Table 2 Factors associated with, and, determinants of malnutrition

Chatindiara [49], 2019, New Zealand, N = 257, median 79 (IQR 7)

46.7, CD, U

MN risk (MNA-SF)

Demographic: age, marital status, ethnicity, sex, education

Social: Living situation, income source Food Intake: dysphagia risk (EAT-10), dental status Psychological: cognitive impairment (MoCA)

Physical function: ADLs, handgrip strength, gait speed, physical performance (FTSTS)

Disease-related: inflammation (CRP), number of comorbidities (> 5), polypharmacy (> 5 drugs), nutrition supplements use

N/A

UV LR

MV LR

age (continuous) [1.09 (1.01–1.17) p = 0.033]; age < 85y [0.30 (0.1–0.79) p = 0.015]; normal swallowing [0.29 (0.09–0.97) p = 0.045]; healthy physical performance [0.22 (0.07–0.71) p = 0.012]; BMI [0.82 (0.74–0.91) p < 0.001]; fat mass [0.86 (0.78–0.94) p = 0.002]; % body fat [0.81 (0.72–0.90) p < 0.001]; FFMI [0.51 (0.34–0.77) p = 0.001]

Craven [23], 2018, Australia, N = 77, 73.3 (5.1)

60.0, CD, S

MN risk (SCREEN 2)

Demographic: age, sex, relationship status, education Food Intake: SR healthiness of diet Social: living arrangement, home care services

Disease-related: SR health, short form health survey (SF-12)- calculated PCS and MCS

N/A

Multiple regression

PCS (ẞ = 0.290, Seẞ = 0.065, p < 0.05); MCS (ẞ = 0.377, Seẞ = 0.073, p < 0.05)

Maseda [45], 2018, Spain, N = 749, 75.8 (7.2)

39.4%, CD attending SC, U-S

MN risk (MNA-SF)

Demographic: age, sex, education, marital status

Social: social support (OARS), living situation, loneliness

Physical function: IADL

Disease-related: QOL (WHOQOL-BREF)

N/A

Multiple LR (forward stepwise)

Total: female sex [0.6 (0.38–0.95) p = 0.028], social resources- total impairment [0.257 (0.08–0.85) p = 0.025], low physical health [1.676 (1.09–2.57) p = 0.018]

Males: single status [0.08 (0.02–0.34) p < 0.001], divorced/separated status [0.096 (0.02–0.39) p < 0.001], poor health satisfaction [4.31 (1.82–10.25) p < 0.001]

Females: social resources- mild impairment [0.51 (0.28–0.96) p = 0.036]

Ganhão-Arranhado [50], 2018, Portugal, N = 337, 78.4 (7.05)

37.7%, CD attending SC, N/A

MN, MN risk (MNA)

Demographic: age group, sex, marital status Social: income, SC attendance, motives for SC attendance, time of SC attendance, social risk, social net, social relationships Food Intake: food security Lifestyle: alcohol consumption, smoking status

Disease-related: SR health, SR health conditions (respiratory, liver and rheumatic diseases, angina, MI, high BP, high blood cholesterol, stroke, DM, cancer, depression)

Psychological: psychological stress

N/A

UV regression, multinomial regression

MN risk: cerebrovascular accident [4.04 (1.19–13.74) P < 0.05]; acute MI [2.12 (0.95–4.72) p < 0.05]; better perceived health status [− 0.54 (0.37–0.79) p < 0.05]; attending SC <5y [− 0.41 (0.16–1.04) p < 0.05]; loneliness [2.01 (1.06–3.81) p < 0.05] MN: food insecurity [1.73 (1.20–2.48) p < 0.05]; female [7.87 (1.33–46.72) p < 0.05]; age 74-85y [− 0.10 (0.02–0.57) p < 0.05]; depression [37.41 (2.06–679.55) p < 0.05]; DM [− 0.105 (0.01–1.06) p < 0.05]

Fjell [51], 2018, Norway, N = 166, 78.7 (3.3)

42%, CD, N/A

MN risk (MNA-SF)

Demographic: age, sex, education, marital status

Social: social support (OSLO 3-SSS) Lifestyle: exercise, alcohol consumption, smoking status

Other: vision, hearing, sleep problems Disease-related: SR pain, hypertension, hypercholesterolemia, eye disease, arthrosis, cancer

Psychological: depression

N/A

MV LR

poor SR health [5.77 (2.04–16.29) p = 0.001]

Grammatikopoulou [52], 2018, Greece, N = 207, 72.4 (8.5)

43.5%, CD, N/A

MN risk (MNA)

Demographic: age, education, marital status, waist circumference, BMI Social: income, receiving financial assistance,

Lifestyle: smoking status

Food intake: appetite (CNAQ), food security (HFIAS), dietary variety (HDDS), diet quality (MEDAS) Disease-related: catabolic disease (cancer/renal/lung), cardiometabolic disease (CVD, hypertension, angina, arrhythmia, hyperuricemia, microalbuminuria, retinopathy, neuropathy, or history of acute MI, stroke or coronary by-pass surgery)

N/A

UV LR

MV LR

smoking [2.35 (1.09–5.08) p = 0.030]; not being married [2.10 (1.06–4.15) p = 0.033]; at risk for 5% WL [7.86 (4.07–15.18) p < 0.001]; food insecure [2.63 (1.21–5.75) p = 0.015]

Bakker [53], 2018, The Netherlands, N = 1325, median (IQR) 80 (77–84)

41.4%, CD attending GP, U-A

MN (BMI < 20 kg/m² and/or unintentional WL > 10% in 6 m and/or unintentional WL > 5% in 1 m)

Demographic: age, sex, marital status, education, income

Social: living situation

Food intake: oral status, irregular dentist visits, oral hygiene, chewing problems, eating problems, speech problems, dental pain, dry mouth, insecurity with oral status, satisfaction with oral status Physical function: frailty (GFI), risk profile (frail, complex care needs, robust), ADL (Katz-15)

Disease-related: number of chronic conditions, polypharmacy (> 4 drugs), complex care (IM-E-SA), QOL (EQ-5D, EQ-VAS)

N/A

UV LR

MV LR

health related QOL [0.97 (0.95–0.995) p = 0.015]

Jung [54], 2017, America, N = 171, 77.5 (8.2)

29.8%, Rural CD excluding mild- moderate dementia (SPMSQ), N/A

MN risk (MNA-SF)

Demographic: age, sex, race or ethnicity, marital status, education

Social: annual income, loneliness (UCLA loneliness scale)

Psychological: depression (GDS)

Disease-related: health status (SHPS),

Physical function: ADL, IADL (Self-Care Capacity Scale)

N/A

SEM

parameter estimate (standard error):

depression −0.30 (0.10) p = 0.001

van der Pols-Vijlbrief [40], 2016, The Netherlands, N = 300, 81.7 (7.6)

31.7%, CD, receiving home-care, A

MN risk (SNAQ⁶⁵⁺)

Demographic: sex, age, education level, marital status

Social: living situation, social network (LSNS-6), social support, monthly income, financial ability to buy food (Determine your health checklist)

Food intake: eating alone, SR oral health, chewing surface (full vs partial/none) appetite (SNAQ^app), taste/smell loss, adequate snacks per day (> 3)

Lifestyle: smoking status, alcohol consumption, PA

Disease-related: number chronic diseases (>  2), polypharmacy (> 5 drugs), hospitalisation in past 6 m, SR health, pain (NHP), nausea, intestinal problems, fatigue

