Determinants of protein-energy malnutrition in community-dwelling older adults: a systematic review of observational studies
Abstract
Protein-energy malnutrition is associated with numerous poor health outcomes, including high health care costs, mortality rates and poor physical functioning in older adults. This systematic literature review aims to identify and provide an evidence based overview of potential determinants of protein-energy malnutrition in community-dwelling older adults. A systematic search was conducted in PUBMED, EMBASE, CINAHL and COCHRANE from the earliest possible date through January 2013. Observational studies that examined determinants of protein-energy malnutrition were selected and a best evidence synthesis was performed to summarize the results. In total 28 studies were included in this review from which 122 unique potential determinants were derived. Thirty-seven determinants were examined in sufficient number of studies and were included in a best evidence synthesis. The best evidence score comprised design (cross-sectional, longitudinal) and quality of the study (high, moderate) to grade the evidence level. Strong evidence for an association with protein-energy malnutrition was found for poor appetite, and moderate evidence for edentulousness, having no diabetes, hospitalization and poor self-reported health. Strong evidence for no association was found for anxiety, chewing difficulty, few friends, living alone, feeling lonely, death of spouse, high number of diseases, heart failure and coronary failure, stroke (CVA) and the use of anti-inflammatory medications. This review shows that protein-energy malnutrition is a multifactorial problem and that different domains likely play a role in the pathway of developing protein-energy malnutrition. These results provide important knowledge for the development of targeted, multifactorial interventions that aim to prevent the development of protein-energy malnutrition in community-dwelling older adults.
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One systematic review of observational studies found strong evidence of no association between social isolation and loneliness and malnutrition in older people living in community dwellings.
“Only one systematic review of observational studies was identified which looked at diet; this found strong evidence of no association between social isolation and loneliness and malnutrition in older people living in community dwellings 33 .”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as [33]
The overview found an association (+) between loneliness and diet, supported by one review or multiple lower quality reviews.
“| Diet (Van der Pols-Vijlbrief et al 2014) | | + | |”
From An overview of systematic reviews on the public health consequences of social isolation and loneliness (2017) · cites this paper as Van der Pols-Vijlbrief et al 2014
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- Authors
- van der Pols-Vijlbrief, R., Wijnhoven, H. A. H., Schaap, L. A., Terwee, C. B., & Visser, M.
- Affiliations
- Amsterdam Public Health (NL)
- Venue
- Ageing Research Reviews
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 18
- Pages
- 112-131
- ISSN
- 1568-1637 (ISSN-L)
- OpenAlex
- W2121378738
- Cited by
- 190
- References
- 88
- Citations by year
- 2026: 9 · 2025: 14 · 2024: 15 · 2023: 19 · 2022: 19 · 2021: 27 · 2020: 11 · 2019: 15 · 2018: 21 · 2017: 20 · 2016: 16 · 2015: 4
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Ageing Research Reviews (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion)
- VU Research Portal (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Academy of Nutrition and Dietetics
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- protein-energy malnutrition, community-dwelling older adults, determinants of malnutrition, appetite loss, edentulism, hospitalization, self-reported health, loneliness, living alone, multifactorial intervention, malnutrition prevention
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Aging, Female, Humans, Male, Protein-Energy Malnutrition, Risk Factors, Geriatric Assessment, Risk Assessment, Independent Living, Observational Studies as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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