Preventing malnutrition in later life

Malnutrition Factsheet 

We regularly review the below statistics and try to keep them as up to date as possible. 

Definition

The National Institute for Health and Care Excellence (NICE) defines a person as being malnourished if they have:

  • a body mass index (BMI) of less than 18.5 kg/m2
  • unintentional weight loss greater than 10% within the past 3–6 months
  • a BMI of less than 20 kg/m2 and unintentional weight loss greater than 5% within the past 3–6 months
“Nutrition Support for Adults,” Section 1.3, NICE guidelines, accessed Jan 2018,  https://www.nice.org.uk/guidance/cg32/chapter/guidance

Malnutrition in Later Life

  • Estimates suggest 1.3 million people over 65 suffer from malnutrition, and the vast majority (93%) live in the community
“Introduction to Malnutrition,” BAPEN, accessed Jan 2018, http://www.bapen.org.uk/about-malnutrition/introduction-to-malnutrition?showall=&start=4

Hospitals

  • One third (32%) of people aged 65 years or over are at risk of malnutrition on admission to hospital
“Nutrition screening surveys in hospitals in the UK, 2007-2011,” BAPEN, accessed Jan 2018, http://www.bapen.org.uk/pdfs/nsw/bapen-nsw-uk.pdf, p.41
  • Of patients in hospital who said they needed help to eat their meals, 17% said that they did not get enough help from staff and 19% only ‘sometimes’ got enough help
“CQC 2016 Adult Inpatients survey,” The Hospital and Ward, CQC, accessed Jan 2018, http://www.cqc.org.uk/sites/default/files/20170531_ip16_national_tables.ods
  • 50% of people admitted to hospital from care homes were at risk of malnutrition
“Nutrition screening surveys in hospitals in the UK, 2007-2011,” BAPEN, accessed January 2018, http://www.bapen.org.uk/pdfs/nsw/bapen-nsw-uk.pdf, p.35

Social Care

Care homes

  • Of residents admitted to care homes and screened, 35% were at risk of malnutrition
“Nutrition Screening Surveys in care homes in the UK,  2007-11,” BAPEN, accessed January 2018, http://www.bapen.org.uk/pdfs/nsw/care-homes/care-homes-uk.pdf , p.7
  • While in 90% of care homes nutrition screening was standard, there were inconsistencies in using and calibrating the equipment as well as translating the findings into care plans for individuals
 “Nutrition screening survey in the UK and Republic of Ireland in 2011,” BAPEN, accessed January 2018, http://www.bapen.org.uk/pdfs/nsw/nsw-2011-report.pdf

Meals on wheels

  • In 2017 it was estimated that just under half of Local Authorities provided meals, compared to 66% in 2015
“A New Direction for Meals on Wheels,” Association for Public Service Excellence, 2017, accessed January 2018, http://www.apse.org.uk/apse/index.cfm/news/2017/a-new-direction-for-meals-on-wheels/

Professional Awareness

  • Professionals whose role involves frontline care were significantly more likely to identify preventing and treating malnutrition as a high priority than those whose role does not involve frontline care (33% and 20% respectively) 
  • Senior staff and those with financial responsibility were more likely to consider this issue a low priority 
  • Overall 47% of health and care professionals felt confident in their knowledge and skills to identify and treat older people at risk of malnutrition. This increased to 60% for those respondents whose role involves front line care
  • 51% of health and care professionals stated that tackling malnutrition was a high or medium priority
  • 54% of professionals didn’t know if services were in place to tackle malnutrition, 55% didn’t know about support services and 61% were unaware of a pathway to tackle malnutrition
“Experiences of Patient Malnutrition,” Dods research for the Malnutrition Task Force, 2016, accessed January 2018,  http://www.malnutritiontaskforce.org.uk/new-research-shows-only-half-of-health-professionals-regard-malnutrition-as-a-priority/   

Consequences of malnutrition

Increased use of health services

Malnourished people:

  • saw their GP twice as often,
  • had 3 times the number of hospital admissions and
  • stayed in hospital more than 3 days longer than those who were well nourished
  • have more ill health (co-morbidities) 
Guest, J. F., Panca, M., Baeyens, J.P., de Man, F., Ljungqvist, O., Pichard, C.,Wait, S & Wilson, L., ‘Health economic impact of managing patients following a community-based diagnosis of malnutrition in the UK’, Clinical Nutrition, Volume 30, Issue 4 , Pages 422-429, August 2011

Costs to system:

  • The cost of malnutrition to the health and care system was around £19.6 billion in 2011-12
  • Treating someone who is malnourished is two to three times more expensive than for someone who is not malnourished 
  • Estimated health and social care expenditure per capita of the population is £2,417.  For those malnourished or at risk, the expenditure rises to £7,408 per person in the population
“The cost of malnutrition in England and potential cost savings from nutritional interventions,” Elia M.on behalf of the Malnutrition Action Group of BAPEN and the National Institute for Health Research Southampton Biomedical Research Centre, accessed January 2018, http://www.bapen.org.uk/pdfs/economic-report-short.pdf, p.5

Impact on carers:

  • Carers UK found that 60% of carers worry about the nutrition of the person they care for. One is six carers is looking after someone at real risk of malnutrition but do not have nutritional support of any kind
“Malnutrition and Caring: The Hidden Cost for Families,” Carers UK, 2012, accessed Jan 2018, http://www.carersuk.org/scotland/news/malnutrition-s-hidden-cost-for-families

Activities of Daily Living

  • Around one in five people in their late 80s have difficulties undertaking five or more activities of daily living, including cooking and shopping  
“Health Survey for England 2015,” NHS Digital, 2016, accessed Jan 2018, http://digital.nhs.uk/media/30014/Health-Survey-for-England-2015-Adult-social-care/Any/HSE2015-soc-car
  • 11% of those aged 65 and over say they find it difficult to access a corner shop
  • 12% of those aged 65 and over find it difficult to get to their local supermarket
“Agenda for Later Life Survey,” TNS for Age UK, 2013, accessed Jan 2018 

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