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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Abstract

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
Volume48
Issue number1
Early online date7 Aug 2018
DOIs
Publication statusPublished - Jan 2019

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Protein-Energy Malnutrition
Malnutrition
Meta-Analysis
Health Priorities
Nutrition Assessment
Far East
Health
Rural Population
Nutritional Status
Public Health
Odds Ratio
Databases
Research
Population

Cite this

Crichton, Megan ; Craven, Dana L. ; Mackay, Hannah ; Marx, Wolfgang ; de van der Schueren, Marian ; Marshall, Skye. / A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex. In: Age and Ageing. 2019 ; Vol. 48, No. 1. pp. 38-48.
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abstract = "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.",
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A systematic review, meta-analysis and meta-regression of the prevalence of protein-energy malnutrition: associations with geographical region and sex. / Crichton, Megan; Craven, Dana L.; Mackay, Hannah; Marx, Wolfgang; de van der Schueren, Marian; Marshall, Skye.

In: Age and Ageing, Vol. 48, No. 1, 01.2019, p. 38-48.

Research output: Contribution to journalArticleResearchpeer-review

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AU - de van der Schueren, Marian

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AB - 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.

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