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

A. Correa-Perez (1) , Iosef Abraha (2) , Antonio Cherubini (2) , Avril Collinson (3, 4) , Dominique Dardevet (5) , Lisette C. de Groot (6) , Marian A. E. de van Der Schueren (7, 8) , Antje Hebestreit (9) , Mary Hickson (3, 4) , Javier Jaramillo-Hidalgo (10) , Isabel Lozano-Montoya (1) , Denis O'Mahony (11) , Roy L. Soiza (12) , Marjolein Visser , Dorothee Volkert (13) , Maike Wolters (9) , Alfonso J. C. Jentoft (1)

1 Servicio de Geriatría
2 INRCA - Italian National Research Centre on Aging
3 Institute of Health and Community
4 Plymouth University
5 UNH - Unité de Nutrition Humaine
6 Division of Human Nutrition and Health
7 department of nutrition and health
8 department of nutrition and dietetics
9 Leibniz Institute for Prevention Research and Epidemiology - BIPS
10 Servicio de Geriatría
11 Department of Geriatric Medicine
12 Department of Medicine for the Elderly
13 Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg

INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Mots clés: protein energy malnutrition; review; systematic; dietary supplementation; elderly

Domaines: Alimentation et Nutrition; Gériatrie et gérontologie

A. Correa-Perez, Iosef Abraha, Antonio Cherubini, Avril Collinson, Dominique Dardevet, et al.. 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. Ageing Research Reviews - ARR, 2019, 49, pp.27-48. ⟨10.1016/j.arr.2018.10.011⟩. ⟨hal-01921576⟩