Impact of malnutrition and its correction on mortality in older adults

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Abstract

BACKGROUND: Malnutrition is associated with decreased levels of physical function, cognitive decline, and an increased risk of all-cause mortality, making it important to identify risk factors for malnutrition, especially in old age.

AIM: To identify factors associated with an increase and decrease in the risk of developing malnutrition, as well as to assess the impact of malnutrition and its correction on mortality in older adults.

MATERIALS AND METHODS: A prospective cohort study of a random sample of 611 people aged 65 years and older. Mini Nutritional Assessment, Geriatric Depression Scale, Mini-Mental State Examination, dynamometry, Barthel Index, chronic noncommunicable diseases, clinical blood count, C-reactive protein. 2 examinations, 9 years of total follow-up.

RESULTS: Risk factors for deterioration in nutritional status are decrease in emotional status (odds ratio 5.439; 95% confidence interval 2.794–10.588), progression of autonomy decline (odds ratio 2.428; 95% confidence interval 1.342–4.393), low physical function (odds ratio 2.877; 95% confidence interval 1.577–5.250). A high level of physical function reduces the risk of malnutrition by 64.1%. Malnutrition increases the risk of five-year mortality by 2.7 times. A normal nutritional status reduces the risk of nine-year mortality by 50.2%. Improve nutrition status leads to a lower risk of mortality.

CONCLUSIONS: The main factors in the deterioration of nutritional status are a decrease in emotional status, loss of autonomy and a low level of physical function. Early detection of older adults with malnutrition and its correction can reduce the risk of mortality.

About the authors

Anna V. Turusheva

North-Western State Medical University named after I.I. Mechnikov

Author for correspondence.
Email: anna.turusheva@gmail.com
ORCID iD: 0000-0003-3347-0984
SPIN-code: 9658-8074
Scopus Author ID: 57189466350
ResearcherId: U-3654-2017

MD, Cand. Sci. (Med.), Assistant Professor

Russian Federation, Saint Petersburg

References

  1. Tkacheva ON, Vorob’eva NM, Kotovskaya YuV, et al. Prevalence of geriatric syndromes in persons over 65 years: the first results of the EVCALIPT study. Russian Journal of Cardiology. 2020;25(10):3985. (In Russ.). doi: 10.15829/1560-4071-2020-3985
  2. Turusheva A, Frolova E, Degryse JM. Age-related normative values for handgrip strength and grip strength’s usefulness as a predictor of mortality and both cognitive and physical decline in older adults in northwest Russia. J Musculoskelet Neuronal Interact. 2017;17(1):417–432.
  3. Bauer S, Lambert MJ, Nielsen SL. Clinical significance methods: a comparison of statistical techniques. J Pers Assess. 2004;82(1):60–70. doi: 10.1207/s15327752jpa8201_11
  4. Kiesswetter E, Pohlhausen S, Uhlig K, et al. Prognostic differences of the Mini Nutritional Assessment short form and long form in relation to 1-year functional decline and mortality in community-dwelling older adults receiving home care. J Am Geriatr Soc. 2014;62(3):512–517. doi: 10.1111/jgs.12683
  5. Ferreira LS, do Amaral TF, Marucci Mde F, et al. Undernutrition as a major risk factor for death among older Brazilian adults in the community-dwelling setting: SABE survey. Nutrition. 2011;27(10):1017–1022. doi: 10.1016/j.nut.2010.11.008
  6. Schuetz P, Fehr R, Baechli V, et al. Individualised nutritional support in medical inpatients at nutritional risk: a randomised clinical trial. Lancet. 2019;393(10188):2312–2321. doi: 10.1016/S0140-6736(18)32776-4
  7. O’Keeffe M, Kelly M, O’Herlihy E, et al. Potentially modifiable determinants of malnutrition in older adults: A systematic review. Clin Nutr. 2019;38(6):2477–2498. doi: 10.1016/j.clnu.2018.12.007
  8. Blazer DG. Depressionin late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003;58(3):249–265. doi: 10.1093/gerona/58.3.m249
  9. Rao TS, Asha MR, Ramesh BN, Rao KS. Understanding nutrition, depression and mental illnesses. Indian J Psychiatry. 2008;50(2):77–82. doi: 10.4103/0019-5545.42391
  10. Marx W, Lane M, Hockey M, et al. Diet and depression: exploring the biological mechanisms of action. Mol Psychiatry. 2021;26(1):134–150. doi: 10.1038/s41380-020-00925-x
  11. Buhl SF, Beck AM, Olsen PØ, et al. Relationship between physical frailty, nutritional risk factors and protein intake in community-dwelling older adults. Clin Nutr ESPEN. 2022;49:449–458. doi: 10.1016/j.clnesp.2022.03.004

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2. Fig. 1. Kaplan–Meier survival curves comparing overall survival of the participants with normal nutritional status and malnutrition, n = 611

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3. Fig. 2. Kaplan–Meier survival curves comparing overall survival of the participants with normal nutritional status or malnutrition after 2nd examination, n = 379. * Significance level p between groups with normal nutritional status, with improvement/deterioration of nutritional status (according to the 2nd test) and malnutrition (according to the 1st and 2nd examinations)

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Copyright (c) 2022 Turusheva A.V.

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