Correlation of Malnutrition with Fall Risk in Elderly: A Systematic Review

Authors

  • Ignasius Adi Dharma Internal Medicine - Division of Geriatric, Wangaya Regional General Hospital, Denpasar, Indonesia
  • Raden Ayu Tuty Kuswardhani Health and Law Postgraduate School, Udayana University, Denpasar, Indonesia
  • Nyoman Kertia Faculty of Medicine - Division of Rheumatology, Gadjah Mada University, Indonesia

DOI:

https://doi.org/10.51601/ijhp.v5i4.493

Abstract

Malnutrition is a common health problem among older adults and has the potential to increase the risk of falls, one of the leading causes of morbidity and mortality in this age group. This systematic review aims to analyze the relationship between malnutrition and the risk of falls in older adults by synthesizing findings from eight observational studies. Literature searches were conducted in the PubMed, EBSCO, and Cochrane databases until August 2025. Nutritional status in these studies was assessed using tools such as the Mini Nutritional Assessment (MNA), MUST, and BMI, while the risk of falling was measured using instruments such as the Morse Fall Scale, Johns Hopkins Fall Risk Assessment Tool, Timed Up and Go Test (TUG), and fall history. The results showed a consistent and significant association between malnutrition and an increased risk of falling, with odds ratios ranging from 1.42 to 4.94. These findings were reinforced by biological mechanisms such as sarcopenia and micronutrient deficiencies that impair muscle strength, balance, and neuromuscular function. Based on the GRADE assessment, the level of certainty of the evidence was moderate. Overall, this review confirms that malnutrition is an important and modifiable risk factor, and that routine nutritional screening should be an integral part of fall prevention strategies for older adults.

Downloads

Download data is not yet available.

References

R. Kakara, G. Bergen, E. Burns, and M. Stevens, “Nonfatal and Fatal Falls Among Adults Aged ≥65 Years — United States, 2020–2021,” MMWR Morb. Mortal. Wkly. Rep., vol. 72, no. 35, pp. 938–943, Sept. 2023, doi: 10.15585/mmwr.mm7235a1.

S. Nugraha, S. Sabarinah, I. H. Susilowati, and T. B. Rahardjo, “Intrinsic and Extrinsic Risk Factor for Fall among Community Dwelling Indonesian Elderly,” Open Access Maced J Med Sci, vol. 10, no. B, pp. 619–624, Mar. 2022, doi: 10.3889/oamjms.2022.8626.

A. Tomasiewicz, J. Polański, and W. Tański, “Advancing the Understanding of Malnutrition in the Elderly Population: Current Insights and Future Directions,” Nutrients, vol. 16, no. 15, p. 2502, July 2024, doi: 10.3390/nu16152502.

M. Mziray, K. Nowosad, A. Śliwińska, M. Chwesiuk, and S. Małgorzewicz, “Malnutrition and Fall Risk in Older Adults: A Comprehensive Assessment Across Different Living Situations,” Nutrients, vol. 16, no. 21, p. 3694, Oct. 2024, doi: 10.3390/nu16213694.

M. Hazmi Sinulingga, D. A. Ariestine, and A. S. Purba, “Relationship Between Nutrition Status (MNA) and Fall Risk (FRQ) in Elderly Patients,” Int J Res Rev, vol. 10, no. 7, pp. 650–655, July 2023, doi: 10.52403/ijrr.20230776.

P. Pavananont, K. Phithakwongrojn, T. Bosittipichet, and T. Leesri, “The relationship between nutritional status and fall risk assessed by timed up and go test in elderly in the primary care network of Bang Kruai hospital: a cross-sectional study,” Int J Community Med Public Health, vol. 12, no. 4, pp. 1669–1675, Mar. 2025, doi: 10.18203/2394-6040.ijcmph20250911.

N. N. Adly, W. M. Abd-El-Gawad, and R. M. Abou-Hashem, “Relationship between malnutrition and different fall risk assessment tools in a geriatric in-patient unit,” Aging Clin Exp Res, vol. 32, no. 7, pp. 1279–1287, July 2020, doi: 10.1007/s40520-019-01309-0.

D. Eglseer, M. Hoedl, and D. Schoberer, “Malnutrition risk and hospital‐acquired falls in older adults: A cross‐sectional, multicenter study,” Geriatrics Gerontology Int, vol. 20, no. 4, pp. 348–353, Apr. 2020, doi: 10.1111/ggi.13885.

