Malnutrition in Older Hip Fracture Patients: Prevalence, Pathophysiology, Clinical Outcomes, and Treatment-A Systematic Review.

Background

Malnutrition is highly prevalent among older patients with hip fractures and significantly impacts recovery and survival. This narrative review synthesizes current evidence on the prevalence, pathophysiology, and clinical consequences of malnutrition in hip fracture patients, along with diagnostic tools and nutritional interventions.

Methods

A literature search of studies from 2000 to 2025 identified consistent associations between malnutrition-defined using tools such as the Mini Nutritional Assessment (MNA), Geriatric Nutritional Risk Index (GNRI), and serum albumin levels-and increased risks of postoperative complications, prolonged hospital stays, functional decline, and mortality. Pathophysiological mechanisms include sarcopenia, systemic inflammation, and impaired bone metabolism.

Results

Notably, malnutrition is associated with fracture type, with low lean body mass and poor nutritional status correlating with intracapsular femoral neck fractures.

Conclusions

Interventional studies demonstrate that oral nutritional supplementation (ONS) reduces complications and improves biochemical parameters but shows mixed effects on long-term mortality and function. The findings support routine nutritional screening and early intervention in older hip fracture patients to improve outcomes and reduce the healthcare burden.