Prevention and Treatment of Malnutrition in Older Adults Living in Long-Term Care or the Community: An Evidence-Based Nutrition Practice Guideline

Malnutrition in older adults can decrease quality of life and increase risk for morbidities and mortality. Accurate and timely identification of malnutrition as well as subsequent implementation of effective interventions are essential to decrease poor outcomes associated with malnutrition in older adults. The Academy of Nutrition and Dietetics Evidence Analysis Center conducted a systematic review of the literature to develop an evidence-based practice guideline for the prevention and treatment of malnutrition in older adults (MiOA). The objective of this guideline is to provide evidence-based recommendations to identify, prevent, or treat protein-energy malnutrition in older adults (mean age of ≥65 years) living in long-term care and community settings. This guideline provides 11 nutrition recommendations to inform shared decision-making among dietitians, members of the healthcare team, family members or caregivers, and older adults living in LTC or the community to prevent or treat malnutrition. Topics include dietitian effectiveness, nutrition assessment tools, oral nutrition supplements, food fortification, and home delivered and congregate meals. Guideline implementation should include consideration of the importance of comprehensive individualized nutrition care for older adults. Future research is needed to address gaps that were identified related to the validity, reliability, and feasibility of nutrition assessment tools as well as the effectiveness of dietitian interventions on outcomes of interest in older adults living in LTC and the community.