Psychological: cognitive decline (IQCODE), depression (CES-D-10)

Physical functioning: ADL (BI), IADL, mobility (bed/chair bound, able to move around the house but unable to leave house independently, able to leave house independently, difficulty climbing stairs, ability to walk 100 m), falls

Other: visual function, hearing function

N/A

MV LR

unable to go outside [5.39 (2.46–11.81) p < 0.001], intestinal problems [2.88 (1.57–5.28) p = 0.001], smoking [2.56 (1.37–4.77) p = 0.003], osteoporosis [2.46 (1.27–4.76) p = 0.007], fewer than 3 snacks per day [2.61 (1.37–4.97) p = 0.003], ADL dependency [1.21 (1.09–1.35) p = 0.001], physical inactivity [2.01 (1.13–3.59) p = 0.018], nausea [2.50 (1.14–5.48) p = 0.022], cancer [2.84 (1.12–7.21) p = 0.028]

Lahmann [44], 2016, Germany,

N = 878, 78.5 (12.2)

37.1%, CD home care recipients, U-A

MN risk (MUST, MNA-SF)

Demographic: age, sex

Social: social living status

Disease-related: duration receiving home care

Physical functioning: functional capacity (BI)

N/A

LR

mental overload [8.1 (2.2–30.2) p < 0.01]; loss of appetite [3.6 (1.8–7.3) p < 0.01]; needs help with feeding [5.0 (2.3–11.2) p < 0.01]; dependent on feeding [1.9 (1.2–2.8) p < 0.01]

Maseda [55], 2016, Spain, N = 749, 75.8 (7.2)

39.4%, CD attending SC, N/A

MN risk (MNA-SF)

Demographic: sex, age, education level, BMI ≥25 kg/m²

Disease-related: co-morbidity (CCI), SR health, polypharmacy (> 5 drugs) Psychological: cognitive impairment (MMSE), depressive symptoms (GDS-SF) Physical functioning: frailty status

N/A

muliple LR (forward stepwise likelihood ratio)

Total: BMI > 25 kg/m² [2.15 (1.28–3.61) p = 0.004]; polypharmacy [0.43 (0.28–0.68) p < 0.001]; poor SR health [0.32 (0.12–0.86) p = 0.023]; depressive symptoms [0.45 (0.23–0.86) p = 0.015]; pre-frail/frail [0.51 (0.28–0.93) p = 0.027]

Females: polypharmacy [0.52 (0.31–0.88) p = 0.014]; poor SR health [0.24 (0.09–0.66) p = 0.005]

Males: BMI > 25 kg/m² [4.35 (1.61–11.75) p = 0.004]; polypharmacy [0.26 (0.11–0.62) p = 0.002]; depressive symptoms [0.10 (0.04–0.31) p < 0.001]

Krzyminska-Siemaszko [38], 2016, Poland, N = 3751, 77.4 (8.0)

52.8%, CD excluding cognitively impaired (MMSE), U-A

MN risk (MNA-SF)

Psychological: depression (GDS), cognitive impairment (MMSE)

Disease-related: polypharmacy (> 5 drugs), number chronic diseases (> 4), anaemia, peptic ulcer, stroke, Parkinson’s, cancer, pain

Food intake: edentulism

N/A

Multiple LR

Total: female sex [1.72 (1.45–2.04) p < 0.001], age [2.16 (1.80–2.58) p < 0.001], depression [11.52 (9.24–14.38) p < 0.001], dementia [1.52 (1.20–1.93) p < 0.001], multi-morbidity [1.27 (1.04–1.57) p = 0.02], anaemia [1.80 (1.41–2.29) p < 0.001], total edentulism [1.26 (1.06–1.49) p = 0.009]

Males: age [1.78 (1.40–2.27) p < 0.001], depression [12.80 (9.40–17.43) p < 0.001], dementia [1.58 (1.15–2.18) p = 0.005], anaemia [1.81(1.34–2.44) p < 0.001], total edentulism [1.31(1.04–1.66) p = 0.02]

Females: age [2.77 (2.11–3.61) p < 0.001], depression [10.80 (7.85–14.87) p < 0.001], multi-morbidity [1.35 (1.01–1.79) p = 0.04], anaemia [1.99 (1.30–3.07) p = 0.002]

Krzymińska-Siemaszko [56], 2015, Poland, N = 4482, 78.6 (8.5)

52.2%, CD, cognitively well (MMSE), N/A

MN risk (MNA-SF)

Demographic: age, sex, marital status, education

Social: living situation

N/A

UV LR

MV LR

female [1.51 (1.19–1.92) p < 0.01]; every 10 y of life [2.18 (1.9–2.51) p < 0.01]; not married [1.50 (1.16–1.95) p < 0.01]

Gunduz [42], 2015,

Turkey,

N = 1030, 71.7 (7)

45.05%

CD, outpatients, cognitively well (MMSE > 17), U-S

MN (MNA)

Demographic: age, sex, marital status, education, no children

Physical functioning: ADL, IADL

Psychological: depression (GDS)

Disease-related: comorbidities, polypharmacy (≥5 drugs)

N/A

MV LR

age [(1.007–1.056) p = 0.012]; low BMI [(0.702–0.796) p < 0.001]; low education level [(0.359–0.897) p = 0.015]; depression score [(1.104–3.051); p = 0.02]; > 4 comorbidities [3.5 (2.30–5.45) p < 0.001]

Bailly [57], 2015, France, N = 464, 77.41 (7.48)

31.3%, CD, N/A

MN risk (MNA)

Demographic: age

Social: living alone, financial satisfaction Food intake: pleasure of eating (HTAQ) Psychological: depressive symptoms (GDS) Disease-related: SR health Physical functioning: IADL

N/A

SEM

Males: depression β = − 0.38; greater pleasure eating β = 0.20; higher SR health β = 0.32; greater IADL score β = 0.16

Females: age β = − 0.13; depression β = − 0.33; greater pleasure eating 0.19; higher SR health β = 0.25; greater IADL score β = 0.32

Wham [58], 2015, New Zealand, Maori: N = 421, 82.8 (2.6) Non-maori: N = 516, 84.6 (0.5)

33%, CD, N/A

MN risk (SCREEN 2)

Demographic: age, sex

Lifestyle: PA (PASE), smoking status, alcohol consumption Social: residential care, living situation, life satisfaction, difficulty getting to shops, drives a car, occupation, deprivation index, income

Physical functioning: HGS, physical function (NEADL)

Disease-related: health related QOL (SF-12), stroke, MI

Psychological: cognitive function (3MS), depression (GDS-15)

N/A

MV LR

Maori: age [0.89 (0.79–0.99) p = 0.04]; primary education [3.41 (1.35–8.62) p = 0.03]; living alone (vs with others) [2.85 (1.34–6.05) p < 0.001]; living alone (vs with spouse) [4.10 (1.90–8.84) p < 0.001]; depression [1.30 (1.06–1.60) p = 0.01]

Non-Maori: male [0.49 (0.30–0.81) p = 0.005]; living alone (vs with spouse) [2.41 (1.42–4.08) p = 0.002]; SF-12 PCS [0.98 (0.96–0.99) p = 0.02]; depression [1.24 (1.08–1.43) p = 0.002]

Wham, 2015 [59], New Zealand, N = 67, 77.0 (1.5)

44%, CD Maori, N/A

MN risk (SCREEN 2)

Demographic: sex, age, education, marital status

Social: living situation, SR standard of living, importance of traditional food, importance of spirituality, use of traditional Māori as first language, living in large extended family area Disease-related: use of Māori medicine and healing

