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Malnutrition in Older Adults and COVID-19

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 45048

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Dr. Harriët Jager-Wittenaar

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Guest Editor

1. Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands;
2. Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Interests: malnutrition; older adults; body composition; dietetics

Special Issue Information

Dear Colleagues,

Malnutrition, i.e., undernutrition, is a common problem in older adults worldwide. Prevalence rates vary from 10% to 40%, depending on the criteria used, type of healthcare setting, and the population studied. Moreover, the prevalence of malnutrition increases with age. Malnutrition in older adults can be the result of various factors, for example disease-related factors, psychosocial and environmental factors, or their combinations.

While older adults are already at risk for malnutrition due to the ageing process and age- comorbidities, the Covid-19 pandemic, including the related self-quarantine, will have a large impact on the prevalence of malnutrition among older adults. However, information is lacking on the extent to which Covid-19 affects the nutritional status of older adults across the various healthcare settings, the determinants of malnutrition during and after the Covid-19 outbreak, and which nutritional interventions are effective to prevent or treat malnutrition in older adults during Covid-19 infection or self-quarantine. In turn, since Covid-19 is a new disease, data are lacking on the relationship between malnutrition and susceptibility to Covid-19, Covid-19 disease severity, and mortality.

With this Special Issue of Nutrients, we aim to gather new insights on causes and consequences of malnutrition in older adults in relation to the Covid-19 pandemic.

We welcome the submission of original research articles (quantitative and qualitative studies), review articles, as well as short communications.

Dr. Harriët Jager-Wittenaar
Guest Editor

Manuscript Submission Information

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Keywords

Malnutrition
Nutritional status
Older adults
COVID-19

Published Papers (5 papers)

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Research

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12 pages, 286 KiB

Open AccessArticle

The Impact of Poor Nutrient Intakes and Food Insecurity on the Psychological Distress among Community-Dwelling Middle-Aged and Older Adults during the COVID-19 Pandemic

by Nurul Fatin Malek Rivan, Hanis Mastura Yahya, Suzana Shahar, Devinder Kaur Ajit Singh, Norhayati Ibrahim, Arimi Fitri Mat Ludin, Noor Ibrahim Mohamed Sakian, Hazlina Mahadzir, Ponnusamy Subramaniam and Mohd Zul Amin Kamaruddin

Nutrients 2021, 13(2), 353; https://doi.org/10.3390/nu13020353 - 25 Jan 2021

Cited by 19 | Viewed by 6004

Abstract

This study aimed to investigate the impact of food insecurity and poor nutrient intake on the psychological health of middle-aged and older adults during the COVID-19 pandemic. A sub-sample of 535 individuals aged 52 years and above, from the earlier cohort and interventional studies (n = 4) from four selected states in Peninsular Malaysia, were recruited during the COVID-19 outbreak (April to June 2020). Telephone interviews were conducted by trained interviewers with a health sciences background to obtain participants’ information on health status, physical activity, food security, and psychological health (General Health Questionnaire-12; normal and psychological distress). Univariate analyses were performed for each variable, followed by a logistic regression analysis using SPSS Statistics version 25.0. Results revealed food insecurity (OR = 17.06, 95% CI: 8.24–35.32, p < 0.001), low protein (OR = 0.981, 95% CI: 0.965–0.998, p < 0.05), and fiber intakes (OR = 0.822, 95% CI: 0.695–0.972, p < 0.05) were found to be significant factors associated with the psychological distress group after adjusting for confounding factors. The findings suggested that food insecurity and insufficiencies of protein and fiber intakes heightened the psychological distress during the COVID-19 pandemic. Optimal nutrition is vital to ensure the physical and psychological health of the older population, specifically during the current pandemic. Full article

(This article belongs to the Special Issue Malnutrition in Older Adults and COVID-19)

11 pages, 247 KiB

Open AccessArticle

Self-Reported Impact of the COVID-19 Pandemic on Nutrition and Physical Activity Behaviour in Dutch Older Adults Living Independently

by Marjolein Visser, Laura A. Schaap and Hanneke A. H. Wijnhoven

Nutrients 2020, 12(12), 3708; https://doi.org/10.3390/nu12123708 - 30 Nov 2020

Cited by 131 | Viewed by 10705

Abstract

The aim was to explore the self-reported impact of the COVID-19 pandemic on nutrition and physical activity behaviour in Dutch older adults and to identify subgroups most susceptible to this impact. Participants (N = 1119, aged 62–98 y, 52.8% female) of the Longitudinal Aging Study Amsterdam living independently completed a COVID-19 questionnaire. Questions on diagnosis, quarantine and hospitalization were asked, as well as impact of the pandemic on ten nutrition and physical activity behaviours. Associations of pre-COVID-19 assessed characteristics (age, sex, region, household composition, self-rated health, BMI, physical activity, functional limitations) with reported impact were tested using logistic regression analyses. About half of the sample (48.3–54.3%) reported a decrease in physical activity and exercise due to the pandemic. An impact on nutritional behaviour predisposing to overnutrition (e.g., snacking more) was reported by 20.3–32.4%. In contrast, 6.9–15.1% reported an impact on behaviour predisposing to undernutrition (e.g., skipping warm meals). Those who had been in quarantine (n = 123) more often reported a negative impact. Subgroups with higher risk of impact could be identified. This study shows a negative impact of the COVID-19 pandemic on nutrition and physical activity behaviour of many older adults, which may increase their risk of malnutrition, frailty, sarcopenia and disability. Full article

