The consequences of malnutrition following discharge from rehabilitation to the community: A systematic review of current evidence in older adults

Chronic diseases and physiological and psychosocial changes that
occur in ageing place older adults at higher nutritional risk, both during
health service admissions and in the community. The prevalence of
malnutrition is high in rehabilitation and community settings; however
the relationship between these two settings has been little explored. The
aim of this systematic literature review was to determine the association
between malnutrition in older adults admitted for rehabilitation and
nutrition status, functional status, quality of life, institutionalisation,
acute care admissions and mortality once discharged to the community.
Six electronic databases were searched for relevant publications (1990–
2013) using controlled vocabulary. Longitudinal papers were included
in which older adults (≥65 y) were admitted for rehabilitation if
nutrition assessment was performed during admission with relevant
outcomes measured following discharge to the community. Five observational studies were eligible for review which had similar populations.
The five studies comprised 1020 participants in total and follow-up
ranged from immediate to 26 months following discharge. Malnutrition
in older adults admitted for rehabilitation was negatively associated
with physical function and quality of life, and positively associated with
risk of institutionalisation, hospitalisation and mortality once discharged to the community. No study repeated a measure of nutrition
status and no intervention studies were identified. Although heterogenic in nature, the reviewed studies were of high quality and strength.
This review highlights an evidence gap along the continuum of care for
malnourished older adults, where further observational and intervention research is needed following discharge from rehabilitation to the
community.