Abstract ID = 78 | Classification: (2) - Malnutrition and related issues

Title: Association between malnutrition, hesalth outcomes and healthcare costs among older Chinese adults

Author(s): Junmin Wei, MD; Linlin Fan, MS;, Yuhui Zhang, PhD; Shirley Li, MD; Jamie Partridge, PhD, MBA; Ling Claytor, MD, PhD; Suela Sulo, PhD

Institution where study was conducted: Beijing Hospital Department of General Surgery, Beijing, China; Abbott Laboratories, Illinois, USA; University of Illinois Urbana-Champaign, Illinois, USA; China Health Economics Association, Beijing, China;

Keywords: Nutrition, Malnutrition, Elderly, China, Depression, Costs

Background: China has the largest elderly population in the world, but limited research assessing the relation between malnutrition and the health of older Chinese adults exists.

Objectives: This research investigated the association between malnutrition, health outcomes, depression, and healthcare costs among community-dwelling older Chinese adults.

Methods: A national sample of over 5,900 adults aged 60 years or older from the 2013 China Health and Retirement Longitudinal Study (CHARLS) survey was used. Handgrip strength, body mass index, and weight loss were utilized as indicators of malnutrition. Functional independence was assessed with activities of daily living (ADLs) and instrumental ADLs (IADLs). Mental health and depressive symptoms were evaluated through the Center for Epidemiological Studies Depression Scale (CES-D). Ordered logit and standard logit regressions were employed to analyze the associations between malnutrition and various health outcomes. Subjects’ socio-demographics were also controlled for.

Results: Malnutrition was associated with significantly lower IADLs (OR = 0.87, p < 0.05), poorer health status (OR = 0.68, p < 0.001), higher probability of stroke (OR = 1.40, p <0.05) and chronic stomach disease (OR = 1.24, p < 0.001). Consequently, malnutrition was associated with an increased hospital cost of ¥214 (14% increase, p < 0.01) per person per year. Furthermore, malnutrition was associated with a 51% higher likelihood of being depressed (OR = 1.513, p < 0.001) and a 66% increase (p < 0.01) in healthcare cost among depressed older adults.

Conclusion: Malnutrition was associated with poorer mental and physical health, and higher hospital costs among community-dwelling older Chinese adults. Our results highlight the importance of malnutrition and depression screening, identification/assessment, and treatment.

Email: scott.goates@abbott.com

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