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

• Published in: Ageing research reviews Vol. 49; pp. 27 - 48
• Main Authors: Correa-Pérez, Andrea, Abraha, Iosef, Cherubini, Antonio, Collinson, Avril, Dardevet, Dominique, de Groot, Lisette C.P.G.M., de van der Schueren, Marian A.E., Hebestreit, Antje, Hickson, Mary, Jaramillo-Hidalgo, Javier, Lozano-Montoya, Isabel, O’Mahony, Denis, Soiza, Roy L., Visser, Marjolein, Volkert, Dorothee, Wolters, Maike, Jentoft, Alfonso J. Cruz
• Format: Journal Article
• Language: English
• Published: England Elsevier B.V 01.01.2019; Elsevier Masson
• Subjects: Activities of Daily Living; Aged; Body Weight; Dietary Supplements; Elderly, dietary supplementation; Exercise - physiology; Food and Nutrition; Geriatry and gerontology; Human health and pathology; Humans; Life Sciences; Malnutrition - diet therapy; Muscle Strength; Nutritional Status; Protein energy malnutrition; Quality of Life; Review, systematic; Elderly, dietary supplementation; Review, systematic; Protein energy malnutrition; protein energy malnutrition; systematic; review; elderly; dietary supplementation
• ISSN: 1568-1637; 1872-9649; 1872-9649
• DOI: 10.1016/j.arr.2018.10.011

•We made a systematic review of non-pharmacological interventions in malnourished older people.•Relevant nutritional and clinical outcomes were agreed by a wide panel of experts in nutrition and geriatrics.•We included 19 studies from 17 systematic reviews after reviewing 7984 references.•Our findings were negative: we did not find high quality evidence on interventions to treat malnutrition in older people.•High quality research studies are urgently needed in this area. 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. 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. 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. 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.