Psychological: depression (GDS-15)

Physical functioning: physical disability (NEADL)

N/A

MV linear regression

language and culture being a little to moderately important [ẞ = 6.70, p < 0.05]; availability of traditional food [ẞ = − 5.23, p < 0.01]; waist-to-hip ratio [ẞ = 20.17, p = 0.01]; depressive symptoms [ẞ = − 0.60, p = 0.02]

Toussaint [60], 2015, The Netherlands, N = 345, 67.1 (6.0) CD; N = 138, 80.9 (7.6) outpatients

46.4%, CD; 34.1%, outpatients, N/A

MN risk (MNA-SF)

Demographic: age, sex

Food intake: olfactory function

Lifestyle: smoking status

Psychological: cognitive function (CD: MMSE; outpatients: DemTect), depressive symptoms (GDS) Disease-related: comorbidities (CCI), polypharmacy (> 5 drugs)

N/A

Linear regression

CD: female [0.259 (0.031–0.488) p = 0.026] Outpatients: MMSE [ẞ (95% CI) p-value] [0.208 (0.059–0.357) p = 0.007]; GDS [− 0.378 (− 0.491- − 0.265) p < 0.001]

Rullier [61], 2014, France, N = 56, 70.9 (11.0)

27%, CD caregivers, N/A

MN risk (MNA)

Demographic: age, sex, education, caregiver relationship with patient

Social: living arrangements

Psychological: Trait anxiety (STAI Y-B), depression (CES-d), caregiver burden (Zarit Burden Interview)

Physical functioning: functional status (AGGIR)

N/A

UV linear regression, multiple linear regression

functional dependency [ẞ = − 0.336, (1.57–6.48) p = 0.002]; depressive symptoms [ẞ = − 0.365, (− 0.199- − 0.054) p = 0.001]; more apathetic patient with dementia [ẞ = − 0.342 (− 0.606- − 0.158) p = 0.001]

Torres [39], 2014, France,

Rural: N = 692, 75.5 (6.2)

Urban: N = 8691, 74.1 (5.5)

62% (rural), 39.7% (urban), CD, U

MN risk (proxy MNA)

Demographic: age, sex, education, marital status

Social: income

Physical function: ADL (Katz ADL scale)

Disease-related: polypharmacy (> 3 drugs)

N/A

MV LR

Rural: BMI < 21 kg/m² [23.09 (5.1–104.46) p < 0.01], BMI 25–30 kg/m² [0.41 (0.18–0.94) p < 0.01], BMI > 30 kg/m² [0.16 (0.05–0.50) p < 0.01], dementia [3.04 (1.08–8.57) p = 0.04], polypharmacy [10.4 (2.59–4.20) p < 0.01]

Urban: females [1.46 (1.22–1.75) p < 0.001], widowed status [1.36 (1.12–1.66) p < 0.01], BMI < 21 kg/m² [9.11 (7.39–11.23) p < 0.001], BMI 25–30 kg/m² [0.74 (0.61–0.89) p < 0.001], depression [20.67 (17.46–24.49) p < 0.001], dementia [3.42 (2.22–2.58) p < 0.001], loss of ADL [6.94 (3.91–12.31) p < 0.001], polypharmacy [3.52 (2.95–4.20) p < 0.001]

Wham [41], 2014,

New Zealand, N = 3893, > 65y, Maori: >75y

46%, CD, U-S

MN risk (ANSI)

Demographic: age, sex, marital status, ethnicity, education

Social: WHOQOL- social, living situation

Physical functioning: ADLs (NEADL)

Psychological: depression (GDS)

Disease-related: chronic diseases, polypharmacy (> 3 drugs)

N/A

UV LR

MV LR

female [1.41 (1.11–1.80) p = 0.006]; being Māori/other ethnicities vs European p = 0.002; not married p = 0.003; higher social health related QOL [0.94 (0.89–1.00) p = 0.036]; living with others related to low risk p < 0.0001; higher functional status [0.94 (0.90–0.99) p = 0.0182]; more depressive symptoms [1.10 (1.02–1.19)]; polypharmacy [1.34 (1.27–1.41) p < 0.0001]

Akin [62], 2014, Turkey, N = 845, 71.6 (5.6)

53.2%, urban CD, N/A

MN risk (MNA)

Demographic: sex, age, weight, BMI, WC, MUAC, education, marital status

Social: living situation, income Physical functioning: 4 min walking speed, fear of falling, IADL, ADL, urinary incontinence

Disease-related: SR chronic diseases (diabetes, hypertension, CHD, cerebrovascular disease, renal failure) Psychological: cognitive impairment (MMSE), depression (GDS)

N/A

UV LR

MV LR

depressive mood [4.18 (2.85–6.11) p < 0.001]; diabetes [1.60 (1.09–2.35) p = 0.017]; moderate income [1.65 (1.08–2.49) p = 0.019]; low income [2.36 (1.48–3.77) p < 0.001]; living alone [2.49 (1.56–3.97) p < 0.001]; WC [0.98 (0.96–0.99) p = 0.015]; MUAC [0.93 (0.83–0.99) p = 0.014]; 4 min walking speed [1.16 (1.07–1.25) p < 0.001]

Geurden [63], 2014, Belgium,

N = 100, 75.2 (17)

22%, urban CD receiving homecare nursing, U-A

MN risk [64]

Demographic: age, sex

Food intake: eating problem, swallowing problem, loss of appetite, concern about eating problem/loss of appetite, GP informed about eating problem/loss of appetite, nutrition intervention prescribed, one warm meal every day Physical functioning: independent shopping, independent cooking, use of informal care, use of professional homecare

Disease-related: hospitalisation in last 3 m, days since last GP visit

N/A

MV LR

loss of appetite p < 0.001

Westergren [65], 2014, Sweden, N = 465, 78.5 (3.7)

46.5%, CD without cognitive deficits, N/A

MN risk (SCREEN 2)

Social: need for help with groceries, need for help with cooking

Physical functioning: falls (Downton falls risk index)

Disease-related: SR health Psychological: SR life satisfaction, anxiety/worries, low-spiritedness, fatigue/tiredness, sleeping well

N/A

stepwise ordinal regression Linear (backward) regression

living alone (females) [4.63 (2.85–7.52) p < 0.001]; living alone (males) [6.23 (3.35–11.59) p < 0.001]; age [0.86 (0.81–0.91) p < 0.001]; quite good SR health [2.03 (1.27–3.27) p = 0.003]; quite/very poor SR health [5.01 (2.23–11.23) p < 0.001]; often/always tired [2.38 (1.26–4.50) p = 0.008]; falls risk [1.21 (1.05–1.40) p = 0.010]

van Bokhorst-de van der Schueren [35], 2013, Netherlands,

N = 448, 80 (7)

38%,

outpatients living independently- in own home or assisted care facility, U

MN (MNA)

Demographic: education, marital status, children

Lifestyle: smoking status, alcohol consumption

Physical functioning: ADLs, IADLs, falls, walking aid

Psychological: depression (GDS), cognitive impairment (MMSE)

Disease-related: polypharmacy (> 6 drugs), multi-comorbidities (> 4 diseases)

N/A

UV LR

MV backward stepwise LR

alcohol use [0.4 (0.2–0.9) p < 0.05]; being IADL dependent [2.8 (1.3–6.4) p < 0.05]; depression [2.6 (1.3–5.3) p < 0.05]

de Morais [66], 2013, 8 European countries (Denmark, Germany, Italy, Poland, Portugal, Spain, Sweden and the UK),

