Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.
BACKGROUND
Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury.


OBJECTIVE
To identify modifiable risk factors associated with malnutrition in older patients.


METHODS
Prospective cross-sectional multicenter study.


METHODS
3 EDs in the South, Northeast, and Midwest.


METHODS
Non-critically ill, English-speaking adults aged ≥65 years.


METHODS
Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor.


RESULTS
In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%).


CONCLUSIONS
Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults.
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Collin E
CE
Burks
Department of Emergency Medicine, Cooper University Hospital, Camden, New Jersey.
Christopher W
CW
Jones
Department of Emergency Medicine, Cooper University Hospital, Camden, New Jersey.
Valerie A
VA
Braz
Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, Michigan.
Robert A
RA
Swor
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Natalie L
NL
Richmond
Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Kay S
KS
Hwang
School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Allison G
AG
Hollowell
Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Mark A
MA
Weaver
Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Timothy F
TF
Platts-Mills
D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004636:Emergency Service, Hospital; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data; D006760:Hospitalization; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000453:epidemiology*; D015596:Nutrition Assessment; D009909:Oral Health / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D014481:United States
emergency medicine; geriatric; malnutrition