Addressing Nutrition Risk in Older Adults in Community Settings

Abstract

Nutrition risk, and subsequent malnutrition, can be common in community- dwelling older adults in Europe and other high-income regions. While a major factor in predicting loss of independence, hospitalization and mortality, they also largely preventable, but older adults often have limited supports to prevent or manage nutrition concerns in communities, compared with hospital settings. Primary care and other community settings are well-situated to provide screening and follow-up, although several barriers may exist when implementing preventative or curative interventions. Indeed, malnutrition prevalence in older adults ranges from less than 1% to almost 20% in high-income countries, which suggests there is disparity in prevention and treatment strategies. This narrative review aims to highlight the prevalence and costs of malnutrition, then focus on recent examples of community-based nutrition risk mitigation to guide the establishment of care pathways for malnutrition management in primary and community care. In particular, care pathways incorporating routine screening, which includes monitoring of dietary intake and weight of patients, with risk-based follow-up are shown to reduce nutrition risk. Likewise, leveraging both medical interventions from dietitians and non- medical interventions such as addressing food insecurity or social isolation are required to mitigate nutrition risk.