Evaluating routine dietetic interventions in geriatric rehabilitation: implications to address malnutrition, sarcopenia and underweight

Background: Although diagnosing and treating malnutrition, sarcopenia and underweight are recommended to be embedded and sustained within nutritional care, it is unknown if that is facilitated in geriatric rehabilitation. This study determined the proportion of geriatric rehabilitation inpatients with malnutrition, sarcopenia or underweight receiving dietetic interventions as part of routine clinical care and if these patients have greater improvements in body weight and composition compared to patients not receiving dietetic interventions. Methods: Geriatric rehabilitation inpatients from the observational REStORing health of acutely unwell adulTs (RESORT) cohort were included (n=971, median age 83.2 [77.7-88.8] years, 58.5% (n=568) females). Malnutrition, sarcopenia and underweight were defined by the Global Leadership Initiative of Malnutrition, European Working Group on Sarcopenia in Older People 2 and age-specific body mass index cut-offs. Data on dietetic interventions initiated by dietitians as part of clinical care was extracted from the centralised hospital database. Changes in body weight (kg), skeletal muscle mass (kg, %), and fat mass (kg, %) from admission to discharge were determined using linear mixed models. Results: Dietetic interventions were received by 306 (62.0%), 138 (71.5%) and 153 (76.9%) of patients with malnutrition (n=493), sarcopenia (n=193) and underweight (n=199). Duration and frequency of dietetic interventions were higher in patients with malnutrition, sarcopenia or underweight compared to patients without those conditions. There were no differences in body weight/composition changes in patients with malnutrition, sarcopenia or underweight receiving dietetic interventions compared to those not receiving interventions. Conclusions: One-third of geriatric rehabilitation inpatients with malnutrition, sarcopenia or underweight are not receiving dietetic interventions and therefore the referral and diagnostic process require improvements. Patients with malnutrition, sarcopenia or underweight receiving dietetic interventions had no greater improvements in body weight/composition compared to those who did not receive interventions. Tailoring dietetic interventions for malnutrition, sarcopenia and underweight diagnosis may improve patient outcomes.