Available studies within the Joint Programming Initiative (JPI) Knowledge Hub 'Malnutrition in the Elderly' (MaNuEL) were used to calculate and compare prevalences of malnutrition indicators: low BMI (<20 kg/m2; age-specific BMI <20 if age 65-<70 and <22 kg/m2 if age ≥70 years), previous weight loss (WL), moderate and severe decrease in food intake, and combined BMI <20 kg/m2 and/or WL in participants aged ≥65 years. RESULTS: Fifteen samples with in total 5956 participants (59.3% women) were included: 7 consisting of community-dwelling persons, 2 studies in geriatric day hospitals, 3 studies in hospitalized patients and 3 in nursing homes. Mean age of participants ranged between 67 and 87 years. Up to 4.2% of community-dwelling persons had a BMI <20 kg/m2, 1.6 and 9% of geriatric day hospital patients, 4.5-9.4% of hospital patients and 3.8-18.2% of nursing home residents. Using age-specific cut-offs doubled these prevalences. WL was reported in 2.3-10.5% of community-dwelling persons, 6% and 12.6% of geriatric day hospital patients, 5-14% of hospitalized patients and 4.5-7.7% of nursing home residents. Severe decrease in food intake was recorded in up to 9.6% of community-dwelling persons, 1.5% and 12% of geriatric day hospital patients, 3.4-34.2% of hospitalized patients and 1.5-8.2% of nursing home residents. The criteria age-specific BMI and WL showed opposing prevalences across all settings. Compared to women, low BMI and moderate decrease in food intake showed low prevalences in men but similar prevalences were observed for weight loss and severe decrease in food intake. In half of the study samples, participants in a younger age group had a higher prevalence of WL compared to those of an older age group. Prevalence of BMI <20 kg/m2 and WL at the same time did not exceed 2.6% in all samples. The highest prevalences were observed based on combined definitions when only one of the three criteria had to be present. CONCLUSIONS: Prevalences for different criteria vary between and within the settings which might be explained by varying functional status. The criteria used strongly affect prevalence and it may be preferable to look at each criterion separately as each may indicate a nutritional problem.
Authors: Viviënne A L Huppertz; Nick van Wijk; Laura W J Baijens; Lisette C P G M de Groot; Ruud J G Halfens; Jos M G A Schols; Ardy van Helvoort Journal: BMC Geriatr Date: 2020-12-14 Impact factor: 3.921
Authors: Charlotte S Kramer; Inge Groenendijk; Sonja Beers; Hugo H Wijnen; Ondine van de Rest; Lisette C P G M de Groot Journal: Curr Dev Nutr Date: 2022-01-29