Nutritional status in older persons according to healthcare setting: A systematic review and meta-analysis of prevalence data using MNA®
Abstract
Background & aims Old persons are more likely to suffer from malnutrition, which may result in higher dependency in activities of daily living. We aimed to provide a quantitative synthesis of prevalence data on malnutrition and its risk as assessed by the Mini Nutritional Assessment across different healthcare settings. The association between nutritional status and setting-related level of dependence was also investigated. Methods Non-interventional studies published as full-text articles in English up to 31th December 2014 were searched for in PubMed and by reviewing references of eligible articles. Meta-analysis and meta-regression of potential sources of heterogeneity were conducted. Results A total of 240 studies/795 citations - providing 258 setting-specific prevalence estimates (113,967 subjects) - fulfilled inclusion criteria for meta-analysis. Prevalence of malnutrition differed significantly across the healthcare settings considered: community, 3.1% (95%CI, 2.3-3.8); outpatients, 6.0% (95%CI, 4.6-7.5); home-care services, 8.7% (95%CI, 5.8-11.7); hospital, 22.0% (95%CI, 18.9-22.5); nursing homes, 17.5% (95%CI, 14.3-20.6); long-term care, 28.7% (95%CI, 21.4-36.0); rehabilitation/sub-acute care, 29.4% (95%CI, 21.7-36.9). For every setting significant heterogeneity in individual study results was observed (I 2 ≥80%, P < 0.001) and meta-regression showed that study quality was the most important determinant. Finally, meta-regression of all the studies included showed that both malnutrition and its risk were directly associated with the setting-related level of dependence (P < 0.001). However, despite multiple adjustments, residual heterogeneity remained high. Conclusion We provided updated estimates of malnutrition and its risk in different healthcare settings. Although the level of dependence appears to be an important determinant, heterogeneity in individual study results remained substantially unexplained. The cause-effect relationship between nutritional status and level of dependence deserves further investigation.
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According to a meta-analysis involving 240 studies, malnutrition has been reported in 3.0% of community dwelling older adults, 6.0% of those in outpatient care, 8.7% among those receiving home care services, 22.0% of those with in-hospital stay, 17.5% of those in nursing homes, and 29.4% in rehabilitation/sub-acute care.
“According to a meta-analysis involving 240 studies, malnutrition has been reported in 3.0% of community dwelling older adults, 6.0% of those in outpatient care, 8.7% among those receiving home care services, 22.0% of those with in-hospital stay, 17.5% of those in nursing homes, and 29.4% in rehabilitation/sub-acute care [24].”
From The Utility of Body Composition Assessment in Nutrition and Clinical Practice: An Overview of Current Methodology (2021) · cites this paper as [24]
Reported prevalence rates of malnutrition are generally below 10% in independently living older persons and increase up to two thirds in hospitalized older patients.
“Reported prevalence rates are generally below 10% in independently living older persons and increase up to two thirds in hospitalized older patients (5,6).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [6]
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- Authors
- Cereda, E., Pedrolli, C., Klersy, C., Bonardi, C., Quarleri, L., Cappello, S., Turri, A., Rondanelli, M., & Caccialanza, R.
- Affiliations
- Policlinico San Matteo Fondazione (IT)
- University of Pavia (IT)
- Corresponding author
- Cereda, Emanuele
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2016-12
- Volume
- 35
- Issue
- 6
- Pages
- 1282-1290
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2324717392
- Cited by
- 499
- References
- 6
- Citations by year
- 2026: 44 · 2025: 68 · 2024: 68 · 2023: 60 · 2022: 58 · 2021: 65 · 2020: 52 · 2019: 32 · 2018: 28 · 2017: 21 · 2016: 2
- FWCI
- 3.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Fondazione IRCCS Policlinico San Matteo
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- malnutrition, older adults, Mini Nutritional Assessment, nutritional status, healthcare settings, malnutrition prevalence, activities of daily living dependence, nursing homes, long-term care, hospital malnutrition, home care, rehabilitation care, study quality heterogeneity
- MeSH terms
- Aged, Aged, 80 and over, Ambulatory Care, Community Health Services, Dementia, Health Facilities, Home Care Services, Hospitals, Humans, Long-Term Care, Nursing Homes, Nutritional Status, Geriatric Assessment, Nutrition Assessment, Malnutrition, Independent Living
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