A.-R. Jo et al., “Association between Falls and Nutritional Status of Community-Dwelling Elderly People in Korea,” Korean J Fam Med, vol. 41, no. 2, pp. 111–118, Mar. 2020, doi: 10.4082/kjfm.18.0112.

J. Neyens et al., “Malnutrition is associated with an increased risk of falls and impaired activity in elderly patients in Dutch residential long-term care (LTC): A cross-sectional study,” Archives of Gerontology and Geriatrics, vol. 56, no. 1, pp. 265–269, Jan. 2013, doi: 10.1016/j.archger.2012.08.005.

C. D. Eckert, E. K. Tarleton, J. Pellerin, N. Mooney, and N. M. Gell, “Nutrition Risk is Associated With Falls Risk in an Observational Study of Community-Dwelling, Rural, Older Adults,” J Aging Health, vol. 34, no. 6–8, pp. 1125–1134, Oct. 2022, doi: 10.1177/08982643221096944.

L. Calcaterra, G. Abellan Van Kan, Z. Steinmeyer, D. Angioni, M. Proietti, and S. Sourdet, “Sarcopenia and poor nutritional status in older adults,” Clinical Nutrition, vol. 43, no. 3, pp. 701–707, Mar. 2024, doi: 10.1016/j.clnu.2024.01.028.

A. J. Cruz-Jentoft et al., “Sarcopenia: revised European consensus on definition and diagnosis,” Age and Ageing, vol. 48, no. 1, pp. 16–31, Jan. 2019, doi: 10.1093/ageing/afy169.

K. Prokopidis et al., “Prognostic and Associative Significance of Malnutrition in Sarcopenia: A Systematic Review and Meta-Analysis,” Advances in Nutrition, vol. 16, no. 5, p. 100428, May 2025, doi: 10.1016/j.advnut.2025.100428.

K. Yilmaz, R. Wirth, D. Daubert, and M. Pourhassan, “Prevalence and determinants of micronutrient deficiencies in malnourished older hospitalized patients,” The Journal of nutrition, health and aging, vol. 28, no. 2, p. 100039, Feb. 2024, doi: 10.1016/j.jnha.2024.100039.

V. F. Mustofa, B. Prasetyo, D. Indriani, and N. A. Rahmawati, “Management of Micro Nutrition and Health Impacts on the Elderly: Literature Review: Manajemen Gizi Mikro dan Dampak Kesehatan pada Lansia: Literature Review,” AMNT, vol. 7, no. 1SP, pp. 37–46, May 2023, doi: 10.20473/amnt.v7i1SP.2023.37-46.

L. Tan, R. He, and X. Zheng, “Effect of vitamin D, calcium, or combined supplementation on fall prevention: a systematic review and updated network meta-analysis,” BMC Geriatr, vol. 24, no. 1, p. 390, May 2024, doi: 10.1186/s12877-024-05009-x.

M. Kupisz-Urbanska and E. Marcinowska-Suchowierska, “Malnutrition in Older Adults—Effect on Falls and Fractures: A Narrative Review,” Nutrients, vol. 14, no. 15, p. 3123, July 2022, doi: 10.3390/nu14153123.

Y. Guigoz and B. Vellas, “Nutritional Assessment in Older Adults: MNA® 25 years of a Screening Tool & a Reference Standard for Care and Research; What Next?,” The Journal of nutrition, health and aging, vol. 25, no. 4, pp. 528–583, Apr. 2021, doi: 10.1007/s12603-021-1601-y.

N. M. Do and C. Tolos, “Empowering Fall Prevention Through Integrated Lifestyle Medicine Strategies—From Recognition of Fall Risks to Implementation of Prevention of Falls for all in Practice,” American Journal of Lifestyle Medicine, vol. 19, no. 7, pp. 1006–1017, Sept. 2025, doi: 10.1177/15598276251316830.

Downloads

Published

2025-12-15

How to Cite

Adi Dharma, I., Ayu Tuty Kuswardhani, R., & Kertia, N. (2025). Correlation of Malnutrition with Fall Risk in Elderly: A Systematic Review. International Journal of Health and Pharmaceutical (IJHP), 5(4), 998–1006. https://doi.org/10.51601/ijhp.v5i4.493