Prevention and treatment of malnutrition in older adults living in long-term care or the community: an evidence-based nutrition practice guideline
Abstract
Malnutrition in older adults can decrease quality of life and increase risk of morbidities and mortality. Accurate and timely identification of malnutrition, as well as subsequent implementation of effective interventions, are essential to decrease poor outcomes associated with malnutrition in older adults. The Academy of Nutrition and Dietetics Evidence Analysis Center conducted a systematic review of the literature to develop an evidence-based nutrition practice guideline for the prevention and treatment of malnutrition in older adults. The objective of this guideline was to provide evidence-based recommendations to identify, prevent, or treat protein-energy malnutrition in older adults (mean age ≥65 years) living in long-term care and community settings. This guideline provides 11 nutrition recommendations to inform shared decision making among dietitians, members of the health care team, family members or caregivers, and older adults living in long-term care or the community to prevent or treat malnutrition. Topics include dietitian effectiveness, nutrition assessment tools, oral nutrition supplements, food fortification, and home-delivered and congregate meals. Guideline implementation should include consideration of the importance of comprehensive individualized nutrition care for older adults. Future research is needed to address gaps that were identified related to the validity, reliability, and feasibility of nutrition assessment tools, as well as the effectiveness of dietitian interventions on outcomes of interest in older adults living in long-term care and the community.
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Evidence in community-dwelling adults on health outcomes in patients with malnutrition is inconsistent because of the lack of studies outside the hospital setting, poor study design, or lack of essential contextual information.
“Unfortunately, similar evidence in community-dwelling adults is inconsistent because of the lack of studies examining health outcomes in patients with malnutrition outside the hospital setting [26], poor study design, or lack of essential contextual information to allow for more definitive conclusions.”
From The Value of Integrating the Nutritional Ecology into the Nutrition Care Continuum—A Conceptual and Systems Approach (2025) · cites this paper as [26]
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- Authors
- Riddle, E., Munoz, N., Clark, K., Collins, N., Coltman, A., Nasrallah, L., Nishioka, S., Scollard, T., Simon, J. R., & Moloney, L.
- Affiliations
- SUNY Oneonta (US)
- University of North Carolina at Chapel Hill (US)
- Nagasaki Rehabilitation (JP)
- Academy of Nutrition and Dietetics (US)
- Corresponding author
- Riddle, Emily
- Clark, Krista
- Collins, Nancy
- Nasrallah, Lamia
- Nishioka, Shinta
- Scollard, Terese
- Moloney, Lisa
- ORCID
- Venue
- Journal of the Academy of Nutrition and Dietetics
- Publisher
- Elsevier BV
- Published
- 2024-07
- Volume
- 124
- Issue
- 7
- Pages
- 896-916.e24
- ISSN
- 2212-2672 (ISSN-L)
- OpenAlex
- W4394010495
- Cited by
- 33
- References
- 20
- Citations by year
- 2026: 18 · 2025: 12 · 2024: 3
- FWCI
- 9.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the Academy of Nutrition and Dietetics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Keywords
- malnutrition, older adults, protein-energy malnutrition, long-term care, community-dwelling older adults, malnutrition prevention, malnutrition treatment, nutrition assessment tools, dietitian intervention, oral nutritional supplements, food fortification, home-delivered meals, congregate meals, shared decision-making
- MeSH terms
- Aged, Aged, 80 and over, Dietetics, Female, Humans, Long-Term Care, Male, Nutritional Status, Geriatric Assessment, Nutrition Assessment, Evidence-Based Medicine, Malnutrition, Nutrition Therapy, Independent Living
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