Associations between malnutrition and cognitive impairment in an elderly Chinese population: an analysis based on a 7‐year database

Abstract

Aim This study aimed to elucidate whether malnutrition is associated with cognitive impairment in an older Chinese population. Methods A cross‐sectional study was conducted in 2365 participants aged 60 years or older from January 2013 to September 2019. Nutritional status was measured by using the Mini Nutritional Assessment Short Form (MNA‐SF). Cognitive function was assessed with the Mini‐Mental State Examination (MMSE). The relationship between malnutrition or each Mini Nutritional Assessment Short Form domain and cognitive impairment was examined with univariate and multivariate logistic regression analysis. Results The prevalence of malnutrition, risk of malnutrition, and cognitive impairment was 5.54%, 33.45%, and 36.74%, respectively. The prevalence was higher in those 80 years and older: 7.88%, 40.75%, and 53.65%, respectively. The Mini‐Mental State Examination score was positively correlated with the Mini Nutritional Assessment Short Form score (r = 0.364, P < 0.001). After adjustment for age, gender, education, marital status, and living alone, malnutrition (odds ratio (OR) = 3.927, 95% confidence interval (CI): 2.650–5.819), anorexia (OR = 1.454, 95%CI: 1.192–1.774), weight loss (OR = 1.697, 95%CI: 1.406–2.047), impaired mobility (OR = 4.156, 95%CI: 3.311–5.218), and psychological stress (OR = 1.414, 95%CI: 1.070–1.869) were significantly associated with an increased risk of cognitive impairment. Conclusions Our results suggest that the prevalence of malnutrition and cognitive impairment is relatively high and increases with age. Malnutrition, anorexia, weight loss, impaired mobility, and psychological stress are significantly associated with an increased risk of cognitive impairment. Therefore, clinicians should assess the nutritional and cognitive status of the elderly regularly to improve early detection and timely intervention.

Malnutrition in Older Adults—Recent Advances and Remaining Challenges

“…Due to the proposed relationship between long-term dietary patterns and cognitive function, malnutrition has also been linked to cognitive impairment [ 49 , 50 ], although the relationship is complex and difficult to disentangle and more studies are needed on this subject [ 50 ]. Similarly, there is a close interaction between malnutrition and depression [ 51 , 52 , 53 ], but causality is difficult to establish, as the relation is most likely mutual.…”

Multimorbidity and Subjective Cognitive Complaints: Findings from 48 Low- and Middle-Income Countries of the World Health Survey 2002–2004

“…In particular, it is possible for SCC to have affected the reporting of some variables due to memory problems (e.g., diagnosis of disorders, sleep problems). Second, although a total of 10 chronic conditions were included in the analysis, there may be other conditions such as malnutrition [48], stroke [49], and HIV infection [50], which were not included in the analysis but may be important conditions in relation to cognition. Third, it is also possible that there was misclassification for chronic conditions based on self-reported diagnosis especially in resource-limited settings as under-diagnosis may be common.…”

The Relationship of Malnutrition With Cognitive Function in the Older Chinese Population: Evidence From the Chinese Longitudinal Healthy Longevity Survey Study

“…Previous studies have demonstrated that nutritional status played a significant role in the progression of cognitive impairment in older patients with dementia or Alzheimer’s disease (AD) ( Ousset et al, 2008 ; Santos et al, 2018 ; Kimura et al, 2019 ; Doorduijn et al, 2020 ). Recent researches have also illustrated that malnutrition was associated with an increased risk of cognitive decline among older adults ( Hsu et al, 2019 ; Assis et al, 2020 ; Mantzorou et al, 2020 ; Yu et al, 2021 ). However, most of the studies have explored the relationship by utilizing Mini Nutritional Assessment (MNA) ( Assis et al, 2020 ; Mantzorou et al, 2020 ) or Mini Nutritional Assessment Short-Form (MNA-SF) ( Hsu et al, 2019 ; Yu et al, 2021 ), but not the Geriatric Nutritional Risk Index (GNRI).…”

“…Recent researches have also illustrated that malnutrition was associated with an increased risk of cognitive decline among older adults ( Hsu et al, 2019 ; Assis et al, 2020 ; Mantzorou et al, 2020 ; Yu et al, 2021 ). However, most of the studies have explored the relationship by utilizing Mini Nutritional Assessment (MNA) ( Assis et al, 2020 ; Mantzorou et al, 2020 ) or Mini Nutritional Assessment Short-Form (MNA-SF) ( Hsu et al, 2019 ; Yu et al, 2021 ), but not the Geriatric Nutritional Risk Index (GNRI). MNA and MNA-SF were defined as those not using biological indicators, such as albumin.…”