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

Vincenzo Malafarina, Jean-Yves Reginster, Sonia Cabrerizo, Olivier Bruyère, John A Kanis, J Alfredo Martinez, M Angeles Zulet, Vincenzo Malafarina, Jean-Yves Reginster, Sonia Cabrerizo, Olivier Bruyère, John A Kanis, J Alfredo Martinez, M Angeles Zulet

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.

Conflict of interest statement

V.M., S.C., O.B., J.A.K., J.A.M., M.A.Z. declare no conflicts of interest with this article. J.-Y.R.: Consulting fees or paid advisory boards: IBSA-GENEVRIER, MYLAN, RADIUS HEALTH, PIERRE FABRE. Lecture fees when speaking at the invitation of sponsor: IBSA-GENEVRIER, MYLAN, CNIEL, DAIRY RESEARCH COUNCIL (DRC). Grant Support from Industry (all through Institution): IBSA-GENEVRIER, MYLAN, CNIEL, RADIUS HEALTH.

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