Malnutrition risk and associated factors in hospitalized older adult patients with neurological diseases: a retrospective cohort study

ABSTRACT

Introduction

Malnutrition risk (MR) in older adults with neurological disorders is high, but there is little evidence for validated screening tools in this group, as well as for the clinical and socioeconomic factors associated with a high MR.

Objectives

To determine the association of MR using the Malnutrition Universal Screening Tool (MUST) with mortality and length of stay (LOS) in older adults with neurological diseases. Secondarily, the association of clinical, and socioeconomic factors with MR and clinical outcomes was sought.

Methods

A retrospective cohort study was carried out at a third-level neurological disease referral center in Mexico. All patients older than 60 years admitted from January 2017 to December 2018 were considered. MUST, clinical and socioeconomic factors were assessed at hospital admission. Outcomes were followed up to hospital discharge or a maximum of 6 months.

Results

A total of 765 patients were included, of whom 24.7% (n = 189) were at high risk. A high MR was independently associated with mortality (OR 3.09; 95% CI 1.60-5.98, p = .001) and LOS >14 days (OR 4.38; 95% CI 2.79-6.89, p = <.001). The only factors independently associated with high MR was economic dependence and unemployment. Patients with high MR and economic dependence (OR 4.0; 95% CI 1.34-11.99, p = .013) or unemployment (OR 3.43; 95% CI 1.17-10.06, p = .025) had the highest mortality.

Conclusions

In hospitalized older adults with neurological diseases, high MR is independently associated with increased mortality and LOS. Economic dependence or unemployment are associated with worse clinical outcomes in patients with high MR.

KEYWORDS:

• Malnutrition
• neurology
• neurosurgery
• MUST
• screening tool
• older adults
• geriatric
• nutritional risk
• stroke

Acknowledgments

We are grateful to all the undergraduate interns and master's rotations who have participated in the NST. Without your help, this work would not have been possible.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data that support the findings of this study are available from the corresponding author, GAL, upon reasonable request.

Additional information

Notes on contributors

Gabriel Alvarado-Luis

Gabriel Alvarado-Luis has a bachelor's degree in human nutrition, with a master’s degree in clinical nutrition. He is currently a nutritionist with the Nutritional Support team at the Instituto Nacional de Neurología y Neurocirugía ‘Manuel Velasco Suarez’.

Claudia Mimiaga-Hernández

Claudia Mimiaga-Hernández has a bachelor's degree in human nutrition, with a master’s degree in clinical nutrition. She is currently the medical coordinator of the Nutritional Support team at the Instituto Nacional de Neurología y Neurocirugía ‘Manuel Velasco Suarez’.