The impact of malnutrition and associated nutritional deficiencies on mortality in older adults

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-24 DOI:10.1016/j.clnesp.2025.09.026

Elifnur Aydın , Müberra Tanrıverdi , Ozge Pasin , Cihan Heybeli , Damla Aslan Kirazoglu , Laurent Boyer , Masoud Rahmati , Pinar Soysal

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引用次数: 0

Abstract

Background & aims

This study aimed to evaluate the effects of various nutritional indicators, including undernutrition, malnutrition risk, malnutrition, weight loss, comorbidities, appetite loss, dysphagia, and deficiencies of vitamin B12, folate, and vitamin D, on mortality in older patients.

Methods

This retrospective cohort study analyzed data from 1911 older outpatients (mean age: 81.0 ± 13.0 years, 70.8 % female). For each patient, age, sex, education level, and comorbid diseases were recorded. Patients with two or more comorbid diseases were classified as having multimorbidity. Nutritional status was assessed using the Mini Nutritional Assessment (MNA), dysphagia was measured using Eating Assessment Tool-10 (EAT-10), and appetite loss was evaluated with Council on Nutrition Appetite Questionnaire (CNAQ). Patients or caregivers reported weight loss over the past three months. Vitamin B12, vitamin D, and folate deficiencies were defined as <200 pg/ml, <30 ng/ml, and <3 ng/ml, respectively.

Results

After a median follow-up of 71.61 months, 413 patients (21.4 %) had died. After adjusting for age, sex, and multimorbidity, multivariate hazard ratio analysis showed a significant correlation with mortality (p < 0.001) for malnutrition (HR: 4.40), undernutrition (HR: 2.86), weight loss ≥3 kg (HR: 2.45), malnutrition risk (HR: 2.13), dysphagia (HR: 1.71), loss of appetite (HR: 1.62), and vitamin D deficiency (HR: 1.62). Multicollinearity and multivariate hazard ratio after adjusted for all confounders, only malnutrition retained statistical significance (HR: 2.10).

Conclusions

Malnutrition, risk of malnutrition and undernutrition, ≥3 kg weight loss (using a question derived from the MNA), dysphagia, loss of appetite, and vitamin D deficiency highlight the critical role of nutritional status, these should be considered in the clinic. No significant association was found with weight loss (<3 kg), vitamin B12, and folate deficiency.

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营养不良和相关营养缺乏对老年人死亡率的影响。

背景与目的：本研究旨在评估各种营养指标对老年患者死亡率的影响，包括营养不足、营养不良风险、营养不良、体重减轻、合并症、食欲减退、吞咽困难以及维生素B12、叶酸和维生素D缺乏。方法：回顾性队列研究分析了1911例老年门诊患者的资料（平均年龄：81.0±13.0岁，70.8%为女性）。记录每位患者的年龄、性别、教育程度和合并症。有两种或两种以上合并症的患者被归类为多病。使用迷你营养评估（MNA）评估营养状况，使用进食评估工具-10 （EAT-10）测量吞咽困难，使用营养委员会食欲问卷（CNAQ）评估食欲下降。患者或护理人员报告在过去三个月内体重有所下降。维生素B12、维生素D和叶酸缺乏被定义为：结果：在中位随访71.61个月后，413名患者（21.4%）死亡。在调整了年龄、性别和多发病因素后，多因素风险比分析显示与死亡率显著相关(结论：营养不良、营养不良和营养不足风险、体重减轻≥3kg（使用来自MNA的问题）、吞咽困难、食欲不振和维生素D缺乏突出了营养状况的关键作用，这些都应在临床中加以考虑。没有发现与体重减轻(

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.