Potentially modifiable determinants of malnutrition in older adults: A systematic review

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dc.contributor.author O'Keeffe, M.
dc.contributor.author Kelly, M.
dc.contributor.author O'Herlihy, Eileen
dc.contributor.author O'Toole, Paul W.
dc.contributor.author Kearney, Patricia M.
dc.contributor.author Timmons, Suzanne
dc.contributor.author O'Shea, Emma
dc.contributor.author Stanton, Catherine
dc.contributor.author Hickson, M.
dc.contributor.author Rolland, Y.
dc.contributor.author Sulmont Rossé, C.
dc.contributor.author Issanchou, S.
dc.contributor.author Maitre, I.
dc.contributor.author Stelmach-Mardas, M.
dc.contributor.author Nagel, G.
dc.contributor.author Flechtner-Mors, Marion
dc.contributor.author Wolters, M.
dc.contributor.author Hebestreit, A.
dc.contributor.author de Groot, Lisette C. P. G. M.
dc.contributor.author van de Rest, O.
dc.contributor.author Teh, Ruth
dc.contributor.author Peyron, M. A.
dc.contributor.author Dardevet, Dominique
dc.contributor.author Papet, I.
dc.contributor.author Schindler, K.
dc.contributor.author Streicher, M.
dc.contributor.author Torbahn, G.
dc.contributor.author Kiesswetter, E.
dc.contributor.author Visser, M.
dc.contributor.author Volkert, D.
dc.contributor.author O'Connor, Eibhlís M.
dc.date.accessioned 2019-03-07T10:28:53Z
dc.date.available 2019-03-07T10:28:53Z
dc.date.issued 2018-12-11
dc.identifier.citation O'Keeffe, M., Kelly, M., O'Herlihy, E., O'Toole, P.W., Kearney, P.M., Timmons, S., O’Shea, E., Stanton, C., Hickson, M., Rolland, Y. and Rossé, C.S., 2018. Potentially modifiable determinants of malnutrition in older adults: A systematic review. Clinical Nutrition. doi: 10.1016/j.clnu.2018.12.007 en
dc.identifier.startpage 1 en
dc.identifier.endpage 22 en
dc.identifier.issn 0261-5614
dc.identifier.uri http://hdl.handle.net/10468/7569
dc.identifier.doi 10.1016/j.clnu.2018.12.007
dc.description.abstract Summary Background & aims Malnutrition in older adults results in significant personal, social, and economic burden. To combat this complex, multifactorial issue, evidence-based knowledge is needed on the modifiable determinants of malnutrition. Systematic reviews of prospective studies are lacking in this area; therefore, the aim of this systematic review was to investigate the modifiable determinants of malnutrition in older adults. Methods A systematic approach was taken to conduct this review. Eight databases were searched. Prospective cohort studies with participants of a mean age of 65 years or over were included. Studies were required to measure at least one determinant at baseline and malnutrition as outcome at follow-up. Study quality was assessed using a modified version of the Quality in Prognosis Studies (QUIPS) tool. Pooling of data in a meta-analysis was not possible therefore the findings of each study were synthesized narratively. A descriptive synthesis of studies was used to present results due the heterogeneity of population source and setting, definitions of determinants and outcomes. Consistency of findings was assessed using the schema: strong evidence, moderate evidence, low evidence, and conflicting evidence. Results Twenty-three studies were included in the final review. Thirty potentially modifiable determinants across seven domains (oral, psychosocial, medication and care, health, physical function, lifestyle, eating) were included. The majority of studies had a high risk of bias and were of a low quality. There is moderate evidence that hospitalisation, eating dependency, poor self-perceived health, poor physical function and poor appetite are determinants of malnutrition. Moderate evidence suggests that chewing difficulties, mouth pain, gum issues co-morbidity, visual and hearing impairments, smoking status, alcohol consumption and physical activity levels, complaints about taste of food and specific nutrient intake are not determinants of malnutrition. There is low evidence that loss of interest in life, access to meals and wheels, and modified texture diets are determinants of malnutrition. Furthermore, there is low evidence that psychological distress, anxiety, loneliness, access to transport and wellbeing, hunger and thirst are not determinants of malnutrition. There appears to be conflicting evidence that dental status, swallowing, cognitive function, depression, residential status, medication intake and/or polypharmacy, constipation, periodontal disease are determinants of malnutrition. Conclusion There are multiple potentially modifiable determinants of malnutrition however strong robust evidence is lacking for the majority of determinants. Better prospective cohort studies are required. With an increasingly ageing population, targeting modifiable factors will be crucial to the effective treatment and prevention of malnutrition. en
dc.description.sponsorship Austrian Federal Ministry of Education, Science and Research (BMWFW-10.420/0003-WF/V/3C/2016); German Federal Ministry of Food and Agriculture (FAU: 2815ERA10E, BIPS: 815ERA09E); The Netherlands Organisation for Health Research and Development (529051008) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier Ltd en
dc.relation.uri http://www.sciencedirect.com/science/article/pii/S0261561418325755
dc.rights © 2018 The Author(s) en
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0 en
dc.subject Malnutrition en
dc.subject Determinants en
dc.subject Older adults en
dc.subject Systematic review en
dc.subject Prospective cohort studies en
dc.title Potentially modifiable determinants of malnutrition in older adults: A systematic review en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Eileen O'Herlihy, School of Microbiology, University College Cork, Cork, Ireland. +353-21-490-3000 Email: eoh@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Department of Agriculture, Food and the Marine en
dc.contributor.funder Health Research Board en
dc.contributor.funder Institut National de la Recherche Agronomique en
dc.contributor.funder Instituto de Salud Carlos III en
dc.contributor.funder Ecole Supérieure d’Agricultires en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Clinical Nutrition en
dc.internal.IRISemailaddress eoh@ucc.ie
dc.internal.IRISemailaddress emma.oshea@ucc.ie en
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