Kok et al performed a systematic review of studies that studied the associations between polypharmacy and malnutrition in older adults. The authors are from HAN University of Applied Sciences and Wageningen University in the Netherlands.
Patient selection: older adult
Polypharmacy: daily use of 5 or more drugs
Malnutrition: Mini Nutritional Assessment (MAN) <= 23.5 (or MNA Short Form <= 11)
Features of the association:
(1) adverse drug effects may interfere with appetite or ability to eat
(2) adverse drug effects may interfere with food absorption
(3) polypharmacy correlates with number of comorbid conditions, which may cause depression, which can reduce appetite
(4) adverse drug effects may prompt more prescriptions
If an older adult shows evidence of malnutrition, then the patient's drug list should be reviewed for polypharmacy.
If a patient has polypharmacy, then the patient should be evaluated for nutritional status.
If the patient has polypharmacy and malnutrition risk, then the patient should be evaluated for:
(1) vitamin, calcium, iron and zinc deficiencies.
(2) frailty
(3) adverse drug effects that may be affecting nutrition
Elimination of unnecessary drugs may reduce risk of malnutrition.