N = 644, 74.8 (5.8)

49.8%, CD, U

MN risk (Determine your health checklist)

Demographic: BMI

Social: living situation

Food Intake: number of fruit and vegetables per day, chooses easy to chew food, changes in appetite

Disease-related: SR health, changes in health/health problems (SF-36)

N/A

backward stepwise LR

low BMI [ẞ (95% CI) p-value] [0.005 (0.001–0.01) p = 0.007]; number fruit and vegetables/day [− 0.21 (− 0.40- -0.03) p = 0.023]; general health [− 0.02 (− 0.03- -0.01) p = 0.006]; chooses easy to chew food [0.32 (0.15–0.49) p < 0.001]; living with another adult [2.82 (1.27–6.25) p = 0.011]; living alone [3.22 (2.00–5.16) p < 0.001]; changes in appetite [0.41 (0.20–0.85) p = 0.016]; changes in health/health problems [7.74 (4.02–14.90) p < 0.001]

Syrjälä [67], 2013, Finland, N = 157, > 75y

29.9%, CD, N/A

MN risk (MNA-SF)

Demographic: sex, education

Food Intake: unstimulated salivary flow, stimulated salivary flow, number of teeth, number of the occluding molars/pre-molars, dentures, SR chewing problems Social: use of a meal service

Disease-related: number of medications, DM

Psychological: cognitive function (MMSE) Physical functioning: IADLs

N/A

MV LR

Stimulated/unstimulated salivary flow not associated with MN risk

Simsek [68], 2013, Turkey, N = 650, 74.1 (6.3)

37.1%, CD living in a low socioeconomic area, U-S

MN risk (MNA)

Demographic: age, sex, marital status, education

Social: self-perceived economic status, social class, social insurance, ownership of house, personal income, living situation Food intake: food insecurity

Physical functioning: orthopaedic disability Disease-related: number chronic diseases, polypharmacy (> 5 drugs), SR health

N/A

MV LR

age [1.06 (1.02–1.10) p = 0.001]; number chronic diseases [1.41 (1.18–1.70) p < 0.001]; not being married [2.13 (1.31–3.46) p = 0.002]; SR poor economic status [2.49 (1.41–4.41) p = 0.002]; orthopaedic disability [1.95 (1.01–3.75) p = 0.047]; food insecurity [2.49 (1.48–4.16) p = 0.001]; poor SR health [4.33 (2.58–7.27) p < 0.001]

Smoliner [69], 2013, Germany,

N = 191, 79.6 (6.3)

28.3%, CD day hospital attendees without Parkinson’s disease or MMSE score < 20, N/A

MN risk (MNA)

Demographic: age

Food intake: olfactory function (Sniffin sticks test)

Psychological: cognitive function (MMSE) Disease-related: number of drugs Physical functioning: self-care capacity (BI)

N/A

Linear regression

BI [0.329 (0.03–0.08) p < 0.001]

Ramage-Morin [70], 2013, Canada, N = 15,669, 77 (No SD)

40.4%, CD, U

MN risk (SCREEN 2-AB)

Demographic: age, education

Food Intake: oral health

Social: income quintile, living situation, social support (Tangible Support MOS Subscale), social participation, driving status

Disease-related: number of medications Psychological: depressive symptoms (subset of questions from CIDI) Physical functioning: level of disability (HUI)

N/A

MV LR

Males: lowest income quintile [1.46 (1.16–1.85) p < 0.05]; living alone [2.86 (2.39–3.42) p < 0.05]; low social support [1.31 (1.06–1.62) p < 0.05]; infrequent social participation [1.46 (1.20–1.76) p < 0.05]; depression [2.77 (1.51–5.06) p < 0.05]; moderate/severe disability [1.59 (1.32–1.90) p < 0.05]; taking 2–4 drugs/day [1.31 (1.10–1.56) p < 0.05]; taking > 5 drugs/day [1.69 (1.17–2.44) p < 0.05]

Females: age [0.98 (0.97–0.99) p < 0.05]; living alone [1.85 (1.61–2.12) p < 0.05]; low social support [1.49 (1.26–1.75) p < 0.05]; infrequent social participation [1.43 (1.22–1.69) p < 0.05]; depression [2.21 (1.54–3.17) p < 0.05]; moderate/severe disability [1.82 (1.58–2.11) p < 0.05]; 2–4 drugs/day [1.42 (1.23–1.63) p < 0.05]; > 5 drugs/day [2.23 (1.71–2.91) p < 0.05]; fair/poor oral health [1.54 (1.27–1.88) p < 0.05]

Söderhamn [71], 2012, Norway,

N = 2106, 74.5 (6.9)

49.5, CD, N/A

MN risk (NUFFE-NO, MNA-SF)

Demographic: age, sex, marital status

Lifestyle: being active

Food Intake: eating sufficiently, preparing food, having access to meals Social: occupation, social support (receiving help to manage daily life), frequency of contact with family/neighbours/friends, loneliness, receiving home nursing, receiving home help

Disease-related: SR health, presence of chronic disease/handicap Psychological: feeling depressed

N/A

UV LR

MV LR (forward stepwise conditional)

NUFFE-NO: single [2.99 (2.17–4.13) p < 0.001]; professional/white collar worker [0.50 (0.36–0.69) p < 0.001]; depressed [1.71 (1.07–2.76) p = 0.026]; chronic disease/handicap [2.15 (1.57–2.96) p < 0.001]; being active [0.26 (0.17–0.39) p < 0.001]; eating sufficiently [0.07 (0.02–0.21) p < 0.001]; receiving home nursing [2.99 (1.37–6.56) p < 0.006]; receiving family help [1.92 (1.40–2.64) p < 0.001]; contact with neighbours [0.73 (0.61–0.89) p = 0.001]

MNA-SF: female [1.70 (1.18–2.43) p = 0.004]; receiving help [1.67 (1.02–2.75) p = 0.042]; perceived helplessness [2.39 (1.41–4.02) p = 0.001]; chronic disease/handicap [1.56 (1.08–2.25) p = 0.019]; eating sufficiently [0.18 (0.08–0.39) p < 0.001]; receiving home help [1.88 (1.25–2.81) p = 0.006]; receiving family help [1.88 (1.25–2.81) p = 0.002]; having contacts with family [0.59 (0.40–0.86) p = 0.006]; having contacts with neighbours [0.76 (0.62–0.93) p = 0.008]

Nykänen [72], 2012, Finland, N = 696, 81 (4.6)

30.6%, CD, N/A

MN risk (MNA-SF)

Demographic: age, sex, education Food Intake: dry mouth/chewing problems Social: living situation

Disease-related: SR health, number of drugs used regularly

Psychological: depressive symptoms (GDS), cognitive impairment (MMSE) Physical functioning: ADLs, IADLs, ability to walk 400 m independently

N/A

UV regression MV regression (stepwise, forward selection)

dry mouth/chewing problems [2.01 (1.14–3.54) p < 0.05]; IADL [0.85 (0.75–0.96) p < 0.05]; MMSE [0.90 (0.85–0.96) p < 0.05]

Tomstad [73], 2012, Norway, N = 158, 73.2 (6.9)

41.8%, CD, N/A

MN risk (NUFFE)

Demographic: age, marital status Physical functioning: self-care (SASE) Social: attitude to life (SOC), living situation, social support, receiving home help, perceived helplessness Lifestyle: being active Psychological: perceiving life as meaningful

