Abstract
ABSTRACT Malnutrition in older adults: A comparative study of factors affecting malnutrition across care settings in the UK and Malaysia. Malnutrition is a serious and common problem in older adults. This study aimed to determine and compare the nutritional status and factors affecting malnutrition in older adults in different care settings in the UK and Malaysia, in order to inform the development of setting and country-appropriate recommendations to reduce the prevalence and impact of malnutrition. An observational study was conducted in the UK and Malaysia involving 151 older adults aged 75 years and over in free-living, care home and hospital Data was collected using the Mini Nutritional Assessment (MNA), the Satisfaction with Food-related Life (SWFL) questionnaire, and 3-day 24hr recalls. Attitudes of 41 staff towards the nutritional care of older patients, the food access experience of 150 patients and a menu audit of 155 lunch time meals served, consumed and wasted were assessed in an additional study in hospital. Dietary data were analysed using Dietplan 6 and all data were analysed using SPSS (v16). Prevalence of malnutrition was higher among Malaysian older adults in all care settings, over their UK counterparts, while older patients in hospitals had the highest prevalence of malnutrition than other care settings in both countries. Although hospital food contained adequate levels of energy and protein, protein consumption was inadequate in the UK hospital setting, suggesting that it is the intake of hospitalised patients rather than the provision that is problematic. However energy consumption was inadequate in all care settings in both countries, suggesting that older adults are not eating enough to meet their estimated needs and the risk of malnutrition is widespread in older adults. This research has identified that the satisfaction with food-related life is the strongest unique indicator of malnutrition in this group and may present a simple early warning measure of malnutrition risk in older adults.