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Malnutrition Common in Older ED Patients but Often Not Recognized

Addressing a frequently unrecognized – and often easy-to-resolve – problem can help avoid some of the issues that cause older Americans to require emergency care, new research suggests.

A study published in the Journal of the American Geriatrics Society points out that malnutrition occurs more frequently than expected among patients 65 and older and that clinicians frequently overlook the problem even though it can negatively affect illness or injury recovery.

A team led by University of North Carolina researchers conducted a study at three emergency departments – one each in the southern, northeastern, and Midwestern United States – in an effort to pinpoint what could be done about malnutrition in elderly patients presenting to EDs.

To do that, they used the Mini Nutritional Assessment Short-Form to determine the presence of malnutrition. The team also assessed food insecurity and inadequate oral health. Other risk factors measured included depression, mobility issues, transportation limitations, loneliness, and side effects from drug therapies.

Among the sample of 252 older ED patients, malnutrition was identified in 12%. Making the diagnosis more likely were the lack of a college degree, admission as an inpatient, and assisted living residency.

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The study also looked at the population attributable risk proportion (PARP) for malnutrition in relation to each risk factor, finding the most serious to be deterioration of oral health at 54%, food insecurity at 14%, and transportation issues limiting food options at 12%.

As for remedies, senior author Tim Platts-Mills, MD, co-director of the Division of Geriatric Emergency Medicine at the UNC School of Medicine, suggested that EDs strive to link patients who don’t have enough food at home to the national system of food assistance programs, such as Meals on Wheels. Fully funding those programs can help avoid the costs of medical care required to treat the effects of malnutrition, they note.

Platts-Mills said future research would look at ways to make connections between those programs and patients who need them.