Nutritional Status and Survival Among Old Adults: an 11-year Population-based Longitudinal Study

Overview

Journal Eur J Clin Nutr

Specialty Nutritional Sciences

Date 2015 Jul 9

PMID 26153193

Citations 26

Authors

B Shakersain

G Santoni

G Faxen-Irving

D Rizzuto

L Fratiglioni

W Xu

Affiliations

Soon will be listed here.

Abstract

Background/objectives: The impact of nutritional status on survival among community-dwelling older adults is unclear. We aimed to investigate the prevalence and association of poor nutritional status, including malnutrition and risk for malnutrition defined by the Mini-Nutritional Assessment-Short Form (MNA-SF) with survival, and to explore the role of relevant biomarkers (hemoglobin, albumin and C-reactive protein) in this association.

Subjects/methods: This study included 3041 participants aged ⩾ 60 in the Swedish National study on Aging and Care-Kungsholmen. On the basis of the total score in MNA-SF, nutritional status for each participant was assessed as normal (score 12-14), risk for malnutrition (8-11) or malnutrition (<8). Over an 11-year follow-up, survival status was observed. Data were analysed using logistic regression, flexible parametric survival and Laplace models.

Results: Of all the participants, 51 (1.7%) had malnutrition and 751 (24.7%) were at risk for malnutrition. The multi-adjusted hazard ratio (95% confidence interval) of mortality was 2.40 (1.56-3.67; P<0.001) for malnutrition and 1.49 (1.29-1.71; P<0.001) for risk for malnutrition. The median ages at death of participants with malnutrition and risk for malnutrition were ~3 and 1.5 years shorter than those with normal nutritional status, respectively, whereas malnutrition or risk for malnutrition together with abnormal biomarker (hemoglobin and albumin) levels was related to 1 year more shortened survival.

Conclusions: Malnutrition and risk for malnutrition are highly prevalent and significantly associated with a shorter survival. Poor nutritional status in combination with abnormalities in the biomarkers is associated with even more shortened survival.

Citing Articles

Development of a local nomogram-based scoring system for predicting overall survival in idiopathic pulmonary fibrosis: A rural appalachian experience.

Mohamed R, Sangani R, Kamal K, LeMaster T, Rudisill T, Scott V Med Adv. 2025; 2(4):336-348.

PMID: 39931115 PMC: 11809524. DOI: 10.1002/med4.86.

The prognostic role of albumin levels in lung cancer patients receiving third-line or advanced immunotherapy: a retrospective study.

Chen Y, Liu T, Feng H, Liu T, Zhang J, Wang J Transl Lung Cancer Res. 2024; 13(6):1307-1317.

PMID: 38973954 PMC: 11225039. DOI: 10.21037/tlcr-24-378.

Comparison of Mini Nutritional Assessment Tool and Geriatric Nutrition Risk Index in Predicting 12-Y Mortality Among Community-Dwelling Older Persons.

Li T, Li C, Liu C, Lin C, Yang S, Lin C J Nutr. 2024; 154(7):2215-2225.

PMID: 38763266 PMC: 11282499. DOI: 10.1016/j.tjnut.2024.05.010.

Incidence of the Risk of Malnutrition and Excess Fat Mass, and Gait Speed as Independent Associated Factors in Community-Dwelling Older Adults.

Lopez-Teros M, Vidana-Espinoza H, Esparza-Romero J, Rosas-Carrasco O, Luna-Lopez A, Aleman-Mateo H Nutrients. 2023; 15(20).

PMID: 37892494 PMC: 10610336. DOI: 10.3390/nu15204419.

Association between hemoglobin-to-red blood cell distribution width ratio and hospital mortality in patients with non-traumatic subarachnoid hemorrhage.

Liu J, Wang J Front Neurol. 2023; 14:1180912.

PMID: 37388548 PMC: 10303799. DOI: 10.3389/fneur.2023.1180912.

