Determinants of malnutrition in older hospitalized patients: a prospective multicenter study with the DoMAP model.

IF 3.8 2区医学 Q2 GERIATRICS & GERONTOLOGY

BMC Geriatrics Pub Date : 2026-05-07 DOI:10.1186/s12877-026-07612-6

Maryam Pourhassan, Stefan Pfannkuch, Kiril Stoev, Maria Schnepper, Isabel Levermann, Baigang Wang, Chantal Giehl, Ulrike Trampisch, Lukas Funk, Ilse Gehrke, Wolfried Schröer, Dorothee Volkert, Rainer Wirth

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Abstract

Background: Few studies have assessed the full spectrum of potential causes of malnutrition in older hospitalized patients using a standardized framework. Applying the "Determinants of Malnutrition in Aged Persons" (DoMAP) model, this study aimed to quantify the prevalence of specified determinants and compare their distribution between malnourished and non-malnourished patients, thereby identifying the most important determinants.

Methods: This multicenter, cross-sectional, prospective, observational study was conducted in three geriatric acute care hospital units. Malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Potential causes of malnutrition were assessed using the DoMAP model. This study was registered in the German Clinical Trials Register with the DRKS-ID: DRKS00030850 on December 14, 2022.

Results: A total of 556 patients (mean age 82.5 ± 6.6 years; 67% women) were included. Malnourished patients exhibited a significantly higher prevalence of most determinants compared to non-malnourished patients, particularly low intake (89 vs. 49%), poor appetite (68 vs. 25%), inflammation (31 vs. 19%), gastrointestinal disease (29 vs. 11%), inflammatory disease (32 vs. 19%), and hospitalization (62 vs. 47%). The mean total determinants count was significantly higher in malnourished participants (12.5 ± 5.3) than in non-malnourished ones (10.1 ± 4.0; p < 0.001). Regression analysis revealed low intake as the strongest determinant at Level1; poor appetite, at Level2; gastrointestinal disease and oral pain at Level3, and anorexia of aging and hospitalization at Level4.

Conclusion: The DoMAP model provides a structured framework for capturing the diverse etiologies of malnutrition in older patients. This study emphasizes the multifactorial nature of malnutrition in hospitalized patients, with low intake and poor appetite emerging as predominant drivers.

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老年住院患者营养不良的决定因素：采用DoMAP模型的前瞻性多中心研究

背景：很少有研究使用标准化框架评估老年住院患者营养不良的全部潜在原因。应用“老年人营养不良决定因素”（DoMAP）模型，本研究旨在量化特定决定因素的患病率，并比较其在营养不良和非营养不良患者之间的分布，从而确定最重要的决定因素。方法：这项多中心、横断面、前瞻性、观察性研究在三家老年急症护理医院进行。根据全球营养不良领导倡议（GLIM）的标准诊断营养不良。使用DoMAP模型评估营养不良的潜在原因。该研究已于2022年12月14日在德国临床试验注册中心注册，注册号为DRKS-ID: DRKS00030850。结果：共纳入556例患者（平均年龄82.5±6.6岁，女性67%）。与非营养不良患者相比，营养不良患者的大多数决定因素的患病率明显更高，特别是低摄入量（89比49%）、食欲不振（68比25%）、炎症（31比19%）、胃肠道疾病（29比11%）、炎症性疾病（32比19%）和住院（62比47%）。营养不良参与者的平均总决定因子计数（12.5±5.3）显著高于非营养不良参与者（10.1±4.0）；p结论：DoMAP模型为捕获老年患者营养不良的各种病因提供了一个结构化框架。本研究强调住院患者营养不良的多因素性质，低摄入量和食欲不佳是主要的驱动因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Geriatrics GERIATRICS & GERONTOLOGY-

CiteScore

5.70

自引率

7.30%

发文量

873

审稿时长

20 weeks

期刊介绍： BMC Geriatrics is an open access journal publishing original peer-reviewed research articles in all aspects of the health and healthcare of older people, including the effects of healthcare systems and policies. The journal also welcomes research focused on the aging process, including cellular, genetic, and physiological processes and cognitive modifications.