Malnutrition in England factsheet

We regularly review the below statistics and try to keep them as up to date as possible. Last update: August 2019

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 Aug 2019, https://www.nice.org.uk/guidance/cg32/chapter/guidance

Malnutrition in Later Life

  • In the UK, 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 Aug 2019, http://www.bapen.org.uk/about-malnutrition/introduction-to-malnutrition?showall=&start=4

Hospitals

  • One third (32%) of people in the UK 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 Aug 2019, 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 18% said they did not get help from staff

“2018 Adult Inpatient Survey”, CQC, accessed Aug 2019, https://www.cqc.org.uk/publications/surveys/adult-inpatient-survey-2018, p.28

  • In the UK, 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 Aug 2019, http://www.bapen.org.uk/pdfs/nsw/bapen-nsw-uk.pdf, p.35

Care homes

  • Of residents in the UK 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 Aug 2019, http://www.bapen.org.uk/pdfs/nsw/care-homes/care-homes-uk.pdf , p.7

  • While in 90% of care homes in the UK, 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 Aug 2019, http://www.bapen.org.uk/pdfs/nsw/nsw-2011-report.pdf

Meals on wheels

  • In the UK, Provision of meals on wheels services by councils has decreased to 42% in 2018. A drop of 24% since 2014 when 66% of councils provided a meals on wheels service

“Meals on Wheels Survey 2018”, NACC and meals on wheels, accessed Aug 2019, http://costsectorcatering.co.uk/sites/default/files/attachment/nacc_-_meals_on_wheels_report_2018.pdf , p.1

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 Aug 2019,  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

In the UK, 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 Aug 2019, 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 Aug 2019, http://www.carersuk.org/scotland/news/malnutrition-s-hidden-cost-for-families

Factors contributing to malnutrition

Activities of Daily Living

Activities of Daily Living (ADLs) are activities that relate to personal care and mobility around the home and are basic to daily living (e.g. eating, bathing, dressing, toileting, etc).

Instrumental Activities of Daily Living (IADLs) are activities which, while not fundamental to functioning, are important aspects of living independently (e.g. money management, cooking, shopping, etc).

  • 44% of those aged 80+ need help with two or more Activities of Daily Living or Instrumental Activities of Daily Living

“Health Survey for England 2017”, National Statistics, 2017, accessed Aug 2019, https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2017

  • 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 Aug 2019

Ageing population

In 50 years there are projected to be an additional 8.6 million people aged 65 years and over in the UK– a population roughly equivalent to the size of London.

The 85+ age group is the fastest growing and is set to double to 3.2 million by mid-2041 and treble by 2066 (5.1 million; 7% of the UK population).

“Living Longer”, Office for National Statistics, 2018, accessed Aug 2019, from https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/livinglongerhowourpopulationischangingandwhyitmatters/2018-08-13

Loneliness

17% of older people report they are in contact with family, friends and neighbours less than once a week; 11% report this contact is as infrequent as less than once a month

“Age UK Loneliness Evidence Review Evidence Review: Loneliness in Later Life”. Age UK, 2015, accessed Aug 2019,   https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/health--wellbeing/rb_june15_lonelines_in_later_life_evidence_review.pdf

24% of people aged 50+ living in England feel lonely some of the time, while 7% (equating to around 1.4 million people) feel lonely often

 “All the lonely people: Loneliness in Later Life”, Age UK, 2018, accessed Aug 2019, https://www.ageuk.org.uk/globalassets/age-uk/documents/reports-and-publications/reports-and-briefings/loneliness/loneliness-report.pdf

Long-term condition

An estimated 4 million older adults in the UK (36% of people aged 65-74, and 47% of those aged 75+) have a limiting long-standing illness; equating to 40% of all people aged 65+

“Later Life in the United Kingdom – Too old to care?” Horsfield, J. 2017,

Dementia

850,000 people are estimated to have dementia in the UK.

“Facts for the media”, Alzheimer’s Society, 2019, accessed Aug 2019, https://www.alzheimers.org.uk/about-us/news-and-media/facts-media

Mental Health

It is estimated that 40% of older people in GP clinics have a mental health problem, this rises to 50% of older people in general hospitals and 60% of those in care homes

Depression is the most common mental health problem among older adults; affecting 22% of men and 28% of women aged 65+

“Suffering in silence: age inequality in older people’s mental health care”, Royal College of Psychiatrists, 2018, accessed Aug 2019, https://www.rcpsych.ac.uk/improving-care/campaigning-for-better-mental-health-policy/college-reports/2018-college-reports/cr221

Poverty

A common definition of poverty is living in a household with an income below 60% of the median household income, taking account for the number of people living in the household

  • 2 million (16%) pensioners in the UK live in poverty on this definition
  • 1.1 million pensioners are in severe poverty (that is with an income less than the 50% threshold of contemporary median income, UK)

Households below average income: 1994/95 to 2017/18, DWP, 2019, accessed Aug 2019,  https://www.gov.uk/government/statistics/households-below-average-income-199495-to-201718

 

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