Associate Professor Karen Charlton

Malnutrition often remains undetected and untreated in older people because it is not considered a clinical priority. Yet it can have serious consequences.

Older people who are malnourished experience increased surgical complications, greater morbidity, increased length of hospital stay, higher rates of mortality and reduced quality of life.

To address this alarming health problem, Coordinare, the South Eastern NSW Primary Health Network (PHN), recently issued a tender for expert advice and a plan of action.

A partnership between IHMRI researchers at UOW and Grand Pacific Health won the tender. Over the next 18 months, the research team, led by Associate Professor Karen Charlton from UOW’s School of Medicine, will develop a model for routine screening for malnutrition in older adults and an accompanying care plan.

She will be assisted by Associate Professor Karen Walton and Professor Andrew Bonney from the School of Medicine, and Professor Liz Halcomb from the School of Nursing.

“Treatment for malnutrition often focuses on in-hospital oral supplementation, which has limited success over the longer term. There are few sustainable community-based interventions that help people get back into the community,” states Associate Professor Karen Charlton.

“This project aims to develop and integrate malnutrition screening and nutrition care plans across primary care, independent-living villages of residential aged care facilities and community-based services to allow older people to maintain independence and functionality for as long as possible.”

The research team has previously demonstrated feasibility that within the community setting, early identification of malnutrition could be included as part of annual health assessments for older adults (75+HA) in general practice, which are currently included on the Medicare Benefits Schedule.

Over a decade ago, as part of the Enhanced Primary Care program, this item was introduced for all Australians aged 75 years or older. Despite being applauded as a major policy innovation in preventive health care, its uptake has been disappointingly low.

This project will integrate strategies within general practices to encourage greater uptake of the 75+HA, in which a validated malnutrition screening instrument, the Mini Nutritional Assessment – Short Form (MNA-SF), will be incorporated.

“An important component of the project will be to upskill General Practice staff to conduct the 75+HA, with special attention to the results of the MNA-SF,” concludes Professor Charlton.

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