Swedish researchers urge that more attention be given to elderly malnutrition

16 Jul 2024 --- Researchers from Sweden’s Uppsala University and the University of Gothenburg concluded in their recent study that a steady provision of nutrients can alleviate malnourishment in elderly patients in hospital. As many as half of all patients admitted to hospital and other healthcare facilities are malnourished.

Malnourishment causes unnecessary suffering, poorer quality of life and mortality. Nutrient boosting can resolve these issues, but more attention should be paid to the science on it. 

“Far too few patients are diagnosed with malnutrition. Underdiagnosis and undertreatment of the condition remains a problem in healthcare and elderly care, not only in Sweden but worldwide. However, by using fairly simple methods, patients and older adults could be made to feel much better,” says Tommy Cederholm, professor of clinical nutrition at Uppsala University.

Function of hospitalized care
The review article, published in the New England Journal of Medicine, summarizes the global state of knowledge over the last 50 years. It emphasizes developments in the last five years and recommends that the healthcare sector should make much greater use of the experience and knowledge revealed in the research. 

Roughly 5–10% of older adults in Sweden are malnourished and the figure rises to 50% of patients being cared for in hospitals, nursing homes and other similar facilities. 

According to the review, there is a global consensus among researchers and clinicians on the criteria for diagnosing malnutrition — weight loss, low body mass index and reduced muscle mass in an individual with poor appetite — either with or without an underlying disease.

Recent large-scale clinical studies clearly show that malnutrition can be reversed. Counseling and treatment offered in collaboration with dietitians and using nutritional drinks can slow weight loss and reduce mortality.

“These are simple measures that are ignored every day. We now know that, with the exception of those in the advanced stages of terminal illnesses such as metastatic cancer, the vast majority of patients can be treated. In Sweden, for example, we have been working on this for many years, but we need to be even better,” says Ingvar Bosaeus, a consultant at Sahlgrenska University Hospital.

An outdated model
Traditionally, weight loss and malnutrition were seen as a natural expression of disease or aging for which nothing could be done. New information on the subject recognizes that the most prevalent cause of the disease causes the person to eat less, leading to the breakdown of organs and tissue.

People suffering from malnutrition will lose weight, and the lack of nutrients may lead to muscle atrophy, making it difficult to cope with everyday life. They may also be more susceptible to infection and require more care, possibly involving long periods of hospitalization.

The researchers propose concrete measures to reduce suffering among older adults.

“It is crucial to register risk factors for malnutrition at an early stage and to be alert to weight loss and loss of appetite. One also needs to recommend nutrient-dense foods at an early stage and begin nutritional therapy in good time with, for example, nutritional drinks. This knowledge must become a more explicit component of basic and specialist training for doctors and nurses,” says Cederholm.

Meanwhile, strides in ultra-high temperature treatment, microparticulation and shelf life stability technologies help companies support malnutrition alleviation cost-effectively. Nutrition Insight sat down with FrieslandCampina Ingredients, Fonterra and dsm-firmenich for an in-depth perspective on the most advanced malnutrition solutions of the era.