From recognizing malnutrition to recognizing risk factors for malnutrition: improving nutritional care

Malnutrition is a complex disorder that is substantially prevalent in all healthcare settings and in the community and caused by reduced dietary intake or absorption, disease, aging, or a combination of these factors. This thesis examined differences between screening methods, identified risk factors for malnutrition to prevent or manage its occurrence. The Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) identified more patients at risk of malnutrition compared to the Short Nutritional Assessment Questionnaire (SNAQ) and was predictive of longer hospital stays. However, proactive screening using the PG-SGA SF requires additional resources, training, and interprofessional collaboration, as barriers such as time constraints and knowledge gaps can hinder its implementation.
The research also focused on community-dwelling older adults. A systematic review and meta-analysis demonstrated that protein supplementation positively impacts body weight, particularly in vulnerable groups such as older adults at risk of malnutrition, (pre-)frail individuals, bedridden patients, or those over 70 years of age. The effect was more pronounced in studies lasting six months. Vitamin D supplementation improved mobility, as measured by the Timed-Up-and-Go test, though no significant effects were observed in other physical assessments. Further findings revealed that older adults with overweight or obesity frequently experience insufficient intake of vitamin D and protein, potentially impairing physical function.
This thesis underscores the importance of early screening, proactive interventions, and preventive strategies to mitigate malnutrition and its consequences, such as prolonged hospitalizations and diminished quality of life, thereby improving outcomes for at-risk populations.