Association Between Malnutrition and Negative Health Outcomes In Italian Older Adults: Findings From The Ilsirente Study

Hélio José Coelho Júnior^1*Riccardo Calvani¹Andrea Russo²Francesco Landi¹Emanuele Marzetti¹

• ¹Catholic University of the Sacred Heart, Rome, Rome, Italy
• ²Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Lazio, Italy

Malnutrition is believed to contribute to adverse outcomes such as falls, fractures, and disability in older adults. However, findings remain conflicting, partly due to differences in operationalization methods. The recent adoption of the Global Leadership Initiative on Malnutrition (GLIM) criteria has shown promise, but evidenceespecially in community-dwelling populations-is still limited and inconclusive. Hence, the present study examined the associations between malnutrition and health-related parameters, including falls, fall-related fractures, disability, and death in communitydwelling older adults. Methods: This was a prospective cohort study of octogenarians who lived in the mountain community of the Sirente geographic area in Central Italy.Malnutrition was operationalized according to the GLIM criteria. History of falls, incident falls, fall-related fractures, and disability status according to basic activities of daily living, were recorded over two years. Survival status was obtained from the participants' general practitioners and was confirmed by the National Death Registry up to 10 years from enrolment. Binary, ordinal, and Cox regressions were conducted to evaluate the association between malnutrition and health outcomes. Results: Data of 334 older adults (mean age: 86.3 ± 4.7 years) were analyzed. Malnutrition was significantly and inversely associated with history of falls, with non-malnourished individuals being less likely to have experienced a higher number of falls. No significant associations were found between malnutrition and the incidence of falls, fall-related fractures, disability (prevalence and incidence), or death. Conclusions: Findings of the present study indicate that malnutrition, operationalized according to the GLIM criteria, is significantly associated with a history of falls in older adults. More studies examining important covariates are required to confirm our findings and expand the current knowledge in the field.