Malnutrition in Older Adults With Chronic Wounds: A Prospective Cohort Study

To determine the prevalence of malnutrition among older adults with chronic wounds.

A prospective cohort study was conducted to assess the nutrition status of adults over the age of 65 with a chronic wound. Participants who met inclusion criteria were recruited at the Sheldon Chumir Wound Clinic in Calgary, Alberta, Canada, from April 1, 2022, to March 31, 2023. The primary outcome was the diagnosis of malnutrition. Secondary outcomes included other nutrition diagnoses and identified diet barriers. Patient demographic and characteristic information were also collected.

A total of 78 patients were included in the study, with a mean age of 75.9±7.7 years. A clinical diagnosis of malnutrition was made in 24.4% of participants, with more than two-thirds of the participants diagnosed with inadequate protein intake (69.2%) and knowledge deficiency (67.9%). Common dietary barriers included loss of appetite (46.2%), eating meals alone (30.2%), and constipation (19.2%). Older age increased the odds of malnutrition (odds ratio, 1.20; P =.004). In contrast, being male was associated with a lower likelihood of malnutrition (odds ratio, 0.07; P =.030). Patients with a psychiatric diagnosis had markedly higher odds of malnutrition (odds ratio, 76.89; P =.006), as did those with hypothyroidism (odds ratio, 20.55; P =.046).

Previously, 34.2% of community-dwelling older adults in Canada were estimated to be at risk of malnutrition. The present study clinically diagnosed malnutrition in 24.4% of older adults with chronic wounds. This finding reinforces the importance of malnutrition screening in multidisciplinary wound clinics and advocates for establishing nutrition assessments as standard of care for geriatric patients with chronic wounds.