Risk factors for malnutrition in older adults

a systematic review

  • Rita Pacheco Universidade Católica Portuguesa, Porto, Portugal
  • Rosa Silva Universidade Católica Portuguesa, Instituto de Ciências da Saúde, Escola de Enfermagem, CIIS, Porto, Portugal. Escola Superior de Enfermagem de Coimbra, UICISA: E, Coimbra, Portugal
  • Tânia Costa Universidade Católica Portuguesa, Instituto de Ciências da Saúde, Escola de Enfermagem, CIIS, Porto, Portugal
  • Armando Almeida Universidade Católica Portuguesa, Instituto de Ciências da Saúde, Escola de Enfermagem, CIIS, Porto, Portugal
  • João Amado Universidade Católica Portuguesa, Instituto de Ciências da Saúde, Escola de Enfermagem, CIIS, Porto, Portugal
Keywords: aged, malnutrition, risk factors, systematic review


Introduction: Population ageing is a worldwide phenomenon that puts the organism through several anatomical, functional, biochemical and psychological changes with repercussions on health conditions. Malnutrition is described by several authors as a common condition in older adults. In this sense, knowing the factors that contribute to malnutrition is an important information for health professionals who care for the older adults on their daily lives.

Objective: To identify the risk factors that contribute to malnutrition in the elderly.

Methods: A systematic review of the literature was developed according to the methodology of the Joanna Briggs Institute. Studies with focus on the risk factors were searched for, with people aged ≥ 60 years old living in any setting. The critical analysis, extraction and synthesis of the results were developed by two independent researchers.

Results: A total of 13 articles were included, with a total of 21568 elderly people and a predominance of women (59.6%). Of the total sample, 2349 (10.9%) were identified as being at risk of malnutrition and 7796 (36.1%) as malnourished. The factors that contribute to malnutrition are several, including age, depression, cognitive deterioration, socioeconomic level, education and institutionalization.

Conclusions: In this context, the need for a multidimensional and multidisciplinary intervention that responds to the health condition of the elderly is reinforced.


Bakker, M., Vissink, A., Spoorenberg, S., Jager-Wittenaar, H., Wynia, K., & Visser, A. (2018). Are Edentulousness, Oral Health Problems and Poor Health-Related Quality of Life Associated with Malnutrition in Community-Dwelling Elderly (Aged 75 Years and Over)? A Cross-Sectional Study. Nutrients, 10(12), 1965. https://doi.org/10.3390/nu10121965

Baz, S., & Ardahan, M. (2019). Relationship between Malnutrition Risks and Functional Abilities of the Elderly in Home Care Services. International Journal of Caring Sciences, 12(2), 603–610.

Boulos, C., Salameh, P., & Barberger-Gateau, P. (2017). Social isolation and risk for malnutrition among older people. Geriatrics & Gerontology International, 17(2), 286–294. https://doi.org/10.1111/ggi.12711

Brabcová, I., Trešlová, M., Bártlová, S., Vacková, J., Tóthová, V., & Motlová, L. (2016). Risk Factors for Malnutrition in Seniors Aged 75+ Living in Home Environment in Selected Regions of the Czech Republic. Central European Journal of Public Health, 24(3), 206–210. https://doi.org/10.21101/cejph.a4283

Carlos, A., Gazzola, J., & Gomes, A. (2016). Funcionalidade de Idosos Institucionalizados: a Influência do Estado Nutricional. Revista Equilíbrio Corporal e Saúde, 8(1), 17–22. https://doi.org/10.17921/2176-9524.2016v8n1p17-22

Costa, A., Cunha, A., & Oliveira, C. (2013). Avaliação do Estado Nutriconal do Idoso Não Institucionalizado .Monografia, Escola Superior de enferagem de Coimbra, Coimbra

Cruz, E. P., Sánchez, D. C. L., & Esteves, M. del R. M. (2014). Asociación entre desnutrición y depresión en el adulto mayor. Nutricion Hospitalaria, 29(4), 901–906. https://doi.org/10.3305/nh.2014.29.4.7228

Donini, L. M., Scardella, P., Piombo, L., Neri, B., Asprino, R., Proietti, A. R., … Morrone, A. (2013). Malnutrition in elderly: Social and economic determinants. The Journal of Nutrition, Health & Aging, 17(1), 9–15. https://doi.org/10.1007/s12603-012-0374-8

Fávaro-Moreira, N., Krausch-Hofmann, S., Matthys, C., Verreecken, C., Vanhauwaert, E., Declercq, A., … Duyck, J. (2011). Research, participation and social transformation: Notes on the unfolding of a research practice. International Journal of Action Research, 7(2), 175–195. https://doi.org/10.1688/1861-9916_IJAR_2011_02_Streck

Grammatikopoulou, M. G., Gkiouras, K., Theodoridis, X., Tsisimiri, M., Markaki, A. G., Chourdakis, M., & Goulis, D. G. (2019). Food insecurity increases the risk of malnutrition among community-dwelling older adults. Maturitas, 119(June 2018), 8–13. https://doi.org/10.1016/j.maturitas.2018.10.009

Grupo de Trabalho Interministerial. (2017). Estratégia nacional para o envelhecimento ativo 2017-2025. República Potuguesa/Serviço Nacional de Saúde.

