Efficacy of non-pharmacological interventions to treat malnutrition in older persons: A systematic review and meta-analysis. The SENATOR project ONTOP series and MaNuEL knowledge hub project

Andrea Correa-Pérez*, Iosef Abraha, Antonio Cherubini, Avril Collinson, Dominique Dardevet, Lisette C.P.G.M. de Groot, Marian A.E. de van der Schueren, Antje Hebestreit, Mary Hickson, Javier Jaramillo-Hidalgo, Isabel Lozano-Montoya, Denis O'Mahony, Roy L. Soiza, Marjolein Visser, Dorothee Volkert, Maike Wolters, Alfonso J.Cruz Jentoft

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review

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Abstract

Introduction: We aimed to perform a review of SRs of non-pharmacological interventions in older patients with well-defined malnutrition using relevant outcomes agreed by a broad panel of experts. Methods: PubMed, Cochrane, EMBASE, and CINHAL databases were searched for SRs. Primary studies from those SRs were included. Quality assessment was undertaken using Cochrane and GRADE criteria. Results: Eighteen primary studies from seventeen SRs were included. Eleven RCTs compared oral nutritional supplementation (ONS) with usual care. No beneficial effects of ONS treatment, after performing two meta-analysis in body weight changes (six studies), mean difference: 0.59 (95%CI -0.08, 1.96) kg, and in body mass index changes (two studies), mean difference: 0.31 (95%CI -0.17, 0.79) kg/m2 were found. Neither in MNA scores, muscle strength, activities of daily living, timed Up&Go, quality of life and mortality. Results of other intervention studies (dietary counselling and ONS, ONS combined with exercise, nutrition delivery systems) were inconsistent. The overall quality of the evidence was very low due to risk of bias and small sample size. Conclusions: This review has highlighted the lack of high quality evidence to indicate which interventions are effective in treating malnutrition in older people. High quality research studies are urgently needed in this area.

Original languageEnglish
Pages (from-to)27-48
Number of pages22
JournalAgeing Research Reviews
Volume49
Early online date2 Nov 2018
DOIs
Publication statusPublished - Jan 2019

Funding

The preparation of this paper was supported by the MalNutrition in the ELderly (MaNuEL) knowledge hub. MaNuEL is supported by the Joint Programming Initiative ‘Healthy Diet for a Healthy Life’ that has received funding from the European Union’s H2020 Research and Innovation Programme under grant agreement nº 696300 . The MaNuEL funding agencies supporting this paper are (in alphabetical order of participating Member State): France: Ecole Supérieure d’Agricultires (ESA) ; Germany: Federal Ministry of Food and Agriculture (BMEL) represented by Federal Office for Agriculture and Food (BLE) ; The Netherlands: The Netherlands Organisation for Health Research and Development (ZonMw) . This work was also supported by the SENATOR trial that has received funding from the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement n° 305930 .

FundersFunder number
Horizon 2020 Framework Programme696300
Seventh Framework Programme305930
European Space Agency
ZonMw
Seventh Framework Programme
Bundesministerium für Ernährung und Landwirtschaft
Bundesanstalt für Landwirtschaft und Ernährung

    Keywords

    • Elderly, dietary supplementation
    • Protein energy malnutrition
    • Review, systematic

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