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Nutrients. 2018 Apr 30;10(5). pii: E555. doi: 10.3390/nu10050555.

Nutritional Status and Nutritional Treatment Are Related to Outcomes and Mortality in Older Adults with Hip Fracture.

Malafarina V1,2, Reginster JY3,4,5, Cabrerizo S6, Bruyère O7,8, Kanis JA9,10, Martinez JA11,12,13,14,15, Zulet MA16,17,18,19.

Author information

1
Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain. vmalafarina@gmail.com.
2
Geriatric Department, Complejo Hospitalario de Navarra, 31008 Pamplona, Spain. vmalafarina@gmail.com.
3
Department of Public Health, Epidemiology and Health Economics, University of Liège, CHUB23, 4000, Liège, Belgium. jyr.ch@bluewin.ch.
4
WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. jyr.ch@bluewin.ch.
5
King Saud University, 11692 Riyadh, Kingdom of Saudi Arabia. jyr.ch@bluewin.ch.
6
Dietician Researcher; 08025 Barcelona, Spain, sonia.abril51@gmail.com. sonia.abril51@gmail.com.
7
Department of Public Health, Epidemiology and Health Economics, University of Liège, CHUB23, 4000, Liège, Belgium. olivier.bruyere@ulg.ac.be.
8
WHO Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium. olivier.bruyere@ulg.ac.be.
9
Centre for Metabolic Bone Diseases, University of Sheffield Medical School, University of Sheffield, Beech Hill Road, Sheffield S10 2RX, UK. w.j.pontefract@sheffield.ac.uk.
10
Institute for Health and Aging, Catholic University of Australia, Fitzroy VIC 3065 Melbourne, Australia. w.j.pontefract@sheffield.ac.uk.
11
Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain. jalfmtz@unav.es.
12
Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain. jalfmtz@unav.es.
13
CIBERobn, Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain. jalfmtz@unav.es.
14
Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain. jalfmtz@unav.es.
15
IMDEA Food, Research Institute on Food & Health Sciences, 28049 Madrid, Spain.. jalfmtz@unav.es.
16
Department of Nutrition, Food Science and Physiology, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain. mazulet@unav.es.
17
Navarra Institute for Health Research (IdiSNA), 31008, Pamplona, Spain. mazulet@unav.es.
18
CIBERobn, Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, 28029 Madrid, Spain. mazulet@unav.es.
19
Centre for Nutrition Research, Faculty of Pharmacy and Nutrition, University of Navarra, 31008 Pamplona, Spain. mazulet@unav.es.

Abstract

Malnutrition is very prevalent in geriatric patients with hip fracture. Nevertheless, its importance is not fully recognized. The objective of this paper is to review the impact of malnutrition and of nutritional treatment upon outcomes and mortality in older people with hip fracture. We searched the PubMed database for studies evaluating nutritional aspects in people aged 70 years and over with hip fracture. The total number of studies included in the review was 44, which analyzed 26,281 subjects (73.5% women, 83.6 ± 7.2 years old). Older people with hip fracture presented an inadequate nutrient intake for their requirements, which caused deterioration in their already compromised nutritional status. The prevalence of malnutrition was approximately 18.7% using the Mini-Nutritional Assessment (MNA) (large or short form) as a diagnostic tool, but the prevalence was greater (45.7%) if different criteria were used (such as Body Mass Index (BMI), weight loss, or albumin concentration). Low scores in anthropometric indices were associated with a higher prevalence of complications during hospitalization and with a worse functional recovery. Despite improvements in the treatment of geriatric patients with hip fracture, mortality was still unacceptably high (30% within 1 year and up to 40% within 3 years). Malnutrition was associated with an increase in mortality. Nutritional intervention was cost effective and was associated with an improvement in nutritional status and a greater functional recovery. To conclude, in older people, the prevention of malnutrition and an early nutritional intervention can improve recovery following a hip fracture.

KEYWORDS:

body mass index; hip fracture; malnutrition; nutritional biomarkers; older adults

PMID:
29710860
PMCID:
PMC5986435
DOI:
10.3390/nu10050555
[Indexed for MEDLINE]
Free PMC Article

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