N/A

MV LR (forward stepwise conditional)

living alone [7.46 (2.58–21.53) p < 0.001]; receiving help regularly [9.32 (2.39–36.42) p = 0.001]; being active [0.17 (0.04–0.65) p = 0.010]; perceived helplessness [6.87 (1.44–32.78) p = 0.016]

McElnay [74], 2012, New Zealand, N = 473, 74.0 (no SD)

43.8%, CD, N/A

MN risk (SCREEN 2)

Demographic: ethnicity (Maori vs not), sex, age

Social: living situation

N/A

UV LR

MV LR (model 1, forced entry; model 2, forward stepwise)

Model 1: Maori [5.21 (1.52–17.90) p = 0.009]; living alone [3.53 (2.06–6.06) p < 0.001] Model 2: Maori [6.44 (1.87–22.11) p = 0.003]

Zeanandin [75], 2012, France, N = 190, 81.2 (4.4)

37.4%, CD, N/A

MN risk (MNA-SF)

Demographic: BMI

Food intake: restrictive diet type, diet duration, diet compliance

Disease-related: comorbidities, polypharmacy

N/A

UV LR

MV LR

absence of diet [0.3 (0.1–0.6) p < 0.001]; increased BMI [1.3 (1.2–1.5) p < 0.001]; on a restrictive diet [3.6 (1.8–7.2) p < 0.001]

Samuel [76], 2012, America,

N = 679, 74.06 (2.8)

0%, CD, N/A

MN risk (MNA-SF)

Demographic: age, race, marital status, education

Social: financial strain, annual income, participation in food stamps program, difficulty driving Disease-related: congestive heart failure, cancer

N/A

MV LR

Enough to make ends meet model: not enough to make ends meet [4.08 (1.95–8.52) p < 0.05]; income < $6000/m [2.54 (1.07–5.99) p < 0.05]; age [1.12 (1.03–1.22) p < 0.05]

Lack of income for food model: lack of money fairly/very often [2.98 (1.15–7.73) p < 0.05]; income < $6000/m [2.77 (1.10–6.98) p < 0.05]; age [1.11 (1.02–1.21) p < 0.05]

Timpini [77], 2011,

Italy, N = 698, 75.6 (6.4)

41.5%, CD, U-S

MN risk (MNA-SF)

Demographic: education

Lifestyle: PA

N/A

UV LR

MV LR models

low education [2.9 (1.2–6.8) p < 0.05]; lack of PA- model 1 [4.5 (2.2–9.8) p < 0.05],

model 2 [4.8 (1.9–11.8) p < 0.05]

Kvamme [78], 2011, Norway,

N = 3111, 71.6 (5.45)

50%, CD, N/A

MN, MN risk [64]

Psychological: anxiety and depression (SCL-10)

N/A

LR

anxiety/depression symptoms with MN risk: males [3.9 (1.7–8.6) p < 0.05], females [2.5 (1.3–4.9) p < 0.05]

Fagerstrom [79], 2011, Sweden, N = 1230, 76.1 (9.9)

42.4%, CD, N/A

MN (BMI < 23 kg/m²)

Demographic: age, sex, living arrangement Psychological: cognitive impairment (MMSE)

Physical functioning: ADLs

N/A

UV LR

MV LR (backward likelihood ratio stepwise)

age [1.02 (1.00–1.04) p = 0.032]; being female [2.20 (1.55–3.11) p < 0.001]; moderate/severe cognitive impairment [3.32 (1.77–6.24) p < 0.001]

Wham [80], 2011, New Zealand, N = 51, 82.4 (1.7)

29.0%, CD, N/A

MN risk (SCREEN 2)

Demographic: age, sex, ethnicity Social: living situation, access to a car, socioeconomic deprivation, strength of social support/network (PANT), loneliness (EASY-Care)

Psychological: depression (EASY-Care), cognitive impairment (EASY-Care) Physical functioning: disability score (EASY-Care)

Disease-related: SR health (EASY-Care),

N/A

multiple linear regression

good SR health [coefficient (SE) p-value] [− 4.31 (1.98) p = 0.035]; poor SR health [− 10.23 (2.31) p < 0.001]; British/Canadian country of origin [− 5.55 (2.14) p = 0.013]; change in living situation, previously with spouse [− 5.31 (2.2) p = 0.02]; good SR health*some evidence depression [12.40 (5.24) p = 0.023]; poor SR health*some evidence depression [14.96 (5.84) p = 0.014]

Romero-Ortuno [81], 2011, Ireland, N = 556, 72.5 (7.1)

30.2%, CD independently mobile (with/without walking aid) outpatients, N/A

MN risk (MNA)

Demographic: age, sex

Social: social support (LSNS-18), deprivation scale (NIDS), personality traits (EPI), loneliness (De Jong gierveld) Physical functioning: mobility (TUG) Disease-related: comorbidities (CCI) Psychological: cognitive function (MMSE), depressive symptoms (CES-d)

N/A

MV LR

TUG [1.11 (1.05–1.18) p < 0.001]; LSNS-18 [0.96 (0.93–0.99) p < 0.005]; NIDS [1.20 (1.03–1.39) p < 0.018]; age [1.07 (1.01–1.13) p < 0.032]

Soderhamn [82], 2010, Sweden, N = 1461, > 75 y

45.2, 98% CD, 2% institutionalised, N/A

MN risk (NUFFE)

Demographic: sex, marital status, education

Social: living setting

Physical function: help to manage daily life Disease-related: perceived health

N/A

MV stepwise LR

living alone [4.85 (3.59–6.56) p < 0.05]; receiving help to manage daily life [2.55 (1.77–3.66) p < 0.05]; perceived health [0.96 (0.96–0.97) p < 0.05]

Sorbye [48], 2008, 11 European sites (Czech Republic, Denmark, Finland, France, Italy, Iceland, Norway, Sweden, Netherlands, Germany, UK), N = 4010, 82.5 (7.3)

26%, CD receiving home care or nursing care services, N/A

unintentional WL (> 5% in past 30 days or > 10% in past 180 days)

Demographic: age, sex, severe MN Food intake: < 1 meal/day, insufficient food and fluid intake, insufficient fluid intake, oral problems with swallowing food, pain in the mouth while eating, dry mouth, tube feeding, reduced appetite, vomiting Disease-related: constipation, diarrhoea, daily pain, pain disrupts normal activity, pressure ulcers, SR health, terminal prognosis < 6 m Physical functioning: fall last 90 days, IADL dependency > 3 (index 0–7), ADL dependency > 3 (index 0–8) Other: vision decline past 90 days Social: reduced social activity, feels lonely, not out of house in last week Psychological: risk of depression ≥1 (index 0–9), cognition [CPS > 3 (hierarchy scale 0–6)]

N/A

MV LR (Wald forward stepwise)

< 1 meal/day [4.2 (2.8–6.4) p < 0.05]; reduced appetite [2.5 (1.9–3.4) p < 0.05]; severe MN [7.1 (4.2–11.9) p < 0.05]; reduced social activity [2.0 (1.6–2.5) p < 0.05]; hospitalisation past 90 days [2.1 (1.6–2.7) p < 0.05]; eating less [2.8 (1.8–4.4) p < 0.05]; constipation [1.9 (1.3–2.7) p < 0.05]; falls [1.5 (1.2–1.9) p < 0.05]; oral problem swallowing food [2.8 (1.8–4.4) p < 0.05]; flare-up of chronic disease [1.5 (1.1–2.1) p < 0.05]; pressure ulcers [1.5 (1.2–1.9) p < 0.05]; daily pain [1.3 (1.0–1.6) p < 0.05]