References

Rendall M, Weden M, Favreault M, Waldron H . The protective effect of marriage for survival: a review and update. Demography. 2011; 48(2):481-506. DOI: 10.1007/s13524-011-0032-5. View

Fuhrman M . The albumin-nutrition connection: separating myth from fact. Nutrition. 2002; 18(2):199-200. DOI: 10.1016/s0899-9007(01)00729-8. View

Furman E . Undernutrition in older adults across the continuum of care: nutritional assessment, barriers, and interventions. J Gerontol Nurs. 2006; 32(1):22-7. DOI: 10.3928/0098-9134-20060101-11. View

Mitrache C, Passweg J, Libura J, Petrikkos L, Seiler W, Gratwohl A . Anemia: an indicator for malnutrition in the elderly. Ann Hematol. 2001; 80(5):295-8. DOI: 10.1007/s002770100287. View

Cereda E . Mini nutritional assessment. Curr Opin Clin Nutr Metab Care. 2011; 15(1):29-41. DOI: 10.1097/MCO.0b013e32834d7647. View

Sullivan D . The role of nutrition in increased morbidity and mortality. Clin Geriatr Med. 1995; 11(4):661-74. View

Persson M, Brismar K, Katzarski K, Nordenstrom J, Cederholm T . Nutritional status using mini nutritional assessment and subjective global assessment predict mortality in geriatric patients. J Am Geriatr Soc. 2002; 50(12):1996-2002. DOI: 10.1046/j.1532-5415.2002.50611.x. View

Saletti A, Johansson L, Yifter-Lindgren E, Wissing U, Osterberg K, Cederholm T . Nutritional status and a 3-year follow-up in elderly receiving support at home. Gerontology. 2005; 51(3):192-8. DOI: 10.1159/000083993. View

Wells J, Dumbrell A . Nutrition and aging: assessment and treatment of compromised nutritional status in frail elderly patients. Clin Interv Aging. 2007; 1(1):67-79. PMC: 2682454. DOI: 10.2147/ciia.2006.1.1.67. View

10.

Ferreira L, do Amaral T, Marucci M, Nascimento L, Lebrao M, de Oliveira Duarte Y . Undernutrition as a major risk factor for death among older Brazilian adults in the community-dwelling setting: SABE survey. Nutrition. 2011; 27(10):1017-22. DOI: 10.1016/j.nut.2010.11.008. View

11.

Fuhrman M, Charney P, Mueller C . Hepatic proteins and nutrition assessment. J Am Diet Assoc. 2004; 104(8):1258-64. DOI: 10.1016/j.jada.2004.05.213. View

12.

Lagergren M, Fratiglioni L, Hallberg I, Berglund J, Elmstahl S, Hagberg B . A longitudinal study integrating population, care and social services data. The Swedish National study on Aging and Care (SNAC). Aging Clin Exp Res. 2004; 16(2):158-68. DOI: 10.1007/BF03324546. View

13.

Johansson L, Sidenvall B, Malmberg B, Christensson L . Who will become malnourished? A prospective study of factors associated with malnutrition in older persons living at home. J Nutr Health Aging. 2009; 13(10):855-61. DOI: 10.1007/s12603-009-0242-3. View

14.

Patel K . Epidemiology of anemia in older adults. Semin Hematol. 2008; 45(4):210-7. PMC: 2572827. DOI: 10.1053/j.seminhematol.2008.06.006. View

15.

Folstein M, Folstein S, McHugh P . "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975; 12(3):189-98. DOI: 10.1016/0022-3956(75)90026-6. View

16.

Morley J . Undernutrition in older adults. Fam Pract. 2012; 29 Suppl 1:i89-i93. DOI: 10.1093/fampra/cmr054. View

17.

Bottai M, Zhang J . Laplace regression with censored data. Biom J. 2010; 52(4):487-503. DOI: 10.1002/bimj.200900310. View

18.

Soeters P, Reijven P, van Bokhorst-de van der Schueren M, Schols J, Halfens R, Meijers J . A rational approach to nutritional assessment. Clin Nutr. 2008; 27(5):706-16. DOI: 10.1016/j.clnu.2008.07.009. View

19.

Cowan D, Roberts J, Fitzpatrick J, While A, Baldwin J . Nutritional status of older people in long term care settings: current status and future directions. Int J Nurs Stud. 2004; 41(3):225-37. DOI: 10.1016/S0020-7489(03)00131-7. View

20.

Lundin H, Saaf M, Strender L, Mollasaraie H, Salminen H . Mini nutritional assessment and 10-year mortality in free-living elderly women: a prospective cohort study with 10-year follow-up. Eur J Clin Nutr. 2012; 66(9):1050-3. DOI: 10.1038/ejcn.2012.100. View