The level of nutritional care that older adults receive when they are admitted to and then discharged from hospital emergency departments is largely lacking, a new study shows.

“There is a significant gap between the clinical practice of assessing nutritional status in the emergency department and evidence-based guidelines,” wrote the authors of a report published Thursday in BMC Geriatrics.

Although there is evidence that malnutrition screening occurs in emergency departments, there is little detail about comprehensive nutrition assessments and therapeutic interventions, the study authors found.

Older adults often experience negative health outcomes, including malnutrition after being discharged from an emergency department. Therefore, the researchers wanted to better understand the level of nutritional care older adults received during an emergency hospital visit and as they were discharged.

The team assessed 22 articles across 19 individual studies in the review. The studies included between 44 and 749 older adult participants. The research used various instruments and questionnaires to assess nutritional care. Only one study referred to the documentation of malnutrition in medical records. None of the studies described nutrition interventions after discharge.

The report’s authors wrote that their findings point to the need for a comprehensive exploration of nutritional care pathways, practice, policy and research to provide evidence on how best to care for older adults.

“Early identification of malnutrition is key to having a significant impact on adverse physiological consequences on body composition,” the authors wrote. “Therefore, older adults discharged from the emergency department while experiencing malnutrition should prompt initiation of a care pathway to mitigate subsequent health deterioration that results in hospital readmission and poor health outcomes.”

There is a gap in published studies on nutrition assessment and dietary intervention and care planning to mitigate the health risks of malnutrition among older adults who are discharged from the hospital to the community.

“Despite the prevalence of malnutrition among older adults admitted to emergency departments, reported nutritional care is limited to screening,” they added.