Gil-Montoya [83], 2008, Spain,

N = 2860, 73.6 (6.8)

42, 88.5% CD, 11.5% institutionalised, N/A

MN risk (MNA)

Demographic: age, sex, institutionalization Food intake: dental status, oral health QOL (GOHAI score)

N/A

multiple linear regression

age [(1.01–1.04) p < 0.001]; male [(1.19–1.66) p < 0.001]; institutionalisation [(1.16–1.92) p < 0.05]; GOHAI [(0.93–0.95) p < 0.001]

Roberts [37], 2007, Canada, N = 839, 79.6 (no SD)

31.3%, CD with no more than MCI, N/A

MN risk (ENS)

Demographic: sex, age, education, marital status

Social: living situation

Physical functioning: physical limitations (walking), ADLs/IADLs ^a

Psychological: cognitive impairment (MMSE)

Disease-related: chronic diseases (CDS), SR health status

longitudinal subset (N = 335 at risk at baseline): 1 y FU

Cross-sectional:

simple LR, MV Longitudinal:

simple LR, MV

Cross-sectional: age [1.05 (1.00–1.09) p < 0.05]; ADL [1.59 (1.02–2.49) p < 0.05]; IADL ‘need’ [1.45 (1.02–2.07) p < 0.05]; psychological distress (feelings of depression, anxiety, irritability, impaired cognition) [2.24 (1.22–4.09) p < 0.05]; current SR health [3.34 (2.01–5.54) p < 0.05]

Longitudinal: SR health among those at low MN risk [OR = 3.30, p < 0.05]

Martin [84], 2007, America,

N = 130, 78 (2.3)

45.4%, CD attending VA outpatient clinics with BMI < 24 kg/m², without dementia (MMSE)/ cancer/heart failure, U

MN (BMI < 19 kg/m²)

Demographic: age, sex, ethnicity, marital status, education, religion

Social: annual income, social support, type of residence

Lifestyle: PA, smoking status, alcohol consumption

Disease-related: medication use, comorbidities, hospitalisation, doctor visits

Psychological: depression (GDS)

N/A

MV LR

having an illness/condition which changed the type/amount of food eaten [4.7 (1.6–13.1) p < 0.05], unintentional WL of > 10 lb. in past 6 m [4.0 (1.5–10.7) p < 0.05], requiring assistance with travel [4.0 (1.4–11.3) p < 0.05]

Chen [36], 2005, America,

N = 240, 81.7 (8.7)

21.7, CD, U-A

MN risk (MNA)

Demographic: age, sex, marital status, ethnicity, education, religion

Social: living situation, income levels, social support (SSQSF), loneliness (UCLA Loneliness Scale)

Disease-related: comorbidities (Co-morbidity checklist), medication use

Food Intake: oral health (BOHSE, GOHAI)

Psychological: depression (GDS)

Physical functioning: physical and social competence (ESDS)

N/A

MV hierarchical LR

annual income > $10,000 [0.40 (0.19–0.84) p = 0.014], depression [1.12 (1.03–1.21) p = 0.008], functional status [1.09 (1.03–1.15) p = 0.005], self-perceived oral health [0.87 (0.78–0.97) p = 0.009]

Locher [85], 2005, America,

N = 1000, 75.3 (no SD)

50.1%, CD, U

MN risk (Determine your health checklist)

Demographic: age, education, marital status Social: rural location, income, reliable transportation, social support, y at address, religious attendance, fear attack, experience discrimination, veteran Physical functioning: mobility (Independent life-space)

N/A

multiple linear regression

Black women: reliable transportation [ẞ = 0.196, t = 2.896, p = 0.004]; independent life-space [ẞ = − 0.344, t = − 4.626, p < 0.001]; income [ẞ = − 0.185, t = − 2.227, p = 0.027]

Black men: independent life-space [ẞ = − 0.245, t = − 3.415, p = 0.001]; being married [ẞ = − 0.245, t = − 3.415, p = 0.001]; religious attendance [ẞ = − 0.185, t = − 2.781, p = 0.006]; fear attack [ẞ = 0.143, t = 2.300, p = 0.023]; experienced discrimination [ẞ = 0.157, t = 2.450, p = 0.015] White women: independent life-space [ẞ = − 0.297, t = − 4.121, p < 0.001]; social support scale [ẞ = 0.156, t = 2.425, p = 0.016]; income [ẞ = − 0.216, t = − 2.259, p = 0.025] White men: reliable transportation [ẞ = 0.195, t = 2.957, p = 0.003]; independent life-space [ẞ = − 0.282, t = − 4.151, p < 0.001]

Johnson [86], 2005, Canada, N = 54, 81 (no SD)

48%, CD, N/A

MN risk (MNA)

Social: perceived social support (LSNS) Psychological: life satisfaction (13-item Life Satisfaction Index Form Z), depression (GDS)

N/A

Hierarchical regression analysis (forward selection)

depression (B = − 0.534, p = 0.001), social support (B = 0.310, p = 0.013)

Weatherspoon [87], 2004, America, N = 324, >  60 y (no mean)

25%, CD, U

MN risk (Determine your health checklist)

Demographic: age, sex, ethnicity

Social: use of home health aide/caregiver Disease-related: SR health, frequency of doctor, clinic and dentist visits, use of visiting nurse, number of nutritionist/dietitian visits, intake of laxatives, sleep medication, tranquilizers, antacids

Food intake: intake of vitamins, fibre supplements, fluid intake

N/A

MV LR

rural location [2.70 (1.2–5.9) p = 0.01]; poor SR health [4.28 (1.02–17.9) p = 0.04]; not visiting GP regularly [0.34 (0.15–0.77) p = 0.01]

Sharkey [88], 2004, America,

N = 908, 78.2 (8.2)

37.8%, CD MOW recipients, A

MN risk (Nutritional Health Screen- modified version of Determine your health checklist)

Demographic: age, sex, ethnicity (Mexican-American vs not), marital status Social: rural area of residence, poverty guideline

Disease-related: multi-comorbidities (> 3 comorbidities)

Physical-functioning: ADLs, IADLs

N/A

MV LR

Mexican-American [1.47 (1.05–2.06) p = 0.026]; rural [1.49 (1.02–2.18) p = 0.04]; not being married [1.77 (1.33–2.36) p = 0.001]; worst IADL score [0.44 (0.27–0.70) p = 0.001]; worst ADL score [1.74 (1.12–2.71) p = 0.014]

Margetts [89], 2003, UK, N = 1632, > 65 y (no mean given)

50.7%, CD: 82.5%, institutionalised: 17.5%, N/A

MN risk (MAG tool: high risk = BMI < 18.5 kg/m² or BMI 18.5–20.0 kg/m² with WL of > 3.2 kg or BMI > 20.0 kg/m² with WL > 6.4 kg; medium risk = BMI 18.5–20.0 kg/m² with < 3.2 kg (unless no long-term illness and no WL) or BMI > 20 kg/m² and WL 3.2–6.4 kg; low risk = BMI > 20 kg/m² with no WL (< 5% BW)

Demographic: age, region, setting

Disease-related: SR health, long standing illness, hospitalisation in the last y

N/A

MV LR

Males: hospitalisation in past y [1.83 (1.06–3.16) p < 0.05]; being institutionalised [2.17 (1.22–3.88) p < 0.05]; longstanding illness [2.34 (1.20–4.58) p < 0.05]; age > 85 y [2.64 (1.30–5.33) p < 0.05]; from northern England/Scotland vs southeast England/London [2.81 (1.54–5.11) p < 0.05]

