Prevalence of malnutrition among older adults in a population-based study - the HUNT Study

Marit Kolberg; Ingvild Paur; Yi-Qian Sun; Linda Gjøra; Håvard Kjesbu Skjellegrind; Pernille Thingstad; Bjørn Heine Strand; Geir Selbæk; Tone Natland Fagerhaug; Lene Thoresen

doi:10.1016/j.clnesp.2023.08.016

Prevalence of malnutrition among older adults in a population-based study - the HUNT Study

Clin Nutr ESPEN. 2023 Oct:57:711-717. doi: 10.1016/j.clnesp.2023.08.016. Epub 2023 Aug 19.

Authors

Affiliations

¹ Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway. Electronic address: marko@tkmidt.no.
² Norwegian Advisory Unit on Disease-related Undernutrition, Oslo, Norway; Section for Clinical Nutrition, Department of Clinical Services, Division of Cancer Medicine, Oslo University Hospital, Norway; Department of Clinical Medicine, Clinical Nutrition Research Group, UiT The Arctic University of Norway, Tromsø, Norway.
³ Center for Oral Health Services and Research, Mid-Norway (TkMidt), Trondheim, Norway; Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
⁴ The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Psychiatry, Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
⁵ HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Levanger, Norway; Levanger Hospital, Nord-Trøndelag Hospital Trust, Levanger, Norway.
⁶ Department of Neuromedicine and Movement Science (INB), Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Health and Welfare, Trondheim Municipality, Trondheim, Norway.
⁷ The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.
⁸ The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
⁹ Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
¹⁰ Oncology Clinic, Trondheim University Hospital, Trondheim, Norway.

PMID: 37739727
DOI: 10.1016/j.clnesp.2023.08.016

Abstract

Background: Malnutrition is common in older adults and is associated with increased morbidity and mortality rates.

Aim: The aim of the study is to describe the prevalence of malnutrition based on low BMI, involuntary weight loss, and reduced food intake, in a Norwegian population of community-dwelling older adults and older adults living in nursing homes.

Methods: This population-based study is part of the fourth wave of the Trøndelag Health Study (HUNT4) and includes participants ≥70 years from the HUNT4 70+ cohort. The HUNT4 70+ cohort consist of 9930 (response rate 51.2%) participants. In the current study 8127 older people had complete dataset for inclusion in the analyses. Participants completed a self-report questionnaire and standardised interviews and clinical assessments at field stations, in participants' homes or at nursing homes. Malnutrition was defined using the following criteria: low BMI, involuntary weight loss and severely reduced food intake. The standardised prevalence of malnutrition was estimated using inverse probability weighting (IPW) with weights for sex, age and education of the total population in the catchment area of HUNT.

Results: Of the 8127 included participants, 7671 (94.4%) met at field stations, 356 (4.4%) were examined in their home, and 100 (1.2%) in nursing homes. In total, 14.3% of the population were malnourished based on either low BMI, weight loss, or reduced food intake, of which low BMI was the most frequently fulfilled criterion. The prevalence of malnutrition was less common among men than among women (10.1 vs 18.0%, p < 0.001), also after adjustment for age (OR 0.53, 95% confidence interval (CI) 0.46-0.61). The prevalence increased gradually with increasing age and the regression analysis adjusted for sex showed that for each year increase in age the prevalence of malnutrition increased with 4.0% (OR 1.04, 95% CI 1.03-1.05). The prevalence was higher both among older adults examined in their homes (26.4%) and residents in nursing home (23.6%), as compared to community-dwelling older adults who met at field stations (13.5%).

Conclusion: The prevalence of malnutrition is high in the older population. Special attention on prevention and treatment of malnutrition should be given to older women, the oldest age groups, and care-dependent community-dwelling older adults and nursing home residents.

Keywords: Elderly; Epidemiology; Nutritional status; Undernutrition; Weight loss.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Female
Humans
Independent Living
Male
Malnutrition* / epidemiology
Nursing Homes
Prevalence
Weight Loss