The impact of malnutrition on health outcomes and healthcare cost among Chinese older adults

Objective This study used multivariate regression analysis to study the prevalence of malnutrition and the impact of malnutrition on independence in activities of daily living, health outcomes, chronic disease and healthcare cost among older Chinese adults. Methods This study was based on data from the 2013 China Health and Retirement Longitudinal Survey(CHARLS). The CHARLS data covers information on demographics, family, health status and functional limitations, health insurance, employment and earnings among mid-aged and older community-dwelling Chinese.This research focused on older Chinese adults aged 60 years and over.As a result, over 5, 900 subjects were included.This study defined malnutrition based on body mass index, weight loss and reduced handgrip strength.Functional status was assessed via adapted versions of the Katz index of independence in basic activities of daily living(ADL)and the Lawton-Brody index of independence in instrumental activities of daily living(IADL). Health outcomes included self-reported health status.Then multivariate regression analysis was used to investigate the relationship between malnutrition and various health outcomes. Results Thirty percent of older Chinese adults were malnourished.Malnutrition was associated with significantly lower IADL(OR=0.868, P<0.05), poorer health status(OR=0.675, P<0.001), as well as higher probability of having stroke(OR=1.399, P<0.05)and chronic stomach disease(OR=1.241, P<0.001). As a significant contributor of poorer self-reported health status, malnutrition, in turn, increased hospital cost by ￥214(14% increase, P<0.01)per person per year. Conclusions Malnutrition leads to functional limitations and worse health outcomes among community-dwelling older Chinese adults.These results imply that nutrition interventions such as nutrition screening and assessment, making scientific and personal nutrition support plans, and providing timely adequate nutrition support therapy can improve the health status and lower the healthcare cost of older adults living in the community. Key words: Malnutrition; Health outcomes; Activities of daily living