Malnutrition in Elderly - A Predictor of Cognitive, Functional Decline, Depression and Prolonged Hospital Stay

Abstract

Malnutrition in the elderly has been associated with deleterious effects on health care outcomes such as functional decline, cognitive impairment, depression, increased hospital stays, and increased morbidity and mortality. This cross-sectional study aims to determine the association of malnutrition with functional status and cognition and duration of hospitalization among 200 elderly patients admitted to medical wards of a tertiary care hospital in India. The nutritional screening was done using Mini Nutritional assessment- short form (MNA-SF). The functional activity was assessed using the Barthel’s Index. Cognitive assessment and screening for depression was done using the Mini-cog test and Geriatric Depression score – 4 respectively. Descriptive analyses were used to estimate the prevalence of malnutrition and associations were assessed using the Pearson chi square test. Among the total patients, 136 (68%) were malnourished. Of these, 45 (22.5%) were severely undernourished. The malnourished patients had poorer functional scores (p<0.001), were likely to be cognitively impaired (33%, 45 of 136) (p < 0.001) and stayed longer in the hospital (n= 9.13 days) compared to the normally nourished. The nutritional status of hospitalized elderly may therefore serve as a surrogate marker of disability and poor clinical outcome. Keywords: Malnutrition, Geriatric, Nutritional assessment, Undernourishment, Functional decline, Elderly