Interventions to optimise nutrition in older people in hospitals and long-term care: Umbrella review.
Silvia Brunner, Hanna Mayer, Hong Qin and 3 others
PMID 34212419WHAT IT FOUND
Mealtime assistance, nutrient-dense snacks, better foodservice, a calm environment and interprofessional collaboration were reported to improve intake or weight in some reviews.
Effects on function and quality of life were inconsistent.
Key findings
01Mealtime assistance was reported to increase energy intake and nutritional status, and to support eating time and self-care abilities.
02Nutrient-dense snacks and oral nutrition supplements were reported to increase energy, protein or food intake.
03Multi-component approaches had mixed effects: some increased dietary intake or improved functional outcomes, while another showed no significant difference in body weight or quality of life.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
No review protocol was registered, and the search was limited to English and German, so relevant reviews may have been missed. The included reviews were very heterogeneous, with different interventions, outcomes and settings, so the authors could not combine them into one meta-analysis or compare the effect of single components. Two included reviews had a high risk of bias, and in five reviews it was unclear whether critical appraisal was done independently. The 18,568 participants include health care workers as well as older people, so this is not a patient-only count. Effects on function, body weight and quality of life were inconsistent; some analyses showed no significant difference. The review excluded palliative, intensive care, community, ambulatory, tube feeding and parenteral nutrition settings, so it may not apply to those patients.
Declared interests
All authors declared no conflict of interest. They also reported no food-industry funding in included studies of oral nutrition supplements.
The easy way to misread this
Do not read this as evidence that one nutrition package has been tested and works. It summarises components from 13 reviews with mixed outcomes, and staff training alone did not clearly improve intake or nutritional status.