Malnutrition in Older Adults

Welcome to the Malnutrition in Older Adults Project

Malnutrition is multifactorial; thus, many tools and resources are needed to support care in different populations and settings. Malnutrition is characterized by inadequate protein and energy intake that can result in loss of fat and muscle stores. Malnutrition can result in decreased quality of life, and increased morbidity and mortality.

Systematic Review

The systematic review focused on two subtopics – Assessment and Intervention. In the Assessment subtopic, the expert panel reviewed the validity, reliability, and predictive ability for mortality, hospitalization, and decline of physical function of identified nutrition assessment tools used in the community and long-term care. The Intervention subtopic addresses oral nutrition supplements, food fortification, and RDN interventions. The target audience is older adults, mean age >/= 65 years.

Key Findings include:

Oral nutrition supplement interventions likely increase calorie and protein intake in older adults living in long-term care, those discharged from acute care to the community, and those living in community settings. Oral nutrition supplements may also improve the nutrition status of older adults living in long-term care.
Registered dietitian nutritionists’ interventions likely increase calorie and protein intake and help maintain or increase body weight in older adults discharged from acute care to the community, and those living in the community. RDN interventions may also improve the nutrition status in older adults discharged from acute care to the community.
Three tools have available data meeting study criteria: Mini-Nutrition Assessment (MNA); Subjective Global Assessment (SGA); and Patient Generated Subjective Global Assessment (PG-SGA)
MNA has moderate validity and reliability for use in the community, and low validity for use in long-term care.
MNA has predictive ability for mortality, hospitalization, and declining physical function in the community, and predictive ability for mortality and hospitalization in long term care.
SGA has moderate validity for use in the community, and low validity for use in long-term care.

Use the links on the left navigation bar to access the results of the systematic review. Expand the section below titled Project Team and Disclosures for a listing of individuals who contributed to the development of the review, disclosures, and project funding information. Expand the section titled Articles for manuscripts published from this project.

Evidence-Based Nutrition Practice Guideline

The development of a guideline is in progress and is expected to be complete in the fall 2023.

5/11/2023

Malnutrition in Older Adults Systematic Review Project Team and Disclosures (2022-23)
The following individuals contributed their valuable time and expertise to this project:

Expert Panel Workgroup Members
- Nancy Munoz, DCN, MHA, RDN, FAND, Chair
  Chief, Nutrition and Food Services, VA Southern Nevada Healthcare System, Las Vegas, NV, USA
- Anne E. Coltman, MSHA, MS, RD, FAND, Co-Chair
  Senior General Manager, Trinity Health, Maywood, IL, USA (through April 2023) Commission on Dietetic Registration, Academy of Nutrition and Dietetics, Chicago, IL, USA (effective April 2023)
- Krista M. Clark, MBA, RD, LD, FAND, NASM-CPT, SFS
  Dietitian, Majestic Care of Fairfield, Cincinnati, OH, USA
- Nancy Collins, PhD, RDN, LDN, FAND
  President, Light Bulb Health Inc., Las Vegas, NV, USA
- Shina Nishioka, PhD, RD
  Deputy Director, Department of Training and Education / Chief, Department of Clinical Nutrition Food Service, Nagasaki Rehabilitation Hospital, Ngasaki City, Nagasaki, Japan
- Emily RIddle, PhD, RD
  Assistant Professor, SUNY Oneonta, Oneonta, NY, USA
- Terese Scollard, MBA, RDN, LD, FAND
  Owner, MySurgeryPlate LLC, Beaverton, OR, USA
- Judy R. Simon, MS, RD, LD
  National Nutritionist, Administration for Community Living, U.S. Department of Health and Human Services, Washington, DC, USA
Patient Advocates
- Lamia Nasrallah, MPH, RDN, LDN
  Clinical Dietitian, UNC Hospitals Outpatient Nutrition Clinics, Chapel Hill, NC, USA
- Beth A. Smith, MS, RDN, LDN, CNSC
  Clinical Dietitian, Memorial Hermann Hospital, Houston, TX, USA
Project Leaders
- Lisa Moloney, MS, RD, Project Manager
  Nutrition Researcher, Academy of Nutrition and Dietetics, Chicago, IL, USA
- Mary Katherine Hoy, MEd, RDN, Lead Analyst
  Nutritionist, ARS-USDA, Beltsville, MD, USA
- Deepa Handu, PhD, RDN, Methodologist
  Senior Scientist, Academy of Nutrition and Dietetics, Chicago, IL, USA
- Amanda Wanner, MLIS, AHIP, Medical Librarian
  Information Specialist Consultant, British Columbia, Canada
Evidence Analysts
- Lisa A. Davis, MS, RD
  Madison, WI, USA
- Sharon Foley, PhD, RDN
  Chicago, IL, USA
- Kay Howarter, MS, RD
  West Lafayette, IN, USA
- Telma Moreira, MS, RDN, LD, CNSC
  Houston, TX, USA
- Keiy Murofushi, MS, RDN
  Los Angeles, CA, USA
- Megan Piotrowski, MS, BSN, RN, CHES
  Grosse Point Farms, MI, USA
- Jessica Schueler, MS, RDN
  Bend, OR, USA
Financial Contributors
- Dietetics in Health Care Communities Dietetic Practice Group
- Academy of Nutrition and Dietetics Foundation
- Academy of Nutrition and Dietetics
The views or interests of the funding bodies did not influence the development of the systematic review.

Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members have with companies that sell products or services that are relevant to this topic. Workgroup members are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have an adverse impact on the content, but they are noted here to fully inform readers.
- Collins N: received compensation for consultant services, lectures, and development of education materials from Abbott Nutrition, Medtrition
5/17/2022
Scoping Review Project Team and Disclosures (2020)
The following individuals contributed their valuable time and expertise to the scoping review:

Project Team
- Lisa Moloney, MS, RD, Project Manager
  Nutrition Researcher, Academy of Nutrition and Dietetics, Chicago, IL, USA
- Brittany Y. Jarret, PhD, RD, Lead Analyst
  Associate Medical Writer, Complete HealthVizion, Chicago, IL, USA
- Deepa Handu, PhD, RD, Methodologist
  Senior Scientist, Academy of Nutrition and Dietetics, Chicago, IL, USA
Content Advisors
- Judi Porter, PhD
  Associate Professor, Monash University, Melbourne, Victoria, Australia
- Jingyi Wang, MPH, RD, LD
  Clinical Dietitian, Providence Seward Medical and Care Center, Seward, AK, USA
Financial Contributors
- Commission on Dietetic Registration
- Dietetics in Health Care Communities Dietetic Practice Group
- Academy of Nutrition and Dietetics
The views or interests of the funding bodies did not influence the development of this scoping review.

Disclosures of Potential Conflicts of Interest: In the interest of full disclosure, the Academy has adopted the policy of revealing relationships workgroup members and content advisors have with companies that sell products or services that are relevant to this topic. Workgroup members and content advisors are required to disclose potential conflicts of interest by completing the Academy Conflict of Interest Form. It should not be assumed that these financial interests will have adverse impact on the content, but they are noted here to fully inform readers:
- None of the content advisors listed above disclosed potential conflicts of interest.
Articles
- Nutrition Assessment and Interventions for the Prevention and Treatment of Malnutrition in Older Adults: An Evidence Analysis Center Scoping Review. Moloney L, Jarrett B. J Acad Nutr Diet 2020