Females: poor SR health [2.82 (1.25–6.38) p < 0.05]; longstanding illness [2.98 (1.58–5.62) p < 0.05]

Sharkey [90], 2002, America, N = 729, 79 (no SD)

0%, CD receiving MOW, N/A

MN risk (Determine your health checklist)

Demographic: age, race

Social: living situation, income, MOW service use

Physical functioning: functional disability (ADL)

N/A

UV ordered LR

MV ordered LR

Total sample: being black [coefficient, p-value] [0.62, p < 0.001]; age 60–74 y [0.80, p < 0.001]; poverty [0.43, p < 0.001]; living alone [0.51, p < 0.001]; increasing m using MOW service [0.096, p < 0.05]

Black women: aged 60–74 y [0.72, p < 0.01] White women: living alone [0.76, p < 0.001]; poverty [0.47, p < 0.05], aged 60–74 y [0.86, p < 0.001]

Pearson [91], 2001, towns within 9 European countries (Belgium, Denmark, France, France, Italy, the Netherlands, Portugal, Spain, Switzerland, Poland), N = 627, 80–85 y (no mean/SD given)

45.9%, CD, N/A

MN risk (MNA)

Demographic: sex, living situation

Psychological: cognitive impairment (MMSE)

Physical functioning: ability to complete all self-care ADLs

N/A

MV LR

Total: diminished cognitive function [2.10 (1.98–2.22) p < 0.05]; diminished self-care ability [2.44 (2.32–2.56) p < 0.001] Males: diminished self-care ability [2.93 (2.76–3.10) p < 0.01]; diminished cognitive function [2.65 (2.46–2.84) p < 0.05]; living alone [1.23 (1.06–1.40) p < 0.05]

Females: diminished self-care ability [2.06 (1.90–2.22) p < 0.05]; diminished cognitive function [1.77 (1.61–1.93) p < 0.05]

Bardon [46], 2018, Ireland, N = 1841, 72 (4.99)

49.8%, CD dementia free (MMSE), S

MN (BMI < 20 kg/m² or WL > 10% over 2 y)

Demographic: age, sex, education, marital status

Food intake: appetite

Lifestyle: smoking status, alcohol consumption, PA

Social: living situation, social support

Disease-related: number chronic disease (> 2), polypharmacy (> 5 drugs), pain, SR health, hospitalisation 1 y before baseline, hospitalisation 1 y before FU

Physical functioning: falls 1 y before baseline, falls during FU, difficulty climbing stairs without rest, difficulty walking 100 m without rest, HGS

Psychological: depression (CES-D), cognitive impairment (MMSE)

2 y

UV LR

MV LR

Total: unmarried/separated/divorced status [1.84 (1.21–2.81) p < 0.05], hospitalisation 1 y before FU [1.62 (1.14–2.30) p < 0.05], difficulty climbing stairs [1.56 (1.12–2.17) p < 0.05], difficulty walking 100 m [1.83 (1.13–2.97) p < 0.05]

Males: falls during FU [1.62 (1.01–2.59) p < 0.05], difficulty climbing flight stairs [2.25 (1.44–3.50) p < 0.05], hospitalisation 1 y before FU [1.73 (1.08–2.77) p < 0.05]

Females: social support [2.44 (1.19–4.99) p < 0.05], cognitive impairment [2.29 (1.04–5.03) p < 0.05]

Hengeveld [92], 2018, America, N = 2212, 74.6 (2.9)

49.6%, well functioning CD, N/A

MN (PEM: BMI < 20 kg/m² and/or involuntary WL ≥5% in the past y)

Demographic: age, sex, race, education, BMI

Social: living situation, income Lifestyle: PA, smoking status, alcohol consumption Food Intake: diet quality (HEI), protein intake (g/kg BW/d), appetite, biting/chewing difficulty Disease-related: SR health status, chronic diseases (cancer, DM, CVD, chronic pulmonary disease, osteoporosis) Psychological: cognitive function (modified MMSE), depression

yearly for 4 y

MV Cox proportional hazards analysis

Developing PEM during 4 y of FU: low energy intake [0.71 (0.55–0.91) p < 0.05] Having persistent PEM (PEM at 2 consecutive FUs): poor HEI score [0.97 (0.95–0.99) p < 0.05]; low EI [0.56 (0.36–0.87) p < 0.05]; low protein intake [1.15 (1.03–1.29) p < 0.05]

Serra-Prat [93], 2012, Spain, N = 254, 78.2 (5.6)

53.5%, CD, U-S

MN risk (MNA)

Demographic: age

Food Intake: impaired efficacy of swallow (impaired labial seal, oral or pharyngeal residue, piecemeal deglutition)

Physical functioning: functional capacity (BI)

1 y

MV LR

No significant results when adjusted for age

Schilp [94], 2011, Netherlands,

N = 1120, 74.1 (5.7)

48.5%, CD (97.9%) and institutionalised (2.1%), S

MN (BMI < 20 kg/m² or SR invol. WL ≥ 5% in previous 6 m)

Demographic: sex, age, education

Food Intake: appetite, chewing difficulties

Lifestyle: smoking status, alcohol consumption, PA (LAPAQ)

Social: loneliness

Physical functioning: limitations climbing stairs, physical performance (chair stands, tandem stand and walk test)

Psychological: cognitive impairment (MMSE), depression (CESD), anxiety (HADS)

Disease-related: medication use, SR pain, chronic diseases

3, 6, 9 y

cox proportional-HR

UV LR

MV LR

poor appetite [1.63 (1.02–2.61) p < 0.05]; difficulties climbing stairs (in those < 75 y only) [HR (95% CI) 1.91 (1.14–3.22)]; one or two medications (vs none in females only) [HR (95% CI) 0.39 (0.18–0.83) p < 0.05]

Jyrkka [78], 2011, Finland, N = 294, 81.3 (4.5)

31%, CD (94.6%) and institutionalised (5.4), U

MN risk (MNA-SF)

Demographic: age, sex, education, residential status (home vs institution) Physical function: functional comorbidity index

Disease-related: polypharmacy, SR health

3 y

Linear mixed model approach

excessive polypharmacy 0.62 points lower MNA-SF scores (p < 0.001); age [ẞ (standard error) p-value; − 0.04 (0.02) p = 0.016]; institution [− 1.89 (0.25) p < 0.001]; moderate [− 0.27 (0.11) p = 0.016] and poor [− 1.05 (0.17) p < 0.001] SR health status

Johansson Y [43], 2009, Sweden, N = 579, 75 y and 80 y cohort

52.5%, CD, N/A

MN risk (MNA)

Demographic: age

Physical functioning: HGS, physical mobility (NHP), walking limitations, limitations climbing stairs, physical health (PGC-MAI) ^b

Psychological: depression (GDS), cognitive impairment (MMSE)

Disease-related: SR health, pain (NHP)

75 y olds: yearly for 5 y

80 y olds: yearly for 3 y

forward stepwise multiple LR

higher age p = 0.005 at 1 y; HGS [0.938 (0.91–0.97) p < 0.001]; physical health [0.65 (0.55–0.76) p < 0.001] predicted risk of MN at baseline; more depression symptoms [1.178 (1.07–1.30) p = 0.001] 1 y predictor; depressive symptoms*males [OR 1.26] depressive symptoms*females [OR 1.03]; lower SR health [0.432 (0.27–0.70) p = 0.001]

