A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex

Megan Crichton, Dana L. Craven, Hannah Mackay, Wolfgang Marx, Marian de van der Schueren, Skye Marshall

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11 Citations (Scopus)
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Background: protein-energy malnutrition is a major health concern in home-dwelling older adults, particularly in the context of an ageing population. Therefore, a systematic review and meta-analysis was undertaken to determine the prevalence of malnutrition among older adults living independently in the community according to geographical region, sampling frame, rurality and sex. Methods: six electronic databases were searched until September 2016. Original research studies which used the Mini Nutritional Assessment, Patient-Generated Subjective Global Assessment or Subjective Global Assessment to determine nutrition status in community samples with a mean age of ≥65 years were critically appraised and pooled using meta-analysis. Meta-regression was used to explore predictors of malnutrition prevalence in pooled statistics with high heterogeneity. Results: 111 studies from 38 countries (n = 69,702 participants) were included. The pooled prevalence of malnutrition in the older community setting ranged from 0.8% (95% CI: 0.2-1.7%) in Northern Europe to 24.6% (95% CI: 0.0-67.9%) in South-East Asia. Of all sampling frames, participants receiving homecare services had the highest prevalence at 14.6% (95% CI: 9.9-20.0%). Malnutrition prevalence in rural communities (9.9%; 95% CI: 4.5-16.8%) was double that in urban communities (5.7%; 95% CI: 4.2-7.3%) and higher among females than males (odds ratio = 1.45 [95% CI: 1.27-1.66]; P < 0.00001). Conclusions: the results of this review provide strategic insight to develop public and community health priorities for preventing malnutrition and associated poor health outcomes.

Original languageEnglish
Pages (from-to)38-48
Number of pages11
JournalAge and Ageing
Issue number1
Early online date7 Aug 2018
Publication statusPublished - Jan 2019

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  • Projects

    Bond University Nutrition and Dietetics Research Group Research Collaborations with External Clinical Partners

    Marshall, S., Isenring, E., MacKenzie-Shalders, K., Kelly, J., Campbell, K., Van der Meij, B., Cox, G., Reidlinger, D., Mayr, H., Banbury, M., Nucera, R., Jenkins, J., McCray, S., Canavan, R., Parker, B., de Groot, L., Cohen, F., Rich, G., Soni, A., McCarthy, A. L., Mackay, H., Young, A. M., Hickman, I., Wilkinson, S. A., Kiss, N. & Ali, A.

    1/01/14 → …

    Project: Research

    Ageing Nutrition: Research Across the Care Continuum

    Marshall, S., Isenring, E., Hugo, C., Agarwal, E., Teleni, L., Reidlinger, D., Campbell, K. & Van der Meij, B.

    1/01/14 → …

    Project: Research

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