title: An investigation into the association between nutritional status and quality of life in older people admitted to hospital.
abstract: BACKGROUND
  Malnutrition is prevalent in acute hospitals and malnourished patients have an increased risk of morbidity and mortality. Studies of malnutrition and quality of life (QoL) are generally limited by both the nutritional and QoL assessment methods employed. The present study aimed to evaluate the relationship between malnutrition, as assessed using a range of nutritional assessment methods, and QoL, as measured by EuroQol-5D-3L and Short-Form (SF)-36 questionnaires.
  
  
  METHODS
  The study comprised a prospective cross-sectional study of malnutrition and QoL in 149 inpatients aged 65-99 years. Exclusion criteria were: terminal illness, active malignancy, lack of capacity to consent and severe communication difficulties. Spearman's rank correlation coefficient was used to test the association between QoL indices and nutritional markers. QoL scores for those scoring above and below thresholds for nutritional risk were compared. Regression models were created to identify nutritional indices contributing to the variability of QoL.
  
  
  RESULTS
  There were significant associations between QoL scores and the Mini Nutritional Assessment (MNA)-SF. Clear differences were evident between malnourished and well-nourished patients (on the MNA-SF), those with low and normal arm muscle circumference and those with good and poor physical function. Regression analysis showed that nutritional scores and functional status made independent contributions to the prediction of QoL. The effect on food intake, mobility and psychological stress/acute disease also had a significant influence.
  
  
  CONCLUSIONS
  Malnutrition risk is linked to a poorer QoL in older people on admission to hospital. Functional status and eating-related factors are major influencers on QoL in this group. These findings reinforce the role of nutrition as a priority with respect to achieving improvements in QoL.
authors.affiliation: Department of Nutrition & Dietetics, Betsi Cadwaladr University Health Board, Bangor, UK.
authors.forename: S
authors.initials: S
authors.lastname: Rasheed
authors.forename: R T
authors.initials: RT
authors.lastname: Woods
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004435:Eating; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D008297:Male; D009132:Muscles; D015596:Nutrition Assessment; D009752:Nutritional Status; D010809:Physical Fitness; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D018570:Risk Assessment; D013315:Stress, Psychological; D011795:Surveys and Questionnaires
keywords: elderly; functional status; malnutrition; outcome measurement; quality of life