Multidisciplinary Reviews · Oct 29, 2026
Malnutrition and cognitive impairment among older adults in India: A review on prevalence, mechanisms, and preventive strategies
By Ravichandran K, Ranganathan R
Malnutrition and cognitive impairment are increasingly recognised as critical public health concerns among older adults, particularly in countries with low- and middle-income economies like India. Age-related physiological, psychological, and social changes increase older adults' vulnerability to nutritional deficiencies and cognitive decline, thereby adversely affecting their functional independence and quality of life. This narrative review aimed to examine the prevalence of cognitive impairment and malnutrition among older adults in India, explore the relationship between nutritional status and cognitive function, identify the major influencing factors and biological mechanisms, and elaborate on preventive and management strategies. The literature search was conducted across Scopus, Web of Science, Google Scholar and PubMed to identify studies published between 2015 and 2026. Evidence from Indian and international studies consistently demonstrated a crucial association between poor nutritional status and cognitive decline. Low body mass index, poor Mini Nutritional Assessment scores, hypoalbuminemia, anaemia, micronutrient deficiencies, depression, social isolation, and low educational status were frequently associated with impaired cognitive functions. Biological mechanisms - vascular dysfunction, oxidative stress, neuroinflammation, and alterations in the gut-brain axis - further explain the two-way relationship between malnutrition and cognitive impairment. Dietary patterns, including the Mediterranean and DASH diets, along with physical activity, cognitive training, and early nutritional screening, were identified as beneficial preventive strategies. The findings pinpoint the need for combined nutritional and cognitive health interventions, regular screening, and region-specific longitudinal research to support healthy ageing and improve geriatric care in India.