Abstract
Background: Malnutrition often remains undetected in older persons, leading to increased health problems and comorbidity, prolonged hospital stays and readmission. Since malnutrition is a multi-factorial condition, a multidisciplinary and integrated approach is recommended for screening and treatment and this is especially the case in community care, where exchange of health information is often challenging.
Methods: Recently, the Global Leadership Initiative on Malnutrition (GLIM) reached a consensus for a global definition of malnutrition. In our study, the GLIM criteria were applied to data from the interRAI Home Care (interRAI HC) and the interRAI Long Term Care (interRai LTCF) instruments to identify malnutrition and to explore factors significantly associated with the development of malnutrition.
Results: The study analyzed data from 6334 older people receiving home care and 5598 nursing home residents. Most people needed extensive assistance with activities of daily living and had moderate cognitive impairment. The findings revealed that a notable proportion of residents were malnourished, with additional cases developing over one year. Key risk factors associated with malnutrition included dysphagia, advanced age, loss of appetite, bladder incontinence, low fluid intake, depressive symptoms, limited mobility, wandering behavior, falls, and visual impairments. while diabetes and visits to the physician appeared to have a protective effect. These significant factors varied across settings.
Conclusion: These results highlight the utility of a holistic assessment as the interRAI for routine screening, enabling the early identification of at-risk individuals. Understanding malnutrition as a multi-factorial condition emphasizes the need for a holistic and integrated approach to its prevention and management, addressing medical, psychological, and social needs simultaneously. Early identification of risk factors through tools like interRAI assessments and comprehensive care planning is critical in reducing malnutrition's prevalence and consequences.The development of a predictive algorithm to support prevention strategies is ongoing. The worldwide use of the GLIM and the interRAI instruments makes these findings relevant for global clinical practice, policy and research. Adapting the interRAI instruments to the GLIM definition improves accurate detection, prevention and early treatment of malnourishment, avoiding further health deterioration in older people.