Malnutrition in Polymorbid Patients

Prevalence and Risk Factors

The prevalence of malnutrition increases with functional decline, with rates below 10% in independently living older persons but escalating to two-thirds of older patients in acute care and rehabilitation hospitals 1, 2
Malnutrition rates are substantially higher in hospitalized polymorbid patients, representing one of the most prevalent geriatric syndromes in this population, although the exact rate is not specified in the cited references 1, 2

Polypharmacy is significantly associated with both malnutrition and sarcopenia, creating drug-drug and drug-nutrient interactions that compromise nutritional status 3
Reduced dietary intake combined with catabolic effects of multiple diseases rapidly leads to malnutrition, particularly during acute illness exacerbations 2
Anorexia of aging is amplified by polymorbidity, with acute and chronic illness making nutritional problems widespread in this population 1, 2

Infection and cancer diagnoses are associated with inadequate energy intake in patients aged 65 years or older 4
Kidney disease predicts response to nutritional treatment, with lower eGFR showing stronger clinical benefit from intervention 5
Chronic heart failure patients demonstrate strong benefit from nutritional support, suggesting disease-specific vulnerability to malnutrition 4

Polymorbid medical inpatients have a malnutrition prevalence of approximately 40-50% in hospitalized populations at tertiary care centers, making this an extremely common and clinically significant problem that directly impacts mortality, morbidity, and quality of life 6, 7, 8
The prevalence of nutritional risk significantly increases within just two weeks after admission (from 40.61% to 48.93%; p = 0.036), indicating that malnutrition worsens during hospitalization if not addressed 6, 7

Malnourished polymorbid patients have 2.38 times higher odds of hospital length of stay ≥3 days (95% CI, 1.45 to 3.88; p < 0.001) 6, 7, 8
Malnourished polymorbid patients have 2.28 times higher odds of readmission within 30 days (95% CI, 1.26 to 4.12; p < 0.006) 6, 7, 8

The European Society for Clinical Nutrition and Metabolism (ESPEN) recommends universal screening for malnutrition risk at hospital admission using validated tools, as early identification and intervention directly reduces mortality, complications, and hospital readmissions 6, 7, 9