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Malnutrition is associated with increased mortality in older adults regardless of the cause of death
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism.ORCID iD: 0000-0002-8367-1189
(English)Manuscript (preprint) (Other academic)
Keyword [en]
cause-specific mortality, malnutrition, Mini Nutritional Assessment, malnutrition, older adults, survival analysis
National Category
Medical and Health Sciences
Research subject
URN: urn:nbn:se:uu:diva-267556OAI: oai:DiVA.org:uu-267556DiVA: diva2:873590
Available from: 2015-11-24 Created: 2015-11-24 Last updated: 2016-01-27
In thesis
1. Nutritional Screening of Older Adults: Risk Factors for and Consequences of Malnutrition
Open this publication in new window or tab >>Nutritional Screening of Older Adults: Risk Factors for and Consequences of Malnutrition
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Aims The overall aim of this thesis was to extend current knowledge about the prevalence of malnutrition, to identify possible risk factors for development of malnutrition, and to describe the consequences of malnutrition in relation to all-cause and cause-specific mortality among older adults admitted to hospital.

Methods The prevalence of malnutrition was estimated in a cohort of 1771 older adults (≥65 years) who were admitted to a Swedish hospital during 2008–2009 (15 months) and screened for malnutrition using the Mini Nutritional Assessment (MNA) instrument. Possible risk factors for malnutrition were recorded during the hospital stay (Study I). Dietary intake 10 years earlier (in 1997) was collected for 725 of these older adults (Study II). All-cause (Study III) and cause-specific (Study IV) mortality were followed up after medians of 3.5 and 5.1 years, respectively, for 1767 of the participants.

Results The prevalence of malnutrition was 9.4% while 55.1% were at risk of malnutrition. Risk factors for malnutrition was an overnight fast >11 hours, <4 eating episodes a day, and not cooking independently. In middle-aged and older adults with a body mass index <25 kg/m2 in 1997, the risk of malnutrition increased for each additional percentage point of energy from total, saturated and monounsaturated fat at follow-up after 10 years. Malnourished older adults had almost four times higher risk of death during follow-up, while those at risk of malnutrition had a 56% higher risk, compared to well-nourished. Furthermore, well-nourished older adults had consistently lower risk of death, regardless of the cause of death.

Conclusions Only 35.5% of older adults admitted to hospital were well-nourished. The identified risk factors could be used in interventions aimed at preventing malnutrition. Normal-weight and underweight middle-aged and older adults should consider limiting the intake of total fat and/or improve the quality of the fat in the diet in order to decrease the risk of becoming malnourished later in life. Malnutrition and risk of malnutrition were associated with increased overall and cause-specific mortality. These relationships emphasize the need for nutritional screening to identify individuals who may require nutritional support in order to avoid preterm death.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2016. 83 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1167
Epidemiology, Malnutrition, Mortality, Older adults, Prevalence, Risk factors
National Category
Medical and Health Sciences Geriatrics
Research subject
Nutrition; Geriatrics
urn:nbn:se:uu:diva-267564 (URN)978-91-554-9435-3 (ISBN)
Public defence
2016-02-26, Vårdskolans aula, ing. 21, Västmanlands sjukhus Västerås, Västerås, 09:15 (Swedish)
Available from: 2016-01-15 Created: 2015-11-24 Last updated: 2016-02-12

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