title: Nutritional status and survival among old adults: an 11-year population-based longitudinal study.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Aging Research Center, Center for Alzheimer Research, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: B
authors.initials: B
authors.lastname: Shakersain
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Aging Research Center, Center for Alzheimer Research, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Santoni
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Faxén-Irving
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Aging Research Center, Center for Alzheimer Research, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: D
authors.initials: D
authors.lastname: Rizzuto
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Aging Research Center, Center for Alzheimer Research, Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Stockholm Gerontology Research Center, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Fratiglioni
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Aging Research Center, Center for Alzheimer Research, Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.
authors.forename: W
authors.initials: W
authors.lastname: Xu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism; D011795:Surveys and Questionnaires; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D012709:Serum Albumin; D002097:C-Reactive Protein