Julio, M. P. M., Clavero, A. E., & Soler, M. L. M. (2018). Nutritional status and factors associated with non-institutionalized people over 75 years of age. Revista Brasileira de Enfermagem, 71(3), 1007–1012. https://doi.org/10.1590/0034-7167-2017-0207

Leij-Halfwerk, S., Verwijs, M. H., van Houdt, S., Borkent, J. W., Guaitoli, P. R., Pelgrim, T., … de van der Schueren, M. A. E. (2019). Prevalence of protein-energy malnutrition risk in European older adults in community, residential and hospital settings, according to 22 malnutrition screening tools validated for use in adults ≥65 years. Maturitas, 126(May), 80–89. https://doi.org/10.1016/j.maturitas.2019.05.006

Lin, W.-Q., Wang, H. H. X., Yuan, L.-X., Li, B., Jing, M.-J., Luo, J.-L., … Wang, P.-X. (2017). The unhealthy lifestyle factors associated with an increased risk of poor nutrition among the elderly population in China. The Journal of Nutrition, Health & Aging, 21(9), 943–953. https://doi.org/10.1007/s12603-017-0881-8

Loureiro, M. (2008). Valisação do Mini-Nutricional Assessement em idosos. Dissertação de Mestrado em Nutrição Clínica. Faculdade de Medicina da Universidade de Coimbra, Coimbra.

Melo, M. (2015). Avaliação do estado nutricional de idosos intitucionalizados no distrito de Braga. Tese de Doutoramento em Enfermagem. Universidade Católica Portuguesa, Porto.

Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Journal of Clinical Epidemiology, 62(10), 1006–1012. https://doi.org/10.1016/j.jclinepi.2009.06.005

Moola, S., Munn, Z., Tufanaru, C., Aromataris, E., Sears, K., Sfetcu, R., … Mu, P. (2017). Chapter 7: Systematic reviews of etiology and risk. In In: Aromataris E, Munn Z (Editors). Joanna Briggs Institute Reviewer’s Manual. anual.joannabriggs.org/.

O’Keeffe, M., Kelly, M., O’Herlihy, E., O’Toole, P. W., Kearney, P. M., Timmons, S., … O’Connor, E. M. (2019). Potentially modifiable determinants of malnutrition in older adults: A systematic review. Clinical Nutrition, 38(6), 2477–2498. https://doi.org/10.1016/j.clnu.2018.12.007

OECD/Observatory on Health Systems and Policies. (2017). Portugal: Country health profile 2017. https://doi.org/http://dx.doi.org/10.1787/9789264283527-en

Park, M., Kim, H., & Kim, S. K. (2014). Knowledge Discovery in a Community Data Set: Malnutrition among the Elderly. Healthcare Informatics Research, 20(1), 30. https://doi.org/10.4258/hir.2014.20.1.30

Pereira, R., Cotta, R., & Frabceschini, S. (2006). Fatores associados ao estado nutricional no envelhecimento. Revista Médica de Minas Gerais, 16(3), 160–164. Retrieved from http://0103-880x

Ribeiro, R. S., Rosa, M. I., & Bozzetti, M. C. (2011). Malnutrition and associated variables in an elderly population of Criciúma, SC. Revista Da Associação Médica Brasileira, 57(1), 56–61. https://doi.org/10.1590/S0104-42302011000100017

Santos, A., Machado, M., & Leite, E. M. (2010). Envelhecimento e alterações do estado nutricional. Geriatrics, Gerontology and Aging, 4(3), 168–175.

Serrano-Urrea, R., & Garcia-Meseguer, M. J. (2013). Malnutrition in an Elderly Population without Cognitive Impairment Living in Nursing Homes in Spain: Study of Prevalence Using the Mini Nutritional Assessment Test. Gerontology, 59(6), 490–498. https://doi.org/10.1159/000351763

Silva, J. L., Marques, A. P. de O., Leal, M. C. C., Alencar, D. L., & Melo, E. M. de A. (2015). Fatores associados à desnutrição em idosos institucionalizados. Revista Brasileira de Geriatria e Gerontologia, 18(2), 443–451. https://doi.org/10.1590/1809-9823.2015.14026

Smoliner, C., Norman, K., Wagner, K.-H., Hartig, W., Lochs, H., & Pirlich, M. (2009). Malnutrition and depression in the institutionalised elderly. British Journal of Nutrition, 102(11), 1663. https://doi.org/10.1017/S0007114509990900

Vellas, B., Villars, H., Abellan, G., Soto, M. E., Rolland, Y., Guigoz, Y., … Garry, P. (2006). Overview of the MNA® - Its history and challenges. Journal of Nutrition, Health and Aging, 10(6), 456–463.

World Health Organization (WHO). (2017). Evidence profile: malnutrition (WHO, ed.). ICOPE guidelines.

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