Work

Potential causes of malnutrition in older adults in primary healthcare—A cross-sectional study

Year: 2025

Type: article

Abstract: OBJECTIVES: To evaluate the prevalence of the Determinants of Malnutrition in Aged Persons (DoMAP) and identify determinants of malnutrition among older adults attending primary healthcare. DESIGN AND SETTING: Prospective, observational, monocentric study in primary healthcare. PARTICIPANTS: 500 older adults. MEASUREMENTS: Malnutrition was diagnosed using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Potential causes of malnutrition were assessed by the attending physician using the DoMAP model with a 1:1 recruitment of malnourished and non-malnourished older persons. RESULTS: Malnourished individuals (mean age 81.7 ± 5.0 years; 59% women) exhibited a significantly higher prevalence of almost all DoMAP determinants compared to non-malnourished persons, particularly low intake (88 vs. 11%), high requirements (83 vs. 49%), poor appetite (73 vs. 9%), shopping difficulties (59 vs. 26%), inflammation (81 vs. 49%), gastrointestinal disease (17 vs. 2%), cancer (11 vs. 1%), depression (35 vs. 19%), dementia (21 vs. 6%), polypharmacy (60 vs. 38%), and hospitalization (27 vs. 4%). The mean total determinants count was significantly higher in malnourished participants (14.9 ± 5.0) than in non-malnourished ones (6.8 ± 4.4; p < 0.001). Regression analysis revealed low intake as the strongest determinant at Level1; poor appetite, forgetting to eat, shopping difficulties and inflammation at Level2; gastrointestinal disease, cancer and depression at Level3, and frailty and hospitalization at Level4. CONCLUSION: This study highlights the complex multifactorial nature of malnutrition in older adults attending primary healthcare, confirming the superior role of low intake and poor appetite among other determinants. The DoMAP model offers a structured framework for potential causative factors of malnutrition in older subjects.

Source: The journal of nutrition health & aging

DOI: 10.1016/j.jnha.2025.100745

Authors: Stefan Pfannkuch, Rainer Wirth, Ulrike Trampisch, Dorothee Volkert, Maryam Pourhassan

Institutions: University Hospitals of the Ruhr-University of Bochum, Universitätsklinik Marien Hospital Herne, Friedrich-Alexander-Universität Erlangen-Nürnberg

Language: English

Topic: Nutrition and Health in Aging

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Zero hunger

Open Access status: gold

Estimated APC paid: $3,450