Nutrition, functional status, polypharmacy, and digestive disturbances in institutionalized patients with dementia:...

Malnutrition, loss of muscle mass, functional decline, and polypharmacy are highly prevalent in people with dementia, contributing to accelerated frailty, dependency, and institutionalization. Early multidimensional assessment at the time of admission to long-term care units is essential for identifying nutritional and functional vulnerabilities and guiding timely, individualized interventions. This study aimed to characterize the nutritional, anthropometric, and functional status of patients with dementia and to examine the association between digestive disturbances and polypharmacy.

A multicenter cross-sectional study was conducted, including adults diagnosed with dementia. Nutritional status was assessed using the Mini Nutritional Assessment (MNA^®) and the Global Leadership Initiative on Malnutrition (GLIM) criteria. Anthropometric evaluation included body mass index (BMI), mid-upper arm circumference (MUAC), triceps skinfold thickness (TSF), mid-arm muscle area (MAMA), and calf circumference (CC). Functional status was evaluated using handgrip strength and the SARC-F questionnaire for sarcopenia risk. Cognitive status, medication profiles, and digestive symptoms were systematically recorded. Multivariate regression models were applied to examine factors associated with anthropometric indicators of muscle mass and digestive symptoms.

Malnutrition was highly prevalent, with nearly all 112 participants classified as malnourished or at nutritional risk according to MNA^®, and 79.5% fulfilling GLIM criteria. Severe loss of muscle mass and marked functional impairment were observed, and more than 85% of participants were identified as being at risk of sarcopenia according to SARC-F. Polypharmacy affected over 90% of patients, and each additional prescribed medication was associated with approximately 23% higher odds of digestive disturbances. Anthropometric muscle mass indicators were independently associated with sex and BMI, whereas functional measures reflected physical performance rather than muscle mass. These findings highlight the need for systematic, multidomain assessment integrating nutritional screening, anthropometric and functional evaluation, gastrointestinal symptom assessment, and medication review to support early, targeted, and interdisciplinary interventions for people with dementia entering long-term care units.