How effective is nutrition education aiming to prevent or treat malnutrition in community-dwelling older adults? A systematic review.

backgroundWhile malnutrition is associated with adverse health outcomes in older adults, little is known about the effectiveness of nutrition education. This systematic review examines the evidence for educational interventions to improve nutritional and other health-related outcomes in community-dwelling older people.

methodsSystematic searches of three databases (Embase, Medline and CINAHL) were conducted. Studies testing educational interventions targeting older adults (mean age ≥ 60 years) or their caregivers were eligible for inclusion. Two authors independently assessed trial eligibility, risk of bias and extracted data. Study heterogeneity was high precluding meta-analysis, therefore a narrative synthesis was conducted.

resultsNine articles reporting on eight studies (n = 7 trials; 1 pre-post-intervention study) met inclusion criteria. There was considerable variability in the format of educational interventions. Nutrition education was either generic or personalised and the intensity was variable (1-6 sessions). We found some evidence (in five out of eight studies) that nutrition education may improve nutrition-related outcomes. Nutrition education involving caregivers was found to reduce nutritional risk in one study, and nutritional counselling following discharge from hospital was found to reduce the risk of readmission in another study. However, the overall quality of the studies was hampered by poor methodology, low sample size and attrition bias, and results need to be interpreted with caution.

conclusionsEducational interventions may have potential to improve malnutrition-related outcomes in older people, but the strength of evidence is poor. More robust, larger studies are needed to ascertain the effectiveness of nutritional education interventions in this population.