(This article belongs to the Special Issue Malnutrition in Older Adults and COVID-19)

Review

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13 pages, 1736 KiB

Open AccessReview

Coronavirus Disease 19 from the Perspective of Ageing with Focus on Nutritional Status and Nutrition Management—A Narrative Review

by Elisabet Rothenberg

Nutrients 2021, 13(4), 1294; https://doi.org/10.3390/nu13041294 - 14 Apr 2021

Cited by 17 | Viewed by 5376

Abstract

The novel severe acute respiratory syndrome coronavirus (COVID-19) has hit older adults harder due to a combination of age-related immunological and metabolic alterations. The aim of this review was to analyze the COVID-19 literature with respect to nutritional status and nutrition management in older adults. No studies only on people aged 65+ years were found, and documentation on those 80+ was rare. Age was found to be strongly associated with worse outcomes, and with poor nutritional status. Prevalence of malnutrition was high among severely and critically ill patients. The studies found a need for nutrition screening and management, and for nutrition support as part of follow-up after a hospital stay. Most tested screening tools showed high sensitivity in identifying nutritional risk, but none were recognized as best for screening older adults with COVID-19. For diagnosing malnutrition, the Global Leadership Initiative on Malnutrition (GLIM) criteria are recommended but were not used in the studies found. Documentation of olfactory and gustatory dysfunction in relation to nutritional status is missing in older adults. Other COVID-19-associated factors with a possible impact on nutritional status are poor appetite and gastrointestinal symptoms. Vitamin D is the nutrient that has attracted the most interest. However, evidence for supplementation of COVID-19 patients is still limited and inconclusive. Full article

(This article belongs to the Special Issue Malnutrition in Older Adults and COVID-19)

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13 pages, 454 KiB

Open AccessReview

The Role of Nutrition in the COVID-19 Pandemic

by Maria Chiara Mentella, Franco Scaldaferri, Antonio Gasbarrini and Giacinto Abele Donato Miggiano

Nutrients 2021, 13(4), 1093; https://doi.org/10.3390/nu13041093 - 27 Mar 2021

Cited by 29 | Viewed by 11776

Abstract

SARS-CoV-2, the cause of the COVID-19 disease, is posing unprecedent challenges. In the literature, increasing evidence highlights how malnutrition negatively affects the immune system functionality, impairing protection from infections. The current review aims to summarize the complex relationship between SARS-CoV-2 infection and nutritional status and the effects of malnutrition in terms of disease severity, patients’ recovery time, incidence of complications and mortality rate. Current studies evaluating the possibility of modulating nutrition and supplementation in combination with pharmacological treatments in the clinical setting to prevent, support, and overcome infection are also described. The discussion of the most recent pertinent literature aims to lay the foundations for making reasonable assumptions and evaluations for a nutritional “best practice” against COVID-19 pandemic and for the definition of sound cost-effective strategies to assist healthcare systems in managing patients and individuals in their recovery from COVID-19. Full article

(This article belongs to the Special Issue Malnutrition in Older Adults and COVID-19)

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24 pages, 530 KiB

Open AccessReview

Nutritional Risk Screening Tools for Older Adults with COVID-19: A Systematic Review

by David Franciole Oliveira Silva, Severina Carla Vieira Cunha Lima, Karine Cavalcanti Mauricio Sena-Evangelista, Dirce Maria Marchioni, Ricardo Ney Cobucci and Fábia Barbosa de Andrade

Nutrients 2020, 12(10), 2956; https://doi.org/10.3390/nu12102956 - 27 Sep 2020

Cited by 55 | Viewed by 9090

Abstract

Coronavirus disease 2019 (COVID-19) is associated with high risk of malnutrition, primarily in older people; assessing nutritional risk using appropriate screening tools is critical. This systematic review identified applicable tools and assessed their measurement properties. Literature was searched in the MEDLINE, Embase, and LILACS databases. Four studies conducted in China met the eligibility criteria. Sample sizes ranged from six to 182, and participants’ ages from 65 to 87 years. Seven nutritional screening and assessment tools were used: the Nutritional Risk Screening 2002 (NRS-2002), the Mini Nutritional Assessment (MNA), the MNA-short form (MNA-sf), the Malnutrition Universal Screening Tool (MUST), the Nutritional Risk Index (NRI), the Geriatric NRI (GNRI), and modified Nutrition Risk in the Critically ill (mNUTRIC) score. Nutritional risk was identified in 27.5% to 100% of participants. The NRS-2002, MNA, MNA-sf, NRI, and MUST demonstrated high sensitivity; the MUST had better specificity. The MNA and MUST demonstrated better criterion validity. The MNA-sf demonstrated better predictive validity for poor appetite and weight loss; the NRS-2002 demonstrated better predictive validity for prolonged hospitalization. mNUTRIC score demonstrated good predictive validity for hospital mortality. Most instruments demonstrate high sensitivity for identifying nutritional risk, but none are acknowledged as the best for nutritional screening in older adults with COVID-19. Full article

(This article belongs to the Special Issue Malnutrition in Older Adults and COVID-19)

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