Abstract
OBJECTIVES: In this study, we aimed to explore the impact of nutrition therapy on clinical outcomes for patients classified according to the Global Leadership Initiative on Malnutrition (GLIM) criteria. DESIGN: Prospective, multicenter cohort study. SETTING: This study was conducted from September 2020 to December 2022 across 28 geriatric centers in China. PARTICIPANTS: A total of 862 patients aged ≥65 years were included. INTERVENTION: All participating physicians completed a 6-h training on nutritional support, following international guidelines before the study. Patients had a nutritional risk screening 2002 score ≥3 points within 48 h of admission. Physicians determined specific nutritional support regimens. MEASUREMENTS: GLIM assessments were conducted after enrollment. Nutritional and functional statuses were evaluated at baseline and 90 days after admission. Clinical outcomes-mortality, readmission, new infections, and falls-were documented after 90 days. RESULTS: Compared to 108 patients without malnutrition per the GLIM criteria, 754 malnourished patients showed lower weight, body mass index (BMI), and Mini Nutritional Assessment-Short Form (MNA-SF) scores and significant reductions in grip strength, calf circumference, and Barthel activities of daily living (ADLs) index. The percentage of patients with adequate caloric intake at the 90-day follow-up was 70.7% (n = 533) and 67.6% (n = 73) in the malnutrition and non-malnutrition groups (p = 0.51) and that of patients with adequate protein intake was 65.9% (n = 497) and 58.3% (n = 63), respectively (p = 0.12). Moreover, malnourished patients showed significant improvements in body weight, BMI, MNA-SF scores, calf circumference, and Barthel ADL index compared to those without malnutrition. Malnourished patients also had lower risks of readmission and falls at follow-up. CONCLUSION: Among older inpatients at nutritional risk, those with malnutrition classified according to the GLIM criteria benefited from nutritional support, demonstrating improved BMI, MNA-SF scores, calf circumference, and Barthel ADL index, as well as reduced readmission rates and incidence of falls.