Determinants of Incident Malnutrition in Community‐Dwelling Older Adults: A MaNuEL Multicohort Meta‐Analysis

Objectives To identify determinants of incident malnutrition in community‐dwelling older adults. Design Meta‐analysis of 6 community‐based longitudinal datasets with follow‐up of 1 to 3 years. Setting Datasets from MaNuEL (MalNutrition in the Elderly) partners were included: 3 studies from Germany a...

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Published in:Journal of the American Geriatrics Society (JAGS) Vol. 66; no. 12; pp. 2335 - 2343
Main Authors: Streicher, Melanie, Zwienen‐Pot, Judith, Bardon, Laura, Nagel, Gabriele, Teh, Ruth, Meisinger, Christine, Colombo, Miriam, Torbahn, Gabriel, Kiesswetter, Eva, Flechtner‐Mors, Marion, Denkinger, Michael, Rothenbacher, Dietrich, Thorand, Barbara, Ladwig, Karl‐Heinz, Corish, Clare A., Clarke, Michelle, Kerse, Ngaire, Muru‐Lanning, Marama, Gibney, Eileen R., O'Connor, Eibhlís M., Visser, Marjolein, Volkert, Dorothee
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01.12.2018
Subjects:
Adults
Age
Analysis
Body mass index
Body weight
Body weight loss
Climbing
Community
community‐dwelling
determinants
Functional impairment
Geriatrics
Hospitalization
Longitudinal studies
longitudinal study
Malnutrition
Marital status
Measurement
Meta-analysis
older
Older people
Physical ability
Stairs
Variables
Walking
Weight loss
meta-analysis
malnutrition
determinants
longitudinal study
older
community-dwelling
ISSN:0002-8614, 1532-5415, 1532-5415
Online Access:Get full text
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Summary:Objectives To identify determinants of incident malnutrition in community‐dwelling older adults. Design Meta‐analysis of 6 community‐based longitudinal datasets with follow‐up of 1 to 3 years. Setting Datasets from MaNuEL (MalNutrition in the Elderly) partners were included: 3 studies from Germany and 1 each from Ireland, the Netherlands, and New Zealand. Participants community‐dwelling adults aged 65 and older (N=4,844). Measurement The same definition of incident malnutrition was used for all cohorts (body mass index < 20.0 kg/m2 at follow‐up or weight loss ≥10 % between baseline and follow‐up). Twenty‐one potential baseline determinants from 7 domains (demographic, nutritional, lifestyle, social, psychological, physical functioning, medical) and 2 follow‐up variables (hospitalization, falls) were harmonized for all studies. Binary logistic regression analyses were performed to assess the association between each variable, adjusted for specific confounders, and incident malnutrition. Combined odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random‐effects meta‐analyses. Results Studies included between 209 and 1,841 participants without malnutrition at baseline; mean age ranged from 71.7 to 84.6. Incidence of malnutrition varied from 5.1% and 17.2%. Meta‐analyses identified 6 variables as independent determinants of incident malnutrition; with increasing age, the risk of developing malnutrition increased continuously. Unmarried, separated, or divorced participants were more likely to develop malnutrition than married participants, whereas no association was found for widowed participants. Participants with difficulty walking (OR=1.41, 95% CI=1.06–1.89) or difficulty climbing stairs (OR=1.45, 95% CI=1.14–1.85) and those who were hospitalized before baseline (OR=1.49, 95% CI=1.25–1.76) and during follow‐up (OR=2.02, 95% CI=1.41–2.88) had higher odds of incident malnutrition. Conclusion In this harmonized meta‐analysis based on prospective data of older, community‐dwelling adults, age, marital status, limitations with walking and climbing stairs, and hospitalization were identified as determinants of incident malnutrition. J Am Geriatr Soc 66:2335–2343, 2018.
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ISSN:0002-8614
1532-5415
1532-5415
DOI:10.1111/jgs.15553