Johansson L [95], 2009, Sweden, N = 258, 74.2 (2.55)

49.6%, CD, A

MN risk (MNA)

Social: social support

Physical functioning: ADLs

Psychological: cognitive impairment (MMSE)

Disease-related: SR health, hospitalisation

4, 8, 12 y

UV LR

MV LR

Total: MOW use [OR 19.6, p < 0.001];

Males; use of MOW [OR 21.9, p < 0.01]; MMSE score (cut-off 23/24) [12.9 (2.9–56.7) p < 0.01]; poorer SR health compared to 4 y ago [OR 5.1, p < 0.05]

Females: increased MOW use [OR 31.0, p < 0.01]; hospital stay during the past 2 m [OR 7.1, p < 0.05]

Keller [96], 2006, Canada, N = 367, 78.7 (8.0)

24%, vulnerable CD ^c, A

MN risk (SCREEN)

Social: social support- MOW use

1.5 y

multiple linear regression

MOW use associated with a 1.6-point higher score in SCREEN at FU [(0.02–3.23) p = 0.04]; increasing help making meals [(2.91–0.49) p = 0.006]

Visvanathan [47], 2003, Australia, N = 250, 79.45 (no SD)

30.8%, CD receiving domiciliary care (all had MMSE > 24), A

MN risk (MNA)

Demographic: age

Lifestyle: smoking status

Social: MOW use, amount of domiciliary care per m

Disease-related: comorbidities, health status and QOL (SF-36)

1 y

UV LR binomial analysis

hospitalisation [RR 1.51 (1.07–2.14) p = 0.015], > 2 emergency hospitalisation [RR 2.96 (1.17–7.50) p = 0.022], > 4 week hospitalisation [RR 3.22 (1.29–8.07) p = 0.008], falls [RR 1.65 (1.13–2.41) p = 0.013], WL [RR 2.63 (1.67–4.15) p < 0.001], >  2 hospitalisations [RR 2.11 (1.04–4.29) p = 0.039], emergency hospitalisation [RR 1.99 (1.28–3.11) p = 0.002]

Shatenstein [86], 2001, Canada, N = 584, > 70 y (no mean given)

40.4%, CD, N/A

MN risk (WL > 5% baseline weight)

Demographic: age, study region, WL Social: ability to shop, bereavement Psychological: cognitive diagnosis at FU, depression, SR interest in life Food Intake: ability to eat independently, loss of appetite Physical functioning: frailty

5 y

MV LR (backward stepwise)

consistent appetite [0.22 (0.12–0.42) p < 0.001]; loss of interest in life [0.56 (0.34–0.90) p = 0.017]

Ritchie [97], 2000, America,

N = 563, Males: 77.3 (4.7), Females: 78.1 (5.3)

43%, CD, N/A

MN (WL > 10% BW)

Demographic: age, sex

Lifestyle: smoking status, alcohol consumption, PA

Food Intake: edentulousness, wears full prostheses, % sites with gingival bleeding, mean attachment loss, mean recession Disease-related: > 2 comorbidities Physical functioning: ADLs Psychological: depression

1 y

UV LR

MV LR

female sex [3.77 (1.71–8.33) p < 0.05], baseline weight [1.02 (1.01–1.03) p < 0.05]; dependent in > 1 ADL [2.27 (1.08–4.78) p < 0.05]; edentulousness [2.03 (1.05–3.96) p < 0.05]

O’Keeffe [98], 2018, Canada, Denmark, Finland, Israel, Japan, Netherlands, Spain, Sweden, Taiwan, USA,

23 studies N = 108–4512, 74 (12)

17–53.5%, N = 15 CD, N = 3 institutionalised, N = 3 acute hospital, N = 2 CD and institutionalised combined, N/A

MN (any definition/screening tool)

Food intake: appetite, complaints about taste, nutrient intake/modified texture diet, hunger, thirst, dental status, chewing, mouth pain, gum issues, swallowing, eating dependency/difficulty feeding Psychological: cognitive function, depression, psychological distress, anxiety Social: social support, living situation, transport, loneliness, wellbeing, MOW, vision and hearing

Disease-related: medication use, polypharmacy, hospitalisation, comorbidities, constipation, SR health Physical functioning: ADLs

Lifestyle: smoking status, alcohol consumption, PA

24 weeks- 12 y

Mixed

Moderate evidence for association: hospitalisation, eating dependency, poor SR health, poor physical function, poor appetite Moderate evidence for no association: chewing difficulties, mouth pain, gum issues, comorbidity, hearing and vision impairments, smoking, alcohol consumption, low PA, complaints about taste of food, specific nutrient intakes

Low evidence determinants: modified texture diets, loss of interest in life, MOW access

Low evidence not determinants: psychological distress, anxiety, loneliness, access to transport, wellbeing, hunger, thirst

Conflicting evidence: dental status, swallowing, cognitive function, depression, residential status, medication intake and/or polypharmacy, constipation, periodontal disease

van der Pols-Vijlbrief [34], 2014

USA, Canada, Netherlands, Sweden, Cuba, France, Japan, Brazil, UK, Israel, Russia,

28 studies N = 49–12,883, mean > 65y

21.3–56.5%,

CD, N/A

PEM (WL over time/ low nutritional intake/ low BW/ poor appetite)

Demographic: sex, age, education

Food Intake: reduced appetite, edentulousness, chewing difficulties

Lifestyle: PA, alcohol use, smoking

Social: few friends, living situation, loneliness, death of spouse

Physical functioning: ADLs

Psychological: depression, cognitive decline, dementia, anxiety

Disease-related: hospitalisation, SR health status, polypharmacy, chronic diseases, cancer

N/A

MV analyses

Association: poor appetite

Moderate evidence for an association: edentulousness, hospitalization, SR health

moderate evidence for no association: older age, low education, depression, chronic diseases

Strong evidence for no association: few friends, living alone, loneliness, death of spouse

No association: chewing difficulties, alcohol consumption, anxiety, number of diseases, heart failure, use of anti-inflammatories

Inconclusive: sex, low PA, smoking, ADL dependency, cognitive decline, dementia, polypharmacy

Streicher [33], 2018, 6 studies: Germany (30, Ireland (1), Netherlands (1), New Zealand (1),

N = 209–1841, 71.7 (5.0)- 84.6 (0.5)

36.6–50.5%, CD, N/A

MN (BMI < 20 kg/m² or WL > 10% over FU)

Demographic: age, sex, marital status, education

Social: living alone, social support

Lifestyle: PA, smoking status, alcohol consumption

Disease-related: comorbidities (> 2), hospitalisation (6 m/1 y before baseline and 6 m/1 y before FU), pain, SR health, polypharmacy (> 5 drugs)

Psychological: cognitive impairment (MMSE < 23, TICS-m < 31), depression (GDS > 6, CES-D > 16, HADS > 8)

Physical functioning: difficulty walking, difficulty climbing stairs, HGS, falls (y before baseline and 1 y/2 y before FU)

Food intake: appetite

1–3 y

LR analyses (UV and MV), random-effects meta-analyses

increasing age [1.05 (1.03–1.07) p < 0.05]; unmarried, separated, or divorced status [1.54 (1.14–2.08) p < 0.05]; difficulty walking 100 m [1.41 (1.06–1.89) p < 0.05]; difficulty climbing stairs [1.45 (1.14–1.85) p < 0.05]; hospitalisation before baseline [1.49 (1.25–1.76) p < 0.05]; hospitalisation during FU [2.02 (1.41–2.88) p < 0.05]