Potentially modifiable determinants of malnutrition in older adults: A systematic review

Beitrag in einer Fachzeitschrift


Details zur Publikation

Autorinnen und Autoren: O'Keeffe M, Kelly M, O'Herlihy E, O'Toole PW, Kearney PM, Timmons S, O'Shea E, Stanton C, Hickson M, Rolland Y, Sulmont Rossé C, Issanchou S, Maitre I, Stelmach-Mardas M, Nagel G, Flechtner-Mors M, Wolters M, Hebestreit A, De Groot LC, van de Rest O, Teh R, Peyron MA, Dardevet D, Papet I, Schindler K, Streicher M, Torbahn G, Kießwetter E, Visser M, Volkert D, O'Connor EM
Zeitschrift: Clinical Nutrition
Jahr der Veröffentlichung: 2018
ISSN: 0261-5614


Abstract

BACKGROUND & AIMS: Malnutrition in older adults results in significant personal, social, and economic burden. To combat this complex, multifactorial issue, evidence-based knowledge is needed on the modifiable determinants of malnutrition. Systematic reviews of prospective studies are lacking in this area; therefore, the aim of this systematic review was to investigate the modifiable determinants of malnutrition in older adults.
METHODS: A systematic approach was taken to conduct this review. Eight databases were searched. Prospective cohort studies with participants of a mean age of 65 years or over were included. Studies were required to measure at least one determinant at baseline and malnutrition as outcome at follow-up. Study quality was assessed using a modified version of the Quality in Prognosis Studies (QUIPS) tool. Pooling of data in a meta-analysis was not possible therefore the findings of each study were synthesized narratively. A descriptive synthesis of studies was used to present results due the heterogeneity of population source and setting, definitions of determinants and outcomes. Consistency of findings was assessed using the schema: strong evidence, moderate evidence, low evidence, and conflicting evidence.
RESULTS: Twenty-three studies were included in the final review. Thirty potentially modifiable determinants across seven domains (oral, psychosocial, medication and care, health, physical function, lifestyle, eating) were included. The majority of studies had a high risk of bias and were of a low quality. There is moderate evidence that hospitalisation, eating dependency, poor self-perceived health, poor physical function and poor appetite are determinants of malnutrition. Moderate evidence suggests that chewing difficulties, mouth pain, gum issues co-morbidity, visual and hearing impairments, smoking status, alcohol consumption and physical activity levels, complaints about taste of food and specific nutrient intake are not determinants of malnutrition. There is low evidence that loss of interest in life, access to meals and wheels, and modified texture diets are determinants of malnutrition. Furthermore, there is low evidence that psychological distress, anxiety, loneliness, access to transport and wellbeing, hunger and thirst are not determinants of malnutrition. There appears to be conflicting evidence that dental status, swallowing, cognitive function, depression, residential status, medication intake and/or polypharmacy, constipation, periodontal disease are determinants of malnutrition.
CONCLUSION: There are multiple potentially modifiable determinants of malnutrition however strong robust evidence is lacking for the majority of determinants. Better prospective cohort studies are required. With an increasingly ageing population, targeting modifiable factors will be crucial to the effective treatment and prevention of malnutrition.


FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Kießwetter, Eva Dr.
Professur für Klinische Ernährung im Alter
Streicher, Melanie
Professur für Klinische Ernährung im Alter
Torbahn, Gabriel
Lehrstuhl für Innere Medizin (Geriatrie)
Volkert, Dorothee Prof. Dr. rer. nat.
Professur für Klinische Ernährung im Alter


Einrichtungen weiterer Autorinnen und Autoren

Centre des Sciences du Goût et de l’Alimentation CSGA
Centre Hospitalier Universitaire (CHU) de Toulouse
École supérieure d'agricultures Angers Loire
Leibniz-Institut für Präventionsforschung und Epidemiologie - BIPS GmbH
Medizinische Universität Wien
Poznan University of Medical Sciences / Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu
Universität Ulm
Université d'Auvergne Clermont-Ferrand I / University of Auvergne
University College Cork (UCC)
University of Auckland
University of Plymouth
Vrije Universiteit Amsterdam (VU) / University Amsterdam
Wageningen University & Research


Zitierweisen

APA:
O'Keeffe, M., Kelly, M., O'Herlihy, E., O'Toole, P.W., Kearney, P.M., Timmons, S.,... O'Connor, E.M. (2018). Potentially modifiable determinants of malnutrition in older adults: A systematic review. Clinical Nutrition. https://dx.doi.org/10.1016/j.clnu.2018.12.007

MLA:
O'Keeffe, M., et al. "Potentially modifiable determinants of malnutrition in older adults: A systematic review." Clinical Nutrition (2018).

BibTeX: 

Zuletzt aktualisiert 2019-22-03 um 13:08