Malnutrition is the inadequate intake of calories and protein that negatively affects growth and development and can result in loss of fat or muscle stores. Malnutrition can decrease quality of life, increase risk of mortality and increase health care costs. Older adults are at risk for malnutrition due to a variety of factors such as physical and mental changes, isolation and limited income. Many older adults live independently in the community, and approximately 6.5% live in long-term care or assisted living facilities. Health care practitioners, particularly registered dietitian nutritionists, need evidence-based guidance to provide quality nutrition care to older adults living in long-term care and community settings.
A systematic review of nutrition interventions to treat or prevent malnutrition in older adults in long-term care or community settings was conducted by the Academy of Nutrition Dietetics’ Evidence Analysis Center to support the development of evidence-based recommendations. The project was funded by the Academy, Academy Foundation and the Dietetics in Health Care Communities Dietetic Practice Group.
Evaluated interventions included oral nutrition supplements, food fortification and RDN interventions. Outcomes evaluated include calorie and protein intake, weight and BMI, nutrition status, physical function, and mortality. Registered dietitian nutritionists’ interventions in community settings likely increase calorie and protein intake and help maintain or increase body weight in older adults. RDN interventions in community settings also may improve the nutrition status in older adults discharged from acute care to the community.
Since being published in June 2023, this systematic review has been updated to an evidence-based practice guideline. The Malnutrition in Older Adults Evidence-based Nutrition Practice Guideline includes evidence-based recommendations to identify, prevent or treat protein-energy malnutrition in older adults living in long-term care facilities and community settings. This guideline is intended for registered dietitian nutritionists or international equivalents; nutrition and dietetics technicians, registered; health care professionals with different training such as physicians and nurses; and community health workers who work with older adults and/or their care providers to make shared decision making to prevent or treat protein-energy malnutrition (undernutrition).
Recommendations for nutrition assessment include the Mini-Nutritional Assessment, Subjective Global Assessment, and Patient-General Subjective Global Assessment Forms. Nutrition Interventions include Oral Nutrition Supplements, Dietitian Effectiveness, Food Fortification, and Home Delivered Meals and Congregate Meals.
View the complete Malnutrition in Older Adults Evidence-based Nutrition Practice Guideline and systematic reviews on the Academy's Evidence Analysis Library.
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