Mild Cognitive Impairment Is Associated with Poorer Nutritional Status on Hospital Admission and after Discharge in Acutely Hospitalized Older Patients

Olivia Bornæs, Aino L Andersen, Morten B Houlind, Thomas Kallemose, Juliette Tavenier, Anissa Aharaz, Rikke L Nielsen, Lillian M Jørgensen, Anne M Beck, Ove Andersen, Janne Petersen, Mette M Pedersen, Olivia Bornæs, Aino L Andersen, Morten B Houlind, Thomas Kallemose, Juliette Tavenier, Anissa Aharaz, Rikke L Nielsen, Lillian M Jørgensen, Anne M Beck, Ove Andersen, Janne Petersen, Mette M Pedersen

Abstract

In acutely hospitalized older patients (≥65 years), the association between mild cognitive impairment (MCI) and malnutrition is poorly described. We hypothesized that (1) MCI is associated with nutritional status on admission and after discharge; (2) MCI is associated with a change in nutritional status; and (3) a potential association is partly explained by frailty, comorbidity, medication use, and age. We combined data from a randomized controlled trial (control group data) and a prospective cohort study (ClinicalTrials.gov: NCT01964482 and NCT03052192). Nutritional status was assessed on admission and follow-up using the Mini Nutritional Assessment-Short Form. MCI or intact cognition (noMCI) was classified by three cognitive performance tests at follow-up. Data on frailty, comorbidity, medication use, and age were drawn from patient journals. MCI (n = 42) compared to noMCI (n = 47) was associated with poorer nutritional status with an average difference of -1.29 points (CI: -2.30; -0.28) on admission and -1.64 points (CI: -2.57; -0.70) at 4-week follow-up. Only age influenced the estimates of -0.85 (CI: -1.86; 0.17) and -1.29 (CI: -2.25; -0.34), respectively. In acutely hospitalized older patients, there is an association between MCI and poorer nutritional status upon admission and four weeks after discharge. The association is partly explained by higher age.

Keywords: acute admission; cognitive dysfunction; comorbidity; frailty; hospital; malnutrition; medication; nutritional status; older adults.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart. * Patients can have more than one reason for exclusion.
Figure 2
Figure 2
The prevalence of malnutrition and risk of malnutrition (assessed with MNA-SF) at baseline and 4-week follow-up for participants with mild cognitive impairment (MCI) and participants with intact cognition (noMCI). Notes to Figure 2: Malnourished = malnutrition (MNA-SF score 0–7); risk = risk of malnutrition (MNA-SF score of 8–11); normal = normal nutritional status (MNA-SF score 12–14); noMCI = intact cognition; MCI = mild cognitive impairment.
Figure 3
Figure 3
Nutritional status (MNA-SF score) at baseline and 4-week follow-up for participants with mild cognitive impairment (MCI) and participants with intact cognition (noMCI) with observation-matrix (MCI/noMCI), n = 89. MCI = Mild Cognitive Impairment; noMCI = Intact cognition, MNA-SF = Mini Nutritional Assessment—Short Form, MNA-SF score 0–7 = Malnutrition; MNA-SF score of 8–11 = risk of malnutrition; MNA-SF score 12–14 = normal nutritional status.
Figure 4
Figure 4
Distribution of sample estimates from sensitivity analysis.

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